Coronary sinus endothelin-1 concentrations after cardioplegic cardiac arrest.

Background: Data from animal experiments demonstrate that endothelin-1 is released into the coronary circulation during myocardial ischaemia and reperfusion, indicating that endothelin-1 may contribute to the pathophysiology of ischaemia and reperfusion. The aim of this study was to investigate the release of endothelin-1 into the coronary circulation during reperfusion of the human heart after hypothermic cardioplegic cardiac arrest.

Methods: Endothelin-1 was measured in arterial, central venous and coronary sinus blood in 19 patients undergoing elective uncomplicated coronary artery bypass grafting before aortic crossclamping and 1, 5, 10 and 20 min after aortic declamping.

Cardiopulmonary resuscitation after thoracic surgery: echocardiographic observations.

We report echocardiographic observations during external chest compression in a patient with marked abnormalities in thoracic anatomy following emergency surgery of aortic arch aneurysm. Transesophageal echocardiography demonstrated direct right ventricular, aortic and left atrial compression, only minimal left ventricular compression and an open mitral valve during closed chest heart massage. Colour flow doppler demonstrated forward blood flow across the mitral valve and along the left ventricular outflow tract during the compression phase.

Prognostic markers in patients with severe accidental hypothermia and cardiocirculatory arrest.

The aim of this retrospective study was to investigate whether plasma potassium, pH and activated clotting time (ACT), obtained from a central venous blood sample immediately after admission to hospital, could predict outcome in patients with severe accidental hypothermia and cardiocirculatory arrest. Twenty-two patients rewarmed with cardiopulmonary bypass were studied retrospectively (12 patients after avalanche accidents, seven patients after cold water submersion and three patients after prolonged exposure to cold). In 12 patients stable spontaneous circulation could not be restored.