Showing papers in "The Annals of Thoracic Surgery in 1987"

TL;DR: New diagnostic techniques and improved therapy have led to more objective preoperative diagnoses as well as better long-term results, and features are clearly demonstrated in a series of 400 consecutive patients with primary lesions of the mediastinum seen at Duke University Medical Center.

TL;DR: Univariate analysis indicated that age, sex, type and mode of surgical procedure, antibiotic prophylaxis, and duration of mechanical ventilation were not significantly associated with wound infection.

TL;DR: The protease inhibitor aprotinin was given in high doses to 11 patients to achieve plasma concentrations of more than 150 kallikrein inactivator units per milliliter during CPB, and this treatment resulted in platelet preservation duringCPB.

TL;DR: The adequacy of warfarin anticoagulation is the most important factor affecting thrombotic and bleeding complications in patients with mechanical valves and over shadows the dubious importance of other phenomena such as atrial fibrillation and left atrial thrombus.

TL;DR: The ultrasound index for detecting gaseous microemboli (MEI) indicated the presence of suchmicroemboli in 22 of the 27 patients during insertion of the aortic cannula during cardiopulmonary bypass surgery, supporting the assumption that the MEI is providing quantitative information regarding the existence of gaseously emboli in the middle cerebral artery.

TL;DR: The right gastroepiploic artery was studied angiographically and histologically to determine its suitability for coronary artery bypass grafting and showed good patency of those grafts.

TL;DR: Two patients with early postoperative spasm of a left internal mammary artery bypass graft are described, one characterized by vasomotor collapse secondary to intractable spasm responsive only to local application of vasodilator agents.

TL;DR: It is concluded that exercise is an important criterion in the preoperative evaluation of patients for pulmonary surgery, and an MVO2 less than 10 ml/kg/min is associated with significant morbidity and mortality.

TL;DR: Although mortality and morbidity have been high, the experiences gained through this series will likely result in an improved outlook for future recipients and provide insight into the immunobiology of the transplanted lung.

TL;DR: Surgical resection is the treatment of choice for non-small cell bronchogenic carcinoma, and it is the only method providing prolonged arrest and chance for cure.

TL;DR: Resection of primary bronchogenic carcinoma in the presence of subaortic nodal metastases is associated with improved survival relative to reports of survival following resection of metastatic disease in other mediastinal node stations.

TL;DR: The case of another patient with left main coronary artery dissection is described; to the authors' knowledge, it is the first to be successfully treated by internal mammary artery bypass grafting.

TL;DR: Recent experience with bronchogenic cysts including 7 located within the mediastinum and a rare instance of a cyst below the diaphragm is reported.

TL;DR: Overall, gastrointestinal operation was successful in only 5% of patients, but aortic valve replacement was effective in 93%.

TL;DR: During the agonal period marked sympathetic activity occurred, with significant increases in circulating catecholamines and systemic vascular resistance, which resulted in acute left ventricular failure and disruption of the anatomic integrity of the pulmonary capillaries.

TL;DR: It is concluded that the Ivor Lewis esophagogastrectomy can be performed with low mortality, can provide adequate palliation, and does result in satisfactory long-term survival for those patients with more favorable postsurgical stages of cancer.

TL;DR: Sixty-four patients with stage III (M omicron) non-small cell lung cancer were treated with cisplatin fluorouracil infusion chemotherapy and simultaneous radiation therapy for 5 days every other week, and in 9 of these patients the resected specimens were histologically negative.

TL;DR: It is concluded that autologous predonation is a simple, safe, and cost-effective method of reducing homologous transfusion and thereby decreasing the risk of transfusion-related reactions and infections.

TL;DR: The likelihood of phrenic nerve injury when iced saline slush is used for topical myocardial cooling and the possibility of developing serious respiratory disability would support the routine use of pericardial insulation when this method of hypothermia is used.

TL;DR: Although the number of patients is small, the addition of postoperative radiotherapy for those with unfavorable operative findings resulted in long-term survival comparable to that of patients with negative nodes and margins.

TL;DR: Actuarial freedom from reoperation for obstruction in 147 patients receiving cryopreserved or fresh allograft valved conduits between a ventricle and the pulmonary arteries was 94% at 3.5 years, and among 24 patients in whom cardiac catheterization was performed on indication late postoperatively, 5 had gradients of more than 40 mm Hg across the conduit.

TL;DR: Since postoperative spinal cord injury most likely results from ischemia or hypoxia of the lower segment of spinal cord, use of adjunctive techniques to preserve spinal cord function during aortic clamping by perfusing the distal aorta adequately with or without systemic hypothermia should be considered.

TL;DR: This technique proved to be simple and effective in protecting the spinal cord for up to 45 minutes of ischemia in the experimental group, and the clinical implications of this concept are promising for patients undergoing operations on the thoracic aorta.

TL;DR: It is believed that patients with cardiac rupture who reach the hospital alive can often be saved by prompt diagnosis and immediate surgical treatment.

TL;DR: Prosthetic valve endocarditis is an infrequent but dread complication, occurring in 1 to 2% of patients both early (less than 60 days) and late postoperatively, and the major cause of improved survival in recent years is earlier operation.

TL;DR: Following CABG, the occurrence of new AV conduction defects is related to the number of vessels bypassed, the cardiopulmonary bypass pump time, and the aortic cross-clamping time.

TL;DR: Investigation of the effects of shivering on oxygen consumption, carbon dioxide production, and hemodynamic performance in patients undergoing elective myocardial revascularization found suppression of the shivering response minimized increases in VO2 and VCO2, improved hemodynamic stability, and resulted in a decreased need for inotropic support.

TL;DR: Right anterolateral thoracotomy is an effective alternative to repeat Median sternotomy for replacement of the mitral valve in patients who have had a previous median sternotomy.

TL;DR: A heart and lung transplantation operation for Eisenmenger's syndrome is reported in which distant donor graft procurement was used with a simple system for preservation.

TL;DR: A modification of this technique, which more extensively dissects the arch branches and clamps the aortic arch almost 50% of the way across the innominate branch, represents an excellent option to the surgeon in the management of this difficult clinical entity.