Problems of surgical indication and technique for the treatment of chronic occlusive arterial diseases remain unresolved, especially in the cases which show poor angiogram run-off. To establish the surgical technique of omental transplantation, anatomical findings of the omental vessels were studied. The anatomical findings of the omentum were classified into two types. Type I (single layer) and Type II (double layer), and subdivided into seven subtypes according to the number of omental arterial branches. Omental transplantation was performed in our clinic in 19 cases (20 limbs) and surgical results were satisfactory. The examination of microscopic findings of the implanted omentum and the ischemic muscle of the implanted limb by consecutive serial sections suggested that the vessels of the omentum might invade the ischemic muscular tissue and supply blood to the muscle. Omental transplantation should be considered one of the most useful surgical techniques in cases with poor angiogram run-off.

Arteriosclerosis Obliterans↗

PubMedDate not supplied

Coronary perfusion under general and selective cardiac hypothermia.

Experiments to assess left ventricular function in dogs during and after 2 hours of hypothermic cardioplegia are reported. During the experiment myocardial temperature was maintained between 15 degrees C and 18 degrees C by controlling the rate of flow of a cool cardioplegic solution into the coronary vessels. Before and after the period of hypothermia the left atrial pressure was gradually changed and the aortic flows and pressures that changed in response were recorded. The left ventricular stroke work (gm) was then calculated using the relationship: LVSM = (formula: see text) where: SV = stroke volume (ml), AP = arterial pressure (mmHg), LAP = left atrial pressure (mmHg). Comparison of the calculated values indicated that this method of maintaining cardiac hypothermia reduced cardiac function only slightly.

Animals↗

PubMedDate not supplied

The double balloon cannula in the treatment of ruptured abdominal aneurysms.

Two cases of ruptured abdominal aneurysm were successfully treated, using the double balloon cannula, which was devised in our surgical department. After cross-clamping of the descending thoracic aorta and both common iliac arteries, a small incision was made in the aneurysm and the cannula was inserted through this incision into the lumen of the abdominal aorta and positioned at the proximal end of the aneurysm. Then the double balloon was inflated, blocking the blood flow just above the aneurysm. The aneurysm was incised, and grafting was performed, in the usual manner, in a bloodless surgical field. The double balloon cannula was beneficial not only in preventing massive blood loss during surgery, but also in maintaining the blood supply to various abdominal organs.

Aorta, Abdominal↗

PubMedDate not supplied

Treatment for cerebral embolism following prosthetic valve replacement.

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Adolescent↗

PubMedDate not supplied

Extracorporeal circulation with perfluorochemicals (Fluosol-DA).

Experimental studies on extracorporeal circulation (ECC) with perfluorochemicals (Fluosol-DA) as a perfusate was performed to examine oxygen carrying capacity and its organ distribution using eight calves. Approximately 80% of the circulating blood volume was withdrawn before ECC and reinfused after completion of ECC. ECC time was 60 minutes in five of the calves and 120 minutes in three of the calves. Hct and Hb decreased to 4-12% and 1.7-6.6 g/dl during ECC. Fct (Fluorocrit: volume percentage of Fluosol-DA) ranged between 5 and 10%. PaO2 and PvO2 were 432-543 mmHg and 93-164 mmHg. Sixty-seven to 86% of the oxygen consumed by the tissues was delivered by Fluosol-DA. One of the complications of ECC with Fluosol-DA, hemolysis was observed in four of the calves which had a relatively high level of Fluosol-DA retention (13.9 g/kg) in the body after ECC. The retention volume of the other four calves which did not show hemolysis was 10.0 g/kg. Retention of Fluosol-DA after ECC was found to be greater in the reticuloendothelial system of the calves sacrificed earlier and became trace or minimal after 10 months.

Alanine Transaminase↗

PubMedDate not supplied

[External valvuloplasty under preoperative angioscopic control].

Intraoperative angioscopy was applied to evaluate the venous valvular incompetence and perform external valvuloplasty in case of venous reflux. Sixty-seven limbs, 43 cases of primary varicose veins were examined using intraoperative angioscopy and the angioscopic findings of the incompetent venous valves were classified into three types as follows: valves with elongated and atrophic cusps 43 (50%)--type I, values with expanded and depressed commissures 36 (42%)--type II, and valves with perforated cusps or other changes 7 (8%)--type III, according to the angioscopie findings, external valvuloplasty was done in 31 subterminal valves of the long saphenous veins and 7 highest valves of the superficial femoral vein. Our external valvuloplasty consisted of two techniques. The first was the total plication technique for valvular annulus by a running suture of prolene and the second was by the venocuff sleeve of the autogenetic femorofascial band. The degree of plication was decided by angioscopic observation. Postoperative observation periods were from 2 to 28 months. There was no recurrence of varicose veins or prominent venous reflux. The application of intraoperative angioscopy is therefore useful for the choosing appropriate surgical procedures and for the evaluation of venous valvuloplasty.

Adult↗