The diversity of conditions inducing an increase in CPK-MB, CPK, LDH and SGOT allows investigation of the quantitative evolution in cardiac patients during heart surgery. In nine patients submitted to valve replacement, three samples were taken respectively: one from the superior and the inferior caval veins and one another from the coronary sinus and immediately centrifuged. The sera were processed to quantitate the CPK, CPK-MB, LDH and SGOT through the three periods of observation. The three sites intended to explore the possible other sources of CPK-MB released at surgery: superior vena cava accounts for upper body regions, inferior vena cava for lower body regions and the coronary sinus for the heart itself. The three sites compared separately through the three periods did not show any significant differences. Only comparing the pre-CPK values to their homologous obtained during and after cardiopulmonary bypass, very evident differences could be registered (P less than 0,05 and less) for CPK, CPK-MB and LDH. While SGOT remained totally unchanged through the three periods. The evolutive CPK, CPK-MB and LDH increase accounted for high sensitivity of these enzymes to the variations of conditions during cardiac surgery. It is highly possible that other sources of CPK-MB could be dissiminated in the body and capable to produce valuable enzymatic amounts during and after cardiac surgery and that the heart is not exclusively alone in releasing this enzyme during cardiac ischemic arrest and in other circumstances. The real importance of CPK-MB principally and of CPK would be surestimated as conclusive parameters in diagnosis of myocardial damages during cardiac procedures.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Valve↗

PubMedDate not supplied

Five-year survival in operated lung cancer.

A total of 1,001 patients with a confirmed diagnosis of lung cancer were treated at the University Hospital Pellenberg - Leuven in the five-year period 1970-1974. One hundred and sixty-four patients (16.4%) were operated and 152 underwent surgical resection of their pulmonary lung lesion. The influence of factors as histology, type of resection, age, staging, anatomic localization of the tumor on the five year survival are considered. The survival was 34.2% for all types of resected tumors, ranging from 42.0% for the lobectomies in squamous cell carcinoma to 0% in small cell carcinoma. The operative (30 days) mortality is included in the statistical follow-up. This mortality was 8.6% for the pneumonectomies and 4.3% for the lobectomies.

Adult↗

PubMedDate not supplied

Experience with 100 consecutive anterior mediastinotomies in lung cancer.

Between January 1978 and March 1981, 100 anterior mediastinotomies were performed in patients with proven or suspected lung cancer. It was done 72 times in patients with a tumor of the left lung, all presenting with a normal mediastinum. Of those 72 patients, 59 had a tumor in the left upper lobe: 30.5% of the latter were found to have involved mediastinal lymphnodes (our yield in this location was 15.1% when using the cervical mediastinoscopy); 16 patients with a left upper lobe tumor had both an anterior negative cervical mediastinoscopy followed by an anterior approach: 4 became positive (25%). The anterior mediastinotomy was performed two times in patients with a suspect mediastinum: the mediastinoscopy was once positive, and once negative. It was done 26 times in patients with a radiologically manifest enlarged mediastinum (7 on the right side, 19 on the left side); in 24 patients the histological diagnosis was unknown. The anterior mediastinotomy was positive in all 26 cases. For the whole group we found positive nodes in 10 of 26, i.e. 38.5% of the patients despite normal findings at cervical mediastinoscopy. We would therefore recommend an anterior mediastinotomy in every patient with a suspect or an enlarged superior mediastinum in order to establish an histological diagnosis or exceptionally to check the operability. If the mediastinum is radiologically normal, the anterior approach has much more chance to yield a positive result than the cervical one when the tumor is located in the left upper lobe.

Humans↗

PubMedDate not supplied

Total pericardectomy for chronic constrictive pericarditis. Early and late results.

The early and late results of total pericardiectomy, performed over a 17 years period in 39 patients with chronic constrictive pericarditis, are presented. The overall operative mortality was 18%. With growing surgical experience and anesthesiological improvement, the operative morality of 26% during the first 12 years decreased to an acceptable 6.2% during the last 5 years. The cumulative 5 and 10 years survival rates were respectively 73% and 68%. Ninety-three percent of the surviving patients were classified in functional class I or II (NYHA classification), while preoperatively 90% of these cases belonged to class III or IV. Viewing these results it is concluded that the tendency towards early surgery should be encouraged, especially because the chronic state is accompanied by several deleterious effects.

Adolescent↗

PubMedDate not supplied

Uremic pericarditis. Treatment by limited pericardiectomy.

Between 1963 and 1979, limited pericardiectomy through left anterolateral thoracotomy was performed in 14 patients with uremic pericarditis. Two patients died after operation and one patient presented an early recurrence. Within a mean follow-up time of 3.3 years there were 7 late deaths but no recurrences or no cases of constrictive pericardidis. After reviewing the literature, it is concluded that the best early and late results in uremic pericarditis are obtained with pericardiectomy through an anterolateral thoractomy, the subxiphoid approach with creation of a pericardial window being a good alternative in critically ill patients.

Adult↗

PubMedDate not supplied

Total correction of tetralogy of Fallot following palliation.

Fifty three patients with Tetralogy of Fallot were totally corrected following palliation. Intracardiac repair was not adversely influenced by a Blalock Taussig shunt or a Waterston shunt which did not produce kinking of the RPA. The results were less satisfactory after correction following a Potts shunt or a Waterston shunt with kinking at the site of the anastomosis.

Adolescent↗