[Weaning of infants from artificial respiration following heart surgery with the combined use of helium and positive pressure respiration].
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Biomedical subjects
Publications and source records attributed to K Tatsuno.
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Therapeutic use of helium-oxygen mixture in continuous positive airway pressure (He-CPAP) was employed for early weaning from mechanical ventilation of 11 infants who underwent cardiac surgery from August, 1974, to April, 1975. With the use of He-CPAP, a 20 to 30 mm. Hg elevation of PaO2 was usually observed and respiratory distress was reduced, as compared to results obtained with nitrogen-oxygen CPAP. In all cases, He-CPAP resulted in the possibility of relatively early removal of the endotracheal tube. Therefore, He-CPAP is recommendable for intermediate respiratory support between mechanical ventilation and nitrogen-oxygen CPAP.
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The smallest commercially available prosthetic valve has an external diameter of 17 mm. Therefore, prosthetic valve replacement has been unfeasible in cases in which the diameter of the aortic valve ring is smaller than this size. A new operative method was used on 2 patients with congenital aortic valve lesions associated with hypoplasia of the valve ring. The procedure consists of a longitudinal incision in the aortic septum placed in the midportion of the two coronary ostia, a vertical incision in the outflow tract of the right ventricle to join the septal incision, prosthetic aortic valve replacement, and patch reconstruction of the outflow tracts of both ventricles by means of two layers of a fusiform Dacron patch. A 23-year-old woman with congenital aortic stenosis associated with hypoplattic aortic valve ring underwent prosthetic placement of the aortic valve and is well 1 year after the operation. Our other patient, a 3-month-old infant with congenital aortic regurgitation, died on the first postoperative day because of postperfusion lung. However, her hemodynamic status had been good in the immediate postoperative period.
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