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Biomedical subjects

R Pinto

Publications and source records attributed to R Pinto.

131 records · Page 8Linked to original sources

[Changes in colloido-osmotic pressure in patients on extracorporeal circulation].

Changes in colloidosmotic pressure (COP) were observed in 15 patients submitted to hemodilution for extracorporeal circulation. Preoperative laboratory tests were within normal limits. COP before hemodilution was above 15 mmHg in 14 cases and 12.6 mmHg in one 9-month-old patient, the mean CP was 18.17 mmHg. During extracorporeal circulation the mean COP decreased to 55% of its initial value (9.92 mmHg). Within the first 4 hrs of the postoperative recovery 13 had COP over 11 mmHg; the remaining two died of cardiorespiratory failure with a COP of less than 7 mmHg. One patient that recovered 100% of its initial COP value between 20 and 24 hrs of the postoperative period had his COP decreased to 6 mmHg and developed fatal pulmonary edema. One patient -who died acute bleeding did not diminish his COP under 12.5 mm Hg. We can conclude that COP lower than 10 mmHg can produce fatal cardiorespiratory failure. Extracorporeal circulation time does not influence the COP recovery. Acute bleeding does not diminish COP values. Hemodilution significantly reduces COP; its recovery and stabilization over 11 mmHg are of prognostic value. COP monitoring is a simple and useful method.

Adult↗

Coronary artery reoperations using arterial conduits: immediate and early results.

This study deals with results of coronary artery reoperations in 21 males aged 54.4 +/- 6.6 years. Native vessel coronary disease at first and second operation was nearly the same (2.7 +/- 0.6 vs 2.8 +/- 0.4 vessel, p = NS). Graft attrition and deterioration in left ventricular ejection fraction (55.9 +/- 9.2 initial vs 36 +/- 15 at reoperation, p < 0.001) necessitated reoperation in majority. Recurrence of angina (71%) and left ventricular failure (23.8%) were the clinical indicators for reoperation. Procedure was successful in 20 (95%) and had to be abandoned in 1 due to severe pericardial and sternal adhesions. Arterial grafts were utilised in 90% (18 cases, Group A and B). Total arterial revascularisation (Group A) was done in 9 (45%) using Y graft 6, combination of both mammary arteries 2, and by both mammary and inferior epigastric artery in 1. Group B patients had arterial grafts (bilateral IMA 1, Y graft 1, bilateral IMA + gastroepipolic 1, RIMA 4, and LIMA 2) in addition to a venous graft. Two patients (group C, 10%) had only venous grafts. There was no in hospital mortality or morbidity and at 10 +/- 5.2 months follow up, all are asymptomatic with negative stress test at 3 months followup in 8 cases. We conclude that coronary artery reoperations using arterial conduits can be performed safely with excellent immediate and early results.

Angina Pectoris↗

Clinical profile and management of post infarction left ventricular pseudoaneurysm.

Three patients with left ventricular pseudoaneurysm are presented. Two patients had inferior and one had an anterolateral wall Q wave myocardial infarction. Echocardiography with Doppler colour imaging provided the diagnosis in one case, whereas the correct diagnosis was possible on left ventriculography in all. Successful surgery using patch closure of the defect in all patients and bypass grafting of the diseased coronary vessels was done in 2 cases. Angiographic follow-up in one case revealed excellent result and during 18 to 30 months of clinical follow-up, all patients are asymptomatic.

Adult↗