Effects of hyperosmotic perfusate on ultrastructure and function of the isolated canine heart.
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Biomedical subjects
Publications and source records attributed to S Levitsky.
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The effect of pulmonary artery banding (PAB) and intracardiac repair on ventricular volumes was studied in 35 patients with uncomplicated complete atrioventricular canal (CAVC). Right ventricular (RV) and left ventricular (LV) end-diastolic volumes (EDV), determined from biplane cineangiograms using Simpson's rule, were expressed as a percent of normal mean (% Nl) for body surface area; normal range (mean +/- 1SD) is equivalent to 75%-125% Nl. In preoperative studies (RV 26, LV 33), EDV averaged 149 +/- 51% and 184 +/- 50% Nl, respectively, P vs Nl less than 0.001 for both. In one of 26 patients, RV was very small (45% Nl), and one of 33 had a small LV (70% NI). In 13 patients studied post-PAB, RVEDV and LVEDV were lower than in the preoperative group (P less than 0.001) and averaged 114 +/- 40% and 126 +/- 52% Nl, respectively. In three of 13, RV was small (67% and 71% Nl) or very small (56% Nl). Three others had a small (71% and 67% Nl) or very small (56% Nl) LV. In serial pre- and post-PAB studies (RV 9, LV 11), EDV was increased or normal in all preoperatively. In seven of nine, RVEDV decreased, falling below normal range in three. In eight of 11, LVEDV decreased, falling below normal in three. Following repair, RV and LVEDV averaged 80 +/- 20% Nl and 126 +/- 23% Nl, respectively, in seven patients. Four of the seven had RVEDV below normal range. Two patients with a small ventricle had intracardiac repair and did well.(ABSTRACT TRUNCATED AT 250 WORDS)
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Fifteen patients with impending uremic cardiac tamponade underwent either anterior pericardectomy or pericardiostomy under general anesthesia. Anesthetic agents and technics were selected in the light of physiopathologic derangements involving fluids and electrolyte balance, excretory and cardiovascular disturbances, and pharmacodynamics. Anesthesia was induced with diazepam and maintained with N2O-O2 (70:30) and fentanyl. Pancuronium was used for muscle relaxation. Adequate preoperative assessment of patient, careful monitoring of vital signs, maintenance of the critical balance of fluid and blood replacement, and selection of anesthetic agents for minimal depression of vital multiorgan systems provided excellent results. No postanesthetic morbidity or mortality occurred.
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