Macroscopic bubbles from dissolved nitrogen during CPB.
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Biomedical subjects
Publications and source records attributed to T E Dye.
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This is a report of an unusual condition in a patient with simultaneous spasms of a vein graft and recipient artery, resulting in acute left ventricular failure in the immediate postoperative period. It is known that coronary artery spasm can complicate perioperative management of the cardiac surgical patient, and spasm of vein bypass grafts themselves can also occur in rare instances. Possible causes of the complication and successful management of this patient are discussed.
Factors other than technical error and poor run-off may account for occlusion or obstruction of aortocoronary vein bypass grafts in the early postoperative period. Four cases are presented in which graft obstruction was caused by venous valves. Discussion of the etiology of this problem and recommendations for its prevention are included.
Adult hypertrophic pyloric stenosis is an unusual disease of obscure etiology which causes varying degrees of gastric outlet obstruction. Diagnosis by history, physical examination, and roentgenography is difficult but can be readily made with fiberoptic gastroscopy where a characteristic pyloric "cervix sign" is seen. All of the many operations for relief of gastric outlet obstruction have been tried with this lesion, with resection and Billroth I reanastomosis the accepted treatment. Two patients are reported with adult hypertrophic pyloric stenosis who had typical endoscopic findings. One was treated with distal gastrectomy, and the other was adequately treated by endoscopic dilatation alone. It is suggested that endoscopic dilatation is acceptable as primary therapy in suitable cases.
A case of mediastinal fibrosis with occlusion of the right inferior and middle lobe pulmonary veins is described. The patient had severe hemoptysis, and the diagnosis was established with thoracotomy. Review of the literature emphasizes the lethal nature of this syndrome if untreated. Resection of the involved bronchopulmonary tissue, when feasible, offers good palliation, although the long-term prognosis is unpredictable.