[Useful concept of a membrane oxygenator for assisted long-term perfusion (with one successful clinical use)].
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Assisted Circulation↗
Biomedical subjects
A Krian
Publications and source records attributed to A Krian.
Limits of coronary artery surgery. Clinical and postmortem findings.
In the first series of 90 continuous patients with coronary artery disease 9 patients died after aorto-coronary bypass procedures (10%). There were 7 operative deaths, and 2 postoperative deaths (respiratory failure after bronchopneumonia and bleeding duodenal ulcer; acute necrosis of the liver following hepatitis). The study of the deceased patients made evident that postoperative impairment of left ventricular function is caused by ventricular aneurysms. This fact can be shown by the poor ventricular function with an elevated left ventricular enddiastolic pressure (LVEDP) of more than 18 mm Hg. The results in patients with congestive heart failure could not be improved by multiple bypass-grafts. Probably the prolonged surgical intervention may cause additional stress to the predamaged myocardium. So, in our group the indication for using multiple grafts in cases with ventricular aneurysm is confirmed with great caution.
Autopsy↗
Ischemic tolerance of the human heart during extracorporeal circulation: clinical experience.
Our clinical experiences with ischemic tolerance of the human heart under the condition of ECC during the last 15 years allow us to state the following points: 1. The healthy human myocardium can be exposed to ischemia without danger on the basis of 15 min and a myocardial temperature of 35 degrees C. This time can be prolonged following the described value of Q10=2. 2. The previous damaged human myocardium is usually not able to cover this range. Frequently ischemic load within these limits causes functional deterioration. So, in such cases ischemic tolerance has to be applied on a distinct lower base. 3. Occasional transgressions of the described ischemic tolerance time without a fatal result do not allow us in our clinic to leave the effective principles in daily routine.
Coronary Disease↗