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A Smolinsky

Publications and source records attributed to A Smolinsky.

56 records · Page 4Linked to original sources
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Effects of antegrade versus combined antegrade/retrograde cardioplegia on postoperative septal wall motion in patients undergoing open heart surgery.

To evaluate the influence of two techniques of myocardial protection on septal wall motion (SWM) and left ventricular ejection fraction, 21 patients with a normal SWM underwent surgery using either conventional antegrade cardioplegia (group I, n = 9) or combined antegrade/retrograde cardioplegia (group II, n = 12). The patients were assessed pre- and postoperatively by radionuclide ventriculography. A resting thallium-201 study was performed in patients (n = 6) with a postoperatively abnormal SWM: in 2 of 9 (22%) in group I and in 4 of 12 (33%) in group II (p = NS). The left ventricular ejection fraction was similar in both groups before surgery (57 +/- 3% in group I vs. 57 +/- 8% in group II; p = NS) and did not change significantly after surgery. All 6 patients with an abnormal SWM had a normal septal thallium-201 uptake. Thus, (1) an abnormal SWM after cardiac surgery is common: (2) it is not due to perioperative ischemia or infarction, and (3) neither the incidence of an abnormal SWM not the global left ventricular function is influenced by the addition of retrograde cardioplegia during open heart surgery.

Adult↗
PubMedDate not supplied

A method for continuous on-line monitoring of systemic vascular resistance (COMS) after open heart procedures.

A new method for continuous on-line measurement (COMS) of systemic vascular resistance (SVR) utilizing simple computer analysis of the peripheral arterial waveform is presented. The fundamental equation of this method is: (Formula: see text) where SVR is systemic vascular resistance, dP/dt is the peak dP/dt of the peripheral arterial waveform, and P' is the pressure at the time of peak dP/dt. F and a are calibration constants determined by taking simultaneous measurements by an independent method (thermodilution) before (low SVR) and immediately after (high SVR) aortocoronary bypass operations. In 22 patients 255 COMS of SVR readings were recorded simultaneously with thermodilution cardiac output measurements. Patients were exposed to situations such as temperature changes, volume load, blood loss, and the effect of drugs such as various catecholamines, nitroglycerin, and nitroprusside. Linear regression analysis was performed to compare the SVR calculated from thermodilution with the COMS-SVR measurements. SVR values ranged from 450 to 4400 dynes/sec/-5 and correlation between COMS and thermodilution was r = 0.98. Correlation coefficients of individual patients ranged from r = 0.9 to r = 0.986. We found COMS SVR measurements accurate, reliable, and extremely helpful in the management of hemodynamically unstable patients.

Adult↗