Coronary revascularisation through re-sternotomy utilising arterial conduits 47 years after correction of pectus excavatum: an unusual technical challenge.
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Biomedical subjects
Publications and source records attributed to A T Forsyth.
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Cardiac troponin T (cTnT) levels were measured in 41 patients undergoing elective coronary artery surgery. Twenty-one patients received continuous warm antegrade blood cardioplegia to maintain asystole whilst 20 patients received antegrade cold blood cardioplegia intermittently. Serum levels of cTnT were determined preoperatively and at 0, 6, 12 and 18 h postbypass. Peak cTnT levels and total cTnT release (calculated from the area under the curve postoperatively) were found to be significantly higher (p < 0.05: Mann-Whitney) when cold cardioplegic solutions were used. Continuous warm cardioplegia results in lower cTnT release than intermittent cold blood cardioplegia suggesting that the former may provide better myocardial preservation.
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Lymphocyte infiltration of heart grafts has been monitored using pulses of Indium-111-labelled syngeneic lymphocytes. The cells were injected into cyclosporin (CSA)-treated or untreated rats that had received an allograft 1, 2, 4, 6, and 8 days previously Accumulation of the labelled cells in the graft was measured 24 hr after injection, and was compared with that in the animal's own heart. For the first three days after grafting, Indium-111-labelled lymphocytes accumulated to the same extent in the grafts of untreated and CSA-treated rats. However, the substantial rapid increase in lymphocyte accumulation in the graft that occurs in the untreated recipient between days 4 and 5 did not occur in CSA-treated recipients. From day 5 until day 9 the accumulation of labelled cells in CSA-maintained grafts was not greater than in syngeneic non-rejecting grafts, and it was significantly less than in the untreated rejecting grafts. At early times after grafting, removal from the labelled cell population of lymphocytes with reactivity against the histocompatibility antigens of the graft resulted in a reduction in the extent to which these lymphocytes accumulated in the graft.