PubMed Health⌕ Search

Biomedical subjects

E Mondori

Publications and source records attributed to E Mondori.

15 recordsLinked to original sources

Effects of extracorporeal circulation on cardiac performance and coronary blood flow (total and regional). A study of differences arising from pre-existent left ventricular load and anoxic arrest.

It was researched how the ECC affects on cardiac performance and the total and regional coronary blood flow, using two groups of dogs with a hypertrophied heart and a non-hypertrophied heart, each group of which was further divided into two subgroups depending on whether the intermittent 40 mins. anoxic arrest was applied or not. Cardiac performance before and 60 mins. after cessation of ECC were compared each other. Coronary hemodynamics was studied before, during (immediately before and after anoxic arrest), and 60 mins. after cessation of ECC, using 15 +/- 5 diameter radioactive microspheres. 1) In the group of a non-hypertrophied heart, no obvious changes of cardiac performance were seen before and after ECC. The total coronary blood flow increased after ECC than before. Though the regional coronary blood flow pattern showed no differences in this group except only immediately after anoxic arrest, when the regional blood flow into the right ventricle, inner and middle layers of the left ventricle increased. 2) In the group of a hypertrophied heart, cardiac performance decreased after ECC, and further significant decrease was observed in the subgroup of anoxic arrest. No significant changes of the total coronary blood flow were observed before and after ECC in this group, even when compared with that in the group of a non-hypertrophied group. However, the increase of blood flow to the right ventricle, inner and middle layers of the left ventricle immediately after anoxic arrest was not observed, that was seen in the group of a nonhypertrophied heart. 3) It follows that the decrease of cardiac performance after ECC in the group of a hypertrophied heart is not due to the changes of the total and regional coronary blood flow. It is considered that the difference of the regional coronary blood flow pattern changes immediately after anoxic arrest between the non-hypertrophied heart group and hypertrophied group may cause the different changes of cardiac performance before and after ECC between the two groups. This consideration should be more justified by evaluating not only coronary hemodynamics but also the relationship between cardiac metabolic needs and the regional coronary blood flow.

Animals↗

Myocardial protection during open-heart surgery: intermittent aortic crossclamping versus coronary perfusion.

Twenty-seven patients undergoing open-heart surgery were divided into three groups, i.e., control, intermittent aortic crossclamping and coronary perfusion groups. Myocardial oxygen extraction, lactate extraction, arterial-coronary sinus hydrogen ion difference, potassium difference and glucose difference were determined during the operation, as well as, postoperative stroke and cardiac indices and comparisons were made. When the ascending aorta was not crossclamped, myocardial metabolism was well preserved during and after the perfusion at a flow rate of 2.0 L./min/m2. Intermittent aortic crossclamping for 15 minutes alternating with a period of perfusion for five minutes at 30 degrees C was sufficient to protect the myocardium from ischemia. Perfusion of the left coronary artery alone at a flow rate of six per cent of total body perfusion (150 to 200 ml per minute) at 30 degrees C was sufficient to protect the myocardium when the aorta was opened. Since intermittent perfusion of the left coronary artery may produce myocardial derangement, coronary perfusion should be continuous. Otherwise topical cardiac cooling or other means of myocardial protection should be used.

Adolescent↗

Surgical correction of Ebstein's anomaly by tricuspid valve replacement and its late problems.

The choice between valve replacement and plasty for surgical management of Ebstein's anomaly still remains controversial. Since 1960, we have treated 16 cases of Ebstein's anomaly, and 7 of the 16 cases have undergone surgical correction. Tricuspid valve replacement (TVR) without plication of the atrialized ventricle was applied in 4 cases, and Hardy's procedure was adopted in three cases. The division of the Bundle of Kent was carried out simultaneously in 2 cases with Wolff-Parkinson-White (W-P-W) syndrome of the TVR group. All patients have survived the operation. Early and late (as long as 14 years) postoperative evaluations have demonstrated superiority of the TVR group. However, the late echocardiographic findings have revealed new problems in the TVR group, such as hypokinetic or paradoxical motion of the atrialized ventricle in two cases and hypofunction of the left as well as the right heart.

Adolescent↗