Biomedical subjects
L Anisimowicz
Publications and source records attributed to L Anisimowicz.
Application of intraoperative thermography in coronary artery bypass grafting without extracorporeal circulation - clinical report.
BACKGROUND: The development of low-invasive cardiosurgical techniques has contributed to an increase of the number of revascularization procedures performed on beating heart. The report presents the changes observed intraoperatively in thermographic images of the heart obtained during surgical revascularization performed without extracorporeal circulation. MATERIAL AND METHODS: In two patients with coronary heart disease, subjected to coronary artery bypass grafting performed without extracorporeal circulation, the images acquired over the operation area were recorded intraoperatively using a thermovision camera (Agema Thermovision SW/TE 900 system). RESULTS: On the basis of thermographic images, the area of lowered temperature corresponding to the region of myocardium with impaired blood flow supplied by the descending anterior coronary artery branch was determined. A rapid temperature increase to the baseline values was observed soon after removing the ligatures from the descending anterior coronary artery and left internal mammary artery used as a bypass. CONCLUSIONS: Recording thermographic heart images allows to observe restricted areas of perfusion disturbances, which take place during procedures performed on beating heart.
A comparison of blood and Fluosol-DA for cardiopulmonary bypass.
Fluosol-DA was compared to blood as a pump prime for total cardiopulmonary bypass in the pig animal model. Nineteen pigs weighing between 14 and 22 kg were studied, nine with blood and ten with Fluosol. Metabolic and hemodynamic measurements were determined before, during and after 60 minute bypass to establish the adequacy of Fluosol to sustain perfusion as compared to blood. The measurements and subsequent calculations included blood gases, arterial and mixed venous oxygen content, oxygen extraction and consumption, cardiac output, systemic and pulmonary vascular resistance and arterial, venous, pulmonary artery and left atrial pressures. The result showed a significant decrease in hematocrit during bypass in the Fluosol group as compared to blood perfusion (20 vs. 30%). While the arterial oxygen content fell from control levels with Fluosol during bypass, in the blood prime group, oxygen content remained at pre-control levels. Whole body oxygen consumption decreased during bypass, in both groups equally, but this decrease did not lead to acidosis and was stable during recovery. Oxygen and carbon dioxide transport were adequately maintained during bypass in both Fluosol and blood groups. Systemic pressures remained stable during bypass and were lower, but stable, during recovery. Pulmonary vascular resistance was elevated in both groups during recovery which probably explains a concomitantly decreased cardiac output. There was a 40% mortality in both experimental groups secondary to postpump pulmonary hypertension. It is concluded that Fluosol is a satisfactory oxygen carrying agent to be used instead of blood during cardiopulmonary bypass, and in the pig model both blood and Fluosol were associated with a high incidence of pulmonary hypertension.