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Biomedical subjects

W Goldstein

Publications and source records attributed to W Goldstein.

22 records · Page 2Linked to original sources
PubMed1975

Ischemic contracture of the left ventricle. Production and prevention.

Ischemic contracture of the left ventricle ("stone heart") is a recognized complication of prolonged periods of interruption of the coronary circulation during open-heart surgery. We have examined the effects of moderate hypothermia (28 degrees C.) and preoperative beta-adrenergic blockade (propranolol, 0.5 mg. per kilogram; 1.0 mg. per kilogram) on contracture development during ischemic arrest of the heart. Four groups of 8 dogs each were placed on total cardiopulmonary bypass, and ischemic arrest of the heart was produced by cross-clamping the ascending aorta and venting the left ventricle. Intramyocardial carbon dioxide tension was continuously monitored by mass spectrometry. When anaerobic energy production ceased, as indicated by a final plateau in the intramyocardial carbon dioxide accumulation curve, the ischemic arrest was terminated and the contractile state of the heart observed. These results are given in the text. We conclude that beta-adrenergic blockade delays, but does not prevent, the onset of ischemic contracture of the left ventricle under normothermic conditions. Moderate hypothermia appears to prevent this complication completely.

Animals↗
PubMedDate not supplied

Surgery for cardiac tumours: the University of Ottawa Heart Institute experience (1980-91).

OBJECTIVE: To review the University of Ottawa Heart Institute's experience with surgery for cardiac tumours. Case series of all patients who had surgical exploration of cardiac tumours from 1980-91 inclusive. Hospital charts, surgical pathology reports, gross photographs and glass microscopic slides were reviewed in each case. SETTING: Tertiary care, specialized cardiac referral centre. PATIENTS: All patients were diagnosed and treated surgically for heart tumours at the University of Ottawa Heart Institute over the 11-year period. The group consisted of 29 adults (14 male, 15 female) aged 15 to 76 years (mean 48) and one male newborn (six days old). Follow-up was available in 24 of 30 cases and averaged three years and four months (range four days to seven years). RESULTS: Twenty-six patients had primary cardiac tumours; 24 were benign (18 myxomas and seven nonmyxomas [one patient with lipomatous hypertrophy had coexistent myxoma]) and two were malignant. Four patients had involvement of the heart by tumours elsewhere: one benign and three malignant. Twenty-two of 24 benign primary tumours were resected successfully with relief of symptoms; two tumours were not resectable. None of the resected benign tumours recurred. Both patients with malignant primary tumours died from their disease. Three of the four patients with tumours arising elsewhere died, while the patient with benign hepatic vein leiomyoma extending into the heart remains well. CONCLUSIONS: Therefore, surgical resection of benign cardiac tumours, whether primary or secondary, is safe and usually curative. Surgery for malignant tumours is diagnostic at best.

Adolescent↗