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W Isom

Publications and source records attributed to W Isom.

6 recordsLinked to original sources
PubMed1983

The effect of nitroglycerin cardioplegia on myocardial cooling in patients undergoing myocardial revascularization.

The effect of intracoronary administration of nitroglycerin on the distribution of cardioplegia and myocardial cooling was assessed in 45 patients undergoing elective myocardial revascularization. The patients were divided into three groups. Myocardial temperature was measured over the right and left coronary artery distributions in Group 1 after the infusion of 1 liter of potassium blood cardioplegic solution (20 mEq of potassium per liter). Similar temperature measurements were made in Group 2 after the addition of 300 micrograms of nitroglycerin to the cardioplegic solution and in Group 3 after the addition of 1,000 micrograms of nitroglycerin. Nitroglycerin did not affect myocardial cooling, and large temperature gradients persisted after delivery of cardioplegia in patients with occlusive coronary artery disease. Unexpectedly, however, the rate of cardioplegia delivery increased by 134%, within the same range of infusion pressures, in patients receiving nitroglycerin. Although nitroglycerin cardioplegia does not affect the regional disparity in the distribution of cardioplegia in patients with severe coronary artery disease, intracoronary administration of nitroglycerin reduces the time required for administration of cardioplegia and thereby decreases the total ischemia time.

Coronary Disease↗
PubMed1983

Management of patients with cold agglutinins who require open-heart surgery.

Cold agglutinins are commonly found in the sera of healthy persons but rarely become clinically important because most agglutinins exert their greatest reactivity at low temperatures. This report describes a patient who successfully underwent aortic valve replacement in the presence of cold agglutinins; it discusses the management of patients with cold agglutinins who undergo open-heart surgery with core hypothermia. Changes in the cell membrane occur when cold circulating antibody combines with complement and antigen present on the surface of the red cell membrane, causing intravascular hemolysis. Two conditions are necessary for the reaction to occur to any appreciable extent: there must be a high enough titre of cold agglutinin and the reactive thermal range must be attained. To avoid these conditions, the core hypothermia should not reach the reactive thermal range or the titre should be reduced either by the standard hemodilution techniques for cardiopulmonary bypass or by plasmapheresis.

Aged↗
PubMedDate not supplied

Pulmonary artery sarcoma: evaluation using Gd-DTPA.

Primary malignant tumors of the pulmonary arteries occur infrequently and diagnosis is often delayed since symptoms are nonspecific. We present a case of pulmonary artery sarcoma and its interesting magnetic resonance findings.

Contrast Media↗