PubMed · 479652
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K Soejima. 1979. [Renal function after open heart surgery in infancy (author's transl)].. https://pubmed.ncbi.nlm.nih.gov/479652/
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KEEP EXPLORING
A technique of myocardial protection using a perfusion circuit in deep hypothermia via the ascending aorta or by selective cannulation of the coronaries has been used over a period of 2 years in almost 200 patients undergoing surgery requiring prolonged aortic clamping. It ensures rapid and homogeneous cooling of the myocardium (10-12 degrees C) and meets its reduced oxygen needs. It may be completed by cardioplegia (infusion of potassium chloride or lidocaine using an automatic syringe at a determined level). This simple technique permits a rapid spontaneous return of normal effective cardiac action. No low cardiac output syndromes have been seen since it has been used. Laboratory, histological, biochemical and haemodynamic studies carried out have confirmed its harmless nature.
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To assess the efficacy of surgical methods of pericardial drainage in preventing the accumulation of pericardial effusion, we performed M-mode and cross-sectional echocardiograms in 26 patients before and one week after the creation of a pericardial window or leaving the pericardium open after cardiac surgery. A pericardial window was created in six patients (group 1) who had pericardial effusions. Group 2 consisted of 20 patients who had heart surgery. Echocardiography disclosed moderate or large pericardial effusions preoperatively in all group 1 patients but in one of the group 2 patients. Following operation, three of the group 1 patients had complete clearing of pericardial effusion, while three showed reaccumulation. In group 2, thirteen patients had either no effusion or a small effusion. Seven patients had moderate or large pericardial effusions that were located posterior to the heart; only one had an anterior pericardial effusion. Cross-sectional echocardiography showed posterior loculation of effusion in six of the seven patients. Pericardial drainage is not always effective in preventing accumulation of pericardial effusions.