Development of Viral Diseases and a Viral Disease-Like Syndrome After Extracorporeal Circulation

Abstract

gradient between 20 and 50 mm mercury. Four had poor results; 2 were late postoperative deaths, 3 and 6 mo postoperatively; 1 has heart block with atrioventricular bundle rhythm, and 1 patient has a residual shunt and outflow tract gradient. All

A Syndrome Resembling Infectious Mononucleosis After Open-heart Surgery

“…Similar lymphadenopathy was noted by Perillie and Glenn (1962) in their three cases, but was not commented upon by Wheeler et al (1962) or Seaman and Starr (1962). Holswade et al (1963) noted lymphadenopathy in only one of their 14 patients, but the frequency of its occurrence in the present series suggests that it may be a fairly common manifestation of the syndrome.…”

“…This is unlikely to be coincidental, as surgery continued throughout the year. A tendency towards sporadic outbreaks of the syndrome was also noted by Holswade et al (1963). Of 14 cases they report, spanning four years, eight occurred in one year.…”

“…Of particular interest is the remaining patient (Case 1), who had a negative result three days after the onset of fever, but positive findings when the test was repeated on the 12th day of fever (titre after guineapig absorption 1:160). A positive result from the Paul-Bunnell test appears to be unusual in the syndrome, only one example being found in the 33 previously reported cases (Holswade et al, 1963).…”

“…The type of oxygenator used (rotating disk or bubble) has differed, but a common denominator has been the use of large volumes of donor blood, both in the actual surgical procedure and in the initial priming of the pump. Holswade et al (1963) favoured a viral aetiology because of the presence of atypical lymphocytes in the peripheral blood. It seems reasonable to suggest that viral disease may be transmitted to a susceptible recipient via donor blood, for the transmission of homologous serum jaundice is well known to occur in this manner.…”

“…A clinical post-perfusion syndrome of fever and splenomegaly with atypical lymphocytes in the peripheral blood was described by Seaman and Starr (1962). This syndrome has been further amplified by the reports of Perillie and Glenn (1962), Wheeler et al (1962), Holswade et al (1963), and Anderson and Larsson (1963). So far 33 examples of the syndrome have been described.…”