The Surgical Anatomy of Atrial Septal Defects

Fj, Lewis; Taufic, M; Varco, Richard L.; Niazi, Suad A.

doi:10.1097/00000658-195509000-00009

Cited by 87 publications

(29 citation statements)

References 5 publications

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“…Hypothermia will protect specific areas of the body or the total body during periods of circulatory arrest ( 1,2), and most investigations have emphasized cerebral protection during this period of anoxia. The heart has been protected by the depressed metabolism of the cooled state, but formidable complications continue, and ventricular fibrillation has been considered a major deterrent to the use of hypothermia( 3,4).…”

Section: Department Of Surgerymentioning

confidence: 99%

Protection of Heart Under Hypothermia with Acetylcholine Arrest.

Moulder¹,

Thompson²

1956

Experimental Biology and Medicine

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Hypothermia will protect specific areas of the body or the total body during periods of circulatory arrest ( 1,2), and most investigations have emphasized cerebral protection during this period of anoxia. The heart has been protected by the depressed metabolism of the cooled state, but formidable complications continue, and ventricular fibrillation has been considered a major deterrent to the use of hypothermia( 3,4). Considering the profound environmental changes associated with hypothermia the heart is remarkably non-sensitive. This is especially true when a relatively normal acid-base relationship is maintained ( 5 , 6 ) . However, with circulatory arrest and continuation of cardiac contractions the heart becomes progressively more cyanotic and weaker ; there is electrocardiographic evidence of deterioration; and resuscitation becomes progressively more difficult.This study was based on the thesis that arrest or inhibition of cardiac activity would afford increased protection of the heart. It has been found that a near total arrest can be obtained with the use of intracoronary acetylcholine and this effect of the acetylcholine can be reversed by atropine given shortly before release of occlusion.Method. Fifteen adult mongrel dogs were used in this study (3 had had prior implantation of yttriumw oxide pellets in the myocardium and were sacrificed for study). Preoperative medication was 45 mg of morphine sulphate only. Four received barbiturates for induction, and all animals had ether-oxygen closed circuit anesthesia with a carbon dioxide absorber in the system. Three dogs were studied at normal body temperature and 12 were cooled to 24-27OC for the experimental period. Cooling and rewarming procedures *This study supported by grants from the Si,mms and Douglas Smith Foundations for Medical Research. of University of Chicago.were done with the use of a Thermo-Rite circulating fluid blanket. Body temperature was observed continuously with the use of a rectal thermocouple and gauge. Lead I1 of the electrocardiogram was used as the monitor throughout the procedure. Standard and augmented limb lead electrocardiograms were obtained at various stages of the procedure. Total circulatory arrest was obtained by ligating the azygos vein, placing bulldog clamps on the superior and inferior vena cavae and cross clamping the aorta and pulmonary artery with a large Satinsky clamp. Respiration was halted during the periods of occlusion. Except for a period when the chest was open and a short time thereafter, the dogs were allowed to breathe normally. When respiration was assisted at the low temperature, the respiratory rate was maintained at 3 per minute. In 9 of the experiments a constant recording COa analyzer was attached to the endotracheal tube at the level of the mouth and records of inspiratory and expiratory COa were obtained.This indicated a level of expiratory C02 to be maintained by the hypoventilation during the tijme the chest was open. Direct blood pressure readings (via a femoral catheter and a Statham transduc...

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Section: Department Of Surgerymentioning

confidence: 99%

Protection of Heart Under Hypothermia with Acetylcholine Arrest.

Moulder¹,

Thompson²

1956

Experimental Biology and Medicine

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“…Hypothermia has been used recently (1)(2)(3)(4)(5) to perform intracardiac operations under direct vision without recourse to the use of extracorporeal blood pumps. The success of this technic is due to the greatly lowered oxygen requirements at reduced temperatures which allow a relatively long period of total inflow occlusion.…”

mentioning

confidence: 99%

Hypothermia in Experimental Hepatic Surgery.

Raffucci

Wangensteen

1953

Experimental Biology and Medicine

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“…This type of defect is illustrated in Fig. 1 (after Lewis et al, 1955) and Fig. 2 (after Geddes, 1912).…”

mentioning

confidence: 99%

“…An excellent anatomical description of this variety of interatrial communication has been given by Lewis et al (1955), who found it to be at least as common as the ostium primum type of defect. The defect occurs high in the dorsicephalic part of the interatrial septum, facing the orifice of the superior vena cava, and has, according to Lewis et 28, 1957. namely, (1) it lies above and independent of the fossa ovalis; (2) its margin is incomplete, being absent superiorly and incomplete posteriorly; and (3) it is associated with anomalous drainage of the right superior, and sometimes of the right middle or inferior, pulmonary vein.…”

mentioning

confidence: 99%

The Sinus Venosus Type of Interatrial Septal Defect

Harley¹

1958

Thorax

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The Surgical Anatomy of Atrial Septal Defects

Cited by 87 publications

References 5 publications

Protection of Heart Under Hypothermia with Acetylcholine Arrest.

Protection of Heart Under Hypothermia with Acetylcholine Arrest.

Hypothermia in Experimental Hepatic Surgery.

The Sinus Venosus Type of Interatrial Septal Defect

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