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A membrane oxygenator with low priming volume for extracorporeal circulation
INTERNATIONAL
ful preoperative
ABSTBACTS
catheter
OF PEDIATRIC
studies.
Right
and
left ventricmar pressures were obtained in all, and pulmonary artery pressures in two. The pulmonary-systemic flow ratio and pulmonary vascular resistance as fraction of systemic were estimated. The cases reported are a selected series and include only those with a near-normal pulmonary vascular resistance. No major communications were present between the pulmonary and systemic circulations. The operative technic is fully described. In the first case, the atria1 septum was completely excised as described by Mustard. A pericardia1 graft was sutured into the atrium so as to redirect the caval return to the left ventricle and pulmonary venous return to the right ventricle. In the subsequent cases, a modification was introduced which consisted of preserving the atria1 septum as a pedicle flap. This method ensured that sutures were not placed in a region close to the atrioventricular node and bundle of His. Secondly. norma tissue with vascular supply which will not contract was preserved. This normal tissue could even stretch, should the pericardial graft contract after operation. In this series, seven out of nine children treated by this operation have survived. The survivors showed two prominent features. First there was a significant incidence of supraventricular arrhythmias. Secondly. there was immense clinical improvement in the survivors.-D. J. Waterston
STAGED REPAIR OF PULMONIC HYP~PLASTIC
RIGHT
STENOSIS AND
VENTRICLE.
G.
D.
Berman, L. M. Linde and D. G. Mulder. Arch. Surg., 91:597, 1965. T\+o infants were reported, wherein severe pulmonary valvular stenosis is associated with hypoplasia of the right ventricle. A closed transventriculotomy was performed as an emergency procedure. This was subsequentIy folIowed with definitive repair. Both children are now asymptomatic and appear to be normal.-Edtr;ard .I. Berman
A
MEMBRANE PRIMING
OXYGENATOR
VOLUME
WITH
Low
FOR EXTRACORPOREAL
CIRCULATION. R. Wilson, and E. Llewellyn-Thomas. 6309, 1965.
D. 1. Sheplcy, Canad. J. Surg.
95
SURGERY
The
authors
describe
a membrane
oxy-
genator utilizing small-bore tubes made of silicone rubber, through which the blood is circulated. The blood first flows into a small lower reservoir, then through the small-bore tubes into an upper reservoir. The apparatus is enclosed in a supporting acrylic plastic jacket, through which oxygen passes. Flow rates up to 50 ml./min. have been obtained. The priming volume is small. Experimentally. the oxygenator has been used to maintain adequate oxygenation of mammalian fetuses of up to 150 Cm. by connecting it into the umbilical circulation as an artificial placenta.-C&n C. Ferguson THE EFFECT OF METHANUROSTENOLONE NITROGEN
EXCRETION
HEART
SURGEIIY.
93:816,
1965.
FOLLOWING
Canud.
Med.
ON
OPEN-
Ass.
J.
Forty-nine patients (adults and children) undergoing open-heart surgery were given methandrostenolone (Danabol) starting on the day before operation. In the children, dose administered was 0.04 mg./lb./day. Alternate patients not given the drug, but undergoing the same type of surgery, served as controls. The purpose of the study was twofold: ( 1) to determine whether a nitrogensparing effect could be demonstrated, and (2 to determine whether the postoperative course was altered in any way by the administration of methandrostenolone. No significant differences were found in the two groups of patients, either as to nitrogen excretion or their clinical recovery.C&n C. Ferguson POST-PERFUSION
Hahas,
LUNG
D. G. Melrose,
B. Robinson. Lancet articles), 1965.
R. A. M. K. Sykes and
SYNDROME.
2:251
and
254
(2
Open-heart surgery under total cardiopulmonary bypass is frequently complicated by postoperative hypoxia as a consequence of venous admixture caused by ventilation perfusion inequalities and right-to-left intrapulmonary shunts. The shunt is much greater following open than closed heart surgery, It causes cyanosis and dyspnea, beginning at about the third day after operation, and may be fatal. At necropsy, the lungs show patchy ^ __ areas ot collapse and haemorrhage. The
ful preoperative
ABSTBACTS
catheter
OF PEDIATRIC
studies.
Right
and
left ventricmar pressures were obtained in all, and pulmonary artery pressures in two. The pulmonary-systemic flow ratio and pulmonary vascular resistance as fraction of systemic were estimated. The cases reported are a selected series and include only those with a near-normal pulmonary vascular resistance. No major communications were present between the pulmonary and systemic circulations. The operative technic is fully described. In the first case, the atria1 septum was completely excised as described by Mustard. A pericardia1 graft was sutured into the atrium so as to redirect the caval return to the left ventricle and pulmonary venous return to the right ventricle. In the subsequent cases, a modification was introduced which consisted of preserving the atria1 septum as a pedicle flap. This method ensured that sutures were not placed in a region close to the atrioventricular node and bundle of His. Secondly. norma tissue with vascular supply which will not contract was preserved. This normal tissue could even stretch, should the pericardial graft contract after operation. In this series, seven out of nine children treated by this operation have survived. The survivors showed two prominent features. First there was a significant incidence of supraventricular arrhythmias. Secondly. there was immense clinical improvement in the survivors.-D. J. Waterston
STAGED REPAIR OF PULMONIC HYP~PLASTIC
RIGHT
STENOSIS AND
VENTRICLE.
G.
D.
Berman, L. M. Linde and D. G. Mulder. Arch. Surg., 91:597, 1965. T\+o infants were reported, wherein severe pulmonary valvular stenosis is associated with hypoplasia of the right ventricle. A closed transventriculotomy was performed as an emergency procedure. This was subsequentIy folIowed with definitive repair. Both children are now asymptomatic and appear to be normal.-Edtr;ard .I. Berman
A
MEMBRANE PRIMING
OXYGENATOR
VOLUME
WITH
Low
FOR EXTRACORPOREAL
CIRCULATION. R. Wilson, and E. Llewellyn-Thomas. 6309, 1965.
D. 1. Sheplcy, Canad. J. Surg.
95
SURGERY
The
authors
describe
a membrane
oxy-
genator utilizing small-bore tubes made of silicone rubber, through which the blood is circulated. The blood first flows into a small lower reservoir, then through the small-bore tubes into an upper reservoir. The apparatus is enclosed in a supporting acrylic plastic jacket, through which oxygen passes. Flow rates up to 50 ml./min. have been obtained. The priming volume is small. Experimentally. the oxygenator has been used to maintain adequate oxygenation of mammalian fetuses of up to 150 Cm. by connecting it into the umbilical circulation as an artificial placenta.-C&n C. Ferguson THE EFFECT OF METHANUROSTENOLONE NITROGEN
EXCRETION
HEART
SURGEIIY.
93:816,
1965.
FOLLOWING
Canud.
Med.
ON
OPEN-
Ass.
J.
Forty-nine patients (adults and children) undergoing open-heart surgery were given methandrostenolone (Danabol) starting on the day before operation. In the children, dose administered was 0.04 mg./lb./day. Alternate patients not given the drug, but undergoing the same type of surgery, served as controls. The purpose of the study was twofold: ( 1) to determine whether a nitrogensparing effect could be demonstrated, and (2 to determine whether the postoperative course was altered in any way by the administration of methandrostenolone. No significant differences were found in the two groups of patients, either as to nitrogen excretion or their clinical recovery.C&n C. Ferguson POST-PERFUSION
Hahas,
LUNG
D. G. Melrose,
B. Robinson. Lancet articles), 1965.
R. A. M. K. Sykes and
SYNDROME.
2:251
and
254
(2
Open-heart surgery under total cardiopulmonary bypass is frequently complicated by postoperative hypoxia as a consequence of venous admixture caused by ventilation perfusion inequalities and right-to-left intrapulmonary shunts. The shunt is much greater following open than closed heart surgery, It causes cyanosis and dyspnea, beginning at about the third day after operation, and may be fatal. At necropsy, the lungs show patchy ^ __ areas ot collapse and haemorrhage. The