- Email: [email protected]
Perforation of the esophagus. A 30 year review
562
obstruction. It is recommended that patients have a cardiac catheterization in the relatively early postoperative period to detect pulmonary venous obstruction. The use of Dacron for the original baffle is suggested.--Thomas M. Holder Surgical Treatment of Complete Atrioventricular Canal. Martin H.‘McMullan, Robert B. Wallace, William H. Weidman, and Dwighr C. McGoon Surgery 729055912 (December),
1972. Twenty-five of 27 patients underwent successful repair of complete atrioventricular canal at the Mayo Clinic. The two deaths (7%) were due to technical problems allowing early recurrence. The details of the operative procedure are presented. Follow-up evaluation 3 mo to 8sA yr later disclosed all but two to be asymptomatic, many with mild nonprogressive mitral regurgitation, and most with resumption of more normal growth rate. The authors believe the prognosis for these patients has been greatly improved in recent years.- William K. Sieber The Rastelli Operation. Its Indications and Results. D. C. McGoon. R. B. Wallace, and G. K. Danielson. J Thorac Cardiovasc Surg 65:65-75 (January), 1973. Between 1967 and 1972, 111 patients at the Mayo Clinic were operated upon employing a homograft of the ascending aorta including its valve to restore continuity between the right ventricle and pulmonary artery. This extensive experience is reviewed in detail. The overall mortality was 32%. The good-risk group included the patients between 5 and 13 yr of age who had transposition of the great vessels, ventricular septal defect, and pulmonary stenosis (6% mortality). The high-risk group included patients less than 5 yr of age having transposition of the great vessels and pulmonary stenosis and patients with truncus arteriosus and a ratio of pulmonary resistance to systemic resistance greater than 0.6%. There are 21 references.Thomas M. Holder
Long-term Evaluation of Aortic Valvuloplasty for Aortic Insufficiency and Ventricular Septal Defect. F. C. Spencer. E. F. Doyle, D. A. Danilowicz, H. T. Bahnson, and C. S. Weldon. J Thorac Cardiovasc Surg 6515-31
(January), 1973. Twenty patients with aortic insufficiency and ventricular septal defect treated by valvuloplasty
ABSTRACTS
and closure of the ventricular septal defect are presented. The valvuloplasty consisted of shortening the elongated edge of the prolapsed cusp. The ventricular septal defect was then closed by way of the right ventricle, allowing evaluation of the aortic valve competence. The ventricular septal defect was closed with a patch to provide support for the cusp. One death occurred, in the patient in which the abnormal cusp was replaced with fascia lata. The other I9 patients are all improved. Seven have some residual insufficiency, but this is stable and not progressing. The lesion apparently is best treated by valvuloplasty rather than by valvular prosthesis. Fourteen references are given.Thomas M. Holder
ALIMENTARY
TRACT
Membranous Esophageal Obstruction Simulating Atresia With a Double Tracheoesophageal Fistula in a Neonate. R. J. Touloukian. J Thorac Cardiovasc Surg 65:191-194 (February), 1973. An infant with an esophageal web opposite a tracheoesophageal fistula is presented. The external appearance of the esophagus at operation was normal (save for the tracheoesophageal fistula). He was successfully treated by division of the TEF and esophageal resection. Twelve references of unusual tracheoesophageal anomalies are provided.-Thomas M. Holder Perforation of the Esophagus. A 30 Year Review. B. E. Berry and J. L. Ochsner. J Thorac Cardiovasc Surg 65: 1-7 (January), 1973. Thirty-one patients with esophageal perforation were treated at the Ochsner Clinic during the past 30 yr. Their ages ranged from I6 mos to 77 yr, with 75% over 50 yr of age, and 75% of the perforations were the result of instrumentation. One unrecognized perforation resulted in death. Three patients were treated successfully with only medical therapy. There were four deaths in the 27 surgically treated patients. Recommended therapy is prompt recognition and, for the cervical perforations, drainage. For the thoracic perforation, the lesion should have suture closure and drainage. All patients should receive broad-spectrum antibiotic coverage. A definitive correction of the underlying esophageal pathology is warranted if the perforation is treated promptly. Twenty references are given.-Thomas
M. Holder
obstruction. It is recommended that patients have a cardiac catheterization in the relatively early postoperative period to detect pulmonary venous obstruction. The use of Dacron for the original baffle is suggested.--Thomas M. Holder Surgical Treatment of Complete Atrioventricular Canal. Martin H.‘McMullan, Robert B. Wallace, William H. Weidman, and Dwighr C. McGoon Surgery 729055912 (December),
1972. Twenty-five of 27 patients underwent successful repair of complete atrioventricular canal at the Mayo Clinic. The two deaths (7%) were due to technical problems allowing early recurrence. The details of the operative procedure are presented. Follow-up evaluation 3 mo to 8sA yr later disclosed all but two to be asymptomatic, many with mild nonprogressive mitral regurgitation, and most with resumption of more normal growth rate. The authors believe the prognosis for these patients has been greatly improved in recent years.- William K. Sieber The Rastelli Operation. Its Indications and Results. D. C. McGoon. R. B. Wallace, and G. K. Danielson. J Thorac Cardiovasc Surg 65:65-75 (January), 1973. Between 1967 and 1972, 111 patients at the Mayo Clinic were operated upon employing a homograft of the ascending aorta including its valve to restore continuity between the right ventricle and pulmonary artery. This extensive experience is reviewed in detail. The overall mortality was 32%. The good-risk group included the patients between 5 and 13 yr of age who had transposition of the great vessels, ventricular septal defect, and pulmonary stenosis (6% mortality). The high-risk group included patients less than 5 yr of age having transposition of the great vessels and pulmonary stenosis and patients with truncus arteriosus and a ratio of pulmonary resistance to systemic resistance greater than 0.6%. There are 21 references.Thomas M. Holder
Long-term Evaluation of Aortic Valvuloplasty for Aortic Insufficiency and Ventricular Septal Defect. F. C. Spencer. E. F. Doyle, D. A. Danilowicz, H. T. Bahnson, and C. S. Weldon. J Thorac Cardiovasc Surg 6515-31
(January), 1973. Twenty patients with aortic insufficiency and ventricular septal defect treated by valvuloplasty
ABSTRACTS
and closure of the ventricular septal defect are presented. The valvuloplasty consisted of shortening the elongated edge of the prolapsed cusp. The ventricular septal defect was then closed by way of the right ventricle, allowing evaluation of the aortic valve competence. The ventricular septal defect was closed with a patch to provide support for the cusp. One death occurred, in the patient in which the abnormal cusp was replaced with fascia lata. The other I9 patients are all improved. Seven have some residual insufficiency, but this is stable and not progressing. The lesion apparently is best treated by valvuloplasty rather than by valvular prosthesis. Fourteen references are given.Thomas M. Holder
ALIMENTARY
TRACT
Membranous Esophageal Obstruction Simulating Atresia With a Double Tracheoesophageal Fistula in a Neonate. R. J. Touloukian. J Thorac Cardiovasc Surg 65:191-194 (February), 1973. An infant with an esophageal web opposite a tracheoesophageal fistula is presented. The external appearance of the esophagus at operation was normal (save for the tracheoesophageal fistula). He was successfully treated by division of the TEF and esophageal resection. Twelve references of unusual tracheoesophageal anomalies are provided.-Thomas M. Holder Perforation of the Esophagus. A 30 Year Review. B. E. Berry and J. L. Ochsner. J Thorac Cardiovasc Surg 65: 1-7 (January), 1973. Thirty-one patients with esophageal perforation were treated at the Ochsner Clinic during the past 30 yr. Their ages ranged from I6 mos to 77 yr, with 75% over 50 yr of age, and 75% of the perforations were the result of instrumentation. One unrecognized perforation resulted in death. Three patients were treated successfully with only medical therapy. There were four deaths in the 27 surgically treated patients. Recommended therapy is prompt recognition and, for the cervical perforations, drainage. For the thoracic perforation, the lesion should have suture closure and drainage. All patients should receive broad-spectrum antibiotic coverage. A definitive correction of the underlying esophageal pathology is warranted if the perforation is treated promptly. Twenty references are given.-Thomas
M. Holder