Prognosis after open heart surgery

College advantageous anesthesia and

in the elderly

patient

and thoracotomy

morbidity.

However,

more formidable

procedure

in whom

general

Unfavorable

mortality

nucleolus

if the

fails,

there

method

the

of subcutaneous-epicardial

California,

Reactions

Los Angeles,

Heparin,

GEORGE

of Southern

growth

and source,

many

unfavorable

whereas,

in effect,

it has produced

should be

side reactions, surprisingly

few.

the

such

manifestations,

most

and local

common.

as

These

namely,

are

reactions

to animal

action

bleeding,

which

is altered from

the norm&,

constitutes

the major

volved in the use of heparin. therapeutic

action

previously

unrecognized

creased

blood

fragility,

in fibrinolytic

administered

Distortion

may be manifest

capillary

globulin,

to long

produce

problem

of the normal

in precipitation

term

with in

in-

of macro-

and in improperly

heparin

dosage.

coumarin

intractable

in-

in patients

dyscrasias,

reaction,

and controlled

added

may

effect,

contaminants.

Therapeutic

rin,

anaphy-

release

are

Hepa-

included

due to factor

on other organ systems until

Current

only alopecia,

studies

matrix

of the

of bony

is a direct

tissue

effect

resorption.

bone-cell

homogenates, two

IX

at three

preliminary

acts to decrease of

Myocardial

Infarction,

FENTON,

J. BING,

School

Myocardial ligation

descending nucleic over

acid

Detroit, was

of the arteries.

synthesis

a period

of intranuclear

nucleic

nucleic

Open

heart

acid whereas

synthesis

of

in dogs and

been classed results.

by

following in protein

and

operation,

are

used,

protein

and

JACK

Medical

School,

surgical

procedures

the relaof

DWIGHT

M.

Boston.

Mass. been

and morbidity.

particularly

evalu-

Cases have

good,

fair

or poor

gross advantages

when

any

E.

MATLOFF,

have

excellent,

overshadow

This

study

prosthetic

other

factors

attempts

during

or after surgery.

be reviewed.

inand

of

valves

that

protection

mi~fht

technics

means

of assessing

this

evaluation

will

of avoiding

of the “mixed

versus

that may occur

hemodynamic

Possible

blessing”

the unde-

of open heart

surgery will be discussed. Coarctation

of

the

Aorta

namic Studies, ALEXIS DAVID

School of Medicine,

There

is general

precarious

state

awareness

in congestive frequently

defects.

There

failure.

hemodynamics

associated

congenital

is good reason of the

and since

tive

other

these

can infants

studies

by right

that these cardiac

information the

be

about the

effect(s)

of

the

in these infants.

for this. Since

aorta

of the

congenital

defect(s)

is often performed

the diagnosis made

are usually

critically

on an emergency heart

of

by clinical basis

catheterization

angiocardiography. infants

were studied

from 2 days to 33 months

by right heart catheterization

angiocardiography

anatomic

and

of the

coarctation

other

heart

Uni-

MO.

and appreciation with

is little definitive

prior

Hemody-

JR., M.D. and

It is also known

have

disturbed

without

St. Louis.

of infants

infants

means?

in Infancy:

F. HARTMANN,

M.D., F.A.c.c., Washington

GOLDRING,

versity

prior

and more important

were as follows: is

The

and

features

Fourteen in

to clarify

to the brain and myocardium

and selective

and mitochon-

contractile

healing.

diet inhibits

by a reduced

the hemodynamic

the

ill, surgery

on subcellular

acids

wound

Heart Surgery,

as having

Often

There

posterior

an early increase

of microsomes

synthesis

University

with glycine-2-Cl4

increase

by

as insulin

and may result in the formation

ated in terms of mortality

coarctation

Studies

synthesis

dria.

PH.D., RICHARD

The rate of protein

indicate

by a marked

State

produced

was studied

of 10 weeks.

Following

Mich. anterior

stimulated such

steroids or low molec-

as indicated

M.D., F.A.C.C.

M.D., Harvard

aorta

M.D. and

of heart muscle

followed

heparin

GUDBJARNASON,

fractions jury,

time

for 10 days. that

Processes

S.

infarction coronary

is in-

clotting

stability.

F.A.c.c., Wayne

of branches

in rat

the

M.D., C. COWAN,

M.D.,

that

suggest

Reparative

of Medicine,

the there

activity

times the normal

lysosomal

upon that

shown

be

to stimulate

Prognosis After Open HARKEN,

sirable

system responsible

when

observations

Mechanism JOHN

of heparin

collagenolytic times

re-

is uncommon.

demonstrated

It has been

to four

is maintained These

effect

have

upon the enzyme

for bone creased

which

of nucleo-

by reconstruc-

on a protein-free

tive incorporation,

by psychometric

Side eflects of heparin

can

hormones

and anabolic known

processes,

damage

depletion. cently

activity

followed

have been improved.

administration,

bleeding

the

thin scars and aneurysm.

urticaria,

histamine

in

Subsequently

and microsomcs.

the animals

reparative

These may be divided into three categories.

protein

in synthetic

anabolic

hormone

start

infarction.

processes

with

Feeding

proces\er

after

ribosomes

reparative

ular substances

to cause

shock,

is an increase

treatment

Calif.

due to its character

Allergic

reparative

plasma and nuclear The

to Heparin,

expected

lactic

The

a few hours

tion of mitochondria

M.D., F.A.c.c., University

C. GRIFFITH,

diminished.

carry a definite

pacing may be employed. The

News

cardiac

Two

patients

malformations.

to

of age

and selec-

surgery,

hemodynamic

and

the

findings

showed no evidence Eight

THE AMERICANJOURNAL

patients

of had

OF CARDIOLOGY