By P. K. Ghosh (auth.), Probal K. Ghosh MD, MS, MCh, FRCSE, Felix Unger (eds.)
Attempts to reconstruct a variety of elements of the center all started even ahead of the start of open cardiac surgical procedure. through the past due Fifties and early 1960 s a number of closed and open methods had already been defined. In that period, numerous surgeons in Europe and the Americas have been rather brought on to advance a number of concepts of valve re building as a result of loss of appropriate valve prostheses and conduits that have develop into to be had to that end. at the moment, a number of congenital lesions nonetheless defied definitive correction, and scientific makes an attempt at left ventricular wall substitute had no longer but received lower than approach. A renaissance in several cardiac reconstructive systems begun firstly of the Nineteen Eighties. because the difficulties when it comes to valve prostheses turned extra normally preferred and the significance of chamber volumes and geometry (atrial or ventricular) was once accorded due value within the long term follow-up, there has been a resurgence of surgical makes an attempt at reconstruction in congenital and purchased cardiac lesions so that it will approximate the ordinary nation. even as a number of features of this reconstructive "discipline" turned obvious. First, cardiac reconstructive surgical procedure has remained a surgical "art" with a steadily expanding variety of cardiac surgeons.
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Four days postoperatively a pulmonary artery pressure of 40/25 mmHg was measured, and the girl was promptly reoperated on. Since the insufficiency of the valve was located centrally, a logical way to solve the problem was, in our opinion, to increase the opening surface of the valve cutting only the sutures of the cleft close to the base of the leaflet and creating in this way and additional orifice of 8 mm in diameter (Fig. 1). The final result was a perfectly competent mitral valve with three orifices, giving a total opening surface adequate for the body surface area of the child.
Particularly interesting is one former premature infant who needed mechanical ventilation for the first 6 months of life due to respiratory distress. Total static lung compliance was reduced to 17% of normal, and the pulmonary vascular resistance index was up to 12 units/m 2 • The infant could be extubated 14 days postoperatively. One year later recatheterization revealed pUlmonary hypertension of two-thirds of the aortic pressure. Catecholamines and other vasoactive drugs were necessary in only three patients.
Liver function analysis was performed in five patients. 1 years) for a total of 132 patient/years. Three patients were lost to followup. Statistical Analysis Standard actuarial and linearized statistical techniques were used to describe survival. Continuous data were presented as means ± standard deviation (SD) and actuarial probability estimates with ± 1 standard error of mean (SEM). 46 G. Touati et al. 3% (4/28). The causes of death were: a low cardiac output related to an elevated pulmonary vascular resistance (2 patients) or an arrhythmia (1 patient).
Cardiac Reconstructions by P. K. Ghosh (auth.), Probal K. Ghosh MD, MS, MCh, FRCSE, Felix Unger (eds.)