Cardiothoracic Surgery

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Browsing Cardiothoracic Surgery by Author "Barnard, P. M."

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    Aneurysm of a peripheral pulmonary artery : case report and brief review of the literature
    (Health and Medical Publishing Group (HMPG), 1975-08) Janson, P. M. C.; Barnard, P. M.; Weich, H. F. H.; MacMahon, A. G.
    A patient is presented in whom a solitary aneurysm of a peripheral pulmonary artery was treated by left lower lobectomy. This is the eighth reported successful resection of such an aneurysm. A brief review of the literature is also presented and the importance of pulmonary arteriography in the diagnosis of this condition is mentioned.
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    Aortokoronêre omleidingschirurgie te Tygerberg-Hospitaal, 1978-1980
    (Health & Medical Publishing Group, 1982-11) Barnard, P. M.; Lubbe, J. J. De W.; Rossouw, J. J.; Weich, H. F. H.
    ENGLISH ABSTRACT: Between January 1978 and December 1980, 118 patients underwent saphenous vein bypass surgery for obstructive coronary artery disease at Tygerberg Hospital. Sixteen patients in addition to bypass surgery underwent mitral and/or aortic valve replacement or resection of a ventricular aneurysm. The operative and hospital mortality was 3.0% (4/134) for all patients and 3.3% (4/118) for patients who had aortocoronary bypass surgery as the sole procedure. Follow-up of the surviving patients for a mean period of 16.4 months revealed a low incidence of late myocardial infarction of 3.6% (4/112) resulting in the death of only 1 patient; 89.1% of patients were free of angina pectoris and the majority of these resumed their normal work or enjoyed their retirement.
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    Penetrating wounds of the heart and great vessels : a new therapeutic approach
    (Health and Medical Publishing Group -- HMPG, 1982-08) Knott-Craig, C. J.; Przybojewski, J. Z.; Barnard, P. M.
    A series of 36 Black and Coloured patients, presenting during a 1-year period with life-endangering intrathoracic trauma secondary to assault, is presented. Penetrating wounds of the heart were documented in 32 of these patients, 6 of whom died almost immediately after having been brought into the Resuscitation Unit of Tygerberg Hospital, Parowvallei, CP. The remaining 26 patients had clinical features of cardiac tamponade and circulatory collapse, and in 4 of these patients an emergency thoracotomy was performed in the Resuscitation Unit as it was considered inadvisable to delay surgery until theatre had been arranged. Three of the latter 4 were discharged home completely recovered. Total peri-operative mortality was 13.3%, most deaths being due to lacerations of the left ventricle. Penetrating wounds of the ventricles accounted for some 85% of the total cardiac lacerations; other lacerations affected the pulmonary artery and its branches, the aorta, left atrium and internal thoracic artery. The incision most frequently employed at surgery was a median sternotomy (53%), followed by left thoracotomy (40%) and right thoracotomy (7%). Pre-operative emergency management based on pathophysiological principles is discussed. The fact that relatively inexperienced surgical registrars performed many of these operations with good results emphasizes the need for the establishment of resuscitation units in more peripheral hospitals where many of these patients could primarily be treated. These units would then be able to manage many of these patients, probably at an earlier stage than if they were referred to a teaching hospital such as Tygerberg.
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    Penetrating wounds of the heart and great vessels : experience with 24 cases including 3 with intracardiac defects
    (Health and Medical Publishing Group (HMPG), 1975-03) De Wet Lubbe, J. J.; Janson, P. M. C.; Barnard, P. M.
    Twenty four cases of penetrating cardiac injuries due to stab wounds, which were seen over a 3 yr period, are reviewed. Ten patients were treated by aspiration alone because tamponade was mild, or because they were seen more than 12 hr after injury. One patient with multiple stab wounds in the ventricles and left atrium died during emergency thoracotomy in the admission room. The mortality rate of 4.2% is considerably lower than rates reported in other series. Two cases of traumatic ventricular septal defects, one case of traumatic aortic incompetence and sinus of Valsalva fistulae with rupture into the right ventricle and right atrium, and one case of ascending aorta innominate vein fistula are discussed. A plan of management is outlined.
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    Post-infarction ventricular septal defect and aneurysm formation : a case presentation with successful surgical correction and review of the literature
    (HMPG, 1981-02) Przybojewski, J. Z.; Barnard, P. M.
    A fairly young man suddenly developed a large ventricular septal defect (VSD) after an extensive anterolateral and anteroseptal myocardial infarction. Because of congestive cardiac failure refractory to medical treatment he underwent simultaneous closure of the VSD and left ventricular aneurysmectomy 6 weeks after the myocardial infarction. Some 14 months after operation the patient is completely asymptomatic on the minimum of medical therapy and is able to live normally. The literature on these two combined lesions complicating acute myocardial infarction and their surgical correction is reviewed. It is postulated that this patient's infarction was caused by coronary spasm of the Prinzmetal variety with underlying normal coronary arteries.
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    Ventrikulere aneurismektomie en infarktektomie
    (Health and Medical Publishing Group (HMPG), 1975-03) Barnard, P. M.; De Wet Lubbe, J. J.; Janson, P. M. C.
    Four patients underwent ventricular aneurysmectomy for congestive cardiac failure. In addition, 1 patient with an aneurysm and 3 patients with acute myocardial infarcts, ranging from 16 to 28 days postinfarction, underwent emergency surgery for recurrent malignant arrhythmias. The preoperative treatment, cardiac catheterization data and surgical findings are outlined. The overall survival rate is 75% for a mean followup period of 12.5 mth (range 8-22 mth). It is concluded that aneurysmectomy, for congestive cardiac failure, and infarctectomy, for life threatening ventricular arrhythmias, are gratifying and worthwhile procedures.