ABSTRACT
The hematocrit change during cardiopulmonary bypass and postoperative period were studied in 34 patients, 15 females and 19 males ranging in age from 15-45 years mean 28 by using extracorporeal circulation (CPB) priming solution without blood. They were 10 patients of congenital heart disease and 24 patients of acquired heart disease. In extracorporeal circuit, priming perfusate composed mainly of Ringer’s lactate solution approximately 1,500-2,000 ml. was reinfused in the form of pack red cells by centrifugation. The result, hematocrit change during CPB was 26-28%, after CPB 1 hour for 6 times and everyday for 7 days hematocrit was 29.67-35.50%. We concluded that hemodilution technique develop mild anemia during CPB but it was be saved for open heart surgery by requiring no blood replacement.
ABSTRACT
The acquired immunodeficiency Syndrome (AIDS) has become a major public health problem worldwide particulary in Thailand where the incidence of HIV positive has increased rapidly. Srinagarind Hospital had 220 cases of HIV positive last year (1992).Now we have nearly a case per day of HIV positive in our hospital. Despite the risk of seroconversion following a needle injury has been estimated only as less than one in 200 (Marcus 1988). Some practitioners in the USA have refused to performed elective surgery on HIV positive patients (Thompson 1987). From 1991 until now we had 2 cases of HIV positive which were undergone open heart surgery without any complition.Both patients were improved their functional class after surgery.Protection of the health care workers, therefore, relies upon identification of these “high risk” patient group so that clinicians are able to decide when to take extraprecautions against transmission of infection from the patient to the health care workers. Such practice is the best way to do for these group of the patients.
ABSTRACT
A 61-year-old woman was referred to Srinagarind Hospital Khon Kaen University because of SVC obstruction. Echocardiography revealed a sizable tumor in RA, RV. outflow tract, main pulmonary artery and right pulmonary artery. All parts of the tumor were successfully excised and the patient was recovered uneventfully. The histological examination of the tumor revealed liposarcoma. This report emphasizes that intracardiac tumor, liposarcoma, should be included in differential diagnosis of SVC obstruction syndrome.
ABSTRACT
Esophageal carcinoma is one of the malignant disease commonly found in the south of Thailand. This article is a preliminary report of esophageal carcinoma in the northeast of Thailand. A total 41 cases of esophageal carcinoma were treated at Srinagarindhospital between December, 1972 and February, 1989. But only 25 cases whose records were available for study. Among these patients, the ratio between male and female was 2.6 to 1 and the average age was 59.4 year-old. All of the pateints were advanced stage (III, VI). The common site of tumor were lower esophagus (48%). The pathological types of our cases were squamous cell carcinoma 13 cases, adenocarcinoma 10 cases and the other 2 cases was not recorded. Twenty-three cases was operated and 2 cases were theated by radiation. In operated group, 2 cases died (8.1%) from esophageal perforation and anastomosis leakage. Long term follow up (18/25 cases) there was 2 cases survived for 5 years and the other survived between one month to fifteen months. Seven cases lost follow up postoperatively. In conclusion surgical patients who were treated by operation (19/23 or 82.9%) can be supported nutrition by mouth themselves, surgical treatment by skillful surgeon should be proper management of esophageal carcinoma even in advance cases.
ABSTRACT
Background: The incidence of cyanotic congenital heart diseases is about 18% of all patients with congenital heart defects and the major mortality occurred during infancy. Most infants even with complex congenital heart lesions now survive the neonatal period, prolonged hypoxemia may also adversely impact neurodevelopment and the outcome of later surgery.Objective: To determine the outcome of medical and surgical treatment in this group of patients.Design: Descriptive study. Setting: Srinagarind hospital, Khon Kaen University.Population and Samples: All patients age younger than 15 years with diagnosis of various cyanotic congenital heart diseases, which were treated between 1January 1992 and 31 December 2002amounted to 1,106 cases. Intervention: Medical treatment and/or cardiac surgery. Measurements: Hospital and surgical mortality.Results: A total of 1,106 patients with diagnosis of various cyanotic congenital heart diseases were included in this study. Cardiopathy types included: 537 tetralogy of Fallot,152 transposition of the great arteries, 94 double outlet right ventricle, 71 dextrocardia, 69 single atrium and/or single ventricle, 64 tricuspid atresia, 52 pulmonary atresia, 25 Ebstein’s anomaly of tricuspid valve, 21 truncus arteriosus, 13 total anomalous pulmonary venous return, and 8 hypoplastic left heart syndrome. Total correction and palliative surgery were performed in 377 and 279, respectively. Among 123 patients who died in hospital, 77 died after cardiac surgery. Causes of death of the remaining 46 patients were anoxic spells, sepsis and brain abscesses.Conclusions: Sixty percent of cyanotic congenital heart patients were repaired surgically. In 35%, the total correction and in 25% the palliative surgeries were performed. Average surgical mortality for all cyanotic congenital heart patients was 11.7%. Tetralogy of Fallot was the most common defects. Eighty four percent of them were underwent cardiac surgery with 9.1% surgical mortality. Complications after surgery were pleural effusion, hemothorax and chylothorax. The majority of cyanotic congenital heart diseases, even the more complex defects such as transposition of the great arteries, were now amenable to correction in Srinagarind hospital, although surgical mortality post arterial switch operation was high (25%). Some of the cyanotic patients were unable to repair,supportive treatment was still the good choice in this group.
ABSTRACT
Background: The incidence of cyanotic congenital heart diseases is about 18% of all patients with congenital heart defects and the major mortality occurred during infancy. Most infants even with complex congenital heart lesions now survive the neonatal period, prolonged hypoxemia may also adversely impact neurodevelopment and the outcome of later surgery.Objective: To determine the outcome of medical and surgical treatment in this group of patients.Design: Descriptive study.Setting: Srinagarind hospital, Khon Kaen University.Population and Samples: All patients age younger than 15 years with diagnosis of various cyanotic congenital heart diseases, which were treated between 1January 1992 and 31 December 2002 amounted to 1,106 cases.Intervention: Medical treatment and/or cardiac surgery.Measurements: Hospital and surgical mortality.Results: A total of 1,106 patients with diagnosis of various cyanotic congenital heart diseases were included in this study. Cardiopathy types included: 537 tetralogy of Fallot,152 transposition of the great arteries, 94 double outlet right ventricle, 71 dextrocardia, 69 single atrium and/or single ventricle, 64 tricuspid atresia, 52 pulmonary atresia, 25 Ebsteinûs anomaly of tricuspid valve, 21 truncus arteriosus, 13 total anomalous pulmonary venous return, and 8 hypoplastic left heart syndrome. Total correction and palliative surgery were performed in 377 and 279, respectively. Among 123 patients who died in hospital, 77 died after cardiac surgery. Causes of death of the remaining 46 patients were anoxic spells, sepsis and brain abscesses.Conclusions: Sixty percent of cyanotic congenital heart patients were repaired surgically. In 35%, the total correction and in 25% the palliative surgeries were performed. Average surgical mortality for all cyanotic congenital heart patients was 11.7%. Tetralogy of Fallot was the most common defects. Eighty four percent of them were underwent cardiac surgery with 9.1% surgical mortality. Complications after surgery were pleural effusion, hemothorax and chylothorax. The majority of cyanotic congenital heart diseases, even the more complex defects such as transposition of the great arteries, were now amenable to correction in Srinagarind hospital, although surgical mortality post arterial switch operation was high (25%). Some of the cyanotic patients were unable to repair, supportive treatment was still the good choice in this group.