Résumé
Postoperative hypoxia in 53 consecutively treat patients who underwent coronary artery bypass grafting (CABG) and who were weaned from mechanical ventilation were studied. The 29 patients who required high concentration oxygen (more than 70% H-group) were compared with the 24 patients who required lower concentration oxygen (less than 70% L-group). The preoperative body mass index (BMI) was significantly higher in the H-group (25.6±3.5) than the L-group (23.3±2.8). (<i>p</i>=0.012). Respiratory index (RI) decreased after extracorporeal circulation in all patients. The RI of the H-group during a stay in intensive care unit was significantly lower than that in the L-group. The RI in obese patients (BMI≥26.5) showed a significant reduction. Late deaths were seen in 3 obese patients in the H-group. These data suggested that careful postoperative respiratory managements is necessary in obese patients.
Résumé
Twenty-two cases with delayed cardiac tamponade following open cardiac surgery were divided into three groups according to the color and hematocrit value of pericardial fluid. In 7 patients (group B) more than half of pericardial fluid consisted of the patient's blood (mean hematocrit 31%), in 9 patients (group D) there was less blood (mean hematocrit 8%), and in 6 patients (group E) it was serous. In group B, compared with group E, the patients had more often received postoperative anticoagulant therapy (100% vs 37%, <i>p</i><0.05), more often developed excess anticoagulation (thrombo test<15%) (71% vs 17%, <i>p</i><0.05), and had undergone longer cardiopulmonary bypass (260±74 vs 194±49min, <i>p</i><0.05). Postoperative anticoagulant therapy seems to be a risk for delayed cardiac tamponade due to intrapericardial bleeding.
Résumé
Femoropopliteal bypass (FP bypass) with woven Dacron grafts was performed in 159 legs of 122 patients from November 1980 to June 1993. The operative mortality rate was 0.8%. Actuarial analysis at 10 years for overall patency of FP bypass was 75.1% (mean follow-up 45.1 months). Both univariate and multivariate analysis revealed three risk factors affecting long-term patency; poor run off, difficulty in anticoagulation therapy and high serum cholesterol. The 5-year patency rate with these factors were 55.8% (<i>p</i><0.01), 61.7% (<i>p</i><0.01) and 63.9% (<i>p</i><0.05), relatively. Therefore we recommend early surgical treatment, and strict control of anticoagulation and adequate treatment of hyperlipidemia are of great importance.