DOUBLE-CHAMBERED RIGHT VENTRICLE: ITS PATHOANATOMIC CHARACTERISTICS AND TREATMENT PROBLEMS / 解放军医学杂志

In the past ten years, 52 patients with double-chambered right ventricle (DCRV) were operated on in Xijing Hospital. They constituted 2.2% (52/1881) of all patients with congenital heart diseases. Of them, there were 32 males and 20 females, whose ages ranged from 4.5 to 30 years old. In one patient there was pure DCRV, and the remaining 51 patients DCRV was associated with other congenital cardiac anomalies, in which VSD was the most common (50), followed in order by pulmonary stenosis (6), aortic valve prolapse (4), atrial septal defect (2), and subaortic stenosis (1). The repair of DCRV and other intracardiac defects was done through the right ventricolotomy in 47 cases and through the right ventricolotomy plus atriotomy in 2 cases. In another 2 cases the operation was done via the right atriotomy and 1 case pulmonary arteriotomy, and only VSDs were closed, but DCRVs were missed. The major postoperative complications included cardiac arrhythmia (11) and low output syndrome (8). Three patients died, with the operative mortality of 5.8%. In this series, according to characteristics of the anomalous muscle bundle and its resulting obstruction, we divided 52 case DCRVs into two types: fibromuscular diaphragmatic type (24 cases, 44.7%) and muscular bundle-gap type (28 cases, 55.7%). In both types, there were not only hypertrophied anmalous muscle bundles on the septal side, but also hypertro-phied ventricoinfundibulum fold on the parietal side. In a few cases, the ventricoinfundibulum fold was more hypertrophic than the anomalous muscle bundle on the septal side.

THE USE OF IMPEDANCE CARDIOGRAPHY FOR PATIENT MONITORING IN CARDIAC SURGERY / 解放军医学杂志

Impedance cardiography,being developed recently,is a noninvasive cardiovascular monitoring technique.In this study,fifty-eight patients undergoing open-heart operations were monitored pre-and posto-peratively by impedance cardiography.It was shown that the results were comparable with the results of other authors using indicator-dilution curves.EVI greater than 1.0?/s indicated normal cardiac fun-ction while EVI less than 0.8?/s indicated markedly subnormal cardiac function.The results indicated that EVI was a sensitive and reliable parameter to estimate myocardial function.TEI less than 1.9? was usually associated with abnormal arterial blood gas analysis,so TFI was useful to assess postoper- ative respiration insufficiency.It was concluded that impedance cardiography was helpful and dependable-in early postoperative patient care in cardiac surgery and it had the advantage of continuous,noniuva-sive,real-time monitoring.