ABSTRACT
Postoperative purulent mediastinitis was observed by the authors in 43 out of 1110 patients. Specific features of the clinical picture and course of this complication are described. The "closed" method of treatment was used in 20 patients. Five of them died from intoxication and arrosive bleeding. The "open" method of treatment of mediastinitis was used in 23 patients with no lethal outcomes.
Subject(s)
Heart Defects, Congenital/surgery , Mediastinitis/pathology , Mediastinitis/therapy , Thoracic Surgical Procedures/methods , Adolescent , Humans , Postoperative Complications , Thoracic Surgical Procedures/adverse effectsABSTRACT
A new method of plastic surgery of the right ventricular outflow tract and the pulmonary artery without use of extracorporeal circulation (occlusion of main arteries) was tested in experiments carried out in 28 dogs. The method involves previous suture of a patch to the site selected for plastic surgery and, using an instrument designed by the authors, excision of the necessary part of the ventricular wall and pulmonary artery. The instrument consists of two handles, similar to those of pincers, and working on a pivot, with oval cavities on the inner sides of its elongated grasping jaws. The tip of lower jaw features a sloping edge to enable perforation of the outer wall of the heart. By pulling together the handles, connected with a spring, the jaws close excising the appropriate part of the heart. The depth of insertion of the jaws into the heart cavity's controlled by means of a graded scale on the outer side of the upper jaw. Using this technique it is possible to perform surgery even of extensive myocardial defects quickly, safely, with virtually no trauma and minimal loss of blood, and to remove large segments of the hypertrophic myocardium while retaining intracardiac circulation, without the need for extracorporeal circulation.
