Coronary artery bypass at the University of the Orange Free State Medical School. Medium-term follow-up of the first 100 cases.

The increasing number of patients undergoing coronary artery bypass surgery has made the investigation and evaluation of the results of the procedure imperative. The first 100 patients who underwent this type of surgery at the University of the Orange Free State Medical School were followed up for a period of 3-8 years in order to obtain a prognostic pattern. The results of the study indicate that the procedure carries a low mortality rate and that the medium- to long-term results are encouraging. Eighty-one per cent of the patients are still actively pursuing their usual daily activities and 50% are completely free of symptoms.

[Crescendo angina - an indication for surgery: A short literature survey and a discussion of three cases]. / Crescendo angina -- 'n aanduiding vir chirurgie ' Kort literatuuroorsig en bespreking van 3 gevalle.

A definition of crescendo angina is given, followed by a short discussion of the literature on this disease. A case of a patient treated surgically for crescendo angina is reported, and the angiograms of 2 other patients are reviewed to further illustrate the problem. The favourable postoperative course of the patients who underwent an operation for this life-threatening disease is a strong indication for this mode of treatment.

Coronary artery bypass surgery at the University of the Orange Free State Medical School.

Fifty patients underwent aortocoronary bypass grafting, and 48 of these survived and are alive at present. Seventy-four per cent of these patients were relieved of angina, 16% were improved, and 10% remained the same, and 72% of these patients have resumed their normal daily work. The morbidity of the operation was negligible. The problems that emerged in this small series were involvement of the perforator artery, sudden occlusion of a major vessel during coronary angiography, preservation of the myocardium during surgery for multiplevessel disease, and lastly the question of when a ventricle is too damaged to be operated on. These problems are discussed and suggestions are made as to how to handle them. On the whole, we see this procedure as a useful adjunct in the treatment of occlusive coronary artery disease.

A conservative approach in selected cases of late diagnosed oesophageal perforation.

A conservative method is presented for the treatment of oesophageal perforation where the diagnosis has been delayed. A system of tubes is described which allows the patient to be fed and at the same time prevents swallowed material from reaching the fistula. A case is reported which was successfully managed using the method.

[Ebstein's anomaly of the tricuspid valve: a case report]. / Ebstein se wanvorming van die trikuspidalisklep 'n gevalbeskrywing

A case of Ebstein's malformation of the tricuspid valve with a complicating ventricular septal defect in a 3-year-old Black child is presented. A pre-operative diagnosis of an atrioventricular canal was made, and only at operation was it discovered to be an Ebstein's anomaly of the tricuspid valve. The clinical picture and diagnoses are reviewed, and the problem of a correct pre-operative diagnosis is discussed. The operative treatment and postoperative result in our patient is described.