A cardioplegia circuit with versatility: the 'ReVerse' system. How to do it.

Various methods of cardioplegia administration have been used in cardiac surgery: crystalloid, blood and mixed crystalloid/blood. Each of these types of cardioplegia administration typically needs a different circuit. This may correspond to an increase in cost and the time needed to change the circuit if required. When various modifications are performed on the circuit, this also increases the risk of contamination. In order to simplify the management of differing cardioplegia circuits, we devised one circuit for all solutions in all situations by adding one modification. The ReVerse cardioplegia circuit system is a description of a two-pump cardioplegia circuit which is adaptable to either blood or crystalloid cardioplegia. The change from one mode to another requires a manoeuvre of two clamps, allowing the blood solution to travel through shunt tubing into the apposite pumphead. In our experience the versatility of this circuit is a fast, safe method to administrate all types of cardioplegia solution, saving the space taken up by storing multiple circuits.

Another look at steroids: intraluminal methylprednisolone in retropectoral augmentation mammoplasty.

The authors report some preliminary results with 150 patients who had a retropectoral augmentation mammoplasty using double-lumen prostheses with intraluminal steroids. Two control groups were also studied: one (35 patients) with steroids placed in only one prostheses and the other (25 patients) with steroid-free prostheses. The use of double-lumen prostheses which might decrease the steroid diffusion rate, and retromuscular positioning of the prostheses may account for the results obtained. The data obtained from the three groups indicate that steroids might have a significant and safe role in preventing capsular contracture.