[Successful resuscitation by extracorporeal circulation after fibrillation during vascular reconstruction]. / Succesvolle reanimatie met gebruik van kunsthart na fibrillatie tijdens vasculaire reconstructie.

Extracorporeal circulation (EC) for reanimation of refractory cardiac fibrillation during vascular surgery. The fibrillation occurred shortly after induction of anesthesia but no specific medication could be incriminated. Postoperative morbidity was significant but the patient eventually made a successful recovery. Use of EC proved lifesaving after all conventional reanimatory measures were unsuccessful.

The cerebro-vascular problem in coronary by-pass surgery.

In 99 of 2250 consecutive C.B.P. cases, signs of cerebro-vascular disease (C.V.D.) were recorded in 87 (3.9%) on admission and in 12 post-operatively. The detection of C.V.D. by auscultation alone is very incomplete. There were 17 post-C.B.P. neurologic deficits (P.O.N.D.) (0.75%): 15 strokes (0.67%) and 2 T.I.A.'s. 26 patients (out of 87 detected on admission) were treated by carotid endarterectomy (C.E.) either pre-by-pass or simultaneously. There were no complications. The remaining 61 patients, who were not treated, had 4 strokes and 1 T.I.A. after their C.B.P. The most probable cause of these deficits was pre-existing C.V.D. Could more extensive pre-operative investigation, and treating the serious lesions by C.E., improve the P.O.N.D. incidence? The published series on simultaneous C.E. + C.B.P. are not yet conclusive. We favour C.E. done before the C.P.B. procedure except in very serious coronary disease when simultaneous operation is preferred.