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Postoperative Care in Open-Heart Surgery FREE

Emerson A. Moffitt, MD; Alan D. Sessler, MD; John W. Kirklin, MD
[+] Author Affiliations

Read before the Section on Anesthesiology at the 115th annual convention of the American Medical Association, Chicago, June 29, 1966.

Reprint requests to Mayo Clinic, Rochester, Minn 55901.


From the sections of anesthesiology (Drs. Moffitt and Sessler) and surgery (Dr. Kirklin), Mayo Clinic and Mayo Foundation, Rochester, Minn.


JAMA. 1967;199(3):161-163. doi:10.1001/jama.1967.03120030065009
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Experience at the Mayo Clinic with whole-body perfusion in open, intracardiac surgery indicates that, although such perfusion is a major deviation from normal physiology, it is remarkably well tolerated. Detrimental changes in tissue and organ function, however, are taking place and are directly related to the length of perfusion. These changes, along with the severity of the disease necessitating operation and the surgical success in correcting that disease, are the major determinants of survival.

REFERENCES

Lyons, W.S.; DuShane, J.W.; and Kirklin, J.W.:  Postoperative Care After Whole-Body Perfusion and Open Intracardiac Operations: Use of Mayo-Gibbon Pump-Oxygenator and Brown-Emmons Heat Exchanger , JAMA 173:625-630 ( (June 11) ) 1960;.
Taylor, L.M., et al:  Patterns of Acid-Base Changes During Surgical Convalescence , Surg Gynec Obstet 114:97-101 ( (Jan) ) 1962;.
McGoon, D.C., et al:  Physiologic Studies During High Flow, Normothermic, Whole-Body Perfusion , J Thorac Cardiov Surg 39:275-287 ( (March) ) 1960;.
Moffitt, E.A.; Kirklin, J.W.; and Theye, R.A.:  Physiologic Studies During Whole-Body Perfusion in Tetralogy of Fallot , J Thorac Cardiov Surg 44:180-188 ( (Aug) ) 1962;.
Rehder, K.; Kirklin, J.W.; and Theye, R.A.:  Physiologic Studies Following Surgical Correction of Atrial Septal Defects and Similar Lesions , Circulation 26:1302-1311 ( (Dec) ) 1962;.
Theye, R.A., and Kirklin, J.W.:  Physiologic Studies Following Surgical Correction of Ventricular Septal Defect , Circulation 27:530-540 ( (April) ) 1963;.
Theye, R.A., and Kirklin, J.W.:  Physiologic Studies Early After Repair of Tetralogy of Fallot , Circulation 28:42-51 ( (July) ) 1963;.
Kirklin, J.W., and Theye, R.A.:  Cardiac Performance After Open Intracardiac Surgery , Circulation 28:1061-1070 ( (Dec) ) 1963;.
Sturridge, M.F., et al:  Basal Metabolic Rate After Cardiovascular Surgery , J Thorac Cardiov Surg 47:298-307 ( (March) ) 1964;.
Carveth, S.W., et al:  Effect of Surgery, With and Without Whole-Body Perfusion on 17-Hydroxycorticosteroids in Man , Ann Surg 161:105-111 ( (Jan) ) 1965;.
Moffitt, E.A.; Maher, F.T.; and Kirklin, J.W.:  Effects of Cardiopulmonary Bypass and Haemodilution on Some Constituents of Blood , Canad Anaesth Soc J 12:458-464 ( (Sept) ) 1965;.
Mielke, J.E., et al:  Renal Performance in Patients Undergoing Replacement of the Aortic Valve , Circulation 32:394-405 ( (Sept) ) 1965;.
Moffitt, E.A., et al:  Acid-Base Balance and Oxygenation in Prolonged Perfusion: Effects of Diluted Heparinized and Acid-Citrate-Dextrose Blood , Anesth Analg , to be published.
Geha, A.S.; Sessler, A.D.; and Kirklin, J.W.:  Alveolar-Arterial Oxygen Gradients After Open Intracardiac Surgery , J Thorac Cardiov Surg 51:609-615 ( (May) ) 1966;.
Beer, R., and Loeschke, G.C.:  Veränderungen der Lungenfunktion nach Operationen mit der Herz-Lungen-Maschine , Anaesthesist 12:306-308 ( (Oct) ) 1963;.
Damman, J.F., Jr., et al:  The Management of the Severely Ill Patient After Open-Heart Surgery , J Thorac Cardiov Surg 45:80-89 ( (Jan) ) 1963;.
Sessler, A.D., et al:  Heparinized Versus Acid-Citrate-Dextrose Blood for Cardiopulmonary Bypass , Mayo Clin Proc 40:859-867 ( (Nov) ) 1965;.
Clowes, G.H., Jr.:  Extracorporeal Maintenance of Circulation and Respiration , Physiol Rev 40:826-919 ( (Oct) ) 1960;.
Sturtz, G.S., et al:  Water Metabolism After Cardiac Operations Involving Extracorporeal Circulation , abstracted, Circulation 16:941-942 ( (Nov) ) 1957;.

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Lyons, W.S.; DuShane, J.W.; and Kirklin, J.W.:  Postoperative Care After Whole-Body Perfusion and Open Intracardiac Operations: Use of Mayo-Gibbon Pump-Oxygenator and Brown-Emmons Heat Exchanger , JAMA 173:625-630 ( (June 11) ) 1960;.
Taylor, L.M., et al:  Patterns of Acid-Base Changes During Surgical Convalescence , Surg Gynec Obstet 114:97-101 ( (Jan) ) 1962;.
McGoon, D.C., et al:  Physiologic Studies During High Flow, Normothermic, Whole-Body Perfusion , J Thorac Cardiov Surg 39:275-287 ( (March) ) 1960;.
Moffitt, E.A.; Kirklin, J.W.; and Theye, R.A.:  Physiologic Studies During Whole-Body Perfusion in Tetralogy of Fallot , J Thorac Cardiov Surg 44:180-188 ( (Aug) ) 1962;.
Rehder, K.; Kirklin, J.W.; and Theye, R.A.:  Physiologic Studies Following Surgical Correction of Atrial Septal Defects and Similar Lesions , Circulation 26:1302-1311 ( (Dec) ) 1962;.
Theye, R.A., and Kirklin, J.W.:  Physiologic Studies Following Surgical Correction of Ventricular Septal Defect , Circulation 27:530-540 ( (April) ) 1963;.
Theye, R.A., and Kirklin, J.W.:  Physiologic Studies Early After Repair of Tetralogy of Fallot , Circulation 28:42-51 ( (July) ) 1963;.
Kirklin, J.W., and Theye, R.A.:  Cardiac Performance After Open Intracardiac Surgery , Circulation 28:1061-1070 ( (Dec) ) 1963;.
Sturridge, M.F., et al:  Basal Metabolic Rate After Cardiovascular Surgery , J Thorac Cardiov Surg 47:298-307 ( (March) ) 1964;.
Carveth, S.W., et al:  Effect of Surgery, With and Without Whole-Body Perfusion on 17-Hydroxycorticosteroids in Man , Ann Surg 161:105-111 ( (Jan) ) 1965;.
Moffitt, E.A.; Maher, F.T.; and Kirklin, J.W.:  Effects of Cardiopulmonary Bypass and Haemodilution on Some Constituents of Blood , Canad Anaesth Soc J 12:458-464 ( (Sept) ) 1965;.
Mielke, J.E., et al:  Renal Performance in Patients Undergoing Replacement of the Aortic Valve , Circulation 32:394-405 ( (Sept) ) 1965;.
Moffitt, E.A., et al:  Acid-Base Balance and Oxygenation in Prolonged Perfusion: Effects of Diluted Heparinized and Acid-Citrate-Dextrose Blood , Anesth Analg , to be published.
Geha, A.S.; Sessler, A.D.; and Kirklin, J.W.:  Alveolar-Arterial Oxygen Gradients After Open Intracardiac Surgery , J Thorac Cardiov Surg 51:609-615 ( (May) ) 1966;.
Beer, R., and Loeschke, G.C.:  Veränderungen der Lungenfunktion nach Operationen mit der Herz-Lungen-Maschine , Anaesthesist 12:306-308 ( (Oct) ) 1963;.
Damman, J.F., Jr., et al:  The Management of the Severely Ill Patient After Open-Heart Surgery , J Thorac Cardiov Surg 45:80-89 ( (Jan) ) 1963;.
Sessler, A.D., et al:  Heparinized Versus Acid-Citrate-Dextrose Blood for Cardiopulmonary Bypass , Mayo Clin Proc 40:859-867 ( (Nov) ) 1965;.
Clowes, G.H., Jr.:  Extracorporeal Maintenance of Circulation and Respiration , Physiol Rev 40:826-919 ( (Oct) ) 1960;.
Sturtz, G.S., et al:  Water Metabolism After Cardiac Operations Involving Extracorporeal Circulation , abstracted, Circulation 16:941-942 ( (Nov) ) 1957;.
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