An acute re-angiography demonstrated graft failure or incomplete re-vascularization in the majority of patients with myocardial ischaemia early after CABG. Re-operation for re-re-vascularization was performed with low risk. Few patients with circulatory collapse could be saved by an immediate re-operation without preceding angiography.

Capillary permeability of 99mtechnetium-diethylenetriaminepenta-acetic acid (99mTc-DTPA; MW 485.0) and 51chromium-ethylenediaminetetra-acetate (51Cr-EDTA; MW 340.2) was studied in an in vivo canine heart preparation by the single injection, residue detection (SIRD) method. In experiments on open chest dogs (group A) these indicators were administered separately as bolus injections into a cannulated diagonal branch of the left anterior descending coronary artery (LAD) and the curve of the response function was recorded by external activity registration. In further experiments on closed and open chest dogs (group B) 99mTc-DTPA was injected via a coronary angiography catheter into the ostium of the left coronary artery and the response curve was obtained by external registration. Regional myocardial perfusion coefficients were determined by the local 133xenon washout technique and from kinetic analysis of SIRD experiments. Plasma perfusion coefficients calculated by kinetic analysis of response curves from 99mTc-DTPA SIRD experiments (group A) were on average 98 v 102 ml.min-1.100 g-1 in 51Cr-EDTA experiments, in good agreement with the average plasma flow rate of 92 ml.min-1.100 g-1 determined by local 133Xe washout technique. Mean values of the extraction fractions (E) were 0.463 and 0.475 for 99mTc-DTPA and 51Cr-EDTA, and the permeability-surface area products (PdS) were 52.8 and 57.5 ml.min-1.100 g-1 respectively. At the conventional capillary surface area estimate of 500 cm2.g-1 the permeability coefficient (Pd) for 99mTc-DTPA was 1.76.10(-5) cm.s-1 and for 51Cr-EDTA 1.92.10(-5) cm.s-1.(ABSTRACT TRUNCATED AT 250 WORDS)

A clinical follow-up study was performed in 11 unoperated patients with symptoms due to vascular ring. The age at diagnosis was 2-48 months (mean 13 months); 7 of the patients were less than 12 months old. The follow-up time varied between 1 and 22 years (median 7 years). Nine patients were entirely free of symptoms, which they had outgrown in the course of 1-2 years after the diagnosis was made; none of these 9 had symptoms after the age of 4 years. Two patients had symptoms due to either oesophageal compression or to severe associated neuromuscular lesions; the follow-up time was 3 and 1 years, respectively. Our findings lead us to support a conservative attitude regarding surgery, at least if only mild symptoms are present, If the patients can be satisfactorily treated medically, they seem to outgrow their symptoms in early childhood.

En-bloc double-lung transplantation with tracheal and bronchial revascularization using the left internal mammary artery has been performed in 14 Danish patients. Primary healing of the tracheal anastomosis was observed in 12 patients, in 10 of whom a successful revascularization has been verified by angiography. Two patients have been operated recently and not yet examined by angiography. Mucosal necrosis and subsequent development of bronchial stenosis had to be treated by left-sided pneumonectomy in two patients with failed revascularization. All patients were early survivors (1-14 months). We conclude that bronchial revascularization with the internal mammary artery is possible with an acceptable success rate and is associated with primary healing of the tracheal anastomosis. The impact on long-term results remains to be seen.