No abstract

Intraoperative application of the proteinase inhibitor aprotinin allows to drastically reduce blood loss during and after cardiopulmonary bypass operation. The side effects of this therapy (if any) have not been systematically registered and a possible interaction with heparin is not excluded. Such an interaction seems to have occurred in one of our patients. He developed a resistance to heparin shortly after prophylactic administration of aprotinin and maintained it for about one hour after discontinuation of the aprotinin. Prophylactic and therapeutic implications of this observation are briefly exposed.

We re cently treated 7 pa tients wit h tricuspid at resia type lb. and o ne patient wit h type IIl b by en largeme nt o f t he ven t ricular septu m defect (VS DI , co mbined w ith pulmonary valvotomy o r infundibular resectio n in 3 cases. Th e res ult was good o r excellent in t he 7 cases with type lb, white t he patie nt wit h type l Hb , suffering f rom associated cardiovascular malformati ons and operated upon in a very poor hemody nam ic state, d ied d uring operati on. Th e procedure is simple and represents no part icu lar risks if one avoids excessive enlarge me nt of the VSD and does not resect in the area of the cardiac co nd uction system. Review of the literature leads us to believe that thi s operation shou ld have a place amo ng t he different for ms of surg ical trea tme nt for tricusp id atresia .