Open Heart Surgery: Results in 600 Cases

Sloan, Herbert; Morris, Joe D.; Mackenzie, James W.; Stern, Aaron

doi:10.1136/thx.17.2.128

Cited by 26 publications

(2 citation statements)

References 18 publications

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“…There is a possible role of elective neuronal loss in psychiatric sequelae, temporary or permanent. 37,38 No clear parallel can be drawn between these experimental results and the neuropathologic findings listed, although there is a possible role of hypotension in the production of both cerebral edema and focal cortical infarcts in cases of open-heart surgery.…”

Section: Resultsmentioning

confidence: 70%

Experimental Brain Damage in Dogs Due To Systemic, Induced Hypotension and Head-Up Tilt for Short Periods

Lewis¹,

Zingg²

1966

Angiology

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In the evaluation of various procedures designed to protect the brain against hypoxic damage, an objective and, if possible, quantitative assessment of the brain damage is necessary. Further investigations of these problems are indicated, among other reasons, because of recent developments in cardiovascular and neurologic surgery which may be complicated by temporary or permanent brain damage. Since the dog has been the principal experimental animal in these fields, this animal was chosen for the present study. It is self-evident that certain types of human brain damage cannot be investigated in the dog, for instance, insults to higher centers. Changes of conditioned reflexes in the experimental animal following the procedure may provide evidence of some insult to the cerebral cortex, but this procedure was considered to be impractical in our laboratory. Certainly short-term survival with persistence of the vital functions, including food and water intake, does not indicate an absence of brain damage. The value of the electroencephalogram under the artificial conditions of extracorporeal circulation and/or hypothermia also has been questioned.2 2 On the other hand, histologic examination of the brain may be useful in the assessment of brain damage, provided the animals can be kept alive until the pathologic changes develop, and provided specific histologic changes are found. Several authors have regarded the presence of pyknosis, metachromasia, vacuolization or a decrease in the number of ganglion cells, as evidence of brain damage. 3-5 It would appear that neither criteria for these changes nor significance is easily defined, so they remain too uncertain to be useful as an assessment of brain damage.The experiments reported here were undertaken as an attempt to produce brain damage associated with obvious clinical signs in dogs surviving long enough to allow the development of histologic lesions. The clinical signs and the histologic findings could then be correlated. In the event that the method was standardized and the results were reasonably uniform, the method could be used in the assessment of various types of treatment designed to protect the brain during periods of hypoxia, such as hypothermia or hyperventilation.These studies were carried out over a prolonged period of time and the many unsuccessful experiments will not be presented. The difference between a period at UNIVERSITE DE MONTREAL on June 12, 2015 ang.sagepub.com Downloaded from

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Section: Resultsmentioning

confidence: 70%

Experimental Brain Damage in Dogs Due To Systemic, Induced Hypotension and Head-Up Tilt for Short Periods

Lewis¹,

Zingg²

1966

Angiology

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“…However, it is clearly a neurological recovery and not a total recovery that is being described, since one patient who had been lethargic and disorientated is said to have recovered completely but to have been left with a 'post-operative senile psychosis'. In other papers in which recovery is said to have been complete after a variety of neuropsychiatric symptoms, the evidence for this is not stated (Bjork et al, 1962;Sloan, Morris, Mackenzie, and Stern, 1962). No study by a psychiatrist has been published.…”

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confidence: 99%

Neurological and Psychiatric Aspects of Open-heart Surgery

Cohen¹

1964

Thorax

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Cerebral Air Embolism

Menkin¹

1977

Arch Neurol

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We discuss five patients who had cerebral air embolisms. Clinically, these patients had early seizures, focal neurological findings, or failure to awaken from anesthesia. The patients that survived had minimal neurological deficits. We also discuss the pathophysiology of cerebral air embolism and its differentiation from "the bends." The necessity for recognizing this entity early is important in order to administer appropriate therapy.

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Open Heart Surgery: Results in 600 Cases

Cited by 26 publications

References 18 publications

Experimental Brain Damage in Dogs Due To Systemic, Induced Hypotension and Head-Up Tilt for Short Periods

Experimental Brain Damage in Dogs Due To Systemic, Induced Hypotension and Head-Up Tilt for Short Periods

Neurological and Psychiatric Aspects of Open-heart Surgery

Cerebral Air Embolism

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