Thomas J. Yeh

Influence of rhythm and anticoagulation upon the incidence of embolization associated with Starr-Edwards prostheses.

The incidence of embolism following aortic and mitral valve replacement with Starr-Edwards prostheses has been analyzed and correlated with cardiac rhythm and anticoagulation. No embolism occurred in the aortic valve replacement group, regardless of use or nonuse of Coumadin. In the mitral group, the incidence of embolism during atrial fibrillation was approximately 1.7 times that during sinus rhythm. Coumadin prophylaxis was extremely effective. The incidence during non-anticoagulation was 40 times that during adequate anticoagulation, and seven times that during inadequate anticoagulation. Embolism occurred as late as 21 months after surgery, often shortly after termination of anticoagulation. Three of the four patients with emboli associated with bacterial endocarditis died. All nine patients with emboli not associated with infection survived, half without permanent sequelae.

Role of Atelectasis in Surfactant Abnormalities Following Extracorporeal Circulation A Clinical and Experimental Study

Surface activity of lung extracts was determined in 36 patients and 28 dogs following extracorporeal circulation. Normal results were usually found. Abnormal surface tension was demonstrated only in a few samples obtained from grossly atelectatic or congested portions of lung, normal surface tension being present in adjoining areas of the same lung. Sources of error in surface-tension measurements and factors to be considered in the interpretation of results are discussed. A possible explanation for the discrepancies in results obtained by various investigators is presented.