William A. Reed

Myotonia dystrophica with A-V dissociation and Stokes-Adams attacks: A case report and review of the literature

Abstract The case of a patient with myotonia dystrophica who developed atrioventricular dissociation with Stokes-Adams attacks has been presented. Since the Stokes-Adams attacks were refractory to medical management, an implantable electronic pacemaker was utilized. This offered an opportunity to inspect the heart and obtain a biopsy which showed diffuse fibrosis in the absence of gross coronary artery disease. These findings lend credence to the concept that the myocardial changes in myotonia dystrophica are not due to associated coronary artery disease.

LIPOMA OF THE HEART.

Abstract Diagnosis and successful surgical removal of an intracavitary right atrial lipoma is reported. The importance of angiocardiography in the diagnosis of such lesions and the necessity for extracorporeal circulation in the surgical removal have been demonstrated.

Long-term follow-up of patients with aortic valve replacement.

T HE USE OF the Starr-Edwards cagedball aortic valve prosthesis in the management of symptomatic aortic valve disease has become an established method of therapy. Since the valves are not free of complications, surgery must be considered palliative rather than curative.2 In order to select surgical candidates properly and to assess the clinical improvement following operative replacement of the aortic valve, it is necessary to compare the surgical results with the prognosis of untreated patients. It is now well established that the prognosis for symptomatic patients with aortic valve disease is poor.3 4 This report summarizes the experience in patient selection, operative treatment, and postoperative follow-up of patients undergoing aortic valve replacement at the University of Kansas Medical Center.

Staged Correction of Total Transposition of the Great Vessels

Proper selection of palliative operation for transposition of the great vessels must be based on a careful anatomical and physiological diagnosis. Subsequent correction, utilizing the interatrial baffle technique, is possible with low risk in selected patients.Details of the clinical course of four patients with transposition from birth to total correction are presented.

SELECTION OF PALLIATIVE OPERATION FOR TRANSPOSITION OF THE GREAT VESSELS.

In view of our present experience, it is our belief that adequate palliation is available for the majority of patients with transposition. Recent success with total correction makes an aggressive approach to palliative surgery more urgent.

Intra-abdominal Homologous Heart Transplantation

Summary A technique of homologous heart transplantation is described which permits study of the multiple aspects of cardiac function and rejection. Some preliminary results are described. Further utilization of this study model is indicated.