HYPOTHERMIA AND CARDIAC SURGERY— SWAN 



407 



mortality figures are without significance. However, we were impressed with its 

 apparent heneficial effect on the operative course of cyanotic chil(h"en and in patients 

 with patent ductus arteriosus and puhnonary hypertension. 



In tahle II is seen our experience with 81 patients who had 84 open-heart opera- 

 tions with total circulatory occlusion. In this tahle, the postoperative results are 

 based on objective data comparing pre- and postoperative studies. If postoperative 

 studies are unavailal)le, the result is described as "too recent" even though the 

 clinical course suggests a successful result. 



This technique, we believe, is particularly adaptable for operations on the ])ul- 

 monary valve and on the outflow tract of the right ventricle. A very deliberate 

 careful plastic operation on the deformed valve can easily be performed in from 

 3 to 5 nu'nutes of circulatory arrest. The danger of coronary air embolism is almost 

 nil in \ie\v of the position of the patient, in table 111, the operations on pulmonary 



TABLE II 

 Direct Vision Ixtra-cardiac Procedures with Circulatory Arrest 



(81 patients, 84 procedures) 



I. Pure (single) defects 



Disease Patients 



Pulmonary valvular stenosis 22 



Pulmonary infundibular stenosis 2 



Auricular septal defect (secundum ) 29 



Auricular septal defect (primum) 4 



\'entricu]ar septal defect 5 



62 



33 



16 



II. Combined (multiple) defects 



Disease Patients 



Tetralogy of Fallot : 



A. Valvular stenosis 6 



B. Infundibular stenosis 7 



Auricular septa! defect : 



A. Pulmonary stenosis (trilogy ) 5 



B. Ventricular septal defect 1 



19 



Total 

 cure 



Partial 

 cure 



Too 



recent 



Died 

 



2 



2 

 1 



12 



TABLE III 

 Operations for Pulmonary Stenosis 



Disease Patients 



Isolated valvular stenosis 22 



Isolated infundibular stenosis 2 



Valvular stenosis witli tetralogy 6 



Infundibular stenosis with tetralogv 7 



Trilogy of Fallot 4 



Total 

 cure 



11 



1 





 



1 



Partial 

 cure 



1 



1 



6 

 5 

 1 



Too 

 recent 



10 

 

 

 



1 



Died 

 

 

 



2 

 1 



41 



13 



14 



11 



