FALSE ANEURYSM OF THE LEFT VENTRICLE: CASE REPORT WITH PRE- AND POSTOPERATIVE EVALUATION

A 66-year-old woman developed chronic congestive heart failure after myocardial infarction of the anterior wall of the left ventricle. Angiographic studies revealed total proximal occlusion of the left anterior descending coronary artery and a large saccular aneurysm located on the anteroapical aspect of the left ventricle. Resection of a false aneurysm at operation resulted in improved cardiac function, and the patient made an uneventful recovery. Repeat evaluation six months later confirmed normal cardiac hemodynamics and left ventricular angiographic characteristics. To our knowledge, this is the first documented case of normalized heart function resulting from resection of a false aneurysm of the left ventricle. Functional classification according to the New York Heart Association improved dramatically, rising from Class IV preoperatively to Class I after operation.     

ARRHYTHMIA WITH MITRAL VALVE PROLAPSE: RESULTS OF ANNULOPLASTY IN TWO PATIENTS

The effectiveness of posterior annuloplasty in two patients who failed to respond to medical treatment for atrial and ventricular arrhythmias related to mitral valve prolapse (MVP) is reported. Although the etiology of arrhythmia in MVP remains mostly speculative, anatomic correction of prolapse or billowing of the mitral leaflets appears to reverse the anatomic and pathologic conditions that cause the arrhythmia.     

SUCCESSFUL AORTOCORONARY BYPASS SURGERY IN A PATIENT WITH CLASSICAL HEMOPHILIA A

A patient with documented Factor VIII deficiency (classical Hemophilia A) and a history of previous severe intra- and postoperative hemorrhage and transfusion reaction underwent myocardial revascularization for advanced triple vessel coronary artery occlusive disease. The coagulation status was investigated, and a replacement regimen was instituted. The surgical procedure and postoperative course were uneventful.     

Antibodies to tubulin and actin bind to the surface of a human monocytic cell line, U937

Intermittent reports of cytoskeleton proteins (actin and tubulin) on the cell surface have appeared over the last 13 years. Whereas most have concentrated on lymphocytes, this study provides evidence for the presence of these proteins on the surface of a human cultured monocyte-like cell line, U937. Both actin and tubulin were detected on the surface of U937 cells by flow cytometry, using an indirect staining procedure based on biotin-streptavidin-phycoerythrin, chosen for greater sensitivity. By use of this procedure, the majority of viable unstimulated U937 cells stained positively for actin and tubulin, although the level of fluorescence intensity was low. With an antibody specific for tyrosine-tubulin, most of the surface tubulin was also found to be tyrosinylated. For vimentin, an intermediate filament protein abundantly present in the cytoplasm of U937 cells, no staining could be detected. Confirmation of the flow cytometry data for surface actin and tubulin on unstimulated U937 cells was achieved by direct vesualization using a confocal laser scanning microscope. When U937 cells were activated with PMA and LPS, a marked reduction in the level of cell surface actin and tubulin occurred. The role of cell surface actin and tubulin on unstimulated U937 cells, in terms of monocyte function, remains to be elucidated.     

Congenital coronary artery-left heart fistulas: Report of three cases

Of 59 patients who underwent operative correction of congenital coronary artery fistulas from May 1956 through May 1980 at our institution, three had fistulas that arose from the coronary artery and terminated in the left heart. The chief indication for surgical correction in such patients is the presence of symptoms or the development of complications, which include rupture, endocarditis, and congestive heart failure. The principal objective of repair is closure or obliteration of the fistulous communication and preservation of distal myocardial perfusion. Because symptoms and complications tend to occur with age, elective ligation is warranted during childhood, even in asymptomatic patients. The three cases described here, as well as the reviewed series of left heart fistulas, substantiate this fact. All three patients were symptomatic before operation and asymptomatic afterward.     

A method of preparing woven Dacron aortic grafts to prevent interstitial hemorrhage

Severe and even fatal hemorrhage may be caused by bleeding through the interstices of a fabric graft. Improved fabrication of grafts with appropriate porosity for the conditions encountered has provided better hemostasis. Yet in some situations, bleeding through the fabric still presents a problem. A method of preclotting with autologous platelet rich plasma (PRP) and autoclaving is described. Gross and microscopic studies along with clinical applications confirm the effectiveness of the technique.     

ABLATIVE TECHNIQUES FOR SURGICAL TREATMENT OF PAROXYSMAL TACHYCARDIA

In this report, the collaborative efforts of cardiologists and surgeons to provide optimal treatment of patients with rhythm disturbances are discussed, along with definitive advances in new surgical techniques to relieve supraventricular tachycardia and paroxysmal ventricular tachycardia. Some of the techniques described are destined to find a permanent place in the surgeon's armamentarium.     

THE DIFFICULT PROXIMAL CORONARY ANASTOMOSIS

Two patients are presented in whom severe calcific aortitis made performance of satisfactory proximal coronary anastomosis impossible. Endarterectomy of the ascending aorta after aortic valve replacement, combined with aortocoronary bypass prior to performance of the proximal anastomoses, was successfully employed in one patient. The second patient underwent resection of an anterior segment of aorta, which was replaced by a woven Dacron patch into which the vein grafts were sewn.     

Crystal and molecular conformation of the fluorescent probe. 8-anilino-1-naphthalenesulfonic acid (ANS).

The crystal and molecular structure of the fluorescent probe 8-anilino-1-naphthalenesulfonic acid (ANS) has been determined as the ammonium monohydrate with two conformationally distinct molecules in the triclinic $P\overline{1}$ lattice. The angles between the aromatic rings and the CNC plane are ?9/22° and 112/22° respectively. There is an NH...O intramolecular hydrogen bond in each molecule indicating that hydrogen bond formation is not dependent on the anilino geometry. There are also short intramolecular H...H contacts involving the hydrogens which have anomalous proton shifts shown in a recent NMR study.