Search

The postoperative deep body temperature rhythms of fifteen patients who received aorto-coronary bypass surgery (group I), and of seven patients who received non-cardiac major surgery (group II), were studied. Postoperative patients, especially those who received aortocoronary bypass surgery, showed greatly disturbed deep body temperature rhythm. There existed infradian and ultradian rhythm in both groups, and there existed two patients in group I who did not show sinusoidal rhythm. The patients of group I also showed a longer period of rhythm than did those of group II. The mesor and amplitude of the patients in group I showed a greater individual variation than did those in group II. The acrophase of both groups deviated widely. The patients who underwent cardiac surgery needed a longer time for temperature rhythm recovery than did those who underwent general surgery.

Thirty-five patients with tetralogy of Fallot (TF), were studied for the postoperative factors which might have some effect on the presence and severity of ventricular premature contraction (VPC) and exercise performance (EP). Using the factors, we tried to make VPC- and EP-scores. Of the 35 patients, 12 (34%) showed VPCs of Lown's grade 2 or higher (group B) and 23 (66%) were free from significant VPCs (group A). Group B patients were found to have significantly higher postoperative right to left ventricular peak systolic pressure ratios (RV/LV) and higher right ventricular peak systolic pressures (RVP) than those of group A. The right ventricular regional wall motion (RVRWM) in the right ventricular outflow tracts of group B patients showed akinetic or paradoxical movements. VPC-scores using RV/LV, RVP and RVRWM showed that 11 patients, whose score were 0, were free from significant VPCs and showed that 6 of 7 patients (86%), whose score were 3, demonstrated significant VPCs. It was shown that RV/LV, left ventricular ejection fraction (LVEF), CTR and pulmonary regurgitation (PR) affected the exercise tolerance. In the case of EP-scores, using RV/LV, LVEF, CTR and PR, the endurance times of the patients who had higher scores seemed to be shorter. VPC- and EP-scores as a tool for predicting the presence of VPCs and the level of exercise performance seem to be quite useful.

Fifty-one patients undergoing total repair of tetralogy of Fallot between November 1977 and June 1985 were analyzed with respect to determinants of operative mortality and postoperative right to left ventricular peak systolic pressure ratio (RV/LV). The risk factors were age, sex (Sex), previous shunting operation (Shunt), extent of right ventricular outflow tract patch (Patch), various PA-indexes, maximal left atrial volume/BSA (LA/BSA), left ventricular end diastolic volume index (LVEDVI), LVEDVI/normal-LVEDVI, RV/LV, Hb, BSA and weight. Univariate analysis indicated that RV/LV and LA/BSA were associated with operative death. A model for operative mortality with three variables emerged from the multiple stepwise regression analysis: Patch, Shunt and Sex (R = 0.421, R2 = 0.177, F = 3.37). A model for predicted RV/LV with five variables: Weight, Shunt, BSA, Patch and Sex (R = 0.602, R2 = 0.363, F = 5.12). However, it was thought difficult to predict operative mortality and postoperative RV/LV by the preoperative variables. Intra- and postoperative factors might have larger influences on operative mortality and RV/LV than the preoperative ones.