Early Clinical Experiences with 102 Cases of Open Heart Surgery

The purpose of this paper is to document analytic review upon 102 cases undergoing open heart surgery from Oct., 1964 to Dec., 1969. 1) ASD - Two of 32 cases in whom secundum type defects of various size were found and repaired by direct sutures, died of postoperative hemorrhage and heart failure due to inadvertent overtransfusion respectively (5.8 per cent of mortality). One with a large ASD of more than 5 cm. in diameter got pulmonary edema for a few days after surgery and then recovered completely. All survivors are doing well so far. 2) VSD - Four of 42 cases undergoing closure of the defect died. The mortality rate was 9.5 per cent. Causes of death were as follows : i) massive bleeding during ventriculotomy under usual cardiopulmonary by-pass because of co-existence of persistent left superior vena cava, ii) right heart failure due to pulmonary hypertension immediately after surgery, iii) irreversible myocardial dysfunction after closure of VSD combined with aortic regurgitation, and iv) pneumonia. On discharge cardiac murmurs were heard in eleven of 38 survivors at any intensity, but residual shunt was suspected in one only.