Abstract
A 21-year-old male patient underwent aortic and mitral valve replacement for progressive cardiac failure due to acute bacterial endocarditis. Ischemic myocardial contracture developed during attempts to restore cardiac activity following hypothermic, ischemic, cardioplegic arrest. An abdominal left ventricular assist device (ALVAD) was implanted and supported the circulation for nearly six days prior to cardiac transplantation. The preoperative EKG showed sinus tachycardia with left anterior hemiblock. Postoperatively, there was complete electromechanical dissociation. The postoperative EKG showed a superior and leftward shift of the axis. There was a marked loss of QRS voltage and variable degrees of atrioventricular block. At times, only P waves were present. On the fourth postoperative day, there was an axis shift to the extreme right. Prior to transplantation, sinus rhythm returned, and the axis shifted leftward once again. The common denominator of all the abnormal postoperative electrocardiograms was the conspicuous low voltage that probably signified early and extensive myocardial damage. To our knowledge, this is the first instance wherein a sequential electrocardiographic analysis of stone heart syndrome has been undertaken.
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Selected References
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- Baroldi G., Milam J. D., Wukasch D. C., Sandiford F. M., Romagnoli A., Cooley D. A. Myocardial cell damage in "stone hearts". J Mol Cell Cardiol. 1974 Aug;6(4):395–399. doi: 10.1016/0022-2828(74)90080-7. [DOI] [PubMed] [Google Scholar]
- Cooley D. A., Reul G. J., Wukasch D. C. Ischemic contracture of the heart: "stone heart". Am J Cardiol. 1972 Apr;29(4):575–577. doi: 10.1016/0002-9149(72)90454-7. [DOI] [PubMed] [Google Scholar]
- Katz A. M., Tada M. The "stone heart" and other challenges to the biochemist. Am J Cardiol. 1977 Jun;39(7):1073–1077. doi: 10.1016/s0002-9149(77)80224-5. [DOI] [PubMed] [Google Scholar]
- Norman J. C., Brook M. I., Cooley D. A., Klima T., Kahan B. D., Frazier O. H., Keats A. S., Hacker J., Massin E. K., Duncan J. M. Total support of the circulation of a patient with post-cardiotomy stone-heart syndrome by a partial artificial heart (ALVAD) for 5 days followed by heart and kidney transplantation. Lancet. 1978 May 27;1(8074):1125–1127. doi: 10.1016/s0140-6736(78)90301-x. [DOI] [PubMed] [Google Scholar]
- Norman J. C., Dacso C. C., Reul G. J., Massin E. K., Klima T., Kahan B. D., Keiser J. T., Cooley D. A. Partial artificial heart (ALVAD) use with subsequent cardiac and renal allografting in a patient with stone heart syndrome. Artif Organs. 1978 Nov;2(4):413–420. doi: 10.1111/j.1525-1594.1978.tb01632.x. [DOI] [PubMed] [Google Scholar]
- Wukasch D. C., Reul G. J., Milam J. D., Hallman G. L., Cooley D. A. The "stone heart" syndrome. Surgery. 1972 Dec;72(6):1071–1080. [PubMed] [Google Scholar]