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March 1968

Circumflex CoronaryA Comparison of Gastric Freezing

Author Affiliations

From the Department of Surgery, Veterans Administration Hospital, and the Joseph B. Whitehead Department of Surgery, Emory University School of Medicine, Atlanta.

Arch Surg. 1968;96(3):328-330. doi:10.1001/archsurg.1968.01330210006002

CARDIOVASCULAR complications have been reported following gastric hypothermia. The balloon circulating a coolant in the distended stomach is separated from the apex of the heart only by the diaphragm. The neck of the balloon is fixed in the lower esophagus, and cooling posterior to the heart occurs concomitantly.

Reynolds1 reported two patients having paroxysmal auricular fibrillation shortly after gastric freezing. Auricular fibrillation occurred in a 67-year-old man with myocardial ischemia as a complication of gastric freezing in a series of 22 patients treated by Doyle and Williams.2 Bernstein et al3 and Heineken and associates4 reported transient T-wave and ST segment changes concomitant with gastric freezing. Rose and Harrell5 found atrial fibrillation to occur in three and paroxysmal auricular tachycardia in one of 26 patients subjected to gastric hypothermia.

Studies by Peter et al6 of the physiologic effects of gastric hypothermia in the dog showed

Reynolds, B.M., and Scherl, N.D.:  Paroxysmal Atrial Fibrillation After Gastric Freezing , New Eng J Med 270:1301-1302 ( (June) ) 1964.Article
Doyle, J.C., and Williams, E.J.:  Elective Treatment of Duodenal Ulcer by Gastric Freezing , Brit J Surg 51:778-783 ( (Oct) ) 1964.Article
Bernstein, E.F., et al:  Interim Report on Results of Gastric Freezing for Peptic Ulcer , JAMA 187:436-441, 1964.
Heineken, T.S., et al:  Gastric Freezing: Preliminary Report on Ten Cases , Amer J Gastroent 39:648-654, 1963.
Rose, H., and Harrell, R.:  Cardiovascular Effects of Gastric Hypothermia , Southern Med J 60:152-155, 1967.Article
Peter, E.T., et al:  The Effect of Gastric Hypothermia on Splanchnic Hemodynamics in the Dog , J Surg Res 3:32-35, 1963.Article
Orahood, R.C.; Wangensteen, S.L.; and Luke, W.K.:  Physiologic Effects of Gastric Hypothermia: II. The Effect on Renal Blood Flow, Renal Plasma Flow, and Glomerular Filtration Rate in the Normal Anesthetized Dog , Surgery 50:656-661, 1961.
Ross, G.:  Electromagnetic Observations on Coronary Blood Flow , Proc Nat Acad Sci USA 52:692 ( (Sept) ) 1964.Article
Spencer, F.C.: " Experimental Cardiac Surgery ," in Ballinger, W.F., II (ed.): Research Methods in Surgery , Boston: Little Brown & Co., 1964, p 54.
Sabiston. D.C., Jr.; Theilen, E.O.; and Gregg, D.E.:  The Relationship of Coronary Blood Flow and Cardiac Output and Other Parameters in Hypothermia , Surgery 38( (3) ):498-505 (Sept) 1955.