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European hydroxyethyl starch: a safe and inexpensive alternative to albumin.

addition, they monitored BP noninvasively and heart rate was not paced, while the level of surgical stimulus was constantly changing. Their patients had their operations 23-28 mo previously, which might be an important factor. The benefit of cardiomyoplasty may derive from late fibrosis preventing further cardiac dilation (5,7), although skeletal muscle contraction may be a more important factor in the maintenance of BP prior to the development of fibrosis (as in the case presented herein). In conclusion, in contrast to previous reports, this case suggests that nondepolarizing muscle relaxants should be used with caution in aortocardiomyoplasty, at least within 3-4 mo of the operation. Other experience also suggests that depolarizing agents, which cause muscle fasciculation, should probably be avoided in these patients (8).