bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraaortic Balloon Counterpulsation: A Review
Authors: Smith James M. , Joyce Lyle D. , Mauer Henry G. , Lillehei Richard C. 
Published: November 2007

The intraaortic balloon counterpulsation pump (IABP) was successfully placed in 54 patients from 1972 to January 1978. Total overall survival was 46% (25/54). In the past 3 years survival was doubled (54% — 21/39) compared to the initial experience from 1972 through 1975 (27% — 4/15). Eleven percent (6/54) of the patients died after the IABP was removed, 19% (10/54) became balloon-dependent, and 24% (13/54) had either a poor response or no re sponse to IABP. Indications for IABP were cardiogenic shock secondary to myocardial infarction (CS-MI), preinfarction angina, postoperative cardiopulmonary bypass dependency (CPBD), the most common indication, or post cardi otomy cardiogenic shock. Preoperative prophylactic placement of the balloon was used in 7 patients with a 57% (4/7) survival. None of the 10 patients treated for CS-MI survived to discharge. Fifty-one percent (18/35) of CPBD patients were long-term survivors. Complications including difficulty passing the device (15/54), thrombosis (6/54), minor dissection (3/54), or combinations of these problems occurred in 41% (22/54) of the patients. Hemodynamic and metabolic parameters were also reviewed. Early recognition of cardiogenic shock and prompt placement of the IABP are essential to insure decreased morbidity and increased survival in these critically ill patients.
Rigid Circumferential Constriction of the Arterial Wall: Part II
Authors: Edmondson H.T. , Moretz W.H. , Nesbit R.R. , Otken L.B. , Pittman V. 
Published: November 2007

The distal thoracic aorta was partially occluded in 51 mongrel dogs. In some dogs single strands of size 00 Dacron, Teflon, and black silk were used, and in others the vessel was constricted by banding with a 2-cm long aluminum cylinder. In all instances the resultant diameter was 50% of the original diameter in systole. This study was performed as a sequel to similar experimentation reported by the authors in 1970 in which stainless steel mesh cylinders and single stainless steel strands were used. Because of unpromising results of earlier investigators—destructive changes of the vessel wall with fatal hemorrhage—we were surprised that all 86 dogs in our first study, and all 51 dogs in the current study, were alive and well at controlled intervals, some for up to 2 years.
Veno-Venous Bypass for Drainage of Occluded Common Iliac Vein: a Case Report
Authors: Assa J. , Iuchtman M. , Zoireff L. , Simon J. 
Published: November 2007

A case of postiliac vein ligation, DVT recanalization, and its sequelae was suc cessfully treated 15 years after onset by a veno-venous crossover bypass with AV fistula. Previous reports on such a procedure were discouraging even when implemented within three years of on set. The inconsistent practice of venous revascularization is the main cause of failures. The advent of AV fistula con struction brings with it much hope for this kind of surgery. This case report discusses hemody namic studies by phlebography, opera tive technique, and problems arising with the construction of AV fistula; the literature is reviewed as well. We con clude that venous reconstructions can be carried out at any time, provided that increased flow is maintained. This increase in flow (by the AV fistula) should be limited in time to avoid de velopment of reversed flow.
Antithrombin III as a Factor in Recurrent Thromboembolism
Authors: Raine Tal , Kerstein Morris D. 
Published: November 2007

A 43-year-old man with recurrent pulmonary emboli associated with antithrombin III deficiency is presented. After laparotomy for penetrating abdominal trauma, thrombophlebitis and emboli were treated with heparin. Subsequent failure of therapy resulted in application of an inferior vena cava clip. Recurrent emboli from the site of the clip were managed by vena cava division and reconstruction. The primary problem was antithrombin III deficiency with levels less than 40% of normal. The first recorded case of ligation of the inferior vena cava (IVC) for pulmonary embolus was by Trendelenburg in 1911.12 Homans2 suggested prevention of pulmonary embolus with ligation of the IVC in 1944. Since then, treatment of deep vein thrombosis with or without pulmonary embolus has focused on anticoagulant therapy. Recent studies have demonstrated a lower morbidity and mortality with anticoagulation than with any surgical procedure.3 The primary indications for IVC interruption are contraindica tion to anticoagulation or failure of anticoagulation to prevent pulmonary embolus. Partial interruption of the IVC with extraluminal plication or clip, or intraluminal device, is the usual surgical approach. We present a case of recurrent pulmonary embolus managed by IVC ligation with difficulties in anticoagulation due to an antithrombin III defi ciency and subsequent clot propogation above an IVC clip. This case illus trates the management of thrombus above a vena cava interuption as well as underlining Virchow's lessons of hypercoagulability and stasis as predisposing factors of deep vein thrombosis.
Carotid-Cavernous Fistula Complicating Thromboendarterectomy for an Occluded Internal Carotid Artery
Authors: Diethrich Edward B. , Koopot Ravi , Pierce Stephen A. 
Published: November 2007

Thromboendarterectomy for revascularization of the totally occluded in ternal carotid artery is becoming more prevalent. New studies have attested to its efficacy in properly selected patients; however, the procedure has a potential for significant morbidity if improperly executed. One particularly rare complication of this opertion is the creation of an internal carotid artery to cavernous sinus fistula. Atherosclerotic changes in the arterial walls and the natural convolutions of the intracranial carotid arteries predispose to this iatrogenic rupture, especially with the rather stiff Fogarty catheter used to remove thrombi. In a recent case of iatrogenic carotid-cavernous fistula following an internal carotid thromboendarterectomy, the fistula proved difficult to close. Initial ligation of the common carotid appeared to resolve the defect, but collateral circulation had been established so that the fistula was fed by retrograde flow via the vertebral and external carotid arteries. A second ligation proce dure on both the internal and external carotid branches was necessary to successfully close the fistula. This case report exemplifies not only a complication of thromboendarter ectomy in the totally occluded internal carotid artery but also the types of problems which can arise when dealing with an intracranial fistula.
Femoral Axillary Bypass: An Alternative Approach to Occlusive Disease of the Aortic Arch Vessels in High-Risk Patients
Authors: Machleder Herbert I. , Hassan Philip W. , Kearny John 
Published: November 2007

Although axillo-femoral bypass grafts have proven to be an effective alternative to the usual anatomic reconstructions for peripheral vascular insufficiency, there are only a few scattered case reports of the reversed flow, femoro-axillary bypass for treatment of the potentially more serious condi tions of cerebral ischemia associated with occlusive disease of the major aortic arch branches. This unique alternative approach becomes particularly compelling in the high-risk patient with occlusive lesions of all the aortic arch vessels. Although theoretically feasible, the effectiveness, practicality, safety, and long-term patency of this approach remain to be proven. The case of a 59-year-old woman with cerebral ischemia secondary to occlusive disease of all aortic arch branches treated by femoro-axillary bypass is presented, and some of the observations of previous case reports are reviewed. The operative course, clinical and hemodynamic changes, and important observations in this unusual case are described. The availability of noninvasive tests for the measurement of cerebral flow and pressure has made it possible, in this case, to correlate clinical changes with objective evidence of concomitant hemodynamic alterations.
Leiomyosarcoma of the Inferior Vena Cava
Authors: Vreede Anton A. , Vaziri Dariush , Cornwall Claude C. 
Published: November 2007

Leiomyosarcoma of the inferior vena cava is a rare tumor. Though gener ally not aggressive this malignancy will ultimately be fatal unless resected. Surgical resection is possible when the tumor is located in the middle or lower segment of the inferior vena cava. The symptomatology produced by the tumor is variable. The patient may present with only minimal pain or may develop a wide spectrum of findings. The lesion may present as a diagnostic problem. The authors have recently seen a case of leiomyosarcoma of the inferior vena cava in whom computerized axial tomography was helpful in identifying the location of the tumor.
Ruptured Carotid Artery Aneurysm
Authors: Sechas Michael N. 
Published: November 2007

Aneurysms of the extracranial carotid artery continue to be rare vascular lesions.2,4,6 Rhodes and associates collected only 19 cases during a 15-year experience at the University of Michigan Medical Center. Recently, there have been many reports of successful resection and recon struction of carotid artery aneurysms. These resections have been carried out electively.2,3,4,6 There are only a few reports about emergency operations for ruptured or expanded aneurysms.5,7,9,11,12 A patient was recently managed at this institu tion for a ruptured carotid aneurysm, treated by excision and end-to-end anastomosis.
Ischemic Necrosis of the Anterior Tibial Compartment
Authors: Serra J.M. , Llorens R. , Enriquez A. , Sanado L. 
Published: November 2007

When there is progressive necrosis in the lower extremity whose etiology is atherosclerosis the ultimate mode of treatment is generally amputation of that part of the extremity. This paper presents case reports of extensive necrosis at the antero-lateral part of the lower extremity which corresponds to the tibial compartment.1 The compartmental syndrome comprises the muscles between the tibia, internal ligament, the external intermuscular septum, and the skin which covers them. The proposed surgical management is debridement of necrotic tissues except the tibial periosteum and external intermuscular septum so that skin graft, Thiersch type, covers the oozing substances, or a muscle flap and skin graft.
Glutaraldehyde Treated Cat Small Bowel as an Arterial Graft
Authors: Dagan R. , Kott I. , Schechter I. , Ben Bassat M. , Kaplan I. 
Published: November 2007

The materials used up to now for grafting arteries have not proved entirely satisfactory. It was the purpose of the project described here to find a more satisfactory method for replacing arteries. Previous experience has shown that glutaraldehyde-treated grafts are non-viable, avascular, and known to pre serve their general structure. In this study small bowel taken from a cat and treated with glutaraldehyde was used to replace the aorta in dogs. Ten dogs were used. The G.A. treated graft in a length of 10 cm bypassed the abdominal aorta. The dogs were sacrificed from 20 days up to one year. Repeated angiographies showed the patency of the graft. After sacrificing the dogs, the grafts were examined macroscopically and microscopically. The site of the anastomosis was strong and no aneurysms were seen. The graft is easy to handle and can be tailored to size.
Sutureless End-to-Side Microvascular Anastomosis Using Neodymium-YAG Laser
Authors: Jain K.K. 
Published: November 2007

A technique for sutureless anastamosis of the rat carotid arteries using Neodymium-YAG laser is described. It has certain advantages over the con ventional suture technique and potential application in human extra- intracranial bypass surgery. Techniques for the repair of injuries to small arteries1 and end-to-end microvascular anastamosis 2 have been described previously. A technique for sutureless end-to-side laser anastamosis has been developed now.
The Sutureless Microanastomosis
Authors: Gestring Gidon F. , Lerner R. , Requena Ramiro 
Published: November 2007

It has recently become clinically feasible to extract highly concentrated fibrinogen from the patient's own blood. In combination with commercial thrombin this fibrinogen/thrombin compound can be used as tissue adhesive, hemostatic agent and intravascular embolizer. In this presentation the authors describe a new end-to-side and side-to-side microanastomosis using this autologous "fibrin glue" (Fibrinkleber) in stead of suture material. The advantages of the new technique consist of: • Simplicity • Greatly reduced OR time • Increased patency rate • Can be done without operating microscope
Superior Vena Cava Syndrome in Behçet's Disease
Authors: Dündar Semra , Yazici Hamza 
Published: November 2007

Behget's disease was first defined by a Turkish dermatologist of the same name, as a trisymptom syndrome which manifested itself with aphthae in the mouth, genital exul cerations and iridocyclitis with hypopyon. 1 Later, some other features have been attributed to this syndrome, namely skin changes, joint involvement, obstruction of arteries or veins, and infection of sterile injection sites.2-16 Some other rare findings have been also noted in Behqet's disease. Aphthae, genital exulcerations, eye lesions and skin changes are the major lesions. If a patient has three of the major lesions or two major + two minor lesions; the disease is considered to be complete in his case. According to the information we now have, the basic pathological disorder in Behget's disease is vasculitis. Thrombosis in the great veins and arteries, and aneurysms, are frequently noted. The majority of the cases, when they first come to the doctor, suffer from superior vena cava obstruction. Superior vena cava obstruction is usually diagnosed easily. This causes the appear ance of many collateral veins over the anterior chest wall, the dilation of neck veins, and the growth of edema of the chest, neck and face. In the majority of superior vena cava syndromes noted in the literature, malignancy is pinpointed as the cause, while, occa sionally, benign lesions are also winnowed out to be the culprit.27,31 The aim of this work was to present the review of the last fourteen years' etiology of the superior vena cava syndromes in our hospital, and to attempt to find out how many of them were caused by Behçet's disease. As a result, it was found that Behget's disease is the second cause of superior vena cava syndrome, after malignancy. It is known that Behçet's disease is most frequently diagnosed in Turkey, Japan and Greece, so perhaps this result is not surprising for Turkey. 7,26 What's more, it is also probable that Behçet's disease might be the underlying cause in most of the cases dubbed "due to unknown reasons." To ascertain this properly, a careful case history and complete physical examination are compulsory.
Two-Dimensional Echocardiographic Evaluation of Right Ventricular Function in Acute Myocardial Infarction
Authors: Arvan Stephen 
Published: November 2007

Twenty-five patients with acute myocardial infarction, 15 inferior wall (IWMI) and 10 anterior wall (AWMI), were studied using two-dimensional echocardiography (2DE) and blood pool scan to evaluate the accuracy of 2DE for measuring right ventricular function. Fractional shortening (FS) of the minor axis of the right ventricle in the apical four chamber view (A4C) and subcostal four chamber view (S4C) for AWMI patients was higher as compared to the control group (41.8± 11 vs 27±9 and 46±8 vs 27±7 respectively). FS of the minor right ventricular axis for isolated IWMI subjects in the same views was not significantly different from the control population (32±7% vs 27±9% and 34± 13 vs 27±7% respectively). However, patients with an IWMI complicated by right ventricular infarction (RVI) had a significant depression of FS of the minor axis as compared to the control group in both the A4C and S4C views (8±5% vs 27±9% and 18±7 vs 27±7% respectively). FS of the minor axis in only the A4C view correlated . well with the corresponding blood pool scan ejection fraction (EF) for the entire infarction group (r=.69, p<.001). Long axis FS was not significantly different from controls for the IWMI and AWMI group and the correlation with the blood pool scan EF was poor (r= .32 and r=.09 respectively). Surface area of the right ventricle in the A4C view was increased in four of six patients with RVI and six of six patients with blood pool scans. FS of the minor axis in the A4C view correlated well with right ventricular function and was accurate in identifying those patients with an RVI. FS of the long axis was not a reliable measurement for evaluating right ventricular function. Surface area determination of the right ventricular cavity did not prove to be a sensitive index of right ventricular function in addition.
Fulminant Hepatic Failure After Open Heart Surgery: A Case Report
Authors: Morishita Yasuo , Taira Akira 
Published: November 2007

Reports on fulminant hepatic failure after open heart surgery are very few. We recently experienced a 38-year-old female with fulminant hepatic failure accompanying encephalopathy after open heart surgery, and possible etiology of this syndrome was discussed. The patient having undergone open mitral commissurotomy for mitral stenosis died on the 27th postoperative day following the postoperative course of a fulminant type of liver failure. No other possible causes of hepatic dysfunction were identified except slight preoperative disturbance in liver function probably due to congestion. We conclude that preoperative congestive heart failure may cause a fulmi nant type of liver dysfunction after open heart surgery.
The Management of Abdominal Aortic Salmonellosis
Authors: Todd George J. 
Published: November 2007

Infection of the abdominal aorta by Salmonella organisms is a rare but com monly fatal condition. Successful man agement depends on rapid diagnosis, ag gressive surgical intervention, extra- anatomic vascular reconstruction and antibiotic therapy. A review of the surgical literature re veals 25 cases of Salmonella aortitis with only five survivors. Pre-operative death from aortic rupture is common and post operative death due to graft infection is to be anticipated if a prosthesis is placed in the normal retroperitoneal location. A successfully managed case is pre sented with a three year follow-up. Therapy consisted of aneurysm resection, axillobifemoral bypass and a six week course of antibiotics. The status of the oversewn aortic stump has been followed at yearly intervals by means of the in travenous digital subtraction angiogram. No aneurysmal dilatation of the aortic stump has occurred during the three year follow-up and the extra-anatomic recon struction has remained patent without the need for thrombectomy. Important con siderations in the operative and post operative management are discussed.
Characteristic Association of Congenital Arterio-Venous Fistulas and Segmentary Arterial Fibrodysplasia: Monomelic Angiodysplastic Syndrome
Authors: Gessaroli M. , D'Addato M. , Stella A. 
Published: November 2007

The clinical, arteriographic and histological study of 5 cases of monomelic congenital arterio-venous fistulas proposes some findings about their pathoge netic thesis. The association of arterial fibroplasia and congenital arterio-venous fistula is seen as caused by hemodynamic alteration and particularly by the embryoge netic changes which occur simultaneously. These observations suggest the presence of a syndrome with characteristic monomelic anomalies.
Clinical Experience Using Blood Potassium Cardioplegia in valve-Surgery With Prolonged Aortic Cross-Clamp Times
Authors: Morishita Yasuo , Taira Akira 
Published: November 2007

The efficacy of cold blood potassium cardioplegia during aortic cross-clamp ing time longer than 150 minutes was evaluated in 27 patients with cardiac valvular surgery at Kagoshima University Hospital from August, 1978, to June, 1983. Ischemic intervals ranged from 150 to 241 minutes with a mean of 173 minutes. Cardiac-related hospital death occurred in two patients (7.4%); one died of massive intrathoracic bleeding in a case with aortic and mitral regurgitation due to infectious endocarditis, and the other was due to an immobilized valve of the implanted aortic prosthesis. Although the patients with aortic cross-clamping time of more than 150 minutes were obviously in more serious condition by preoperative assessments than the patients with aortic cross-clamping time less than 150 minutes, there was no significant relationship between the length of cross-clamping time and cardiac-related hospital death or the occurrence of postoperative low-output syndrome. These findings suggest that cold blood potassium cardioplegia provides ex cellent myocardial protection during aortic cross-clamp times longer than 150 minutes.
Subclavian Steal Syndrome. Correction by Transthoracic or Extraanatomic Repair
Authors: Schlosser V. 
Published: November 2007

Proximal subclavian artery stenosis may cause severe disturbances of cere bral blood supply well known as subclavian steal syndrome. On the other hand subclavian artery stenosis may produce problems of the perfusion of the arm. But in the presence of a well established collateral circula tion with reversal flow in the ipsilateral vertebral artery the reduced perfusion of the arm in the presence of proximal subclavian artery stenosis seldom re quires operative treatment.
A Tridimensional Study of Microcirculation in Skeletal Muscle
Authors: Gaudio E. , Pannarale L. , Marinozzi G. 
Published: November 2007

The authors used a microcorrosion cast technique to study the microvascular bed of skeletal muscles in the rat. They also tried to clarify the differences, in this respect, between fast twitch and slow twitch muscles. For this purpose they studied as fast twitch muscles, the tibialis anterior muscle and the pectineus muscle and, as a slow twitch mus cle, the soleus muscle. Thanks to the peculiar technique used, they were able to distinguish differ ent sections of the microvascular bed. They also found astonishing differences between the capillary networks in the soleus and tibialis anterior muscles, on the original bases of peculiar charac teristics of the capillary network in the soleus.
Myocardial Protection With Combined Selective Profound Hypothermia and Hyperkaliemic Cardioplegic Arrest In Aortic Valve Replacement
Authors: Wellens F. , Deuvaert F. , Depaepe J. , Primo G. 
Published: November 2007

To analyse the results of combined profound myocardial hypothermia and cardioplegic hyperkalemic arrest for aortic valve replacement a series of 100 consecutive patients undergoing isolated or combined aortic valve replacement was reviewed. There was no operative or early postoperative mortality, only one patient presented with low cardiac output syndrome. Inotropic support was used in 8, vasodilator therapy in 4 and external pacing in 8 instances. Reoperation for bleeding occurred twice. Postpericardiotomy syndrome was present in 7 patients; requiring surgical drainage in 2. Conduc tion defects ( > 48 H) were present in 3 and supraventricular arrhythmias in 15 patients successfully treated with medical therapy in 5 and D.C. countershock in 10. The clinical results confirm that this simple myocardial protection technique provides an excellent myocardial preservation for all patients operated for sin gle or combined aortic valve replacement.