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A Figueroa

Publications and source records attributed to A Figueroa.

At least 37 records · Page 2Linked to original sources
PubMed1998

Alternative techniques in rigid fixation of the craniomaxillofacial skeleton.

Rigid fixation techniques in pediatric craniofacial surgery have enhanced our clinical results by offering greater stabilization and control of bone grafts and osteotomized free segments of the craniofacial skeleton. A potential disadvantage of rigid fixation techniques in the growing craniofacial skeleton includes possible long-term growth restrictions, which have been demonstrated in various animal models. Our goal was to evaluate alternative fixation techniques in the growing craniofacial skeleton of the rabbit to study how altering fixation techniques affects craniofacial development. Eighty New Zealand White rabbits were used in this study. Rabbits were divided into eight groups of 10 each, and seven variant fixation techniques were used to stabilize the frontal bones after bifrontal craniectomies. In all groups except Group 1, the animals underwent a bifrontal craniectomy with orthotopic replacement of the frontal bones. Fixation for each group was as follows: Group 2, wire; Group 3, full microplate; Group 4, suture; Group 5, microplate removal at 4 weeks; Group 6, anterior plate; Group 7, posterior plate; Group 8, soft plate. It was demonstrated that long-term effects on craniofacial development in this animal model are significantly influenced by the type and location of rigid fixation hardware. Significant differences in growth of the craniofacial skeleton for the different fixation groups are presented and discussed.

Animals↗
PubMed1997

Hemodynamic effects of fructose 1,6-diphosphate in patients with normal and impaired left ventricular function.

We compared the short-term hemodynamic effects of intravenous fructose 1,6-diphosphate (FDP) administration in patients with coronary artery disease. Hemodynamic measurements were performed before and after administration of FDP in two groups of patients: those with impaired left ventricular (LV) function, elevated LV end-diastolic pressures (LVEDP > or =12 mm Hg, n = 30), and those with normal LV function (LVEDP <12 mm Hg, n = 17). In those with impaired LV function, FDP induced a decrease in LVEDP from 22 +/- 1.31 to 16.73 +/- 1.46 mm Hg (p< 0.0001). The cardiac index increased (2.50 +/- 0.11 to 2.81 +/- 0.13 L/m2 [p < 0.0001]), as did the LV stroke work index (31.7 +/- 2.04 to 40.3 +/- 2.67 gm x m x m2 [p < 0.0001]). FDP induced no significant change in heart rate and mean aortic pressure. Pulmonary pressure and resistance declined (p<0.002 and p< 0.0001, respectively). Systemic vascular resistance decreased because of increased cardiac output and unchanged arterial pressure (p < 0.001). In those patients with normal baseline LVEDP (5.06 +/- 0.27 mm Hg), FDP decreased heart rate (p< 0.0001) and systemic and pulmonary resistance (p < 0.03 and p < 0.004, respectively), whereas LVEDP and mean aortic and pulmonary pressures remained unchanged. FDP moderately increased cardiac output (p < 0.05), stroke volume index, and LV stroke work index (p< 0.002 and p< 0.003, respectively). The observed improvement in LV function in those patients with elevated LV filling pressures is thought to be a result of an increased energy production by the Embden-Meyerhoff pathway and to act as a positive inotrope.

Cardiac Catheterization↗
PubMed1996

Teaching model for closure of oronasal fistula and bone grafting of the maxilla.

Secondary bone grafting of the maxilla and closure of the residual oronasal fistula at the stage of transitional dentition has become a well-accepted treatment modality. This procedure, in conjunction with orthodontic treatment, has been incorporated into the management protocol of many cleft teams around the world in an effort to further improve functional and esthetic habilitation of patients with unilateral or bilateral clefts of the lip, alveolus, and palate.

Bone Transplantation↗
PubMed1995

Balloon mitral commissurotomy in patients with previous annuloplasty. Our experience.

Balloon mitral commissurotomy is an alternative to surgical commissurotomy in the treatment of mitral stenosis and different studies have shown its usefulness for restenosis following surgical commissurotomy. We describe our experience in balloon mitral commissurotomy in five patients with previous commissurotomy and annuloplasty. Among 360 balloon commissurotomies performed in our hospital up to December 1993, 29 procedures were performed on patients with restenosis after surgical commissurotomy, five of whom also had an annuloplasty (flexible ring in four and rigid in one). The balloon commissurotomy was performed without complications using the Inoue single balloon technique. Mitral valve area increased from 0.9 +/- 0.1 cm2 to 1.0 +/- 0.1 cm2 by pressure half-time, and from 1.0 +/- 0.2 cm2 to 1.3 +/- 0.1 cm2 by Gorlin formula. Two patients in functional class III underwent mitral valve replacement, 32 and 11 months later; the other three patients were in class II 38, 10 and 7 months later. The presence of a mitral ring should not constitute a contraindication to balloon commissurotomy. However, the haemodynamic results are not favourable in our patients, probably due to the practical absence of commissural fusion and the ring's restrictive effect on valvular stretching.

Adult↗
PubMed1995

Effect of rigid microfixation on the craniomaxillofacial skeleton.

Rigid microfixation has enhanced the immediate results in pediatric craniomaxillofacial surgery. The effects of rigid fixation on the development of the craniofacial skeleton, however, remain uncertain. The long-term effects of rigid microfixation on the growing craniofacial skeleton in the rabbit model were evaluated in this study. Bifrontal craniectomies were preformed in 9-day-old rabbits. The frontal bones were replaced orthotopically and fixed both anteriorly and posteriorly with either wire osteosynthesis or titanium microplates and screws. The animals were allowed to grow to craniofacial maturity, and craniofacial development was evaluated with both cephalometric and craniometric analyses. All data were statistically analyzed through analysis of variance. Regional adverse growth effects on the craniofacial skeleton with the use of both wire and rigid fixation were observed. The adverse effects were greatest with the use of rigid fixation.

Analysis of Variance↗
PubMed1994

Assessment of tricuspid regurgitation by Doppler color flow imaging: angiographic correlation.

The correlation between data obtained by Doppler color flow imaging and angiographic severity has been investigated in mitral and aortic regurgitation. However, similar studies have not been performed for tricuspid regurgitation (TR). This study was performed to establish the correlation between measurements of regurgitant jet area by Doppler color flow imaging and the angiographic severity of TR. Fifty-four patients with rheumatic heart disease who underwent right ventriculography and transthoracic Doppler color flow imaging were studied. The regurgitant jet area was measured as the largest clearly definable flow disturbance in apical four-chamber and right ventricle inflow views, and expressed in both views as the absolute jet area or as the ratio of maximal jet area to right atrial area. Correlation of all Doppler color flow measurements with angiographic grades of TR were comparable, absolute jet area in apical four-chamber view being closest at r = 0.80. A regurgitant jet area in apical four-chamber view < 5 cm2 predicted minimal or mild TR by angiography with a sensitivity of 78% and a specificity of 100%, whereas a regurgitant jet area > 10 cm2 predicted severe TR with a sensitivity of 92% and a specificity of 91%. Values between 5 and 10 cm2 predicted moderate TR with a sensitivity of 89% and a specificity of 89%. Sensitivity and specificity were not improved with use of the ratio of jet area to right atrial area or with use of right ventricle inflow view. Thus, Doppler color flow jet measurements correlate closely with angiographic results in the evaluation of TR.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1994

Craniomaxillofacial surgery in the Jehovah's Witness patient.

The reconstruction of severe craniofacial anomalies in patients who will not accept blood transfusions presents a considerable challenge to the craniofacial team. Traditionally, these patients have been refused major reconstructions, receiving no treatment or a highly compromised substitute. A management protocol was developed utilizing preoperative erythropoietin and ferrous sulfate therapy, intraoperative in-line normovolemic hemodilution, and meticulous intraoperative hemostasis which allows us to perform major craniomaxillofacial reconstructions in Jehovah's Witness patients without the use of homologous or predonated autologous blood transfusions.

Adolescent↗
PubMed1993

Leveling of the occlusal plane during model surgery.

A level occlusal plane is a prerequisite for success in all orthognathic surgical procedures. Occlusal plane leveling must be obtained at the time of model surgery and splint manufacturing or an occlusal cant will be translated to the operating theater. We describe the use of a small-scale flat-line level, utilized during model surgery for two jaw procedures, to level the occlusal plane accurately and quickly.

Dental Articulators↗
PubMed1993

Longitudinal assessment of mental development in infants with nonsyndromic craniosynostosis with and without cranial release and reconstruction.

The effect of cranial release and reconstruction on the mental development of infants with nonsyndromic craniosynostosis was evaluated. Longitudinal assessment of mental development for infants before and after cranial release and reconstruction and for infants not undergoing surgical treatment was obtained by using the mental scale of the Bayley Scales of Infant Development. Severity of anatomic craniofacial deformity, perinatal medical risk factors, and age at time of surgery also were investigated. None of the infants displayed mental retardation [Mental Development Index (MDI) score < 70] before or after cranial release and reconstruction. Scores ranged from borderline retardation to very superior following a normal distribution. Severity of anatomic craniofacial deformity and perinatal risk factors were unrelated to mental development. Cranial release and reconstruction did not affect mental development positively or negatively but did result in improvement of the original craniofacial deformity.

Child Development↗
PubMed1993

[A right-to-left shunt through a patent foramen ovale without pulmonary hypertension].

We report the case of a man 67-years-old with right-to-left shunt through a patent foramen ovale in absence of pulmonary hypertension. The contrast and transesophageal echocardiography showed significant right-to-left shunt and provided insight about the mechanisms that cause it. The aortic root was enlarged compressing the right atrium. Surgical repair was performed, the foramen ovale was closed and right atrial enlargement with a patch was carried out. Disappearance of the shunt was confirmed by means of transesophageal echocardiography in surgical-room.

Aged↗
PubMed1991

[Extracorporeal lithotripsy of urinary calculi: experience with Modulith SL-20 (Storz Medical)].

The results of extracorporeal lithotripsy on 250 patients with renal and ureteral stones are reported. Stone size varied from less than 1 cm (64%), 1 to 2 cm (31%) to over 2 cm (4%). 51% of patients were treated on an ambulatory basis. Complete fragmentation was obtained in 97% of patients and 78% were free of any demonstrable stone after 90 days. lithotripsy is an effective procedure allowing ambulatory non surgical treatment of urinary stones in many patients.

Adolescent↗
PubMed1990

Percutaneous atherectomy with the Kensey catheter: early and midterm results in femoropopliteal occlusions unsuitable for conventional angioplasty.

Forty-six femoropopliteal occlusions in 44 patients (aged 45-95 years) were recanalized with the percutaneous rotating tip atherectomy catheter completed by balloon dilatation. Thirty-one patients had tight intermittent claudication of the lower limbs, five had resting pain and 10 had skin disorders. The length of the occlusion ranged from 2 to 24 cm. Of 46 procedures, 40 (87%) were immediately successful (increase of mean Doppler systolic ankle-arm index from 0.44 to 0.89) and six (13%) were failures. In two it was impossible to pass through the lesion and in four arterial perforation occurred without any clinical consequences. Of the six failures, five occurred in calcified arteries. Five recanalizations (11%) reoccluded within 48 hours, bringing the total number of early failures to 11. Of these 11 failures, nine were treated by femoropopliteal vein bypass and two by medical treatment only. Two postoperative asymptomatic posterior tibial artery embolisms were treated medically, and one popliteal artery embolism was treated using a Fogarty catheter. At the present time, 25 of 35 primary successes had been followed for six months, and 20 for 12 months with primary patencies 18 of 25 (72%) and 14 of 20 (70%), respectively. If massively calcified lesions are excluded, femoropopliteal recanalization with the percutaneous rotary Kensey atherectomy catheter followed by balloon catheter dilatation is efficacious and reliable with an 80% primary success rate and a 70% patency rate at one year.

Aged↗
PubMed1990

[Simultaneous transvesical adenomectomy and pre-peritoneal hernioplasty].

Fifty-three patients submitted to simultaneous treatment of prostatic disease and herniorhaphy are analyzed herein. These patients underwent 64 herniorhaphy procedures utilizing the Nyhus technique, approximating the inferior border of the transverse muscle aponeurosis to Cooper's ligament for direct hernia repair and narrowing the deep inguinal ring with interrupted sutures between the upper border of the deep inguinal orifice and the iliopubic ligament. A recurrence rate of 16.9% was observed relative to the number of patients and 14% relative to the number of hernioplasty procedures. Recurrence presented at 2 years in 8 cases (88.8%); only 1 patient had recurrence at 10 years. Since the pathologic conditions were corrected in 86% of the patients with one anesthetic and surgical procedure, this approach is advocated because it reduces operative morbidity.

Aged↗
PubMed1989

Mitral valve rupture during percutaneous dilation of aortic valve stenosis.

A 62-year-old patient underwent catheter balloon valvuloplasty for aortic valve stenosis. During the procedure, iatrogenic severe mitral regurgitation was induced, requiring emergency surgery. At operation, extensive laceration of the septal mitral leaflet was found; chordae tendinae were intact. Retrospective examination of the cineangiogram revealed the presence of balloon indentation at the chordal level during inflation, which disappeared at full inflation. Mitral valve rupture was probably related to balloon entrapment in chordae tendinae, severe chordal stretching at inflation, and subsequent valve laceration. This severe complication or aortic valvuloplasty in adults has not been reported previously and probably could be avoided by careful observation of guidewire and balloon position before inflation.

Aortic Valve Insufficiency↗
PubMed1989

[Dysfunction in a Hancock mitral valve bioprosthesis caused by thrombosis and resolved with heparin].

Thrombotic malfunction is a rare and shortly documented complication of cardiac bioprostheses. Surgical treatment is usually needed. We report a patient with thrombotic occlusion of a Hancock mitral prosthesis which was resolved with heparin. Clinical and therapeutic features are discussed. To our knowledge, this is the first case of a bioprosthetic thrombotic obstruction successfully managed with heparin therapy.

Bioprosthesis↗