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Biomedical subjects

A J Tector

Publications and source records attributed to A J Tector.

At least 55 records · Page 3Linked to original sources
PubMed1976

Atherosclerosis of the internal mammary artery.

To better evaluate the incidence of atherosclerosis in the internal mammary artery (IMA), 215 IMA segments from routine postmortem examinations were evaluated microscopically. Significant atherosclerotic narrowing was seen in 9 patients (4.2%). No patient had more than a 50% reduction in lumen diameter. The degree of incipient atherosclerosis correlated well with age, hypertension, diabetes, and peripheral vascular disease.

Adult↗
PubMed1976

Factors predictive of perioperative myocardial infarction during coronary operations.

The diagnosis of perioperative myocardial infarction (PMI) in our patients was based upon electrocardiography, vectorcardiography, and postoperative enzyme changes. A group of 303 patients operated on between January and September, 1972, formed the basis of this study. Three groups were identified from among these patients. Group A was composed of 90 consecutive patients in whom MI was excluded by all criteria. Group B comprised 25 patients with proved MI and yielded the 8% incidence of MI among our patients. Group C included 34 patients with triple-vessel disease who did not sustain MI. Significantly more patients sustaining MI had preinfarction angina and severe coronary artery disease. The incidence of MI was also higher in patients with diffuse disease and those in whom the lesions could not be totally bypassed. A statistical correlation with longer pump runs and periods of anoxia was obtained. There was some suggestion that the preoperative location of the hypokinetic segment determined the site of MI in patients.

Angina Pectoris↗
PubMed1976

Experience with internal mammary artery grafts in 298 patients.

The internal mammary artery (IMA) was used as a graft in 298 patients undergoing coronary bypass procedures. Two patients died during the operative period and 2 others died one year later. Most of the survivors are free of angina. Of the IMAs restudied 9 to 24 months postoperatively, 95% were patent. This group included nearly all the patients having angina after operation. There are some situations in which the IMA may have inadequate flow in comparison to the vein graft. These results suggest the IMA is an excellent graft in most coronary bypass procedures.

Adult↗
PubMed1976

Surgery for congenital heart disease in the adult.

A total of 205 adults with a variety of congenital heart lesions underwent operation for total correction of their defects. Operative and long-term mortality were 3 and 4 percent, respectively. There has been only one operative death in the past five years (85 patients). While most defects were repaired with good hemodynamic and symptomatic improvement, the three lesions associated with the worst results were cyanotic tetralogy of Fallot, severe pulmonic stenosis complicated by atrial septal defect, and ostium primum atrial septal defect. Myocardial failure due to end-stage myocardial fibrosis was the major cause of operative mortality. Myocardial fibrosis and irreversible pulmonary changes seemed to be the two factors limiting operative correctio

Adolescent↗
PubMed1976

Reduction of blood usage in open heart surgery.

A series of 142 adult patients undergoing open-heart surgery were studied. All known blood-conservativing methods were utilized in an attempt to use as little blood as possible. Hemodilution, autologous transfusion, prevention of wasting of blood, and management of postoperative anemia were the measures employed. An average of 2.66 units of blood were given per patient during the entire hospital stay. Twenty patients were not given any blood at all. The patients were removed from cardiopulmonary bypass without difficulty when the hematocrit reading was in the high teens or low twenties. Later in the postoperative period the patients seemed to progress without difficulty with hematocrit readings of 22 to 25 percent.

Blood Transfusion↗
PubMed1975

Topical myocardial cooling. An intensive laboratory investigation.

To better understand efficacy of topical cooling in myocardial protection, three groups of 12 dogs each were studied. Group 1 dogs had systemic cooling to 30 C; group 2 had cooling to 30 C and outside cooling of left ventricle; group 3 was cooled in the same way as group 2 was but also had inside of left ventricle topically cooled. Measurements were taken of left ventricular function curves, regional blood flow distribution to the subendocardium, sequential pH, PCO2, PO2, and lactate and serum glutamic oxaloacetic transaminase (SGOT) levels. Lower midseptal and subendocardial temperature (means, 11 and 7 C, respectively) in group 3 correlated with higher survival and greater preservation of left ventricular function. Lower levels of SGOT and lactate in coronary sinus efflux, and higher regional flow to subendocardium postoperatively, also correlated with minimal evidence of subendocardial necrosis in group 3 dogs. Rapid of cooling of subendocardium was noted as achieving maximum preservation of left ventricular function.

Animals↗
PubMed1975

Comparative hemodynamic properties of vein and mammary artery in coronary bypass operations.

To understand better the observed differences in bypass flows between vein and internal mammary artery (IMA) grafts, a technique was devised for anastomosing both vein and IMA to the same anterior descending coronary artery in 14 patients. In the stable postperfusion state, flows in the two bypass conduits were simultaneously recorded as well as pressure relationships in both grafts and the left ventricle. The supply/demand ratio for left ventricular performance was calculated with respect to the diastolic pressure-time index/tension-time index (DPTI/TTI) for each bypass independently and simultaneously and then compared. The DPTI/TTI ratio was nearly two times greater with the vein bypass than with the IMA. This difference was further confirmed by the flow studies, in which blood flow through the vein ranged 2 to 3 times higher than IMA flow to the same coronary bed. By present criteria the DPTI/TTI ratio for IMA grafts to the left ventricle was inadequate in the majority of patients studied, and atrial pacing markedly lowered the DPTI/TTI ratio of the IMA. The choice of vein or IMA as a bypass is a critical determinant of the resultant bypass-left ventricular DPTI/TTI ratio. Vein bypasses exhibited far superior hemodynamic capability in the resting state, and the effect of atrial pacing on the DPTI/TTI ratio in IMA-vein-left ventricle bypasses confirms this point.

Coronary Artery Bypass↗
PubMed1975

A method for revascularization of circumflex marginal coronary arteries.

The transverse sinus route for bypassing high marginal circumflex coronary arteries facilitates the operation and obviates potential kinking sites at the left atrial appendage and pericardial reflection over the pulmonary veins. The vein bypass emerges from the transverse sinus and closely parallels the marginal circumflex coronary vessels.

Arteries↗