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Biomedical subjects

B G Wisoff

Publications and source records attributed to B G Wisoff.

At least 37 records · Page 2Linked to original sources
PubMed1976

New Q waves after bypass grafting: correlations between graft patency, ventriculogram and surgical venting technique.

New Q waves were observed in 35 (11%) of 321 patients undergoing saphenous vein bypass grafting with an overall mortality rate of 1.1%. Twenty-eight (80%) had postoperative arteriograms and ventriculograms and are reported. Ventricular venting was used intra-operatively in 17 patients and atrial venting in 11. The incidence of new Q wave was 22% in patients with ventricular venting and 5.5% in those with atrial venting (p less than 0.05). Complete or incomplete revascularization did not affect the incidence of new Q waves. New Q waves appeared in a zone of myocardium supplied by a grafted artery in all except two patients with ventricular venting in whom Q waves occurred within the zone of myocardium supplied by diseased ungrafted vessels. In the ventricular venting group, seven (41%) demonstrated an improved or unchanged postoperative ventriculogram and ten (59%) had deteriorated ventriculograms. In 11 patients with atrial venting, nine (82%) showed improved or unchanged postoperative ventriculograms and two (18%) had deteriorated ventriculograms. Ventricular venting patients with improved or unchanged postoperative ventriculograms had 7% graft closure as compared to 5% of those with atrial venting (pNS). Graft closure rate was 44% in ventricular venting and 20% (pNS) of patients with atrial venting who had deteriorated left ventriculograms. These findings indicate poor correlation between new Q waves and graft closure. Improved postoperative ventriculograms corrleated well with graft patency despite new Q waves. The etiology of new post bypass graft Q waves are varied. They include ventricular trauma and conduction delays resulting from surgery or venting, as well as infarction. This may be due to compromised arterial inflow either in nonoperated vessels or in the vessels distal to the anastomosis with patent grafts, or due to occluded grafts.

Coronary Artery Bypass↗
PubMed1976

Results of open heart surgery in the septuagenarian.

Open heart surgery has been extended to the septuagenarian. At the Long Island Jewish-Hillside Medical Center, 42 patients 70 to 79 years old underwent 43 open heart procedures in the past 7 years. Their average age was 73 years and 62% were male. Eighteen underwent aortic valve replacement; 7 had mitral valve replacement; 18 had coronary bypasses (3 with valve replacement); exploration for pulmonary embolism was done in 1; 1 patient had tricuspid replacement with mitral commissurotomy; 17% (7/42) died during hospitalization or within 30 days of surgery. Mean follow-up is 25 mo., and an additional 19% (8/42) have died at an average of 27 mo. after surgery. Open heart surgery is feasible for the elderly, but at an increased risk when compared to the younger patient submitted to the same procedure.

Age Factors↗
PubMed1976

Patent ductus arteriosus with hypoplastic lung.

A median sternotomy approach was used for closure of patent ductus arteriosus associated with a hypoplastic right lung. The anterior approach to the left ductus is indicated if left thoracotomy is contraindicated.

Child, Preschool↗
PubMed1976

Medical-surgical aspects of left main coronary artery disease.

Disease of the left main coronary artery compromises circulation to the major part of the left ventricle and thus threatens massive myocardial infarction and sudden death. Cardiac catheterization and coronary bypass surgery, in previous reports, have been associated with high mortality and morbidity rates. We report 50 patients with over 50 per cent narrowing of the left main coronary artery. The clinical pattern in these patients was variable and a left main coronary artery lesion could not be predicted before coronary angiography. There was only one death during cardiac catheterization. One patient died while waiting for elective surgery. Coronary bypass surgery was performed in 42 patients; one died during surgery. Forty-one patients are alive at 2 to 39 months follow-up (mean, 19 months). Thirty-six patients are asymptomatic or have minimal symptoms. Compared to the prognosis in patients with left main coronary artery stenosis treated medically, coronary bypass surgery performed on urgent basis offers a much better prognosis. Both coronary angiography and bypass surgery can be performed in these patients with a very low risk.

Adult↗
PubMed1976

Analogy tests and psychopathology at follow-up after open heart surgery.

A study of 100 coronary bypass and cardiac valvular surgery patients investigated whether preoperative brain damage, as measured by the Conceptual Level Analogy Test (CLAT), is a major risk factor for postoperative psychiatric symptoms and mortality. Three cognitive psychological tests, including the CLAT, and psychatric interviews were given preoperatively, postoperatively, and at 18-month follow-up. Surgical outcome was specified as: Catastrophic Outcome (death or severe stroke), Psychiatric Complications, or Good Outcome (survival with no psychiatric complications). Inhospital outcome related significantly to analogy test scores, as did both surgical procedure and diagnosis of rheumatic heart disease. However, long-term outcome was unrelated to medical diagnosis and only weakly related to surgical procedure, but highly significantly related to preoperative analogy scores. The CLAT was a more consistent predictor of both short- and long-term outcome than any of the other ten variables considered (medical and surgical variables, inhospital outcome, demographic measures, other psychological tests).

Brain↗
PubMed1975

Preoperative coronary angiographic prediction of bypass flow and short-term patency.

A quantitative preoperative coronary angiographic index was defined in 148 patients undergoing coronary revascularization. Each diseased vessel was scored 0-3, for both diameter and quality of run-off. The sum of the scores for diameter and run-off constituted the numerical index for the diseased vessel. Correlations between the index and graft flow measured by electromagnetic flow meter at surgery were established in 259 bypassed vessels. The highest scores (5-6) were associated with higher flows, and the lower scores (0-4) with the lower flows (P less than 0.005). Repeat angiography performed 2 wk postoperatively in 110 patients demonstrated 174 graft patencies and 15 graft closures. Mean flow in open grafts was 82 +/- 41 ml/mn vs. 60 +/- 23ml/mn in closed grafts (P less than 0.005). It is concluded that graft flow is predictable from preoperative Coronary Angiographic Index and that higher flow and index scores are more likely to be associated with graft patency than low flows and index scores.

Angina Pectoris↗
PubMed1975

Risk of coronary surgery. Two hundred consecutive patients with no hospital deaths.

Revascularization surgery must carry a low morbidity and mortality rate to be a valid alternative treatment of obstructive coronary disease. A consecutive series of 200 patients underwent coronary bypasses at LIJ-HMC. The average age was 53.9 years (33 to 77) with 81.5 per cent of the patients men. Clinical presentation was as follows: 28 per cent were in New York Heart Association Class III and 72 per cent in Class IV (or unstable). Previous infarctions were documented in 37 per cent. Sixteen patients (8 per cent) had disease of the main left coronary artery. Single bypasses were placed in 37.5 per cent, double in 40.5 per cent, and triple or quadruple in 22 per cent. The rate of vein graft patency was 95.3 per cent (245 of 257 studied grafts). There were no hospital deaths in this consecutive group of 200 patients. There have been two late deaths after an average follow-up period of 16 months.

Adult↗