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Biomedical subjects

C Del Campo

Publications and source records attributed to C Del Campo.

At least 19 recordsLinked to original sources

Prosthetic replacement of the superior vena cava with a custom-made pericardial graft: an experimental study.

Prosthetic replacement of the vena cava has been disappointing, mainly because of the hemodynamic characteristics of the venous system and the physical properties of the prostheses used. Spiral grafts constructed with autogenous saphenous vein have been the most successful prostheses to date, but their use is limited to replacement of short segments, and intraoperative construction is time consuming. The authors report their experience with a graft constructed of extra-thick bovine pericardium (PX) and surgical staples. Externally stented polytetrafluoroethylene (PTFE) was used as a control. The superior vena cava was replaced in 13 ewes; PTFE was used in 6 (group 1) and PX in 7 (group 2). Mean follow-up was 15 +/- 8 months for group 1 and 13 +/- 8 for group 2. Cumulative graft follow-up totalled 4612 graft-days. There was one graft occlusion in each group. Patency rates (80%) were similar for the two groups. Histologic changes in pericardial grafts were more marked but did not influence patency. This study reports the longest experimental follow-up (maximum 23 months) and graft patency to date for replacement of the superior vena cava. Both types of graft performed excellently.

Animals

Prospective evaluation of a totally implantable drug delivery system. Improved results at 4-year follow-up.

Totally implantable drug delivery systems have facilitated chemotherapy in cancer patients. The incidence of complications has been acceptable but not optimal. A series of 140 consecutive implants over a 4-year period is presented. The total follow-up was 41,185 days. Reversible obstruction was present in 12.8% of portals. The infection-erosion rate was 4.2%; only 6.3% of patients required removal of the system because of failure. In the last 111 patients only one device failed (0.9%). The reasons for these improved results are analysed, and recommendations are made to improve the current management of these devices.

Adult

Mediastinal packing for refractory nonsurgical bleeding after open-heart surgery.

Patients with infective endocarditis and disseminated intravascular coagulation may require emergency valve replacement because of acute hemodynamic decompensation. After cardiopulmonary bypass is discontinued, nonsurgical hemorrhage, refractory to conventional treatment, may occur. The author describes a technique of mediastinal packing for temporary control of bleeding until the coagulation disorder can be corrected. The pack can be removed transcutaneously without reoperation. This method should be used only when all other approaches have failed to achieve hemostasis.

Anticoagulants

Pulmonary embolectomy: a review.

Massive pulmonary embolism continues to be a major cause of death in spite of improved medical therapy. Only a small number of patients with pulmonary embolism refractory to medical treatment are referred for pulmonary embolectomy. A literature review of patients with massive pulmonary embolism treated by pulmonary embolectomy showed that the operation was highly successful in those who were unlikely to survive with other modes of therapy. Specific indications and management are outlined on the basis of these cumulative data.

Cardiopulmonary Bypass

Simplified insertion of the Port-A-Cath implantable drug-delivery system.

The increasing frequency with which antineoplastic drugs are being used demands improved vascular access for their administration. Venous access through implantable catheters facilitates treatment when veins are no longer available. Totally implantable catheters of the Port-A-Cath type are preferred because they give better performance and cosmetic results, and are more convenient for the patients. The flexibility of these catheters makes their introduction difficult. The author describes a simplified technique, using a commercially available introducer that has been used satisfactorily in thousands of pacemaker implantations. The author has used this technique routinely with a 50% decrease in operative and fluoroscopy time and without complications.

Antineoplastic Agents