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Biomedical subjects

C E Kinley

Publications and source records attributed to C E Kinley.

At least 37 records · Page 2Linked to original sources
PubMed1984

Staple closure of the left atrial appendage.

Closure of the fibrillating left atrial appendage has been recommended during mitral valve repair or replacement to prevent systemic emboli postoperatively. Closure of the left atrial appendage has been accomplished in the past by direct intra-atrial suture or by external ligation. The authors have used the TA-55 automatic stapler in 40 patients to close the left atrial appendage during mitral valve surgery. In all patients the closure was effected successfully at the first attempt without complication.

Atrial Fibrillation↗
PubMed1983

Spiral vein graft for obstruction of the superior vena cava: a case report.

Catheter-induced superior vena caval thrombosis is a rare complication of the placement of transvenous pacemakers. The authors report such a case in a 44-year-old man. A composite spiral graft of saphenous vein was used to bypass the obstruction. It was anastomosed end to side to the innominate vein and then to the right atrial appendage. The patient improved remarkably immediately after the operation and had an uncomplicated postoperative course. The authors discuss the surgical technique involved and recommend for this rare condition an initial trial of anticoagulant therapy followed by bypass grafting, using the technique they describe, if anticoagulation fails.

Adult↗
PubMed1980

Hypertension following myocardial revascularization: its prevalence and etiology.

Of 11 patients who underwent elective aortocoronary bypass operation using nonpulsatile flow with moderate hypothermia (28 degrees C), 8 had hypertension defined as blood pressure of 160/100 mm Hg or greater. The plasma renin level was not elevated during bypass by postoperatively in the intensive care unit it became significant (P < 0.05) elevated. An increase in the release of renin was associated with a rise in systemic vascular resistance and coincided with the onset of hypertension. Although the values of plasma catecholamines were elevated during bypass and in the intensive care unit, they did not appear to contribute appreciably to increases in systemic resistance. The authors conclude that an increase in the release of renin is associated with increased vascular resistance and elevated blood pressure following myocardial revascularization.

Adult↗
PubMed1980

Does vascular steal occur following femorofemoral bypass grafting?

Vascular steal has been reported following aortoiliac and crossover femoral vascular reconstruction. Although the steal phenomenon has been described in clinical situations some have denied its existence. The authors attempted to determine whether or not vascular steal occurs after femorofemoral bypass operation. Fifteen adult mongrel dogs underwent femorofemoral bypass grafting. Stenosis of the iliac artery was simulated with a specially designed device. Blood flow was measured with the femoral graft open and closed in combination with superficial femoral and deep femoral artery obstruction in the donor and recipient circulations. There was no statistically significant decrease in flow to the donor leg in any situation. Thus the authors conclude that vascular steal does not occur following femorofemoral bypass operation.

Animals↗
PubMed1979

Inline blood gas analysis by gas chromatography in patients during and after coronary artery surgery.

A system was evaluated of measuring Pao2 and Pao2 by an inline sensor in the brachial artery and gas chromatography. Eight patients having coronary artery vein grafts were studied during anaesthesia, operation, perfusion and for 24 hours afterward. Compared to conventional blood gas analysis by polarography (electrodes), the chromatographic method gave readings for Pao2 which were not significantly different during normothermia. During hypothermic perfusion, the chromatographic system read significantly higher than the bench electrode, due at least in part to a difference in temperature correction. For Pao2 the correlation between the two methods was close and differences were clinically insignificant. The Sentorr blood-gas analyser provides a sensitive, accurate indicator of changes in oxygenation, ventilation and circulation during anaesthesia and in the intensive care unit.

Anesthesia, Inhalation↗
PubMed1979

Does pulsatile flow influence the incidence of postoperative hypertension?

Twenty patients undergoing primary elective aorta--coronary artery bypass were divided into two equal groups, both receiving identical premedication, anesthetic, and pump primes. The control patients received hypothermic nonpulsatile flow and the study patients received hypothermic pulsatile flow. Hypertension, defined as a pressure of 160/100 mm Hg or higher, was observed in 80% of the control patients and 20% of the patients receiving pulsatile flow (p less than 0.05). Serial renin measurements demonstrated maximum values in the intensive care unit and coincided with the onset of postoperative hypertension in the control patients. Those patients who had received pulsatile flow did not demonstrate notable renin stimulation. Catecholamines were markedly elevated during bypass and in the intensive care unit, but there was no significant difference between the two groups. Peripheral vascular resistance was not significantly lower with pulsatile flow, except in the first study performed in the intensive care unit. We conclude that catecholamines and the renin-angiotensin system contribute to the production of postoperative hypertension and that pulsatile flow diminishes renin stimulation. Pulsatile flow results in a decreased incidence of postoperative hypertension.

Cardiopulmonary Bypass↗
PubMed1979

Aortocoronary bypass for critical stenosis of the left main coronary artery.

Over a 2-year period 33 patients with symptomatic stenosis (greater than 75%) of the left main coronary artery underwent aortocoronary bypass. Intra-aortic balloon counterpulsation was used preoperatively in only two patients as a therapeutic measure for medically unstable angina. There were no operative deaths. Follow-up study 3 to 27 months (mean 13.3 months) after operation revealed one death. Twenty-two patients were free of pain. The authors conclude that aortocoronary bypass surgery for severe stenosis of the left main coronary artery can be safely accomplished, without prophylactic use of intra-aortic balloon counterpulsation in the majority of cases, with an acceptable operative mortality and morbidity.

Adult↗
PubMed1975

Correlation between hemodynamic changes and the presence, size, and site of myocardial infarction.

Values for eight measured and calculated hemodynamic variables were recorded in 12 dogs before and after experimental anterior myocardial infarction. Changes were noted in stroke work and stroke power only; the changes in stroke work and stroke power were closely correlated with the presence of the infarct, whereas the changes in the other six dynamic variables were unpredictable and uncorrelated. The degree of correlation between the stroke work and power, and the size and site of the infarction, however, suggested that none of the eight variables would be an adequate indicator of all three characteristics of the infarction.

Animals↗