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Biomedical subjects

H E Garrett

Publications and source records attributed to H E Garrett.

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

In vitro observations of greater saphenous vein valves during pulsatile and nonpulsatile flow and following lysis.

A significant number of saphenous vein femoral-popliteal bypass graft failures have been attributed to flow abnormalities caused by venous valves. Seventy-seven greater saphenous vein valves were observed and photographed through a 0-degree choledochoscope during pulsatile and nonpulsatile flow. No valve was seen to lie flat against the vein wall. With pulsatile flow the valves were noted to close during diastole. Stasis was noted within the valve cusps. Twenty-three valves produced photographs of sufficient quality to allow measurement of the luminal obstruction caused by the valves. This valvular obstruction represented 61% +/- 12% of the total vein lumen. Fifty venous valves were lysed by five different techniques: the microscissors, the Connolly vein stripper, the Mills valvulotome, the venotomy valvulectomy of Hall, and eversion valvulectomy. The first three methods created valvular incompetence, but flaps of valve cusps were observed to disturb flow and place potentially thrombogenic surfaces within the vein lumen. Valvulectomy, whether by venotomy or eversion, removed the valve cusps satisfactorily.

Blood Vessel Prosthesis↗
PubMed1983

Coronary artery bypass grafts. Success after selective intracoronary thrombolysis in acute myocardial infarction.

Thirteen of 19 patients undergoing streptokinase infusion within five hours after acute myocardial infarction were deemed satisfactory candidates for bypass surgery. In all cases, operation was performed within less than a week, with no demonstrable ill effects from the enzyme. There was only one pulmonary-related death and only two patients in whom the results have been less than satisfactory. Eleven patients have markedly benefited from the combination of procedures, demonstrating excellent functional myocardial preservation. Radioisotope myocardial scan, exercise ECG, and repeat cardiac catheterizations have been used to assess myocardial status.

Adult↗
PubMed1983

Arteriographic measurement of the abdominal aorta, iliac, and femoral arteries in women with atherosclerotic occlusive disease.

Arteriographic measurements were made in 73 consecutive women undergoing arterial reconstruction for aorto-iliac occlusive disease. The anatomical distribution of atherosclerosis was unaffected by arterial size. Women with isolated aorto-iliac atherosclerosis had the same size arteries as those with concomitant outflow disease. Aortic, iliac, and femoral artery diameters were distributed as a single group, with no distinct subgroup of "small arteries." However, women whose aorta was less than 1 S.D. below the mean were younger and had less cardiovascular disease even when the effects of age and body size on arterial diameter were excluded. Women with this statistical definition of "small aorta" were clinically analogous to those previously identified anecdotally. The authors propose that a "small aorta" in a women with aorto-iliac atherosclerosis be defined as less than 19 mm in diameter above and less than 13 mm below the renal arteries and less than 10 mm at the bifurcation.

Adult↗
PubMed1983

Coronary artery bypass surgery in the septuagenarian.

Analyzed during a 3-year period were 86 patients from 70 to 80 years of age who underwent coronary artery bypass grafting without other cardiac procedures. The series included 57 men (66%) and 29 women (34%). The average follow-up period was 27 months. The early mortality rate for the men was 5.2%, and the overall mortality was 8.7%. This compared with an age-adjusted nationally expected death rate of 12.1% for this age group during this period of time. The early mortality rate for the women was 6.9%, with an overall mortality rate of 13.9%. This compared with an 8.7% age-adjusted nationally expected death rate. Factors which did not affect mortality in this particular series included smoking, hypertension, diabetes, and ejection fraction. Factors which did affect mortality included peripheral vascular disease (29% mortality), and postoperative complications (38% mortality). Of the 86 patients operated on from 1978 through 1980, ages 70 to 80, 88% are alive (76 of 86 patients). Of the patients living, 60.5% have no chest pain, and 26.3% describe their chest pain as significantly improved. When medical treatment alone fails, coronary artery bypass grafting is possible in the older age group to relieve disabling angina and improve the quality of life, with very acceptable mortality rates.

Journal Article↗
PubMed1981

Emergency coronary revascularization in the early postoperative coronary artery bypass patient.

A patient underwent myocardial revascularization for acute ischemia following early postoperative graft closure and ventricular fibrillation. Extensive myocardial infarction was prevented by electrocardiographic and enzyme criteria. The time lapse between onset of the ischemic episode and revascularization is critical. Our knowledge of the patient's coronary anatomy obviated the need for angiography; the graft occlusion was diagnosed by electrocardiogram.

Adult↗
PubMed1980

Aortoiliac occlusive disease in women.

Seventy-five women with aortoiliac (A-I) occlusive disease requiring vascular reconstruction during the past 4 years were reviewed. They represented a growing proportion (39%) of all patients with A-I disease And presented at the same meAn age (57 years) as males. Standard cardiovascular risk factors were high in this group and cigarette smoking was especially predominate (93%). Women presented with elevated triglyceride levels as opposed to increased cholesterol, with frequent type IV hyperlipoproteinemia. An operative mortality rate of 0%, a 4-year graft limb patency of 94%, and a 4-year life-table survival of 93% were observed. Good or excellent long-term relief of symptoms occurred in 96% of patients despite tandem ((superficial femoral) disease in 42% but only 4% superficial femoral reconstruction. A definition of women with "small vessels" was established by using aortic diameter > 1 SD below the overall mean (> 1 cm diameter at the aortic bifurcation). Women in this subgroup presented at a younger age with less severe symptoms, fewer risk factors, and more localized disease. An emphasis on postoperative reduction of cigarette smoking and dietary modification among hyperlipidemic patients probably contributed to the satisfactory results achieved in this increasing percentage of women with A-I occlusive disease.

Adult↗
PubMed1976

Report of the Inter-Society Commission for Heart Disease Resources. Optimal resources for vascular surgery--a supplement.

This supplement is an updated and expanded planning and optimal resource guideline for vascular surgery. Activities relating to examination and certification in vascular surgery are reviewed and hospital resource requirements are identified for different categories of vascular operations. There is a detailed summary of results of common vascular operations as reported by leading vascular surgeons. The statement will be of value in planning and organizing vascular surgery programs and in assessing the results of vascular operations locally.

Aorta, Abdominal↗