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Biomedical subjects

H Najafi

Publications and source records attributed to H Najafi.

135 records · Page 8Linked to original sources
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Subendocardial myocardial necrosis: a preventable lesion.

Left ventricular subendocardial hemorrhagic necrosis, a lesion entirely different from conventional myocardial infarction, has been an important cause of serious morbidity and mortality in open heart surgery, particularly aortic valve replacement. An established experimental model in which this lesion could be consistently produced in calves, was utilized to examine the protective role of hypothermia and/or Solumedrol infusion. Solumedrol infusion and systemic hypothermia were not sufficiently effective in protecting the myocardium against 40 minutes of left coronary artery occlusion during total cardiopulmonary bypass. Profound continuous irrigation of the pericardial cavity with 4 degrees centigrade Ringers lactate solution, with or without Solumedrol infusion, under similar circumstances yielded excellent results, both in terms of myocardial performance and preservation. This experiment has encouraged the clinical use of this technique in our institution.

Animals↗
PubMedDate not supplied

Atrial septal defect: repair in patients over thirty-five years of age.

Fifty-eight patients over age 35 underwent repair of atrial septal defect. The operative mortality was zero for the seven N.Y.H.A. class I and 26 N.Y.H.A. class II patients. One of 16 class III patients and two of nine class IV patients died; consequently, overall hospital mortality was five percent. The operative mortality was not related to age or level of pulmonary hypertension. Long-term clinical improvement was documented in 75 percent of patients who had been symptomatic preoperatively. The suggestion in early reports that pulmonary hypertension, or age per se, many contraindicate repair of an ASD cannot be supported by our results.

Adult↗
PubMedDate not supplied

Superiority of aortic over femoral cannulation for cardiopulmonary bypass, with specific attention to lower extremity neuropathy.

The advantage of aortic cannulation over femoral cannulation in cardiopulmonary bypass has been well established in our experience. Over a four year period, we compared the incidence of complications of these two modalities in a large group of patients. Specific emphasis is placed on the lack of lower extremity neurological deficit and retrograde dissection in patients who underwent aortic cannulation.

Adult↗
PubMedDate not supplied

Reflections in a normal eye: the effect of aortic stenosis on oculopneumoplethysmography.

The association of aortic stenosis and syncope is well recognized. Oculopneumoplethysmography (OPG) can provide an accurate index of carotid stenosis and indirectly measure cerebral perfusion. The possibility that OPG would be influenced by aortic valve disease was assessed in patients prior to valve replacement. 31 patients were studied. 19 patients had aortic stenosis (AS), 3 had aortic insufficiency (AI), and 10 had mixed lesions. OPG was positive in 15 patients (48%). Considering all forms of aortic valve disease, the likelihood that a positive OPG was indicative of AS with a gradient of greater than 60 mmHg was significant (P = .002). Of 18 patients with AS alone, no patient with a valve gradient greater than 60 mmHg had a negative OPG (P = .0001). OPG became normal in 11 of 12 patients restudied postoperatively. Critical aortic stenosis results in uneven distribution of blood flow into the brachiocephalic vessels. OPG accurately identifies this effect which becomes evident at aortic valve gradients greater than 60 mmHg.

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