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J S Raichlen

Publications and source records attributed to J S Raichlen.

21 records · Page 2Linked to original sources

Quantitative assessment of right and left ventricular growth in the human fetal heart: a pathoanatomic study.

We quantitated the growth patterns of the normal fetal heart and the right and left ventricles from postmortem hearts obtained from 55 spontaneously aborted human fetuses from the completion of cardiogenesis to term. Fetal gestational age was assessed by menstrual history of the mother, crown-rump length, head circumference, and body weight and ranged from 8 to 40 weeks. Each heart was perfused and fixed at constant pressure and dissected to obtain right and left ventricular free wall, left ventricular, and total heart weights. Right and left ventricular free wall thicknesses were measured and the respective surface areas were calculated. The changes in each of these parameters with gestational age were examined by regression analysis. Total heart and right and left ventricular wall weights increased linearly with body weight, but exponentially with head circumference, crown-rump length, and menstrual history. Right and left ventricular free wall weights were similar throughout gestation and the percent that each contributed to total heart weight were constant at 29 +/- 2% and 30 +/- 2%, respectively. Right and left ventricular wall thicknesses did not differ significantly, increasing linearly with menstrual age, crown-rump length, head circumference, and body weight from 8 to 40 weeks. The surface areas of the right and left ventricular free walls that we used as an index of changing ventricular architecture were indistinguishable throughout the period of gestation studied.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

The effect of the site of placement of temporary epicardial pacemakers on ventricular function in patients undergoing cardiac surgery.

Temporary epicardial pacing leads are routinely placed in patients after cardiac surgery, but the positioning of ventricular leads and the use of atrial leads is not uniform. We examined the effect of the epicardial pacing site on ventricular function in 18 patients undergoing coronary surgery. Pacing wires were sutured in the right atrium, left ventricular apex, right ventricular apex, and right ventricular outflow tract before cardiopulmonary bypass. After atrial pacing, eight patients were ventricularly paced (group I) and 10 were atrioventricular (AV) sequentially (PR = 0.12 sec) paced (group II) at 100/minute from the three ventricular sites. Comparison of the groups showed that the addition of atrial activation during ventricular pacing resulted in higher cardiac indexes (2.54 +/- 0.61 vs 1.67 +/- 0.45 liters/min/m2;p less than .00005), higher systolic blood pressures (121 +/- 24 vs 89 +/- 26 mm Hg; p = .006), lower central venous pressures (5.5 +/- 3.2 vs 10.2 +/- 2.2 mm Hg; p = .048), and similar pulmonary arterial pressures (19.5 +/- 7.6/10.8 +/- 6.7 vs 24.7 +/- 3.5/15.4 +/- 3.4 mm Hg; p = NS). Cardiac index did not differ among group I patients during pacing from the different ventricular sites. In group II, cardiac index during pacing from the right ventricular apex was higher than during pacing from the right ventricular outflow tract or the left ventricular apex (2.62 +/- 0.57 vs 2.49 +/- 0.54 and 2.51 +/- 0.76 liters/min/m2, respectively; p = .03). Right ventricular outflow tract pacing resulted in higher cardiac indexes than left ventricular apical pacing in patients with stenosis of the left anterior descending coronary artery of 90% or more, while left ventricular apical pacing produced higher cardiac indexes in the absence of such lesions (p = .006).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗