Search PubMed⌕ Search

Biomedical subjects

L L Bailey

Publications and source records attributed to L L Bailey.

At least 127 records · Page 7Linked to original sources
PubMed1980

Septal wall motion. Its significance on outcome of left ventricular scar resection.

To assess the importance of septal wall motion on patient outcome after resection of large akinetic and dyskinetic segments of left ventricle, the records of 70 patients undergoing left ventricular scar excision alone or in combination with myocardial revascularization procedures between January 1970 and January 1977 were reviewed. Patients requiring simultaneous prosthetic valve replacement were excluded. Preoperative left anterior oblique ventriculograms categorized this series of patients into two distinct groups, group A (36 patients) having normal septal wall motion and group B (34 patients) having akinetic or dyskinetic septal walls. Indications for operation and preoperative ejection fractions were similar in both groups. Analysis of these patients subjected to surgery with and without preoperative evidence of septal wall motion demonstrated no significant difference in either functional clinical capacity or in mortality. Mortality for both groups was 11%. Absence of ventricular septal wall motion has no significant effect on outcome of left ventricular scar resection and should not be used as a contraindication to surgery.

Angina Pectoris↗
PubMed1978

Interrupted aortic arch complex: successful total correction in the neonate.

Two neonates subjected to definitive repair of interrupted aortic arch complex during the first week of life are presented. Results correlated well with preoperative status. Our definition of complete correction, including direct aortic anastomosis, is discussed along with the surgical strategy employed for successful repair of this otherwise dismal anomaly.

Aorta, Thoracic↗
PubMed1978

Corrected transposition. Another approach for repair of associated intracardiac malformations.

A variety of surgical approaches have been used for repair of cardiac lesions associated with corrected transposition of the great vessels. These techniques have met with variable success and generally high surgical mortality rates. In an effort to simplify the surgical approach to repair of ventricular septal defect and replacement of left atrioventricular valve in a 4-year-old youngster, we chose to correct the defects through a left posterolateral thoracotomy and through the left atrium utilizing profound hypothermia and circulatory arrest. Ease of intracardiac assessment and repair and postoperative results to date have been most gratifying.

Child, Preschool↗
PubMed1977

Cervico-mediastinal thymic cyst with vocal cord paralysis.

An unusual case of congenital cervico-mediastinal thymic cyst with vocal cord paralysis is presented together with a brief history and classification of these cysts. A discussion of thymic cyst symptomatology and the surgical approach to these lesions is included. Simple thymic cysts should be considered in the differential diagnosis of cervico-mediastinal masses, particularly in children and young adults.

Adult↗
PubMed1976

Nonoperative management of late failure of a Glenn anastomosis. Transvenous wafer occlusion of patent superior vena cava--right atrial junction.

A case is presented illustrating delayed failure of a right Glenn anastomosis due to patency of the superior vena cava-right atrial (SVC-RA) junction. Clinical deterioration was rectified by a unique nonoperative approach. A transvenous catheter was designed, constructed, and used to accurately place an umbrella-like occlusive wafer at the SVC-RA junction. In this manner the integrity of the cavopulmonary shunt was re-established. A gratifying and uncomplicated palliation has thus far been achieved.

Cardiac Catheterization↗
PubMed1976

Surgical management of congenital cardiovascular anomalies with the use of profound hypothermia and circulatory arrest. Analysis of 180 consecutive cases.

An initial series of 180 patients subjected to definitive repair of cardiac malformations during infancy is presented. The operations were performed with profound hypothermia and circulatory stasis. Statistics relating to the entire series of patients are presented and discussed, after which the results among eleven individual groups of patients categorized by type of cardiovascular lesion are analyzed. There was 113 survivors, representing an over-all mortality rate of 37 per cent. The mortality rate was highest among patients severely ill preoperatively and among those with complex malformations. Deaths were also more frequent among infants under 6 months of age and less than 5 kilograms in weight. Analysis shows a steady increase in percentage of patient survival over the years reported from December, 1967, to April, 1975.

Heart Arrest, Induced↗
PubMed1976

Use of balloon-tipped vena caval cannulas during open cardiac surgery.

Experience over the past twelve months with the use of balloon-tipped vena caval cannulas for central cannulation during cardiopulmonary bypass is reported. Based on this experience, we fell that such cannulas should become useful to the cardiac surgeon, particularly for complex reoperation.

Cardiac Catheterization↗
PubMedDate not supplied

Survival following orthotopic cardiac xenotransplantation between juvenile baboon recipients and concordant and discordant donor species: foundation for clinical trials.

It has been more than a decade since the last clinical trial of cardiac xenotransplantation in a newborn infant. Since that event, laboratory research at Loma Linda University has focused on survival studies of orthotopically xenografted juvenile baboon recipients. Both concordant and discordant donor species have been used. Transgenic donors have not been explored at Loma Linda. Instead, simplified host immunoregulative protocols, consistent with those used in neonatal cardiac allografting, have been adapted to xenotransplant research. Xenograft bridge to alloengraftment was evaluated in a series of five juvenile baboon recipients. Heterotopically implanted cardiac xenografts stimulated host production of xenoreactive antibody. Orthotopic cardiac allografting was then carried out. Xenoantibody appeared to play little role in immediate or chronic survival of experimental hosts. A clinical protocol of xenobridging to allotransplantation would likely succeed. Two consecutive series of orthotopically xenotransplanted hosts using rhesus monkey cardiac donors demonstrated unprecedented long-term survival. Splenectomy combined with maintenance therapy consisting of FK-506 and methotrexate contributed to survival of up to 502 days in one series of xenografted baboon hosts selected for ABO blood grouping, mixed lymphocyte culture, and crossmatch compatibility. Survival beyond a year (maximum 515 days) among three consecutive juvenile baboon recipients of orthotopically implanted rhesus monkey hearts, in which splenectomy was omitted and cyclosporine was substituted for FK-506, represents a benchmark achievement. Commencing maintenance immunosuppression several weeks prior to transplantation appeared to improve chronic survival significantly. Investigation of discordant (pig-to-baboon) host survival has focused on adsorption of naturally occurring xenoreactive antibody at the time of transplantation. This strategy, combined with pretransplant total lymphoid irradiation and both pre- and posttransplant immunosuppression, succeeded in preventing hyperacute rejection and resulted in survival of up to 24 days, thereby permitting observation of the delayed xenograft rejection phase. Data support consideration of additional clinical trials of concordant neonatal cardiac xenotransplantation and offer promise for the development of discordant xenotransplantation as an ultimate therapeutic resource.

Animals↗
PubMedDate not supplied

Right ventricular outflow tract reconstruction using a Goretex membrane monocusp valve in infant animals.

We examined the feasibility of using a polytetrafluoroethylene membrane (goretex) valve and transannular patch (TAP) for right ventricular outflow tract (RVOT) reconstruction in growing animal models. Eleven infant goats (Group A) and 12 infant sheep (Group B) underwent RVOT reconstruction under cardiopulmonary bypass. In Group A, a monocusp valve was constructed of goretex, and the RVOT was roofed over utilizing a TAP of bovine pericardium. In Group B, both a monocusp valve and a TAP were constructed of goretex. Animals were sacrificed at 6 or 12 postoperative months. Two goats in Group A died at 9 days and 4 months postoperatively due to RVOT obstruction caused by thrombus formation. Seven goats in Group A and 11 in Group B showed no pressure gradient across the valve. All animals in Group B revealed mild to moderate valvular insufficiency, but no ventricular deterioration. In contrast to the bovine pericardium, which showed a prominent fibroinflammatory reaction with calcified areas causing TAP shrinkage and RVOT stenosis, there was minimal calcification and inflammatory reaction directed against the goretex valve and TAP. We conclude that goretex can be used as a material from which to create both a monocusp valve and TAP for long-term RVOT reconstruction.

Animals↗
PubMedDate not supplied

Emergency implantation of a left ventricular assist device in adolescents with biventricular failure.

Adolescents with congestive cardiomyopathy who present with intractable arrhythmia or progressive ventricular failure have a very poor prognosis and often die awaiting cardiac transplantation (CTx). We present our recent experience with a pneumatically powered left ventricular assist device (LVAD) implanted emergently to salvage adolescents with severe biventricular failure. Four patients, aged 15-17 years, body surface areas of 1.5-1.7 m2, with dilated cardiomyopathy (LV diastolic dimension, 7.1-8.3 cm); two presented with cardiovascular collapse, one with refractory ventricular tachycardia, and one with cardiac arrest. Hemodynamic and biochemical data before and 1 week after LVAD placement are expressed as mean and range values. None of the patients required right ventricular assist, and all patients achieved functional recovery while on LVAD support (8-71 days). Currently, all four patients are alive (11-22 months) after successful CTx. We conclude that emergency implantation of an LVAD in adolescents with biventricular heart failure can be life saving. As has been shown in the adult population, such a ventricular assist system restores normal circulatory hemodynamics, reverses multi-organ dysfunction, and provides a "safe" bridge to transplantation.

Adolescent↗
PubMedDate not supplied

Laser adapter for tracheoscopy.

This adapter makes it possible for the operating microscope to be used monocularly, to see axially down the CO2 laser beam, to use the aiming light and its joy stick control. This makes the laser useful for upper tracheal lesions through a tracheoscope.

Endoscopes↗