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Biomedical subjects

M G Warner

Publications and source records attributed to M G Warner.

6 recordsLinked to original sources
PubMed1995

Major determinants of survival and nonsurvival of intraaortic balloon pumping.

The purpose of this study was to find the major determinants of survival and nonsurvival after intraaortic balloon pump (IABP) support. One hundred twenty-nine consecutive patients with IABP support from January 1988 to January 1992 were analyzed retrospectively. Differences between the survival and nonsurvival groups were tested with the Student's t test, chi-squared test, and frequency analysis. The overall survival rate was 50.4% (65 of 129). Nonsurvivors (64 of 129, 49.6%) had higher rates of chronic heart failure (21.9% vs 9.2%, p < 0.05), acute myocardial infarction (53.1% vs 24.6%, p < 0.01), cardiomyopathy (9.4% vs 1.5%, p < 0.05), New York Heart Association functional class IV (51.6% vs 13.9%, p < 0.01), and depressed left ventricular ejection fraction (29.38% +/- 8.99% vs 42.88% +/- 5.24%, mean +/- SD, p < 0.01). The nonsurvival group also had longer duration of cardiopulmonary bypass (115.80 +/- 24.43 vs 78.34 +/- 3.81 min, mean +/- SEM, p < 0.02) and aortic occlusion (57.55 +/- 13.03 vs 41.00 +/- 2.79 min, mean +/- SEM, p < 0.05) than the survival group. The major determinants of death after IABP are acute myocardial infarction, left ventricular ejection fraction < 30%, New York Heart Association functional class IV, and longer duration of cardiopulmonary bypass and aortic occlusion. IABP is effective in sustaining hemodynamics, but severe myocardial pump failure portends a poor treatment outcome.

Adolescent↗
PubMed1988

Symptomatic sinus node dysfunction after heart transplantation.

When donor hearts are studied systematically after transplantation, by programmed electrical stimulation, sinus node dysfunction has been found to be common though data regarding symptoms related to this phenomenon are not available. In this case report we describe a heart transplant recipient who experienced serious symptomatic sinus node dysfunction associated with transient atrial fibrillation 17 days after cardiac transplantation; there was no evidence of donor heart rejection. Intracardiac electrophysiology testing confirmed sinus node dysfunction of the donor heart, but only with relatively rapid atrial pacing rates.

Adult↗
PubMed1987

Postoperative complications necessitating right lower lobectomy in a heart-lung transplant recipient with previous sternotomy.

Heart-lung transplantation for treatment of end-stage cardiopulmonary disease continues to be plagued by many problems. Three primary ones are the technical difficulties that can be encountered, particularly in those patients who have undergone previous cardiac operations, the additional restriction on donor availability imposed by the lack of satisfactory preservation techniques, and the need for lung size compatibility. Two of these difficulties and others surfaced postoperatively in a heart-lung transplant recipient who presented a series of unique operative and therapeutic challenges. A 42-year-old woman with chronic pulmonary hypertension and previous atrial septal defect repair underwent a heart-lung transplantation in August 1985. The operative procedure was expectedly complicated by bleeding from extensive mediastinal adhesions from the previous sternotomy and bronchial collateralization. Excessive chest tube drainage postoperatively necessitated reoperation to control bleeding from a right bronchial artery tributary. Phrenic nerve paresis, hepatomegaly, and marked abdominal distention caused persistent atelectasis and eventual right lower lobe collapse. Arteriovenous shunting and low oxygen saturation necessitated right lower lobectomy 15 days after transplantation, believed to be the first use of this procedure in a heart-lung graft recipient. Although oxygenation improved dramatically, continued ventilatory support led to tracheostomy. An intensive, psychologically oriented physical therapy program was initiated to access and retrain intercostal and accessory muscles. The tracheostomy cannula was removed after 43 days and gradual weaning from supplemental oxygen was accomplished. During this protracted recovery period, an episode of rejection was also encountered and successfully managed with steroid therapy. The patient continued to progress satisfactorily and was discharged 83 days after transplantation. She is well and active 20 months after discharge.

Adult↗
PubMedDate not supplied

The evaluation of the abdominal aorta: a "how-to" for cardiac sonographers.

A thorough evaluation of the abdominal aorta can be readily achieved by use of the standard views of the echocardiographic examination. The ultrasound evaluation of the abdominal aorta represents a logical extension of the standard echocardiographic examination of the adult patient. This article provides the information needed to carry out a complete ultrasound examination of the abdominal aorta including the anatomy, the vascular disease, and the steps involved in accomplishing the ultrasound examination of the abdominal aorta.

Aortic Dissection↗
PubMedDate not supplied

The JH/LVOH method in the quantification of aortic regurgitation: how the cardiac sonographer may avoid an important potential pitfall.

Color flow Doppler allows for methods in which to quantitate the severity of valvular regurgitation. In particular, the regurgitant jet height/left ventricular outflow tract height (JH/LVOH) method of quantitating the severity of aortic regurgitation has been validated and is routinely used in the adult echocardiography laboratory. A potential pitfall exists in the measurement of the LVOH. This article points out this potential source of error and, in addition, proposes steps that may be taken by the cardiac sonographer to avoid this potential measurement pitfall.

Aorta↗