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Biomedical subjects

N A Stolf

Publications and source records attributed to N A Stolf.

At least 109 records · Page 6Linked to original sources
PubMed1983

Surgical treatment of ruptured aneurysms of the innominate artery.

The cases of 3 patients with an aneurysm of the innominate artery treated surgically are reported. The clinical manifestations were different, and the surgical procedures employed also varied. In 1 patient, the neck of the aneurysm was isolated and clamped near the aortic arch. It was closed, and a graft was interposed between the ascending aorta and the right carotid and subclavian arteries. In the second, the aneurysm was resected under cardiopulmonary bypass, deep hypothermia, and total circulatory arrest. The neck was closed with a large Teflon patch, and a tube graft was interposed between the ascending aorta and the right carotid artery. In the third, a graft was interposed between both carotid arteries; conventional cardiopulmonary bypass was instituted, and the aorta was clamped between the innominate and the left carotid arteries. The neck of the aneurysm was closed, and a graft was interposed between the ascending aorta and the right carotid and subclavian arteries. All patients had an excellent postoperative course. Our comments regarding the clinical and surgical aspects of this condition are based on the present experience and reports in the literature.

Aged↗
PubMed1983

Morphological alterations in dura mater encephali used as ventricular wall grafts in the canine heart.

Structural changes within homologous dura mater patch-grafts surgically implanted in the right ventricular wall of the heart were studied in nine adult dogs utilizing light microscopy and transmission and scanning electron microscopy. Physical examination of the dogs after surgery presented no clinical signs of abnormalities caused by either the surgery or the nature of the graft. After one week of implantation, a fibrous organization extending from the wound margins over the entire graft greatly increased its thickness. In addition, it was observed that (1) an increase in cellularity, vascularity and connective tissue elements occurred on the external surface of the patch-graft, (2) these same changes occurred regardless of which surface (periosteal or arachnoidal) was used as the external or pericardial surface, (3) the graft core underwent a transition from a relatively acellular and avascular connective tissue structure into one that was heavily infiltrated by a variety of cellular elements and new blood vessels, and (4) these morphological changes were interpreted as an attempt to incorporate the graft into the host tissue, resulting in an increase in both viability and stability of the graft. These findings indicate that homologous dura mater is a suitable material for use in the surgical repair of the cardiac wall.

Animals↗
PubMed1983

Study of the periosteal and arachnoidal aspects of dura mater implanted surgically in the ventricular wall of the canine heart.

After surgical removal of a portion of the cardiac wall, homologous dura mater cardiac grafts were sutured to the margins of the incision in the sternocostal wall of the right ventricle of the canine heart and recovered after 1, 4, 6 and 8 weeks of implantation. Representative tissue specimens were processed for and studied by means of SEM and TEM. The primary objectives were to study morphological changes in the dura mater grafts used to repair the lesions or defects in the cardiac wall and to compare alterations in the periosteal and arachnoidal aspects of the dura mater grafts after being implanted for varying periods of time. After one week of implantation, an amorphous layer of fibrin was deposited on or near the luminal surface of the original dura mater grafts. At four weeks of grafts implantation, a 'remodeling' process was apparent below the luminal surface of the graft. Although a large accumulation of fibrin was still present at this time, there was also an increase in the number of cellular and fibrillar components within the implant. Large numbers of macrophages and active fibroblasts were visible at this time along with new collagen. At the sixth week of implantation, an abundance of active fibroblasts, the presence of normal collagen and a darkly staining material interpreted as recently synthesized connective tissue components, fibrin deposits and/or degenerating collagen were also observed. Phagocytosis of the remaining fibrin was noted during this period indicating a continuation of the remodeling process at the luminal surface. Finally, after eight weeks of implantation, it was revealed that the original densely woven and relatively acellular graft had become infiltrated with various blood cells and vascular channels.

Animals↗