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Biomedical subjects

R D Fisher

Publications and source records attributed to R D Fisher.

At least 37 records · Page 2Linked to original sources
PubMed1975

Unstable coronary artery disease: comparison of medical and surgical treatment.

In eighty-eight patients with arteriographic findings of obstructive coronary artery disease and the clinical picture of unstable angina pectoris, a decision on operative or nonoperative management was made by the attending physician. Fifty-three of them subsequently underwent aortocoronary saphenous vein bypass grafting and 35 were continued on a program of medical therapy. A marked difference in the course after the first 30 days was noted, with most of the surgically managed patients being either asymptomatic or greatly improved following coronary artery bypass. Two-thirds of the medically treated patients had persistent severe angina pectoris and non was asymptomatic in a follow-up period averaging 20 months. There were 2 late deaths in the medical group and none in the surgical group. These findings indicate that coronary artery bypass operations can be performed with low risk during the unstable phase of coronary artery disease and that relief of angina can be anticipated. In contrast, nonoperative management of unstable coronary artery disease carries an appreciable risk of death or myocardial infarction, and the majority of patients treated nonoperatively continue to experience angina.

Adult↗
PubMed1975

Effect of blood flow rate on subendothelial proliferation in venous autografts used as arterial substitutes.

The effect of augmented and reduced blood flow rates through autogenous vein grafts (AVG) on the histological characteristics of veins used for arterial substitutes was studied in 22 dogs. In each animal autogenous jugular veins were implanted as conduits to replace excised segments of both iliac arteries. In one group (control) blood flow through the AVG conduits was not modified, but in the remaining animals blood flow rate was either augmented by a distal femoral arteriovenous fistula or reduced by a distal arterial stenosis. In the control group in which there was no modification of blood flow, subendothelial proliferative lesions (SEPL) were found in the vein graft, and typical SEPL were found at each anastomosis. However, in those animals in which blood flow was reduced by an average of 44% through the graft, SEPL were more numerous throughout the length of the vein graft, and the anastomotic SEPL were more prominent. In contrast, those animals in which a unilateral distal arteriovenous fistula augmented blood flow through the AVG (average 6.7-fold increase), no SEPL were detected along the length of the graft. Although SEPL were present at the suture lines, the lesions were much less prominent. These findings suggest that the magnitude and distribution of SEPL in AVG are determined, in part, by the rate of blood flow through the graft.

Animals↗
PubMed1975

Traumatic pericardial hematoma simulating tricuspid valve obstruction.

A large pericardial hematoma caused profound hypoxia, cyanosis, and hypotension in a patient who had sustained trauma in an automobile accident. Angiographic and cardiac catheterization findings suggested intracardiac obstruction at the level of the tricuspid valve. This case emphasizes that localized accumulations of blood or fluid within the pericardial space can simulate intracardiac masses or valve obstruction. Partial pericardiectomy was curative in this patient.

Accidents, Traffic↗
PubMed1975

Complete atrioventricular canal associated with tetralogy of Fallot: clinical experience and operative methods.

Data on 8 children with the combined anomalies of complete atrioventricular canal and tetralogy of Fallot are presented. Six of the children had only a palliative procedure, and only 1 of these patients is doing relatively well at the present time from a clinical standpoint. Two of the remaining 5 children undergoing palliative procedures have not been helped significantly, and 3 of the children in this group subsequently died. Two children have had an attempted total correction of this complicated intracardiac problem. One of these children, in whom the diagnosis of atrioventricular canal was not made preoperatively, died in the early postoperative period. In the other child, the correct diagnosis was made preoperatively, and a satisfactory, totally corrective procedure was achieved. The patient is asymptomatic at this time.

Adolescent↗