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Biomedical subjects

R O Heimbecker

Publications and source records attributed to R O Heimbecker.

At least 37 records · Page 2Linked to original sources
PubMed1980

Persistent sciatic artery: a case report.

A persistent sciatic artery was an incidental finding in a 29-year-old man who was being investigated for severe varicose veins and venous ulceration. The authors review the embryology and literature pertaining to persistent sciatic artery. Because it has a propensity for aneurysm formation and thrombosis they recommend that elective surgery be considered for this condition. In young asymptomatic patients the condition of the anomalous artery should be monitored by ultrasonography until operative intervention is indicated. The operative procedure should consist of occlusion with a balloon catheter or ligation of the persistent artery following by femoropopliteal bypass.

Adult↗
PubMed1979

Influence of alternate sources of bllod flow on the reactive hyperemia response in aorta-coronary saphenous vein bypass grafts in man.

Reactive hyperemia responses (RHR) of various magnitudes were obtained after release of a brief occlusion in six of 10 coronary bypass grafts. All of the vein grafts responded to an injection of sodium nitroprusside (50 microgram) directly into the open graft with an increase in blood flow that was always greater than the flow recorded after release of the occlusion. This response indicates that there were no flow-limiting stenoses and that the distal vascular beds were responsive to vasodilator stimuli. RHR's, expressed as percent repayment of calculated flow debt, were correlated significantly (r = 0.96, p less than 0.01) with the magnitude of the decrease in vein graft pressure measured during occlusion of the graft. It is suggested that the decrease in pressure is related to the amount of blood flow from alternate sources to the vascular bed during occlusion of the graft, and that this collateral flow is an important determinant of the magnitude of RHR in bypass grafts.

Administration, Topical↗
PubMed1979

Recycling blood.

Explore the source record for details and available documents.

Blood Banks↗
PubMed1978

A simplified cardiac cannulation technique.

A technique for venous cannulation, left heart venting, and aortic root cannulation is described. It is simple and tidy and permits full mobility of the cannula with minimal manipulation and no blood loss.

Cardiac Catheterization↗
PubMed1978

Intraoperative autotransfusion in elective and emergency vascular surgery.

Intraoperative autotransfusion was studied in 62 patients undergoing elective or emergency thoracic or abdominal vascular surgery systemic heparinization. The results in 58 patients who received a mean autotransfusion volume of 1.8 liters were compared with a group of four patients in whom 9 liters of blood was autotransfused. The quality of the autotransfused blood also was studied and was shown to have a normal platelet count (mean, 144,000/cu mm) and normal fibrinogen value (mean, 212 mg%). No significant differences in the hematological or coagulation parameters measured were detected in the groups given moderate or massive autotransfusion. The mean homologous blood requirement during the hospital admission in the "moderate" group was 300 ml and in the "massive" group 1,000 ml. With careful technique excessive hemolysis or pulmonary microaggregate embolism does not occur; 75% of patients required no homologous blood throughout their hospital admission. No complications which would be attributed to autotransfusion were seen in either group. It is concluded that intraoperative autotransfusion is safe and effective and deserves wider application.

Abdomen↗
PubMed1977

Penetrating chest wound: a case report.

An unusual penetrating chest injury was caused by a ball-point pen. Because of apparent penetration of the heart, preparations were made for an emergency open-heart procedure before emergency thoracotomy was undertaken, with the pen still in situ. The pen had bruised the epicardium but had not penetrated the pericardial sac. After removal of the pen, the wound was closed and a chest tube left in place. Recovery, apart from minor degrees of basal atelectasis, pleural effusion and wound infection, was uneventful. The outcome was consistent with that associated with current aggressive management of penetrating chest injuries. Management is based on three approaches. The primary one is intercostal thoracostomy tube drainage and fluid and blood replacement. In cases of massive hemorrhage or air leak, thoracotomy is necessary. The third approach is to prevent post-traumatic pulmonary insufficiency by using fine, high-efficiency filters during blood transfusion, avoiding excessive administration of intravenous fluids, performing tracheostomy after prolonged endotracheal intubation, and using a volume respirator with positive end-expiratory pressure. The average mortality for penetrating wounds of the heart is 25%.

Drainage↗
PubMed1976

A new approach to left heart decompression.

A simple, safe, indirect technique for decompression of the left heart is described. Pulmonary artery venting produces immediate and total decompression of the left heart through spontaneous retrograde pulmonary flow across the open mitral valve in the hypothermic (29 degrees C) electrically fibrillated heart. This allows free retrograde flow of left heart blood across the pulmonary valve into the right ventricle, where it is taken up by the usual caval cannulas. In 25 of 66 consecutive patients undergoing elective ventricular fibrillation and anoxic arrest, left heart venting was necessary as indicated by rising left heart pressures. Total cardiac decompression was immediately and completely achieved by this simple indirect technique. Direct left heart venting, with its associated risks and disadvantages, was never necessary, and we now consider it obsolete.

Cardiac Catheterization↗
PubMed1976

Intraoperative autotransfusion in major elective vascular operations: a clinical assessment.

Six patients undergoing major elective vascular operations received an average of 1,700 ml. of intraoperative autotransfusion of shed blood. The patients were anticoagulated systemically during operation. The mean platelet count (156,000 per cubic millimeter and fibrinogen value (257 mg. per 100 ml.) were normal in autotransfused blood and the mean hemoglobin level was slightly below normal (11.5 Gm. per 100 ml.). Plasma hemoglobin values were variable. No patient suffered any complication that could be attributed to autotransfusion. Donor blood transfusion was avoided in five of the six patients by salvage and reinfusion of shed blood. No evidence of coagulopathy was found in any patient as measured by platelet count, fibrinogen level, prothrombin time, partial thromboplastin time, euglobulin clot lysis, and fibrin degradation products. The technique of intraoperative autotransfusion is described in detail.

Blood Coagulation↗
PubMed1976

Value of intraoperative arteriography in arterial embolectomy surgery.

Clinical assessment of the adequacy of arterial embolectomy and reconstruction is often unsatisfactory and inadequate. Objective information on the state of the distal circulation can be readily obtained at the time of surgery by arteriography. Illustrative cases demonstrating the usefulness of control arteriography obtained during the surgical procedure are presented.

Adult↗
PubMed1975

Bloodless open heart surgery with atraumatic extracorporeal circulation.

With careful refinements in the pump oxygenator and a nonblood prime, bloodless open heart surgery may be performed almost routinely. In our series these measures reduced blood trauma, with a remarkable preservation of blood elements, especially platelets, and a corresponding elimination of postoperative bleeding. The mean hematocrit value decreased from 38 to 27% and recovered to 33% in the first 3 hours of postoperative diuresis. Mannitol and furosemide were rarely needed. Of 61 adult patients whp underwent open heart surgery for aortocoronary bypass or valve replacement, the last 43 had a bloodless procedure. Of the 43, 26 (60%) required no bank blood postoperatively (in the operating room or the intensive care unit). In these 26 the operative mortality was 4% (1 patient). Bloodless techniques are invaluable during periods of bank blood shortage. They avoid the dangers of hepatitis and transfusion reaction, and they may minimize the incidence of postperfusion lung syndrome as well as renal complications.

Blood Cell Count↗