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S J Phillips

Publications and source records attributed to S J Phillips.

At least 127 records · Page 7Linked to original sources
PubMed1979

LV wall rupture.

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Heart Rupture↗
PubMed1979

Anoxic hypothermic cardioplegia compared to intermittent anoxic fibrillatory cardiac arrest. Clinical and metabolic experience with 1080 patients.

Appropriately applied, hypothermic cardioplegia allows an excellent surgical setting that can significantly reduce the myocardial ischemic injury resulting from anoxia. One thousand eighty adult and pediatric patients underwent a variety of corrective cardial surgical procedures utilizing cold potassium cardioplegic solution injected into the coronary arteries via the aortic root. Myocardial septal temperature was maintained at 18--20 degrees during arrested time. This group of patients was compared to a group of 220 patients that underwent intermittent normothermic ischemic arrest to perform cardiac surgical procedures. Significant reduction in morbidity, mortality, perioperative myocardial infarction was noted in favor of the cardioplegic group. Metabolic coronary sinus blood analysis in the group undergoing surgery with cardioplegia revealed favorable changes in myocardial lactate and oxygen extraction.

Adult↗
PubMed1979

Emergency coronary artery revascularization: a possible therapy for acute myocardial infarction.

Cardiac muscle death caused by coronary artery occlusion is a dynamic process that often takes hours or days. Emergency revascularization (saphenous vein bypass graft (SVBG) during acute myocardial infarction (MI) can interrupt myocardial necrosis, salvage ischemic myocardium and revascularize vessels with obstructive lesions not involved in the MI. In this report we describe a preliminary experimental study of 75 patients in which emergency SVBG was the therapy for acute MI. Group 1, 16 patients, required vasoactive medications and/or intraaortic balloon pumping to maintain their blood pressure preoperatively. There was one operative death and two late deaths. Group 2 consisted of 59 hemodynamically stable patients. There were no deaths. The average preop CPK in group 1 was 892 vs 504 in group 2 (p greater than 0.05). Surgical techniques were routine. The average time from the onset of chest pain that continued to surgery was 6.5 hours. Forty patients were restudied. Post- vs presurgical hemodynamics revealed ejection fraction increased by 34% (p greater than 0.05), left ventricular end-diastolic pressure reduced by 40% (p greater than 0.01). End-systolic and end-diastolic volume reduced by 30% (p greater than 0.05), and 15% (p greater than 0.01), and stroke volume improved 25% (p greater than 0.05). Operative mortality was 1.3% and late mortality 2.8%. These results suggest that cautious continued trial of emergency SVBG in patients with evolving MI is warranted.

Acute Disease↗
PubMed1979

The preparation and immunosuppressive properties of equine antihuman thymocyte membrane immunoglobulin G.

Human thymocytes separated by a Ficoll gradient produced a cell population that was 99% pure thymocytes and free of platelets, leukocytes, and epithelial cells. These cells, disrupted by a nitrogen bomb, produced a membrane-ribosome antigen fraction confirmed by enzyme analysis. Equine antithymocyte membrane-immunoglobulin G (ATM-IgC) prepared against this antigen in four of five horses contained immunosuppressive properties capable of prolonging monkey skin allograft survival longer than 21 days. No adverse effects were noted by the intramuscular and intravenous administration of this antisera to primates, and autopsy examination showed marked depletion of paracortical lymphocytes in the spleen and mesenteric lymph nodes. A moderate thrombocytopenia occurred during a 4 hour intravenous administration of ATM-IgG to primates with a marked decrease in the peripheral lymphocyte count. The deposition of ATM-IgG upon monkey glomerular basement membrane could not be demonstrated by immunofluorescent techniques. The specificity of this globulin to contain anti-T-cell antibody was confirmed by an immunofluorescent assay in that ATM-IgG reacted with both human thymocytes and peripheral blood thymus-dependent cells, but was nonreactive when tested against a panel of human cells free of thymus-dependent antigens.

Animals↗
PubMed1978

Cardiac surgery.

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Adult↗
PubMed1977

A newly designed arterial monitoring/perfusion cannula for cardiac operations.

A newly designed arterial monitoring and perfusion cannula for cardiopulmonary bypass eliminates the need for cannulation of a peripheral artery for pressure monitoring. The double-lumen cannula is designed as follows: the large central lumen (12 to 26f) acts as the arterial inflow conduit from the pump oxygenator, while a second, smaller lumen (18 gauge)constructed in the wall of the first cannula acts as the pressure-monitoring port and the source for blood sampling and drug infusion. This monitoring/perfusion cannula has been used succesfully in more than 250 clinical patients in a variety of settings--total cardiopulmonary bypass, left heart bypass, and when multiple arterial inflow lines were necessary (as in aortic arch replacement). Use of this cannula is advantageous in the infant and pediatric patient or in the emergency setting, when insertion of a peripheral arterial line can be difficult. Used in conjunction with a Doppler system, the cannula provides accurate, dependable blood pressure monitoring.

Blood Pressure↗
PubMed1977

Cardiac hypothermia.

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Cardiac Surgical Procedures↗