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Biomedical subjects

S J Phillips

Publications and source records attributed to S J Phillips.

At least 145 records · Page 8Linked to original sources
PubMed1976

A temporary catheter-tip aortic valve: hemodynamic effects on experimental acute aortic insufficiency.

A catheter-mounted polyurethane cusp was designed to act as a temporary prosthetic aortic valve in the ascending aorta. Acute aortic insufficiency was created in 15 dogs by transventricular tearing of the two aortic valve leaflets with a wire hook. Hemodynamic variables were measured during aortic insufficiency and with the prosthetic valve in place. Comparison of the values showed that the prosthesis functioned as a competent aortic valve. Aortic diastolic pressure increased by 62 +/- 42%, pulse pressure was lowered by 44 +/- 9%, and left ventricular end-diastolic pressure decreased by 45 +/- 18%. Neither cardiac output, coronary blood flow, nor peak systolic pressure was significantly altered. The observed hemodynamic improvement and the simplicity of the design and application suggest that the prosthetic aortic valve may be applicable in the temporary treatment of decompensated aortic insufficiency.

Acute Disease↗
PubMed1976

Improvement in forward coronary blood flow by using a reversed saphenous vein with a competent valve.

Reversed segments of saphenous vein have been the grafts of choice for aortocoronary bypass (ACB). Internal mammary arteries and free radial autografts have recently been shown to have a higher ppatency rate, but flow is usually lower. Normally forward coronary blood flow ceases and retrograde flow occurs during cardiac systole. Prevention of retrograde flow with a rapidly acting valve proximal to the coronary artery anastomosis should improve forward coronary blood flow. Thirty-nine reversed saphenous veins containing a competent valve were implanted in 32 patients undergoing ACB. After accurate zero flow was determined and a resting state achieved, mean (22 veins) and pulsatile (17 veins) flows were measured distal to the valve with the valve competent and temporarily incompetent. A competent valve in 10 right coronary artery vein grafts increased mean flow by 29.7% (+41 ml/min; p less than 0.005) and pulsatile flow in 6 veins by 17.7% (p less than 0.001). A competent valve in 12 left coronary artery vein grafts increased mean flow by 31.3% (+34 ml/min; p less than 0.01) and pulsatile flow in 11 veins by 13.7% (p less than 0.001). This study suggests that a portion of reversed saphenous vein containing a competent valve provides greater coronary artery blood flow than veins without valves and may be the conduit of choice for coronary artery revascularization.

Blood Flow Velocity↗
PubMed1976

Preparation and immunosuppressive potency of equine anti-human thymocyte membrane IgG.

Anti-human thymocyte cell membrane antibody prepared by hyperimmunization of the horse produced an antiserum capable of prolonging skin allografts in the rhesus monkey for an average of 26 days. Lymphocyte depletion was present in paracortical areas of mesenteric lymph nodes of these animals after 28 days of treatment; the intravenous administration was tolerated without ill effects. Immunofluorescent studies identified both broad specificity antibodies reacting with numerous human cell types as well as thymus-dependent (T) cell antibodies reactive with human thymocytes and peripheral T-cells.

Animals↗
PubMed1975

"No-vent" technique of coronary artery bypass.

Isolated coronary artery bypass grafting was performed in 100 patients without the use of a left ventricular vent. Distention of the left ventricle did not occur. There was 1 late death unrelated to this technique. Vents in the left heart are not required under most circumstances.

Adult↗
PubMed1975

Surgical considerations in patients undergoing repeat median sternotomy.

A retrospective review of 122 repeat median sternotomy incisions in 100 consecutive patients was made to evaluate complications and management. Eighty-one patients had one repeat sternotomy, )6 had two repeat sternotomies, and 3 had three repeat sternotomies. All had valve procedures in the past and were reoperated upon for progressive rheumatic valvular disease or for complications related to the prostheses. Complications included operative hemorrhage in 8 patients, postoperative hemorrhage in 2, seroma in 4, and dehiscence, wound infection, and hematoma in 1 patient each. The most serious complication was hemorrhage and was the cause of the only operative death. Seven other patients survived hemorrhage encountered during repeat sternotomy. Control of massive hemorrhage during repeat sternotomy has been possible due to an organized approach to the patient with adhesions from previous surgery.

Adolescent↗
PubMed1974

Treatment of the severely burned child with skin transplantation modified by immunosuppressive therapy.

The IgG fraction of equine antithymocyte globulin administered by the intravenous and intramuscular route to two patients with severe thermal injury was associated with survival of the skin allografts to 19 and 42 days. In the second patient the IgG fraction was discontinued 28 days after skin grafting and rejection occurred 14 days later while the patient was receiving azathioprine and 1% topical hydrocortisone cream to the skin allografts. Although no comparison can be made between the immunosuppressive properties of antithymocyte globulin, azathioprine and topical steroids, skin allograft survival was prolonged temporarily until autograft skin from previous donor sites could be obtained. The use of skin allografts protected by immunosuppressive therapy in patients with severe thermal injury deserves further consideration.

Animals↗