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Biomedical subjects

S Stewart

Publications and source records attributed to S Stewart.

At least 325 records · Page 18Linked to original sources
PubMed1978

Current results with construction and interruption of the Waterston anastomosis.

The Waterston anastomosis was constructed in 21 infants and neonates between 1973 and 1977. Sixteen neonates were 1 week old or less and 8 were less than 24 hours old. There were 2 operative deaths, giving a hospital survival of 90%. There were 3 late deaths. All surviving infants received satisfactory palliation except 1 who required a Potts anastomosis one year later. During the same time interval, 9 other patients who had had a Waterston anastomosis underwent complete intracardiac repair. Seven of them had significant angulation of the right pulmonary artery necessitating patch reconstruction. All patients survived operation, and follow-up pulmonary angiograms demonstrated only a slight persistent narrowing of the right pulmonary artery in 2 patients. We conclude that the Waterston anastomosis can be constructed with a low operative mortality even in the severely cyanotic neonate and that it can be taken down at the time of complete repair with minimal morbidity and no mortality even if it has significantly angulated the right pulmonary artery.

Aorta↗
PubMed1978

The determinants of survival following reoperation on prosthetic cardiac valves.

In an effort to identify the determinants of survival following reoperation on patients with prosthetic cardiac valves, the experience with a group of 33 patients at the University of Rochester Medical Center was reviewed. The survival rate was 58% (19/33). Survival was not related to the valve involved, the age of the patient, or the technical hazards of a second cardiac operation. Ten (77%) of the 13 patients in New York Heart Association (NYHA) Functional Class II survived compared with 8 (40%) of the 20 in Class III or IV. The survival rate for patients with a paravalvular fistula was 79% (11/14); with valve dysfunction, 50% (6/12); and with prosthetic valve infection, 29% (2/7). The determinants of survival seem to be similar to those for primary operation (i. e., NYHA patient classification and indication for operation) and less related to the potential operative complications of a reoperation.

Age Factors↗
PubMed1977

Automated identification of cardiac conduction tissue in L-TGV and Ebstein's anomaly.

The specialized cardiac conduction tissue was identified quickly and easily at operation in 2 patients with corrected transposition (L-TGV) and 1 with Ebstein's anomaly. In each of the former cases the tissue was located along the upper rim of the VSD, beneath the pulmonary outflow tract; in neither patient was there a disturbance in cardiac rhythm as a result of operation. In the patient with Ebstein's anomaly the bundle of His descended onto the ventricular septum more directly than was anticipated. There was only a transitory disturbance in atrioventricular conduction following tricuspid valve replacement. Accurate identification of the cardiac conduction tissue is a prerequisite to the safe repair of certain forms of complex congenital heart disease.

Adolescent↗
PubMed1977

A technique to narrow the lumen of a Waterston anastomosis.

A technique is described for narrowing the Waterston anastomosis by placing a horizontal mattress suture buttressed with felt pledgets through the aortic wall at the cephalad side of the anastomosis. This maneuver produces a slight but safe narrowing of the anastomotic lumen.

Aorta↗
PubMed1977

Double-outlet right ventricle (S,D,D), VSD related to pulmonary artery, and pulmonic stenosis absent. Correction with an intraventricular conduit in infancy.

The case history of a 5-month-old infant with double-outlet right ventricle (S,D,D) ventricular septal defect (VSD) related to the pulmonary artery, and absence of pulmonic stenosis is reported. The anomaly was repaired with an internal intraventricular conduit. This is the youngest infant with this subset of DORV to survive complete repair and the youngest in whom an intraventricular conduit was used. The diagnosis was not suspected preoperatively, and it is fortunate that the intracardiac anatomy permitted this type of repair at this age. The optimal management program for this subset of DORV should be initial pulmonary artery banding with later complete repair.

Heart Septal Defects, Ventricular↗
PubMed1976

Dissection of the aorta complicating intra-aortic balloon counterpulsation.

A 61-year-old man with recent myocardial infarction complicated by a ventricular aneurysm and recurrent ventricular tachycardia underwent intra-aortic balloon counterpulsation prior to angiography and left ventricular aneurysmectomy. A dissecting aneurysm of the descending aorta adjacent to the position of the balloon catheter was found at autopsy. No intimal tear or cystic medial degeneration of the aorta was present to account for the dissection. The authors suggest that lateral and shearing forces generated by inflation of the balloon could result in dissection of the aorta.

Aortic Dissection↗
PubMed1976

Effects of Ritalin on underachieving children: a replication.

Effects of Ritalin upon scholastic achievement of 18 academically deficient children were studied, in an attempt to validate findings of an earlier study of similar design. Results, in keeping with the previous research, indicate that while Ritalin affects behavior, it does not enhance learning, and may in fact mask academic problems. It is urged that the drug be used sparingly and critically, and only in conjunction with other modes of intervention.

Child↗
PubMed1976

Closure of a ventricular septal defect through the aortic valve: a note of caution regarding resultant narrowing of the aortic valve annulus.

Closure of ventricular septal defects through the aortic valve annulus has been described for a variety of cardiac anomalies. This technique is most appropriate when simultaneous aortic valve replacement is anticipated. A continuous suture through the patch material may produce a purse-string effect upon the aortic valve annulus. The appropriate size of the aortic valve prosthesis should be determined after the closure of the ventricular septal defect is completed to avoid selecting one which may be too large.

Adult↗
PubMed1976

Support of the myocardium with intra-aortic balloon counterpulsation following cardiopulmonary bypass.

Intra-aortic balloon counterpulsation (IABC) was instituted in 27 patients in cardiogenic shock who had undergone cardiopulmonary bypass (CPB). Patients who required IABC either prior to CPB or else to be weaned from CPB had a survival rate of 22 per cent (2/9). In contrast, the survival rate for those patients requiring IABC after CPB had been discontinued was 72 per cent (13/18). The composition of these two groups was different. The first group contained primarily patients with either severe coronary artery disease or aortic valve stenosis, whereas the latter group contained patients with either less severe coronary artery disease or mitral valve disease. Most patients had an initial satisfactory response to IABC. The over-all survival rate was 55 per cent (15/27). IABC was particularly beneficial for those patients in cardiogenic shock following CPB who had not had massive and irreveraible myocardial injury.

Adult↗