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Biomedical subjects

T J Fogarty

Publications and source records attributed to T J Fogarty.

At least 91 records · Page 5Linked to original sources

Evaluation of aortic valve replacement with a porcine xenograft without long-term anticoagulation.

From June, 1971, through November, 1974, 75 patients underwent aortic valve replacement with a Hancock "Stabilized Glutaraldehyde Process" porcine xenograft. Patients who underwent multiple valve replacements are not included in the study. Thirty-nine per cent of the patients had procedures for associated lesions or for removal of a Starr-Edwards prosthesis. The operative mortality rate was 6.7 per cent. Six patients died in the late postoperative period. Only one death was thought to be secondary to a valve-related problem. Actuarial analysis predicts 84 per cent survival at 3 years. Three patients initially received long-term antithromboembolic therapy. There have been three suspected or documented thromboembolic episodes (0.24 per cent per patient-month). Ten per cent of the patients surviving the operation developed murmurs of aortic insufficiency. There have been no documented valve failures. Ninety-eight per cent of the survivors have experienced an improvement in their New York Heart Association (N.Y.H.A.) classification.

Adult↗

Initial approach to blood access for the chronic hemodialysis patient--the bovine heterograft.

Experience with the modified bovine heterograft arteriovenous fistula for hemodialysis in 79 grafts in 73 patients over an 18 mo period is analyzed. An immediate (30 day) patency rate of 97.5%, and a 12 mo cumulative patency rate of 73.9% was observed. Early and late complication rates were acceptably low, despite early usage in 80% of cases. It is concluded that the bovine fistula provides an acceptable blood access route for the initial approach to the patient in urgent need of hemodialysis.

Animals↗

Mitral valve replacement with the Hancock stabilized glutaraldehyde valve. Clinical and laboratory evaluation.

From March 1971 through April 1975, one hundred twenty patients underwent mitral valve replacement with a Hancock "stabilized glutaraldehyde process" porcine aortic xenograft. A simultaneous canine experimental series was also carried out. In the clinical series, the early mortality was 8.3%. Actuarial analyses of all patients predicts survival at two years of 81.0% and at four years of 70.0%. The predicted survival for patients without coronary disease or prior prosthetic valve replacement is 87.5% at two years and 77.5% at four years. There were four thromboembolic episodes, a rate of 2.4% per patient-year. None were fatal. No valve failure were noted. Histologic examination and shrink temperature analysis of recovered valves show excellent tissue preservation at 40 months. The data indicate that the Hancock valve is durable, enjoys a low incidence of thromboembolism, and may be the valve of choice for mitral valve replacement.

Adult↗

Surgical treatment of atherosclerotic lesions of the subclavian artery.

Of eight patients with atherosclerotic lesions (seven occlusive, one aneurysmal) of the subclavian artery, five were operated upon because of the subclavian steal and three for severe ischemia of the hand and fingers. Removal or bypass of these lesions was uniformly successful in relieving symptoms. In most cases transcervical carotid-subclavian saphenous vein bypass graft is the treatment of choice, provided no carotid obstruction exists or, if there is obstruction, it can be dealt with at operation.

Adult↗