Search PubMed⌕ Search

Biomedical subjects

V Parsonnet

Publications and source records attributed to V Parsonnet.

At least 127 records · Page 7Linked to original sources
PubMed1981

A revised code for pacemaker identification. Pacemaker Study Group.

The three-position ICHD code designating pacemaker function has been widely adopted. A revision, expanding the code from three to five positions, incorporates the first three positions as in the earlier version, but includes position IV, programmable functions, and position V, tachyarrhythmia functions. The code indicates how the pacemaker is employed, not necessarily the purpose for which it was designed. For example, a single-chamber inhibited pulse generator with multiprogrammable capabilities which interrupts a tachycardia by a burst of rapid pacing is designated as VVI,MB if placed in the ventricle, and AAI,MB if in the atrium.

Arrhythmias, Cardiac↗
PubMed1980

Infected aneurysms of the abdominal aorta.

Infected aneurysms of the abdominal aorta are relatively uncommon, but potentially lethal if improperly managed. Two case reports emphasize the importance of the preoperative aortogram for accurate diagnosis. We stress the principles of total excision of infected tissue and revascularization in uninfected tissue planes. A useful vascular reconstructive technique consisting of unilateral axillofemoral bypass and an ilioiliac anastomosis was used in both patients.

Aged↗
PubMed1980

A 12-year experience with femorofemoral crossover grafts.

One hundred thirty-three patients with unilateral iliac artery obstruction were treated with crossover femorofemoral grafts and followed up for one to 12 years. Cumulative patency was 73.3% at five years and 63.6% at ten years. There were 17 early closures with ten unsuccessful revisions and 22 late failures between three and 122 months. Inability to establish adequate runoff was the primary cause of early failure, and the progression of distal disease was the major cause of late failures. In only five cases did progressive disease of the donor artery cause failure of the graft. Operative morbidity and mortality were low (6%), and the results compare favorably with alternative methods of treating unilateral iliac artery occlusions.

Adult↗
PubMed1980

Clinically recognized limb ischemia in the neonate after umbilical artery catheterization.

During a 4 year period, 1,461 critically ill neonates were admitted to the newborn intensive care unit of the Newark Beth Israel Medical Center, and 507 (35 percent) had umbilical artery catheters inserted for physiologic monitoring. In five patients (1 percent) clinically significant limb ischemia developed as a result of catheter complications. Frank gangrene was observed in three patients; two died from the primary illness soon after the onset of gangrene and the third survived after leg amputation. The other two infants had advanced ischemia that responded favorably to catheter removal and heparinization. Irreversible limb ischemia in this setting is infrequent, and milder forms are usually unrecognized or undocumented. High placement of the catheter or the length of time it is in place were not related to complications. Limb ischemia occurred soon after catheter insertion rather than after its protracted use. Major complications may be reduced by placement of the catheter in the lower abdominal aorta or internal iliac artery, clinical awareness and observation and frequent noninvasive monitoring. Immediate catheter removal and intravenous anticoagulation are warranted if ischemia persists. From this study, we believe that the benefits derived from judicious umbilical artery catheterization outweigh any inherent risk.

Catheterization↗
PubMed1980

Characteristics of intracardiac electrograms II: Atrial endocardial electrograms.

The intra-atrial electrograms (P-wave and QRS complex) of newly implanted electrodes were recorded, and the time and frequency domain characteristics compared. The sensing impedance properties of the atrial electrode were studied in relation to the characteristics of both atrial and ventricular electrograms, and specific differences between the P and R-waves were identified. These values, particularly the amplitude and frequency components, were sufficiently distinct to make differentiation by pacemaker sensing circuits selective and reliable.

Cardiac Pacing, Artificial↗
PubMed1980

An experimental method for thermal control of heart rate: work in progress.

Evaluation of the postoperative course of coronary artery bypass patients shows that a number develop supraventricular arrhythmias that may be responsive to sino-atrial node (SAN) cooling. The sinus rate can be controlled within a clinically useful range with topical cooling probes (thermodes). The data on the variations of heart rate caused by modest nodal hypothermia indicate that a nonpharmacologic clinical system for control of supraventricular tachyarrhythmias is feasible. Prototype thermodes suitable for SAN implantation have been developed.

Animals↗
PubMed1980

Limb ischemia during intra-aortic balloon pumping: indication for femorofemoral crossover graft.

Catheter insertion for intra-aortic balloon pumping (IABP) was successful in 91% of 332 candidates. Fifty-three patients (16.5%) had significant catheter-associated vascular complications, of which lower extremity ischemia with threatened limb loss was the most prevalent (70%). Thirty-six of these patients required an angioplastic repair or vascular grafting. Of the 36, 19 patients with ischemia who needed continued balloon support received femorofemoral (F-F) grafts to restore and maintain adequate limb perfusion. Wound infection occurred in six of the patients but there was no limb loss. F-F grafting is a simple procedure that requires little time and allows one to maintain IABP for prolonged periods without concern for critical obstruction to limb perfusion.

Adult↗
PubMed1979

Method for the rapid and atraumatic insertion of permanent endocardial pacemaker electrodes through the subclavian vein.

One hundred sixty-four permanent pacemaker implantations through the subclavian vein were accomplished by 17 different physicians at four institutions utilizing a specially constructed peel-away introducer. Fourteen attempts (8.3 percent) to cannulate the subclavian vein were unsuccessful. There were four cases of pneumothorax (2.4 percent) and two cases of hematoma formation (1.2 percent). The procedure has the advantage of a rapid and atraumatic insertion of a variety of transvenous pacemaker electrodes, and the avoidance of surgical dissection for a venous entrance site.

Cardiac Catheterization↗
PubMed1979

Beat-to-beat stability of implanted pacemakers.

A method of measuring and analyzing beat-to-beat interval stability of implanted pacemakers has been devised, and a number of normal and failing pacers have been studied in this way. It was seen that normal pacer rates were remarkably stable, but that abnormalities in beat-to-beat interval were found in 67.4% of all failing pacers. The abnormalities consisted primarily of excessive interval (rate) scatter, linear and cyclic fluctuation, and transients following application of a magnet. It is expected that in problem cases a beat-to-beat analysis will be of help in differentiating normal from abnormal pacer function, and will provide confirmation signs of pacer failure; it may also uncover unusual and heretofore unpredictable failure modes.

Computers↗