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At least 559 records · Page 31Linked to original sources
PubMed1992

Competitive flow from a fully patent coronary artery does not limit acute mammary graft flow.

The shriveled, stenotic mammary graft sometimes observed after internal mammary artery (IMA) to coronary artery bypass grafting has been attributed to competitive flow from the insufficiently stenosed native coronary vessel. To study further the effects of native coronary artery competing flow on IMA graft flow, 10 dogs (mean weight, 23.5 +/- 3.69 kg) underwent coronary artery bypass grafting using the pedicled left IMA anastomosed to a normal, fully patent proximal circumflex (CFX) coronary artery. The procedure was performed through a left thoracotomy, off pump, using a brief local occlusion to perform the anastomosis. Native in situ IMA flow, CFX flow distal to the anastomosis, and IMA graft flow were measured using calibrated electromagnetic flow probes. When the CFX proximal to the anastomosis was occluded transiently, IMA flow increased to supply 100% of the previously measured distal CFX flow (60.2 +/- 7.9 mL/min). When both the IMA graft and CFX proximal to the anastomosis were patent, total distal perfusion was maintained (58.9 +/- 7.8 mL/min) and relative IMA graft flow (26.5 +/- 3.3 mL/min) was proportional to the relative diameter of the IMA graft to the native coronary artery (r = 0.96). The mean flow in the IMA in situ on the chest wall before its division was 23.8 +/- 8.1 mL/min. These results suggest that, at least acutely in a canine model, IMA graft flow is maintained above in situ levels even when grafted to a completely patent coronary artery and that acute competitive flow probably does not cause mammary artery shriveling.

Animals↗
PubMed1996

Closure of a patent foramen ovale and tricuspid valve replacement after heart transplantation.

Patent foramen ovale has been noted after cardiac transplantation. Rarely is surgical intervention warranted. In this communication we report a case of severe tricuspid regurgitation and paradoxical embolism secondary to a patent foramen ovale in a patient 19 months after heart transplantation. The patient underwent successful closure of the patent foramen ovale and tricuspid valve replacement.

Bioprosthesis↗
PubMed1994

Laparoscopic incidence of contralateral patent processus vaginalis in boys with clinical unilateral inguinal hernias.

In 38 boys with clinical unilateral inguinal hernias (CUIH), the contralateral processus vaginalis was examined laparoscopically before surgical manipulation at the time of elective inguinal herniorrhaphy. General anesthesia was used in each case, and a 30 degrees, 2.7-mm laparoscopic was introduced using standard techniques. Positive laparoscope findings prompted surgical exploration. The age range was 2 to 134 months. Twenty-four had a right CUIH, and 14 had a left CUIH. Overall, the contralateral processus vaginalis was patent in 52.6%, with 58.3% and 42.8% patency on the nonclinical left and right sides, respectively. In boys under 2 years of age, 50% of those with a right CUIH had a contralateral patent processus vaginalis, as did 60% of those with a left CUIH. In two of these 38 patients in whom there was no clinically proven hernia, the only patent processus vaginalis was on the side opposite the one with a clinical history. Laparoscopic examination of the internal inguinal ring provided accurate information useful in determining the need for contralateral inguinal exploration in these 38 children.

Child↗
PubMed1994

The prevalence of patent lungworm infections in herds of dairy cows in The Netherlands.

The results of a survey on the prevalence of patent lungworm infections in herds of dairy cows in the Netherlands are presented. Low patent infections were recorded in February-March on six out of 40 farms in at least one out of 40 cows. Between mid-April and mid-June low patent infections were detected on 28 out of 39 of these farms in one to four of 40 cows. Two farms on which cows were positive in the first round were negative in the second round. One to three positive cows were found on six out of a total of 15 farms revisited in July-August. These results show that lungworm infections are cycled within herds of dairy cows in the Netherlands at a low level. This indicates that dairy cows are important as carriers for lungworm, particularly in spring. The increased patency of lungworm in cows from winter to spring may be explained by maturation of inhibited larvae.

Animals↗
PubMed2007

Hypersensitivity reaction against patent blue during sentinel lymph node removal in three melanoma patients.

BACKGROUND: In order to identify the sentinel lymph node (SLN) in melanoma patients intradermal injection of a radiocolloid tracer and a blue dye are commonly used. Life-threatening side effects such as allergic reactions to the injected dye have been described. We report 3 cases with systemic allergic reactions. METHODS: Three patients suffering from systemic reactions such as hypotension and rash during SLN biopsy were tested for sensitisation against patent blue and methylene blue with skin prick, scratch, and intradermal test. RESULTS: All 3 patients showed positive skin tests to patent blue confirming allergic reaction to the injected dye. In addition, all patients showed positive skin tests with methylene blue indicating immunologic cross-reactivity between patent blue and methylene blue. CONCLUSIONS: Although allergic reactions to blue dye during SLN biopsy are rare, they may be life threatening. It is important that the attending anesthetist is aware of this.

Adult↗
PubMed2004

[Patent omphalomesenteric duct (a case report)].

PURPOSE: To report a rare case of patent omphalo-mesenteric duct and discuss the pathogenesis, clinical and radiological findings of this pathology. CASE REPORT: A two-month-old infant presented with umbilical liquid production since birth. Local examination showed an inflammatory umbilical tumefaction. Catheterization and injection of contrast material through the canal evidenced a communication with the gut, consistent with a patent omphalo-mesenteric duct. DISCUSSION: Persistent omphalo-mesenteric duct is a rare affection. Diagnostis is based on clinical and radiological findings. Clinical findings may be atypical in some cases. Complications are severe and include prolapsus, occlusion, ulcus, haemorrhage and perforation. CONCLUSION: Diagnostis of patent omphalo-mesenteric duct must be precocious to avoid complications.

Diagnosis, Differential↗
PubMed2005

Prolonged skin staining after intradermal use of patent blue in sentinel lymph node biopsy for breast cancer.

AIMS: To investigate the duration of staining of the skin after intradermal injection of patent blue during sentinel lymph node biopsy (SLNB) for breast cancer. METHODS: The clinical data of 33 consecutive patients who underwent a SLNB in combination with breast conserving therapy (BCT) in our hospital were retrospectively reviewed. Also, patients were interviewed at intervals of 3 months until the blue staining of their skin had disappeared. RESULTS: At mean follow-up of 18 months (range: 12-28) patent blue was visible at the site of injection after 3, 6, 9 and 12 months in 70, 64, 44 and 41% of the patients, respectively. CONCLUSIONS: Use of the intradermal injection technique of patent blue during sentinel lymph node biopsy in BCT may result in remarkably long discolouring of the skin at the site of injection.

Breast Neoplasms↗
PubMed2005

Comparison of transthoracic echocardiography using second harmonic imaging, transcranial Doppler and transesophageal echocardiography for the detection of patent foramen ovale in stroke patients.

AIMS: The comparison of three imaging methods to determine which is the most accurate and reliable for the detection of right-to-left shunt. METHODS AND RESULTS: One hundred and seven patients who were hospitalized for stroke underwent: a transthoracic echocardiography (TTE) using second harmonic, a transcranial Doppler (TCD) and a transesophageal echocardiography (TEE) from August 2003 to April 2004. All studies were recorded on a videotape and were studied by a physician blinded to the study. With TTE and TEE, we found 44 (41%) patent foramen ovales. All contrast tests were positive with TCD for these 44 patients. For two patients, the contrast test was positive only with TTE and TCD. We found four false negative contrast tests with TTE. Among the 63 patients who had a negative contrast test with TEE and TTE, the results were the same with TCD for 59 of them; we were not able to determine a cause for the four positive tests. CONCLUSION: This study confirms that transesophageal echocardiography has limitations in the diagnosis of patent foramen ovale. In this study, the negative predictive value of transcranial Doppler was excellent. Therefore, this examination is able to exclude a patent foramen ovale with a high level of confidence.

Adult↗
PubMed2006

Hemidiaphragmatic paralysis: an underestimated etiology of right-to-left shunt through patent foramen ovale?

OBJECTIVE: To report a specific pathophysiology of hemidiaphragmatic paralysis that may result in severe hypoxemia. DESIGN: Case series. SETTING: Intensive care unit in a cardiology hospital. PATIENTS: The series included three patients with refractory hypoxemia in whom a diagnosis of right-to-left-shunt through a patent foramen ovale was made by contrast echocardiography. The three patients had a complete right hemidiaphragmatic paralysis. INTERVENTION: Permanent percutaneous closure of the patent foramen ovale was successfully proceeded in all cases. MAIN RESULT: These procedures resulted in complete normalization of arterial oxygen saturation. CONCLUSION: To our knowledge, only three previous reports have described the association of right-to-left shunt through a patent foramen ovale and hemidiaphragmatic paralysis. Such association may be underestimated.

Aged↗
PubMed2004

Patent ductus venosus in children: a case report and review of the literature.

A 10-year-old girl with a patent ductus venosus associated with multiple autoimmune disorders presented with hypoxia, cyanosis of her lips, and exertional dyspnea. Ultrasonography and abdominal computed tomography of the liver showed a communication between the portal vein and the inferior vena cava through a patent ductus venosus. Portography showed flow from the portal vein directly into the inferior vena cava via the portosystemic shunt. The portosystemic venous shunt ratio was estimated to be 71.8% by scintigraphy using 123I-IMP. Intraoperatively, the authors diagnosed this portosystemic shunt as patent ductus venosus because of the absence of the ductus venosus on real anatomic position. The portal venous pressure was 8.2 cm H2O, which increased to 17.7 cm H2O when the ductus venosus was temporarily occluded. After surgical ligation of the ductus venosus, the color of liver improved, indicating restored liver circulation. The postoperative course was uneventful, and the patient has been asymptomatic for 6 months.

Child↗
PubMed2006

Patients blue on patent blue: an adverse reaction during four sentinel node procedures.

Patent blue V is a well-known dye for visualisation of the lymph nodes in a sentinel lymph node biopsy in breast carcinoma. We present four cases of an adverse reaction to patent blue V, one of which was an anaphylactic shock. The adverse reactions to patent blue and isosulphan blue as found in the literature are discussed and an alternative is suggested.

Aged↗
PubMed2004

Sentinel lymph node detection in early cervical cancer with combination 99mTc phytate and patent blue.

OBJECTIVE: The purpose of this study was to examine sentinel lymph node (SLN) detection in patients with early stage cervical cancer using (99m)Tc phytate and patent blue dye and to compare our method with published findings utilizing other radioisotopic tracers. PATIENTS AND METHODS: A total of 20 consecutive patients with cervical cancer scheduled for radical hysterectomy and total pelvic lymphadenectomy at our hospital underwent SLN detection study. The day before surgery, lymphoscintigraphy was performed with injection of 99m-technetium ((99m)Tc)-labeled phytate into the uterine cervix. At surgery, patients underwent lymphatic mapping with a gamma-detecting probe and patent blue injected into the same points as the phytate solution. RESULTS: At least one positive node was detected in 18 patients (90%). A total of 46 sentinel nodes were detected (mean, 2.3; range, 1-5). Most sentinel nodes were in one of the following sites: external iliac (21 nodes), obturator (15 nodes), and parametrial (7 nodes). Eleven (24%) sentinel nodes were detected only through radioactivity and two (4%) were detected only with blue dye. The sensitivity, specificity, and negative predictive value for SLN detection were all 100%. Nine published studies involving 295 patients had a summarized detection rate of 85%. Summarized sensitivity, specificity, and negative predictive value were 93%, 100%, and 99%, respectively. CONCLUSION: Combination of (99m)Tc phytate and patent blue is effective in SLN detection in early stage cervical cancer.

Adult↗
PubMed1996

Diagnosis of patent foramen ovale by contrast versus color Doppler by transesophageal echocardiography: relation to atrial size.

To ascertain the factors related to the transesophageal echocardiographic diagnosis of patent foramen ovale, the primary echocardiographic data were reviewed from 74 patients with that diagnosis. Similar detection rates were observed with contrast echocardiography (82%) and color flow mapping (78%), but contrast was more sensitive in patients with normal-sized atria (94%) and isolated right atrial enlargement (100%) than in those with enlarged left atria, all but three of whom had biatrial enlargement (52%) (p < 0.001 by chi-square test). Doppler flow mapping was less sensitive for normal-sized atria (66%) than for isolated enlarged right atria (81%) and left (bi-) atrial enlargement (96%) (p = 0.024). Patent foramen ovale was directly visualized by two-dimensional echocardiography in 80%, with close agreement to the size of the color flow jet (r = 0.90, delta = 0.1 +/- 0.4 mm); foramen ovale size was related to right atrial area (r = 0.31, p = 0.015). Thus both saline contrast and color flow imaging are necessary to exclude the diagnosis of patent foramen ovale.

Case-Control Studies↗
PubMed1999

Injury to a patent left internal thoracic artery graft at coronary reoperation.

BACKGROUND: The purpose of this study was to determine the prevalence, outcome, and operative strategies for patients having injury to a patent left internal thoracic artery (LITA) graft to the left anterior descending coronary artery (LAD) at coronary reoperation. METHODS: Of 655 patients with a patent LITA graft to the LAD undergoing coronary reoperation from 1986 to 1997, 35 (5.3%) sustained intraoperative injury to the LITA graft. RESULTS: Strategies to restore flow to the LAD included new saphenous vein graft to the LAD in 15 patients, saphenous vein graft to the LITA stump in 7, saphenous vein graft to the LAD and repair of the LITA graft in 6, and other strategies in 7. All or part of the LITA graft to the LAD was salvaged in 20 patients (57%). Fourteen patients (40%) sustained perioperative myocardial infarction, and 3 patients died (8.6%). The 3 patients who died all had stenosis or thrombosis of the graft to the LAD documented at autopsy. CONCLUSIONS: We conclude that (1) the prevalence of injury to a patent LITA graft is 5.3%; (2) a variety of techniques can be used to restore blood flow to the LAD; and (3) ineffective revascularization of the LAD in this situation is associated with operative mortality. At primary coronary artery bypass grafting, the LITA pedicle should be positioned in the left chest away from the posterior sternal table; this strategy may minimize the risk of LITA graft injury at coronary reoperation.

Adult↗
PubMed1982

Congenital patent urachus associated with complete (hypospadiac( duplication of the urethra and solitary crossed renal ectopia.

The literature is reviewed on the incidence of patent urachus. Three cases are reported and 1 is described in detail. In that case the patent urachus was associated with complete duplication of the urethra and solitary crossed renal ectopia. The rarity of these associated lesions is stressed, especially the fact that the second urethra was situated in the hypospadiac position. Two years after excision of the patent urachus urine retention developed, which was treated by dividing the septum between the 2 urethras in the region of the prostate.

Child↗
PubMed1989

Patent foramen ovale and decompression sickness in divers.

30 patients with a history of decompression sickness were examined for the presence of patent foramen ovale by bubble contrast, two-dimensional echocardiography and colour flow doppler imaging. With bubble contrast, 11 (37%) of the patients had right-to-left shunting through a patent foramen ovale during spontaneous breathing. 61% of a subset of 18 patients with serious signs and symptoms had shunting. This number was significantly higher than the 5% prevalence seen with the same diagnostic technique in 176 healthy volunteers. The presence of patent foramen ovale seems to be a risk factor for the development of decompression sickness in divers.

Acute Disease↗
PubMed1989

Functional failure of patent femorodistal in situ grafts.

We have treated several patients who required major, proximal extremity amputations despite a patent infrainguinal in situ saphenous vein bypass graft. To determine those factors predisposing to such paradoxical limb loss, we studied a group of 45 patients who underwent 48 in situ, femorodistal bypass grafts for tissue necrosis and who maintained a patent graft throughout the perioperative period. Within this cohort, we compared two distinct subgroups: Group I, whose limbs (n = 8) ultimately required a major proximal amputation; Group II, whose limbs (n = 40) emerged with a viable foot and did not require a major amputation. There was no significant difference in the incidence of diabetes, renal failure, smoking, or postoperative ankle/brachial index between the two groups. The presence of gangrene (88% vs 45%), invasive sepsis (63% vs 23%), and combined gangrene and sepsis (63% vs 18%) was significantly (p less than 0.05) more prevalent in Group I versus Group II. Forty-three percent of patients with both gangrene and foot sepsis required a major proximal amputation despite a patent graft. Such patients are at high risk for limb loss even if they undergo successful revascularization.

Aged↗
PubMed1987

The influence of patent branches on in situ vein graft haemodynamics.

The effect of patent graft branches on intra-operative graft flow and pressure has been studied in 50 patients undergoing in situ vein femoro-distal arterial bypass. In 35 grafts in which patent branches in the calf and thigh were preserved as arteriovenous fistulae, release of temporary branch occlusion increased mean proximal graft flow by 178.6% in 32, and reduced distal graft flow by 49.7% in 30. Seventeen limbs had thigh fistulae only: release of temporary fistula occlusion produced a fall in distal graft flow in only three. We identified three types of fistula: (a) cutaneous branches usually found in the thigh, which do not affect graft flow; (b) perforator branches which increase graft inflow but have no effect on distal graft flow: (c) perforator branches which increase graft inflow and decrease graft outflow, and are most frequently found in the calf. Discrimination between these haemodynamically differing branches at operation proved difficult. Since patent branches never improve distal graft flow and may reduce it, we recommend that all fistulae are ligated at operation.

Adult↗