The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Oct 1981
Stabilization of flail chest by compression osteosynthesis--experimental and clinical results.
It has been demonstrated that the impaired ventilatory parameters can be normalized after early stabilization of flail chest. Most methods for operative fixation, however, have given disappointing results and only plate fixation procedures have been effective. The experimental results of osteosynthesis with dynamic compression plates are presented and demonstrate the superiority of compression osteosynthesis in rib fractures. ⋯ Flail chest combined with intra-thoracic lesions which require thoracotomy. 3. Flail chest combined with lesions which require a prone position for surgical exploration. 4. Respiratory distress patients when the unstable chest wall interferes with mechanical ventilation or with underlying organs.
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Thorac Cardiovasc Surg · Aug 1981
Replacement of the ascending aorta and aortic valve with a composite graft. Results and follow-up in 71 patients.
Composite graft replacement of the ascending aorta and aortic valve was performed in 71 patients over an 8-year period. Degenerative lesions of the aortic root in Marfan's syndrome (annuloaortic ectasia) was the indication for operation in 51 cases. Other causes of aortic root dilatation and aortic valve disease were present in the remaining 20 patients. ⋯ Four year actuarial survival was 77%. Composite graft replacement eliminates paraprosthetic leakage and the risk of aneurysm formation of the sinuses of Valsalva; postoperative hemorrhage is also reduced. It appears to be the method of choice for the aortic root complications of the Marfan's syndrome.
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Thorac Cardiovasc Surg · Jun 1981
Systemic-pulmonary artery shunt using PTFE prosthesis (Gore-Tex). Early results and long-term follow-up on 105 consecutive cases.
One hundred-five patients (median age 14 months) in whom a PTFE prosthesis was used to create a systemic-pulmonary artery shunt were studied between 1978 and 1980. The prosthesis was mainly used to create a modified Blalock-Taussig anastomosis. Nine patients died in hospital (8.5%, 70% confidence limits: 5.7% to 12.3%). ⋯ One graft, which was damaged intraoperatively, occluded 3 months later. The remaining patients have a patent graft 3 months to 36 months (mean 24 months) postoperatively. In 6 patients the patency was assessed angiographically and no damages of the pulmonary artery were observed, therefore this type of palliation is advisable for any patient, particularly in the first year of life.
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Traumatic aneurysms and arteriovenous fistulas may be as common in the developing and less industrialized countries as they are in the developed countries. In a 4 year period 12 cases of traumatic aneurysms and arteriovenous fistulas were seen at the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria. Nine of these resulted from civilian injuries while 3 were due to military activities. ⋯ The vascular lesions were assessed by arteriography in 9 cases. All but one case were treated by excision, the vessels being reconstructed in 7 cases. There was one death due to septicemia.
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Thorac Cardiovasc Surg · Jun 1980
Clinical TrialClinical trial with a percutaneously inserted intra-aortic balloon pump: a wider spectrum of patient application.
The intra-aortic balloon pump has been proven to be an effective form of therapy in a variety of situations involving actual or potential ventricular power failure. An experience with 12 newly-designed percutaneous PERCOR-TM intra-aortic balloon pumps is discussed. Emphasis is made on the ease of insertion and removal, and on the fact that a trained surgical team in an operating room setting is not necessary. Effectiveness of the balloon in comparison to the traditional intra-aortic balloon pump is also discussed.