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Techniques for fabrication and use of external catheter molds. 外导管模具的制造和使用技术。
Pub Date : 1976-05-01 DOI: 10.1177/153857447601000302
G R Smith, G A Weis
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引用次数: 0
Bypass to anterior descending coronary artery in patients with aneurysm or scarring of left ventricle. 冠状动脉前降支搭桥术治疗左心室动脉瘤或瘢痕。
Pub Date : 1976-05-01 DOI: 10.1177/153857447601000301
S Gerami, L C Nunnally, M L Scott

Fifteen cases who have had myocardial infarction with aneurysm formation or severe scarring of the left ventricle as a result of occlusion of left anterior descending coronary artery are presented. Bypass to left anterior descending coronary artery using internal mammary artery or saphenous vein was done in all of these patients. Ten of these had plication or excision of the left ventricular aneurysm. All of them survived the operation and are doing well. Early results in this series of patients indicate that left anterior descending coronary artery bypass in these patients is of great value by allowing perfusion to patent brances of left anterior descending coronary artery.

本文报告15例因左冠状动脉前降支闭塞而致心肌梗塞并左心室形成动脉瘤或严重疤痕的病例。所有患者均经乳腺内动脉或隐静脉转左冠状动脉前降支。其中10例有左心室动脉瘤增生或切除。他们都在手术中幸存下来,目前情况良好。这一系列患者的早期结果表明,在这些患者中,左前降支搭桥术可以使灌注通畅左前降支,具有重要的价值。
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引用次数: 2
The experimental use of distal arteriovenous fistulae in canine iliofemoral thrombophlebitis. 动静脉远端瘘管在犬髂股血栓性静脉炎中的实验应用。
Pub Date : 1976-03-01 DOI: 10.1177/153857447601000206
W D Turnipseed, W E Evans
From the Department of Surgery, Division of Peripheral Vascular Surgery, The Ohio State University Hospital, 410 West Tenth Avenue, Columbus, Ohio 43210. Address for Reprints: William D. Turnipseed, M.D., University of Wisconsin Hospitals, Department of Surgery, 1300 University Avenue, Madison, Wisconsin 53706. * Present address: William D. Turnipseed, M.D., Assistant Professor of Surgery, University of Wisconsin Medical School, Madison, Wisconsin. Acute ileofemoral venous occlusion due to thrombophlebitis is frequently accompanied by massive edema of the lower extremity. Inflammatory destruction of valves, static venous hypertension, and incomplete recanalization ultimately result in chronic changes of the postphlebitic syndrome. Various surgical techniques, including the use of early thrombectomy, autogenous vein grafts and patches, prosthetic conduits, and venovenous cross
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引用次数: 1
Popliteal aneurysms. 腘动脉瘤。
Pub Date : 1976-03-01 DOI: 10.1177/153857447601000205
W E Evans, W D Turnipseed

Eighty-six popliteal aneurysms in 52 patients have become limb threatening. Popliteal aneurysms should be sought for and when found elective replacement should be considered.

52例患者中86例腘动脉瘤已危及肢体。腘窝动脉瘤应及时寻找,发现后应考虑择期替代。
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引用次数: 7
Intraoperative antibiotics in the prevention of experimental dacron graft infection. 术中抗生素在预防实验性涤纶移植物感染中的应用。
Pub Date : 1976-03-01 DOI: 10.1177/153857447601000202
F Parsa, H E Gordon, S E Wilson
Moore and colleagues have shown that newly inserted Dacron-) vascular grafts are very susceptible to infection from circulating bacteria.’ Since S. Martin Lindenauer demonstrated in 1967 that prophylactic use of penicillin prevented the infection of Teflon patch grafts in a group of five dogs, experiments have been designed to justify the widespread use of prophylactic antibiotics in vascular surgery.’ 6
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引用次数: 3
Risk factors and coronary artery obstruction in male and female patients with aortocoronary bypass operation. 男性和女性冠状动脉绕道手术患者的危险因素及冠状动脉阻塞。
Pub Date : 1976-03-01 DOI: 10.1177/153857447601000204
J J Barboriak, A A Rimm, A J Anderson, F E Tristani, J A Walker, R J Flemma

In order to learn about some possible reasons for the low proportion of women among the patients with aortocoronary bypass operation (12-20%) we have compared the prevalence of hypertension, hyperlipidemia, history of smoking and chest pain in 110 women and 813 men with this surgical intervention. In spite of the similar or even higher prevalence of abnormal risk factors, the women patients showed less extensive coronary artery impairment than the male patients indicating their higher tolerance of the risk factors and lesser need for the bypass operation.

为了了解女性在冠状动脉搭桥术患者中所占比例较低(12-20%)的一些可能原因,我们比较了110名女性和813名男性接受该手术的患者的高血压、高脂血症、吸烟史和胸痛的患病率。尽管异常危险因素的发生率相似甚至更高,但女性患者冠状动脉损害的广泛性低于男性患者,这表明女性患者对危险因素的耐受性更高,对搭桥手术的需求较小。
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引用次数: 2
Reconstruction of the cardiac valves with autologous tissue. 自体组织重建心脏瓣膜。
Pub Date : 1976-03-01 DOI: 10.1177/153857447601000207
C P Bailey, J Zimmerman, T T Hirose, F S Folk, A A Bakst

A rather long and extensive experience with tissue reconstruction in patients with mitral valve disease, and a much less extensive one with oartic lesions, has convinced us of the superiority of the presented techniques of reconstruction, and of the preferability of fascia lata over all other tissues so far tried for this purpose. Despite an early increment of shrinkage of the order of about 30% of each linear measurement, late studies of fascia lata removed from reconstructed valves after several years (over five) indicate no loss of cellularity and no measurable loss of tissue strength or flexibility. Late calcification was not observed in any of our baboons, although it appears to be a consistent development in dogs. It has been seen in only one patient (after four years) to date. It is now believed that we can offer prolonged clinical benefit approaching actural "cure" to many of the younger patients who otherwise would have no recourse but to prosthetic palliation. It is true that recently Willen, Dubiel and Johansson (50, 51), Gersbach and Wegmann (52), and Senning and Rothlin (53) have demonstrated that repetitive deposits of fibrin upon the surfaces of fascia lata implanted within the cardiovascular chambers lead to progressive encapsulation with organizing connective tissue (scar). At some time period following surgery, closer to 10 years than to 5, degeneration of the fascia takes place, presumably due to "strangulation" by the organized exudate which interrupts the "normal" mechanism of its nutrition which is based upon diffusion from the flowing blood. The recent contributions of Sullivan, Harken and Gorlin (54), Weily and Genton (55), and Harker and Slicter (56) to our understanding of the role of the platelets in initiating such fibrinous deposition now provide us with a way to prevent such late degeneration of valves made of fascia lata. The regular administration of platelet dispersing agents (aspirin, Persantin, or inderol) in ordinary therapeutic dosage would seem to be completely protective. Undoubtedly, anticoagulant therapy would be equally effective. However, the permanent maintenance of a proper level of "anti-coagulation" such as is usually deemed necessary following implantation of a prosthetic heart valve is a heavy psychological and biological burden for a patient to bear. Many such individuals live precariously between the risks of thromboembolism and the risks of hemorrhage. Thromboembolism really only represents a farther point along the spectrum of the readiness of fibrin accumulation following initial platelet aggregation and deposition. Since frank thromboembolism appears "never" to follow intracardiac implantation of fascia lata, it would seem that platelet dispersive therapy sould suffice in such cases.

对二尖瓣疾病患者进行组织重建的长期和广泛的经验,以及对耳廓病变的不那么广泛的经验,使我们确信所提出的重建技术的优越性,以及阔筋膜比迄今为止尝试的所有其他组织更可取。尽管每次线性测量的早期收缩幅度约为30%,但对几年后(超过5年)从重建瓣膜中移除的阔筋膜的后期研究表明,没有细胞的损失,也没有可测量的组织强度或柔韧性的损失。在我们的狒狒中没有观察到晚期钙化,尽管它在狗身上似乎是一致的发展。到目前为止,只有一位患者(四年后)出现了这种情况。现在相信,我们可以为许多年轻患者提供接近真正“治愈”的长期临床益处,否则他们将别无选择,只能求助于假肢姑息治疗。最近,Willen, Dubiel和Johansson (50,51), Gersbach和Wegmann (52), Senning和Rothlin(53)证明,植入心血管腔内的筋膜表面纤维蛋白的重复沉积会导致结缔组织(瘢痕)的进行性包裹。在手术后的一段时间内,大约10年而不是5年,筋膜变性发生,可能是由于有组织的渗出物“扼杀”,从而中断了基于流动血液扩散的“正常”营养机制。Sullivan, Harken和Gorlin (54), Weily和Genton(55),以及Harker和Slicter(56)最近对血小板在启动这种纤维沉积中的作用的理解,为我们提供了一种预防阔筋膜瓣膜晚期变性的方法。常规治疗剂量的血小板分散剂(阿司匹林、泊桑丁或吲哚酚)似乎具有完全的保护作用。毫无疑问,抗凝治疗同样有效。然而,在植入人工心脏瓣膜后,永久维持适当的“抗凝”水平通常被认为是必要的,这对患者来说是一种沉重的心理和生理负担。许多这样的人生活在血栓栓塞的危险和出血的危险之间。血栓栓塞实际上只代表了在初始血小板聚集和沉积后纤维蛋白蓄积准备程度谱上的一个更远的点。由于明显的血栓栓塞似乎“永远不会”在心内阔筋膜植入后发生,因此在这种情况下,血小板分散治疗似乎就足够了。
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引用次数: 1
Pulmonary artery dissection and rupture in Eisenmenger's syndrome. 艾森曼格综合征肺动脉剥离与破裂。
Pub Date : 1976-03-01 DOI: 10.1177/153857447601000203
B Placik, S Rodbard, J McMahon, S Swaroop

A patient with ventricular septal defect and pulmonary arterial hypertension (Eisenmenger's syndrome) associated with aortic coarctation with follow-up for 19 years, and with rupture of an aneurysmatic pulmonary artery is described. An incident of extreme fright with a possible transient systemic hypertension may have precipitated the dissection of the pulmonary arterial intima and the rupture.

本文报道一例室间隔缺损合并肺动脉高压(艾森门格综合征)合并主动脉缩窄的患者,随访19年,并发动脉瘤性肺动脉破裂。一次可能伴有一过性全身性高血压的极度惊吓事件可能导致肺动脉内膜剥离和破裂。
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引用次数: 22
Long term evaluation of allogenic veins as arterial grafts. 同种异体静脉作为动脉移植的长期评价。
Pub Date : 1976-03-01 DOI: 10.1177/153857447601000208
R R Kraeger, J A Lagos, H B Barner

Ten pairs of mongrel dogs had bilateral femoral artery reconstruction using the femoral veins from the other of each pair. Four grafts failed in the first two weeks and 16 grafts failed in pairs within two to four weeks of each other up to 15 months. Five dogs died with patent grafts between 15 and 42 months and five dogs were sacrificed at 42 months with patent grafts. Aneurysmal degeneration did not occur. Normal architecture of the vein was destroyed by fibrous replacement, but a few smooth muscle cells and adventitial elastic fibers persisted. Gross and microscopic mural thrombi were present in half the grafts indicating continued endothelial instability at 42 months. Osseous metaplasia was found in five grafts. Allogenic vein is an acceptable substitute when autogenous vein is lacking for femorotibial bypass and urgent femoropopliteal bypass.

10对杂种犬用另一对的股静脉重建双侧股动脉。4例移植在头两周内失败,16例移植在两到四周内成对失败,直至15个月。5只狗在15 ~ 42个月间死亡,5只狗在42个月时死亡。未发生动脉瘤样变性。静脉的正常结构因纤维置换而被破坏,但少量平滑肌细胞和外膜弹性纤维仍然存在。肉眼和显微镜下有一半的移植物存在附壁血栓,表明42个月时内皮细胞继续不稳定。5例移植物发生骨化生。同种异体静脉在股胫搭桥术和紧急股腘搭桥术中缺乏自体静脉时是一种可接受的替代方法。
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引用次数: 10
Postoperative arrhythmias in open-heart surgery, A study on fifty cases. 心内直视手术后心律失常50例分析。
Pub Date : 1976-01-01 DOI: 10.1177/153857447601000106
G Gürsel, A Karamehmetoğlu, A Y Bozer, A Saylam

50 consecutive patients undergone open heart surgery were analyzed regarding postoperative arrhythmias in the first postoperative 3 days. Disturbances of rhythm occurred in each case of our group, serious or not serious (100%). Ventricular premature beats were the most frequent type of arrhythmia in the first and second postoperative days (80%). Two cases expired postoperatively. In one of them complete atrioventricular block developed after double valvular replacements (mitral and tricuspid). The other died of low cardiac output syndrome. Etiology of the arrhythmias after open heart surgery is not clear in the absence of electrolyte and metabolic disturbances, digitalis intoxication and surgical trauma to the conduction system and coronary arteries. Low cardiac output syndrome, hypotension and hypoxia can also be blamed in the formation of these arrhythmias. Other factors such as the prolongation of anoxic arrest, irritation of the ventricular septum by valvular prostheses, cardiac irritation by thoracic tubes, psychologic trauma, halothane anesthesia and coronary arterial disease in the old age group may be the possible predisposing factors in these patients.

分析50例连续行心内直视手术患者术后3天内的心律失常情况。本组每例患者均出现节律紊乱,严重或不严重(100%)。室性早搏是术后第一天和第二天最常见的心律失常类型(80%)。2例术后死亡。其中一例在双瓣膜置换术(二尖瓣和三尖瓣)后发生完全性房室传导阻滞。另一个死于低心输出量综合征。在没有电解质和代谢紊乱、洋地黄中毒、传导系统和冠状动脉手术损伤的情况下,心内直视手术后心律失常的病因尚不清楚。低心输出量综合征,低血压和缺氧也可归咎于这些心律失常的形成。其他因素如缺氧停搏时间延长、瓣膜假体对室间隔的刺激、胸管对心脏的刺激、心理创伤、氟烷麻醉和老年人群的冠状动脉疾病等可能是这些患者的易感因素。
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引用次数: 2
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Vascular surgery
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