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Unusual congenital coronary arterio-venous fistulae with surgical correction. 不寻常的先天性冠状动脉-静脉瘘的手术矫正。
Pub Date : 1977-01-01 DOI: 10.1177/153857447701100103
Z Feigenberg, E Kaplinsky, L Kissin, M J Levy

A typical case of anginal syndrome in a fifty year old male has been described. The underlying lesion was congenital coronary arterio-venous fistula between the left anterior descending branch of the left coronary artery and pulmonary artery. Diagnosis has been made by coronary angiography and proved at operation. The patient underwent successful operation where a multiple fistulous ostia draining into the pulmonary trunk were obliterated by means of extracorporeal circulation. The pertinent literature related to this congenital anomaly and symptomatology has been reviewed.

一个典型的案例心绞痛综合征在一个50岁的男性已被描述。基础病变为先天性冠状动脉动静脉瘘,位于左冠状动脉左前降支与肺动脉之间。经冠状动脉造影诊断,手术证实。病人接受了成功的手术,其中多个瘘口引流到肺干被体外循环闭塞。有关这种先天性异常和症状的相关文献已被审查。
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引用次数: 4
A new method to revascularize the celiac axis. 腹腔轴血运重建的新方法。
Pub Date : 1977-01-01 DOI: 10.1177/153857447701100107
F Robicsek, H K Daugherty, J W Cook, B J Owen
While the fact that chronic celiac artery obstruction is compatible with long-term survival has been known to the patholgist for more than a century,3 the clinical significance of this condition as a possible cause of upper abdominal discomfort and pain has been appreciated only for the past three decades. 1, 2, 4-26 Three different factors have been incriminated as the principal cause of this disease: arteriosclerosis 6, 8, 1g°’s fibroelaStoSiS2’ and compression by the arcuate ligament. 1, 7, 9, 17, 24, 26 Operative indication for celiac artery disease is a controversial issue. While most investigators’, 6, 9, 12, 14, 16 believe that isolated celiac artery obstruction could indeed cause significant clinical symptoms, others 13, &dquo;° 18, 24 state that blood flow through the mesenteric artery usually compensates for celiac artery disease, and the syndrome of &dquo;abdominal angina&dquo; does not occur unless both of these vessels are diseased. Szilagyi, 25 a noted authority in the field, even doubts the existence of celiac artery obstruction as a clinical syndrome. In cases where the impediment of the celiac flow is caused by external compression by the arcuate ligament, simple division of this ligament proved to be an effective solution.!’ 9, 16, z4° ~’b If the cause of the obstruction, however, lies in the arterial wall or within the lumen, it is evident that a more radical procedure is necessary. Studying the pathologic anatomy of celiac artery disease in 1961, Morris&dquo; found that a direct attack on this short and hidden artery had a number of undesirable technical features, and recommended the &dquo;adaption of the bypass principle as the safest and most satisfactory method&dquo; for restoring normal circulation in the splanchnic area. To him the splenic artery appeared to be the most suitable vessel to receive a bypass graft intended to revascularize the entire celiac system. Morrisl8° 19 indeed performed a number of successful such operations using knitted Dacron tubes anastomosed end-to-side to the abdominal aorta and the
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引用次数: 6
Intracardiac repair after previous pulmonary artery banding. 先前肺动脉绑扎后的心内修复。
Pub Date : 1977-01-01 DOI: 10.1177/153857447701100102
J D Marco, H Laks, H B Barner, V L Willman
Surgical treatment of infants with a large ventricular septal defect (VSD) unresponsive to medical therapy is sometimes indicated. Pulmonary artery banding originally described by Muller in 19521 has proven to be an adequate operation for controlling high pulmonary flow. In the past, a two staged procedure consisting of pulmonary artery banding followed by debanding and VSD closure has been used.2 More recently primary closure during infancy using deep hypothermia has been advocated.3 We have reviewed the results of debanding and VSD closure in an attempt to set a standard with which to compare primary closure which we now use.
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引用次数: 0
Anomalous venous drainage of the right lung with associated dextroposition: a case report. 右肺异常静脉引流伴右位1例。
Pub Date : 1977-01-01 DOI: 10.1177/153857447701100108
T L Fudge, J L Ochsner
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引用次数: 0
Correction of transposition of the great arteries using homologous dura mater: a preliminary report. 用同源硬脑膜矫正大动脉转位:初步报告。
Pub Date : 1977-01-01 DOI: 10.1177/153857447701100104
C R Moraes, G Tompson, M Arruda, J R Lagreca, I Cavalcanti, E Victor, M Escobar, M D de Oliveira
were present. His blood pressure was 100/70 mm Hg, and the pulse regular at 100/minute. The heart showed a hyperdynamic right ventricular impulse. A Grade II/VI systolic murmur was heard in the second and third intercostal spaces at the left sternal edge. The second heart sound was loud at the pulmonic area. The ECG showed right ventricular hypertrophy. On the chest x-rays, the heart appeared slightly enlarged and an increase in pulmonary vascular markings could be noted. Cardiac catheterization data is given in Table I. The cineangiograms (Fig. 1) established the diagnosis of simple transposition of the great arteries.
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引用次数: 3
Arterial emboli and malignant disease. 动脉栓塞和恶性疾病。
Pub Date : 1977-01-01 DOI: 10.1177/153857447701100105
G Acharya, E Garick
Four cases of Arterial Emboli are reported. Association is suggested be tween peripheral arterial emboli and malignant disease. No definite mecha nism for this association has been established but a malignancy-induced alteration of the clotting mechanism is postulated. In any general hospital, peripheral arterial embolization is not an uncom mon event. Immediate therapy since the introduction of the Fogarty catheter, has become fairly standardized and has been very successful in salvaging ischemic limbs. The long-range outlook, however, is dependent on the identification of the source of emboli and the institution of appropriate corrective or preventive measures. In many clinical reviews of peripheral arterial embolization, the probable source of the embolus could be reasonably established in 90% of the cases. Nevertheless, in each series there remains 10% of cases in which no source of embolus could be identified. 1 Over the past two years at The Memorial Hospital we have accumulated a series of patients with peripheral arterial embolization and all of whom had proven malignancies. We are presenting this series as a postulated causative association between peripheral arterial embolization and the malignant state.
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引用次数: 6
The effects of methylprednisolone on the complications of coronary artery surgery. 甲基强的松龙对冠状动脉手术并发症的影响。
Pub Date : 1977-01-01 DOI: 10.1177/153857447701100101
G Rao, J King, W Ford, G King

Complications of coronary artery surgery were analyzed in a prospective controlled study of 150 patients, one group receiving methylprednisolone before temporary cardiopulmonary bypass. The patient population was comparable in both the groups. The number of deaths were the same in both the groups, myocardial infarction and cardiac arrhythmias were definitely lower in the Solu-Medrol group. Cerebral vascular accidents were higher in the control group and there were none in the drug treated group. Incidences of pulmonary embolism was reduced by the drug. Oxygen consumption by the tissues was higher in the Solu-Medrol treated group. There were no known complications of the drug, such as stress ulcer and infection. One patient did receive prophylactic antibiotics. Solu-Medrol was deliberately given in patients who were known to have uncomplicated duodenal ulcer. Post-operative bleeding in patients with duodenal ulcer was not noted. This could be explained due to the short acting nature of Solu-Medrol. We feel that Solu-Medrol does minimize serious sequelae of heart-lung machine in coronary artery surgery.

在一项150例患者的前瞻性对照研究中分析了冠状动脉手术的并发症,其中一组在临时体外循环前接受甲基强的松龙治疗。两组患者人群具有可比性。两组的死亡人数相同,舒美劳组的心肌梗死和心律失常明显较低。对照组脑血管意外发生率较高,药物治疗组无脑血管意外发生。该药降低了肺栓塞的发生率。舒美劳组组织耗氧量较高。该药物没有已知的并发症,如应激性溃疡和感染。一名患者确实接受了预防性抗生素治疗。对已知无并发症的十二指肠溃疡患者故意给予甲地劳。十二指肠溃疡患者术后出血未见报道。这可能是由于索罗-美德龙的短效性质造成的。我们认为舒美劳在冠状动脉手术中可以减少心肺机的严重后遗症。
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引用次数: 28
The effect of suture material in the development of vascular infection. 缝合材料在血管感染发展中的作用。
Pub Date : 1977-01-01 DOI: 10.1177/153857447701100106
P Dineen
Seven different suture materials were evaluated in a standard rabbit aortotomy model as to infectability. Two monofilament sutures were found to have the lowest infection rate on the suture line as compared to multifilament material. It is assumed that this result is on the basis of the physical properties of the suture material. Infection of vascular anastomeses is an extremely serious complication. In 1971, the ten year experience of this Center was reported. The overall attack rate was low (0.25%) which represented 15 infections in 5,988 vascular procedures. However, of the 15 infected anastomoses 11 patients died a mortality of 73%. The most common etiologic agent in these infections was Staphylococ-
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引用次数: 17
Metastatic Wilms' tumor in the right atrium propagated through the inferior vena cava. 右心房转移瘤经下腔静脉扩散。
Pub Date : 1976-11-01 DOI: 10.1177/153857447601000503
A Aytac, T Tuncali, K Tinaztepe, C Ikizler, A Saylam

A patient with a rare case of cardiac tumor in the right atrium secondary to Wilms' tumor of the right kidney, underwent open heart surgery and removal of the mass was presented. This is the 10th. case of intracardiac tumor secondary to renal malignancy. Careful auscultation of the heart is necessary in patients with malignancy in the kidney to detect the possible right heart metastases through the inferior vena cava. Cardiac symptoms precede the renal manifestations in most cases. Malignant renal metastases to the heart should always be in mind in space occupying masses of the right heart chambers.

一例罕见的右心房心脏肿瘤继发于右肾Wilms肿瘤的病例,接受了心内直视手术并切除了肿块。这是10号。肾恶性肿瘤继发心内肿瘤1例。对于肾脏恶性肿瘤患者,仔细的心脏听诊是必要的,以发现可能通过下腔静脉的右心转移。在大多数病例中,心脏症状先于肾脏表现。恶性肾转移到心脏应始终铭记在空间占位性肿块右心室。
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引用次数: 14
Popliteal artery entrapment syndrome. 腘动脉夹持综合征。
Pub Date : 1976-11-01 DOI: 10.1177/153857447601000502
H A Berkoff, A B Crummy
Intermittent claudication in the young is unusual. The most common cause is premature atherosclerosis; however, conditions such as thromboangitis obliterans, embolism, trauma, cystic disease of the adventitia or popliteal artery entrapment are diagnostic considerations. Entrapment of the popliteal artery by an anomalous muscle attachment or fibrotic band may result in external compression of the popliteal artery. Such compression can cause acute ischemia, and over a period of time the artery may develop irreversible changes secondary to repeated trauma. Certain aspects of the symptoms complex may serve to alert one of the possible presence of the popliteal artery entrapment syndrome. The following case is illustrative.
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引用次数: 3
期刊
Vascular surgery
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