ABSTRACT
In order to place the issue of CABG surgery in the elderly in a personal perspective, we have reviewed our series of 250 consecutive patients 70 years or greater in age at the time of surgery and have noted a very acceptable (3.6%) operative mortality. Good short and long term survival has been documented. A modest but important elevation of postoperative CNS morbidity has been documented and remains of concern. We have continued to offer CABG to those patients with acceptable risks who have either intractable angina, intractable ischemic heart failure and multi-vessel disease. Left main obstruction of a significant degree or those with threatening three vessel anatomy in association with a sentinel ischemic event are candidates for the CABG procedure. Substantial preoperative evaluation to include the family support substrate must be an important part of the decision process as well as open communication with concerned family members. We feel that the improved life style and enhanced survival justifies CABG in those elderly patients identified with severe coronary artery disease.
Subject(s)
Coronary Artery Bypass , Aged , Aged, 80 and over , Anesthesia, General , Coronary Artery Bypass/methods , Coronary Artery Bypass/mortality , Coronary Disease/physiopathology , Coronary Disease/surgery , Female , Humans , Male , Risk Factors , Survival RateABSTRACT
A newborn infant with aortic atresia and aortico-left ventricular tunnel was successfully treated by Konno aortoventriculoplasty. A 15 mm Ionescu-Shiley pericardial xenograft was inserted when the patient was 5 days old and it was replaced with a 19 mm St. Jude Medical prosthesis at 2 years of age.
Subject(s)
Aorta/abnormalities , Aortic Valve/abnormalities , Cardiac Surgical Procedures/methods , Heart Ventricles/abnormalities , Bioprosthesis , Blood Vessel Prosthesis , Heart Valve Prosthesis , Humans , Infant, NewbornABSTRACT
Forty-seven Mobin-Uddin interruption filters were successfully placed and observed for an average of four years. One patient had a recurrent nonfatal pulmonary embolus. One patient died as a direct result of filter placement, secondary to retroperitoneal hemorrhage. Postoperative venous sequellae were evident in 17 of 33 patients observed for long term follow-up study, eight of whom required symptomatic therapy. Ultimate venous sequellae correlate primarily with preoperative venous conditions.
Subject(s)
Vena Cava, Inferior/surgery , Adult , Aged , Filtration , Fluoroscopy , Follow-Up Studies , Gastrointestinal Hemorrhage/etiology , Humans , Methods , Middle Aged , Postoperative Complications/mortality , Prostheses and Implants , Pulmonary Embolism/surgery , Recurrence , Time FactorsABSTRACT
Extensive information has been made available relative to the physical aspects necessary for calculation of radiation absorbed dose from radiopharmaceuticals. A similar data base for the biological factors involved in these calculations has not been documented as thoroughly. The authors present an extensive literature review for the radiation absorbed dose of 131I-ortho-iodohippurate and discuss the rationale for adjusting previously accepted values with new biodistribution information.
