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Biomedical subjects

A A Sader

Publications and source records attributed to A A Sader.

At least 19 recordsLinked to original sources

Viability of single-pedicled tracheal flaps: an experimental study.

1. The objective of the present study was to test the viability of tracheal flaps of different widths and lengths for tracheal reconstruction in dogs, as well as the location of their pedicles. 2. Six types of single-pedicled tracheal flaps were prepared in 30 dogs as follows: narrow flaps with upper pedicles, wide flaps with upper pedicles, narrow flaps with lower pedicles, wide flaps with lower pedicles, narrow flaps with side pedicles, and wide flaps with side pedicles. 3. Flap condition was determined on the basis of clinical signs and by tracheoscopic, macroscopic and microscopic examination. 4. No statistically significant difference in viability was observed between narrow and wide flaps or between flaps with upper and lower pedicles, but all were less viable than side-pedicled flaps. 5. Poor coaptation of the flap borders produced deformities of tracheal architecture, with a significant incidence of necrosis occurring in poorly positioned flaps. The presence of poor coaptation was statistically significant in narrow flaps. Focal infection appears to influence the development of necrosis. We did not observe fibrosis or granulation tissue in sufficient amounts to cause significant stenosis of the tracheal lumen. 6. We conclude that single-pedicled tracheal flaps are viable and can be used for tracheal reconstruction when they are prepared with a length-width ratio of 5 to 10.

Animals

[Surgical treatment of dysphagia lusória].

Two cases of this anomaly, in women (26 and 49 years old), with symptoms of short duration (4 and 3 months) of dysphagia, regurgitation and esophagitis, without loss of weight, are presented. In both, the final diagnosis was made by mean of thoracic aortogram. Esophagoscopy realized only in the first patient, demonstrated the pulsatile esophageal compression. The first patient was operated on through a right cervical incision, made in the anterior border of the sternomastoid muscle. In the second, a partial sternotomy, combined with a right supraclavicular prolongation, was used. In both, the anomalous artery was taken from the aorta and behind the esophagus, and anastomosed to the right common carotid artery. The dysphagia disappeared in the second case, but persisted attenuated, in the first one. Manometric studies realized in the 3rd and 18th months postoperatively demonstrated an aperistaltic segment of the esophagus (between 4 and 7 cm from the superior sphincter).

Adult

Intraoperative measurement of the orifice area in patients with mitral valve stenosis.

This study was carried out in ten patients in order to compare results of mitral valve area evaluated by a new intraoperative technique and those provided by conventional hemodynamic methods. The results obtained correlated very well (r = 0.95) with values calculated by the Gorlin formula. Paired data checking were closer than 0.3 cm2 in all but one of patients with moderately severe mitral stenosis. It is concluded that the method for intraoperative measurement of the mitral valve area is simple, safe and reliable.

Adolescent

Impairment of baroreflex control of the sinoatrial node after cardiac operations with extracorporeal circulation in man.

The sensitivity of the baroreceptor reflex to transient hypertension was determined in 13 patients before (control) and after (72 hours) open cardiac operations with extracorporeal circulation (ECC). In all patients early postoperative values were appreciably decreased (p less than 0.01) as compared to the preoperative values. This decrease suggested severe impairment of baroreflex control of the sinoatrial node. These changes were not correlated with concurrent alterations in heart rate or systemic arterial, left atrial, or right atrial pressures. In addition, respiratory sinus node arrhythmia was absent in all subjects. In four patients, subsequent studies 4, 8, 10, and 12 months, respectively, after the operation revealed good recovery of baroreflex sensitivity and respiratory influences on beat-to-beat variation. No similar effects were observed in two patients studied before and after cardiac operations without ECC. It is possible that direct trauma to the nervous supply of the sinoatrial node is a major factor in that reversible dysfunction; in fact, in three patients evidence was obtained that while sinoatrial node responses were impaired, the reflex control of the atrioventricular region remained unaltered. These findings point to further impairment of the fine control of heart rate imposed by the conditions of cardiac operations with ECC in patients with previously curtailed cardiac reserve.

Adolescent