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Biomedical subjects

A M Hayden

Publications and source records attributed to A M Hayden.

7 recordsLinked to original sources
PubMed1998

Transmyocardial revascularization surgery.

Transmyocardial revascularization (TMR) surgery is a palliative and investigative surgical procedure with the goal of increasing the quality of life for patients with intractable angina pectoris who are unsuitable for percutaneous transluminal coronary angioplasty or coronary artery bypass graft surgery. It improves myocardial perfusion and oxygen supply to the left ventricle, thus decreasing the frequency and intensity of anginal episodes. Many patients continue to have episodes of angina post-operatively but the frequency of those episodes should decrease. TMR may be a good treatment option for otherwise untreatable patients who live with severe, debilitating angina.

Critical Care↗
PubMed1997

Balloon atrial septostomy increases cardiac index and may reduce mortality among pulmonary hypertension patients awaiting lung transplantation.

The prognosis for patients with pulmonary hypertension is extremely poor. Predictors of poor prognosis among these patients include a cardiac index less than 2.8 L/m/m2, a mean pulmonary artery pressure higher than 50 mm Hg, a mean right atrial pressure more than 10 mm Hg, and PaO2 less than 70 mm Hg. Balloon atrial septostomy was performed as a palliative procedure in six patients with pulmonary hypertension to limit further deterioration while they awaited lung transplantation. The goal of balloon atrial septostomy was to increase cardiac output while limiting the reduction in systemic oxygen saturation to less than 10% of baseline. This procedure may proven to be a valuable adjunct to reduce morbidity and mortality from right ventricular failure for pulmonary hypertension candidates awaiting lung transplantation.

Adolescent↗
PubMed1996

Relationship between donor/recipient lung size mismatch and functional outcome in single lung transplantation for COPD.

Single lung transplantation is an effective treatment for patients with severe chronic obstructive pulmonary disease. Pulmonary hyperinflation, which is seen in most patients with severe chronic obstructive pulmonary disease, makes the task of appropriately matching the donor and recipient difficult. It seems that the optimal matching strategy remains undefined. No correlation between donor/recipient size match (actual and predicted) and the degree of functional improvement after single lung transplantation was found. There were no significant differences noted when comparing the functional outcomes of right and left lung transplant recipients. It was concluded that the chronic hyperinflation associated with severe chronic obstructive pulmonary disease allows for the use of significantly larger donors. The use of expanded donor/recipient size match criteria in patients with severe chronic obstructive pulmonary disease may shorten the waiting period prior to single lung transplantation and provide better utilization of donor organs.

Aged↗
PubMed1993

Primary diagnosis predicts prognosis of lung transplant candidates.

Optimal timing for consideration of lung transplantation remains unknown. This study examined survival in patients with end-stage lung disease awaiting transplantation. Primary disease group and relevant indicators were evaluated. Ninety-three patients who met selection criteria for lung transplantation were included in this retrospective review. Of this total, 31% underwent transplantation, 38% remain waiting, and 31% died. Results demonstrate that the six-month actuarial survival rate was 89% for Eisenmenger's syndrome, 81% for emphysema, 74% for cystic fibrosis, 60% for primary pulmonary hypertension, and 38% for interstitial lung disease. Parameters found to be significant included a higher mean right atrial pressure in primary pulmonary hypertension patients who died awaiting transplantation, and lower forced expiratory volume in one second and forced vital capacity measurements in cystic fibrosis patients who died awaiting transplantation. We conclude that primary disease significantly affects survival in candidates awaiting transplantation. Reliable indicators predictive of survival are not available. Earlier referral for consideration of lung transplantation is recommended.

Adolescent↗
PubMed1990

Effects of background event rate on sustained attention of mentally retarded and nonretarded adults.

Mentally retarded and nonretarded adults performed four, 60-minute visual vigilance tests in which single digits were presented at either a fast or slow rate. The target event was a "skipped" digit. During two tests the event rate shifted without warning to the alternate event rate after 30 minutes of the vigil. Retarded observers detected fewer targets and made more false alarms than did nonretarded observers in all test conditions. Shifts in event rate influenced the frequency of false alarms made by retarded observers. The differences in performance of retarded and nonretarded adults favor a memory deficit explanation.

Adolescent↗
PubMedDate not supplied

Lung transplantation without the use of antilymphocyte antibody preparations.

Survival, infection, and rejection rates and functional data are reported in 35 lung recipients treated with triple-drug immunosuppression without antilymphocytic antibody therapy. Early mortality (less than 60 days) was 6%. Thirty recipients (86%) are alive, with a mean follow-up period of 16 months (range, 1 to 36 months). Actuarial survival was 91% at 1 year and 83% at 2 years. Thirty-seven infections occurred in 24 patients. Actuarial freedom from infection was 61% at 3 months and 27% at 1 year. Only one patient died of infection (aspergillosis). Thirty-six episodes of acute rejection were treated in 23 patients. Time to first rejection was 14 +/- 7.8 days. Actuarial freedom from acute rejection was 36% at 2 months. Significant functional improvement was evident in all operative survivors. Pulmonary function and exercise performance data in patients without bronchiolitis obliterans remain stable 1 year after transplantation. We conclude that the use of triple-drug immunosuppression without antilymphocytic antibody preparations in lung transplantation provides effective immunosuppression with a low risk of serious infectious complications.

Actuarial Analysis↗