Regional blood flow distribution with whole-body perfusion.
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Animals↗
Biomedical subjects
A S Hudspeth
Publications and source records attributed to A S Hudspeth.
Experimental pulmonary infarct: an embolus technique for producing pulmonary infarcts in healthy dogs.
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Animals↗
Case report. Aortic pseudoaneurysm with aortobronchial fistula: diagnosis with CT angiography.
We report the case of an 82-year-old man with a 12-month history of recurrent hemoptysis caused by an aortobronchial fistula. Twenty-five years earlier, the patient underwent placement of an aortic graft for aortic transection sustained in a motor vehicle accident. Chest radiography and bronchoscopy showed nonspecific abnormalities. We emphasize the role of CT angiography with 2D and 3D reconstructions for the diagnosis of and surgical planning for this rare but potentially lethal aortic postoperative complication.
Aged↗
Subxiphoid pericardial window for pericardial effusive disease.
A subxiphoid pericardial window made in 123 patients allowed drainage and diagnosis of pericardial effusions. In 40 patients with malignancy and effusions, median drainage was 450 ml; cytology was positive in 17 or 36 (47%), and pericardial biopsy showed cancer in 13 (43%) of 30 patients. In 11 patients with malignancy, both cytology of effusions and biopsy of the pericardium were negative. In 83 patients with benign effusions, median drainage was 400 ml. Effusions recurred in 14 of the 123 patients (11%); nine patients in the benign group and five in the malignant group. Five of these 14 underwent thoracotomy (3 to 542 days postoperatively); two underwent median sternotomy and one underwent pericardiocentesis. Two intraoperative deaths resulted from cardiac arrest. Mortality at 30 days was 25% (10/40 patients) in the malignant group and 11% (9/83 patients) in the benign group. No deaths resulted from recurrent effusions. The establishment of a subxiphoid pericardial window allows rapid and safe drainage of pericardial effusions with sampling for cytology and pericardial biopsy. It has minimal morbidity and few recurrent effusions.
Drainage↗
Open mitral commissurotomy: long-term results with echocardiographic correlation.
Over 11 years, 91 patients with isolated mitral stenosis underwent open mitral commissurotomy. Twenty-nine were 50 or more years old; 15 had had prior commissurotomies. Four (4.4%) died perioperatively; 87 were followed for one to nine years (average: five years). Overall actuarial survival was 94% at 5 years. Sixty-nine patients (79%) were NYHA Functional Class (FC) I or II at latest follow-up. Arterial embolism occurred in five patients; 14 patients (16%) had a second valve operation. Patients who remain in FC I or II and who are free of embolism and reoperation are classified as complication-free. Actuarial analysis demonstrated 76% to be so classified at five years after operation. Actuarial curves show that age older than 40 years, sex, previous commissurotomy, and "radical" versus simple open mitral commissurotomy did not influence survival or the incidence of good results. Follow-up M-mode and 2D echocardiograms were obtained in 42 patients. The estimated mitral orifice accurately separated FC I patients (orifice equal to or larger than 2 cm2) from FC II and FC III patients (orifice smaller than 2 cm2), and showed that echocardiographic evidence of a 2 cm2 or larger mitral orifice correlates with a good result.
Adult↗
Tumors of the heart: surgical considerations.
A series of 23 cardiac tumors is reported. Six were diagnosed at autopsy; 17 tumors were surgically explored. Eleven of the 17 were myxomas within the left atrium. Eight of the 17 patients presented with congestive heart failure; peripheral and cerebral emboli were also common. The diagnosis was made preoperatively in 10 patients. Two-dimensional echocardiography was the most reliable diagnostic tool. Follow-up averages 55 months; there have been no late deaths or recurrences. The other six surgically treated tumors were: a left ventricular rhabdomyoma, a septal lipoma, a right atrial calcified endocardial mass, a right ventricular fibrosarcoma, a rhabdomyosarcoma, and a sarcoma metastatic to the pericardium and right atrium. From this series and a review of the literature, we concluded that: benign cardiac tumors can usually be excised with a low morbidity and excellent long-term results; malignant cardiac tumors have a dismal prognosis, and operation is primarily diagnostic; tumors metastatic to the heart should be operated upon only if successful palliation seems possible.
Adult↗