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Biomedical subjects

B F Mitchel

Publications and source records attributed to B F Mitchel.

At least 19 recordsLinked to original sources
PubMed1979

The treatment of postperfusion bleeding using epsilon-aminocaproic acid, cryoprecipitate, fresh-frozen plasma, and protamine sulfate.

The evaluation of excessive hemorrhage was carried out in 774 patients after cardiopulmonary bypass. Excessive hemorrhage was defined in any adult patient as chest tube drainage of more than 600 ml within the first eight hours after operation. Using the prothrombin time, partial thromboplastin time, fibrinogen level, and tri-F titer tests, it was possible to differentiate medical from surgical bleeding. Hyperfibrinolytic bleeding was the most frequently identifiable coagulation disorder and occurred in 159 patients (20%). All these patients were successfully treated with Amicar (epsilon-aminocaproic acid) alone, or with Amicar supplemented with cryoprecipitate or fresh-frozen plasma. Three patients (0.4%) were noted to have residual heparin and required additional protamine sulfate. Five patients (0.6%) had normal coagulation studies and required immediate reexploration. The overall blood consumption per patient was 2.1 units of packed cells. Whole blood and platelets were not used.

Aminocaproates↗
PubMed1977

Treatment of severe coronary artery disease with 5, 6, and 7 saphenous vein bypasses: review of 131 consecutive patients.

One hundred thirty-one consecutive patients who received 5, 6, and 7 bypass grafts are analyzed. Ages ranged from 31 to 74 years. The male-to-female ratio was 7:1. As an indication of severity of disease, 25% were classified as having impending myocardial infarction and 46.6% were classified in New York Heart Association Functional Class IV. Left ventricular function was impaired in 37.4%, and 30% of the patients had left main coronary obstruction. Nonfatal perioperative myocardial infarction occurred in 4.6%. The hospital mortality was 3%. One hundred percent follow-up (5 to 55 months) revealed 4 late deaths, 3 presumably of cardiac origin. Only 7 patients in the postoperative follow-up group have complained of angina; 1 has since undergone successful reoperation.

Adult↗
PubMed1976

Embolization of disc occluder of a Wada-Cutter mitral prosthesis with survival.

The second recorded survivor following emergency prosthesis replacement after embolization of the Teflon disc occluder of a Wada-Cutter mitral valve is reported. Difficulties encountered while attempting to locate the missing occluder are presented and a useful operative technique for aortic control is described. A plea is made for incorporation of a radiopaque material during manufacture of all future valve poppets.

Adult↗
PubMed1975

Myocardial revascularization in patients with poor ventricular function.

Eighty patients with evidence of impaired ventricular function by ventriculography were reviewed. On the basis of the ejection fraction, these patients were divided into three groups. Those with ejection fractions less than 0.2 were considered in very poor condition, those with ejection fractions of 0.2 to 0.4 were considered in poor condition, and those with ejection fractions with between 0.4 and 0.6 were considered fair. Suitability of vessels for bypassing and the presence or absence of collateral cirulation on the cinearteriograms was also noted for possible influence on result. Operative mortality rate in patients having complete repair, defined as bypassing all major vessels with significant obstruction, was 7 per cent. In 26 patients having incomplete repair, the operative mortality was 30 per cent. However, the late mortality rate was not favorably influenced by complete repair, 75 per cent are in improved or good clinical condition, as compared with 65 per cent in the incomplete repair group. As patients with impairment of ventricular contractility are at high risk, it is believed that they should continue to be evaluated on an individual basis for bypass surgery and not categorically denied treatment.

Adult↗