Biomedical subjects

C B Austin

Publications and source records attributed to C B Austin.

5 recordsLinked to original sources

PubMed1998

Less invasive techniques for mitral valve surgery.

OBJECTIVE: Minimally invasive surgical techniques aim at reducing the consequences of currently used large incisions, such as bleeding, pain, and risk of infection. Although this new approach developed rapidly in coronary surgery, it remains questionable in mitral valve surgery. This article reports the longest experience with minimally invasive mitral valve surgery, with particular attention to approach and techniques. METHODS: From February 1996, the date of the first case of minimally invasive mitral valve reconstruction, to April 1997, 22 patients with a mean age of 54 +/- 2.7 years were subjected to mitral valve surgery performed with less invasive techniques. Exposure of the mitral valve was achieved through a minithoracotomy (n = 12) or a ministernotomy (n = 10). Video assistance was used in all cases. Peripheral arterial cannulation (n = 21) and venous drainage (n = 22) were used in most cases. RESULTS: In this series, valve surgery consisted in 19 repairs, two replacements, and one closure of a periprosthetic leak. In two cases it was necessary to convert to a larger incision. The average duration of cardiopulmonary bypass was 157 +/- 8.2 minutes, ventilatory assistance 16 +/- 4.6 hours, and intensive care unit stay 2.1 +/- 0.4 days. Two patients required reoperation for bleeding and another for early recurrence of mitral valve regurgitation. There were no deaths and all patients were discharged with normal valve function. At most recent follow-up, all patients were in functional class I, with resumption of normal activity. CONCLUSION: Mitral valve surgery can be performed safely by means of less invasive techniques, but with increased technical difficulty. A low asymmetric median sternotomy seems preferable to an anterior thoracotomy.

Cardiopulmonary Bypass↗

PubMed1989

Reevaluation of indications for percutaneous placement of the Greenfield filter.

In our institution twice as many Greenfield filters were inserted in the year after percutaneous placement was begun as in the previous year when all filters were surgically inserted. Review of the indications for surgical and percutaneous filter placement in our hospital reveals that more filters were inserted percutaneously for all indications except recurrent emboli. The rates of percutaneous and surgical filter insertion for prophylaxis with acute deep venous thrombosis were similar (40% and 42%, respectively) and were higher than the majority of reported filter series because of the large number of high risk patients in our hospital population. In evaluating each patient for risk factors concerning the development of venous thromboembolism, the contraindications to anticoagulation, and the effectiveness and possible complications of anticoagulant therapy, we have defined a much broader range of patients as candidates for Greenfield filter insertion than had been considered in our institution in the past.

Adolescent↗

PubMed1989

Femoral vein thrombosis following percutaneous placement of the Greenfield filter.

Following percutaneous insertion of the Greenfield inferior vena cava filter via the femoral route, patients were evaluated for femoral vein thrombosis by real-time ultrasound or Duplex sonography. In 23 patients (24 veins) the femoral vein was dilated with an 8-mm (24 F) angioplasty balloon catheter. Eight of 24 common femoral veins were thrombosed (33%). These findings indicate that thrombosis is a significant complication of percutaneous filter insertion. Dilation was performed in 20 patients (22 veins) with a 9-mm (27 F) balloon catheter; only three veins were thrombosed (14%). Over-dilation of the femoral vein to 27 F to accommodate the 24 F sheath/dilator set may decrease the incidence of thrombosis.

Bloodletting↗

PubMed1988

Percutaneous insertion of the Greenfield inferior vena cava filter: experience with ninety-six patients.

This article evaluates the ease, safety, and convenience of percutaneous Greenfield filter placement and compares percutaneous with surgical placement. Greenfield filters were inserted percutaneously into the inferior vena cava in 96 patients. Ninety filters were placed via the femoral route and 12 were placed from the right internal jugular vein. Six patients had two filters inserted. An inferior venacavogram was performed before filter insertion in all patients. Cavography provided vital information concerning diameter of the inferior vena cava, the level of the renal veins, and the presence and location of thrombus. Filter placement was accomplished in all patients in whom it was attempted. There were four minor complications and one periprocedural death. The incidence of documented femoral vein thrombosis that could be related to percutaneous placement via the femoral veins was 33%; however, none of these patients had permanent venous stasis sequelae. Percutaneous insertion of the Greenfield filter is a safe and convenient procedure and is superior to surgical placement in terms of time, logistics, and the accuracy of filter positioning.

Female↗

PubMed1987

Massive acroosteolysis in adult T-cell leukemia/lymphoma.

Adult T-cell leukemia/lymphoma is a relatively uncommon disease, most often found in Japan, the Caribbean, the southeastern United States, and South America. To date there have been few reports of its skeletal manifestations. A case is reported in a 44-year-old man in which a short history of swelling of the hands and feet and painful motion in the fingers was followed by the rapid development of severe acroosteolysis.

Adult↗