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Biomedical subjects

C Del Campo

Publications and source records attributed to C Del Campo.

At least 19 recordsLinked to original sources
PubMed1995

Postoperative management of cerebral air embolism: gas physiology for surgeons.

Cerebral gaseous microemboli are present in most, if not all, cardiopulmonary bypass-assisted operations. Fortunately, the great majority are subclinical. Clinically significant cases of cerebral air embolism are largely underdiagnosed, undertreated, and underreported. The management of cerebral air embolism has been challenged due to the lack of prospective, randomized studies. Preventive measures that have been implemented throughout the years, resulting from empirically acquired knowledge, have avoided frequent major mishaps. Perfusion accidents, in which massive amounts of gas are pumped into patients, are managed intraoperatively by common-sense heroic measures which, at best, remove 50% of the embolized gas. Postoperative confirmation of a neurologic insult after a cardiopulmonary bypass-assisted operation, in which a cerebral air embolism is likely the source, is one of the most distressing situations a surgical team has to confront, due in part to the lack of pathognomonic diagnostic tools and to the absence of a "scientifically proven" (supported by prospective, randomized studies) therapeutic regimen. In lieu of the latter, we present the physical and physiologic bases that will justify the use of several therapeutic tools when facing a suspected CAE. These tools, when applied rationally, will represent some of the most innocuous modalities in the medical armamentarium.

Aortic Valve↗
PubMed1995

Transabdominal access to the thoracic aorta for aortofemoral bypass grafting.

When acute thrombosis of the abdominal aorta occurs in a comatose patient, direct examination of the intraabdominal organs becomes mandatory. Once a laparotomy has been performed, media calcinosis of the infrarenal aorta is a contraindication to its use as an inflow source. We describe a technique for exposing the thoracic aorta through the abdomen, which obviates the need for a thoracoabdominal incision in such critically ill patients.

Anastomosis, Surgical↗
PubMed1995

Successful myocardial revascularization and neurologic recovery in a patient with prolonged refractory cardiac arrest and a chronically occluded left internal carotid artery.

Heretofore, the longest successfully treated cardiac arrest reported in the literature, secondary to myocardial ischemia, was one that required 45 minutes of cardiopulmonary resuscitation before coronary bypass surgery. We present a unique case of successful resuscitation after a cardiac arrest secondary to myocardial ischemia. The arrest lasted 78 minutes (30 minutes of closed cardiac massage and 48 minutes of open cardiac massage). As soon as a perfusionist was available, cardiopulmonary bypass was initiated. After completion of the distal anastomosis and upon removal of the aortic cross clamp, the patient spontaneously recovered sinus rhythm for the 1st time since her cardiac arrest 2 hours and 10 minutes earlier. This 70-year-old woman, with a history of chronic occlusion of the left internal carotid artery, recovered fully, without evidence of neurologic or myocardial insult. We believe that vigorous closed and open cardiac massage, followed by cardiopulmonary bypass and the correction of myocardial ischemia, enabled this patient to survive a prolonged refractory cardiac arrest.

Aged↗
PubMed1992

Prosthetic replacement of the superior vena cava with a custom-made pericardial graft: an experimental study.

Prosthetic replacement of the vena cava has been disappointing, mainly because of the hemodynamic characteristics of the venous system and the physical properties of the prostheses used. Spiral grafts constructed with autogenous saphenous vein have been the most successful prostheses to date, but their use is limited to replacement of short segments, and intraoperative construction is time consuming. The authors report their experience with a graft constructed of extra-thick bovine pericardium (PX) and surgical staples. Externally stented polytetrafluoroethylene (PTFE) was used as a control. The superior vena cava was replaced in 13 ewes; PTFE was used in 6 (group 1) and PX in 7 (group 2). Mean follow-up was 15 +/- 8 months for group 1 and 13 +/- 8 for group 2. Cumulative graft follow-up totalled 4612 graft-days. There was one graft occlusion in each group. Patency rates (80%) were similar for the two groups. Histologic changes in pericardial grafts were more marked but did not influence patency. This study reports the longest experimental follow-up (maximum 23 months) and graft patency to date for replacement of the superior vena cava. Both types of graft performed excellently.

Animals↗
PubMed1991

Prospective evaluation of a totally implantable drug delivery system. Improved results at 4-year follow-up.

Totally implantable drug delivery systems have facilitated chemotherapy in cancer patients. The incidence of complications has been acceptable but not optimal. A series of 140 consecutive implants over a 4-year period is presented. The total follow-up was 41,185 days. Reversible obstruction was present in 12.8% of portals. The infection-erosion rate was 4.2%; only 6.3% of patients required removal of the system because of failure. In the last 111 patients only one device failed (0.9%). The reasons for these improved results are analysed, and recommendations are made to improve the current management of these devices.

Adult↗
PubMed1985

Mediastinal packing for refractory nonsurgical bleeding after open-heart surgery.

Patients with infective endocarditis and disseminated intravascular coagulation may require emergency valve replacement because of acute hemodynamic decompensation. After cardiopulmonary bypass is discontinued, nonsurgical hemorrhage, refractory to conventional treatment, may occur. The author describes a technique of mediastinal packing for temporary control of bleeding until the coagulation disorder can be corrected. The pack can be removed transcutaneously without reoperation. This method should be used only when all other approaches have failed to achieve hemostasis.

Anticoagulants↗
PubMed1985

Pulmonary embolectomy: a review.

Massive pulmonary embolism continues to be a major cause of death in spite of improved medical therapy. Only a small number of patients with pulmonary embolism refractory to medical treatment are referred for pulmonary embolectomy. A literature review of patients with massive pulmonary embolism treated by pulmonary embolectomy showed that the operation was highly successful in those who were unlikely to survive with other modes of therapy. Specific indications and management are outlined on the basis of these cumulative data.

Cardiopulmonary Bypass↗
PubMed1985

Simplified insertion of the Port-A-Cath implantable drug-delivery system.

The increasing frequency with which antineoplastic drugs are being used demands improved vascular access for their administration. Venous access through implantable catheters facilitates treatment when veins are no longer available. Totally implantable catheters of the Port-A-Cath type are preferred because they give better performance and cosmetic results, and are more convenient for the patients. The flexibility of these catheters makes their introduction difficult. The author describes a simplified technique, using a commercially available introducer that has been used satisfactorily in thousands of pacemaker implantations. The author has used this technique routinely with a 50% decrease in operative and fluoroscopy time and without complications.

Antineoplastic Agents↗