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Biomedical subjects

D B Dobnik

Publications and source records attributed to D B Dobnik.

9 recordsLinked to original sources
PubMed1984

Removal of renal cell carcinoma extending into the right atrium using cardiopulmonary bypass, profound hypothermia and circulatory arrest.

An operation is indicated in patients with renal cancer growing into the inferior vena cava and right atrium because the tumor in the right atrium presents an immediate risk to life if acute obstruction of the tricuspid valve or pulmonary emboli occur. In addition, patients treated by such an operation may enjoy reasonable survivals. We believe that the best technique for operative management includes cardiopulmonary bypass, profound hypothermia and total circulatory arrest. Although perhaps seemingly complicated, it is the only technique that simplifies the operative dissection and permits as complete removal as possible of the cancer without the risk of tumor embolization or uncontrollable hemorrhage.

Adenocarcinoma↗
PubMed1983

Graft replacement of the thoracic aorta with a sutureless technique.

A sutureless intraluminal graft requiring only ligature fixation was used for replacement of the thoracic aorta in 8 patients. The graft was deployed in the ascending and descending thoracic aorta as well as in the arch. It was used for aortic dissection and atherosclerotic aneurysms. Insertion was easy and relatively quick. Fixation was secure and without serious complications. Seven of the 8 patients became long-term survivors.

Aged↗
PubMed1981

Infection in remnant of left ventricular assist device after successful separation from assisted circulation.

There have been two long-term and two short-term survivors among 10 patients in our hospital in whom the left ventricular assist device (LVAD) was implanted for cardiogenic shock after cardiac operations. Two of these four patients developed graft infection in the LVAD remnants left attached to the ascending aorta and left ventricle; one died of sepsis and the other required repeat operations for a chronic draining sinus and hemorrhage from a left ventricular--cutaneous fistula. This experience with infection and demonstration of the feasibility of total removal of both limbs of the LVAD without cardiopulmonary bypass lead us to recommend complete removal of the LVAD conduits in patients weaned from assisted circulation.

Aorta↗
PubMed1979

Simple method for measurement of cardiac output by thermodilution after cardiac operation.

Cardiac output by the thermodilution technique was measured by a new No. 2 Fr. transthoracic (2F-TT) thermistor catheter placed at cardiac operation into the pulmonary artery directly through the right ventricular outflow tract. Cold (0 degree C) 5% dextrose in water (D5W) was used as indicator and injected through a percutaneously placed central venous pressure (CVP) catheter in the jugular vein. Comparison to the No. 7 Fr. Swan-Ganz (7F-SG) catheter demonstrated a close correlation (r = 0.87) and almost identical mean thermodilution cardiac output values during 530 determinations in 10 patients. No difficulty was experienced in insertion or removal of the 2F-TT catheter and no bleeding complications were noted. Experiments in six dogs showed that variation in position of the tip of the CVP catheter within the superior vena caval venous system and right atrium was not a critical factor in measurement of thermodilution cardiac output. The thermodilution cardiac output technique in general and the ease of insertion, as well as the small size of the 2F-TT catheter, should make this method especially advantageous in infants and small children.

Cardiac Output↗
PubMed1976

Autologous blood transfusion during cardiopulmonary bypass.

Immediately prior to cardiopulmonary bypass, two units of blood were removed from each of 25 patients undergoing open-heart surgery, and the autologous blood was reinfused after cessation of support with the pump oxygenator. Pertinent data on blood balance and hematologic measurements were compared to a matched group of control subjects. There were no significant differences in the amount of operative or postoperative bleeding, the requirements for homologous blood and blood products, or the amount of protamine needed for neutralization of heparin.

Adult↗