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D R Craddock

Publications and source records attributed to D R Craddock.

At least 19 recordsLinked to original sources
PubMed1996

Thirty years experience with heart valve surgery: isolated aortic valve replacement.

BACKGROUND: Thirty years have elapsed since the commencement of open-heart surgery in South Australia. A retrospective study was performed to evaluate mortality and complication rates and to identify factors associated with poor outcomes in all patients who underwent prosthetic aortic valve replacement during this period. METHODS: Questionnaires and personal contact have been used to generate a combined database of pre-operative and post-operative information and long-term follow-up on 1322 patients who underwent isolated prosthetic aortic valve replacement at the Cardio-Thoracic Surgical Unit of the Royal Adelaide Hospital between 1963 and 1992. RESULTS: Complete survival follow-up data were obtained for 94% (1241) of the patients. The Bjork-Shiley valve was used in 66% (875) of the patients, a Starr-Edwards prosthesis in 31% (412), a St Jude prosthesis in 2% (26), and only 0.7% (9) bioprosthetic valves were inserted. The hospital mortality rate for the 30-year period was 2.9%. Progressively older and less fit patients have undergone surgery in recent years. The long-term survival of patients with aortic stenosis and aortic incompetence was not significantly different. Long-term survival was significantly shorter for patients with higher New York Heart Association (NYHA) functional classifications, and for patients in pre-operative atrial fibrillation. Pre-operative dyspnoea was significantly improved following aortic valve replacement. The rates of postoperative haemorrhagic and embolic complications were low by comparison with other published series. CONCLUSIONS: Aortic valve replacement can be performed with low hospital mortality and complication rates, and significant symptomatic improvement can be expected. Aortic valve recipients have a favourable prognostic outcome compared with an age- and sex-matched population, and risk factors that determine long-term survival can be identified pre-operatively.

Adolescent↗
PubMed1996

Thirty years experience with heart valve surgery: isolated mitral valve replacement.

BACKGROUND: Thirty years have elapsed since the commencement of open-heart surgery in South Australia. A retrospective study was performed to evaluate mortality and complication rates and to identify factors associated with poor outcomes in all patients who underwent prosthetic mitral valve replacement during this period. METHODS: Questionnaires and personal contact have been used to generate a combined database of pre-operative and post-operative information and long-term follow-up on 938 patients who underwent isolated prosthetic mitral valve replacement at the Cardio-Thoracic Surgical Unit of the Royal Adelaide Hospital between 1963 and 1993. RESULTS: Complete survival follow-up data were obtained for 92% (865) of the patients. The Starr-Edwards valve was used in 95% (891) of the patients, a Bjork-Shiley prosthesis in 2.5% (23) of the patients, and only 24 (2.5%) other valves were inserted. The hospital mortality rate for the 30-year period was 4.7%. The mean age of the patients who underwent surgery was greater in each of the three successive decades. A long-term survival advantage was observed for patients with mitral stenosis, however, survival was significantly shorter for patients with higher New York Heart Association (NYHA) functional classifications and for patients in pre-operative atrial fibrillation. Pre-operative dyspnoea was significantly improved following mitral valve replacement. The rates of postoperative haemorrhagic and embolic complications were low by comparison with other published series. CONCLUSION: Mitral valve recipients do not regain a normalized life expectancy, but risk factors that determine long-term survival can be identified pre-operatively to aid appropriate patient selection.

Adolescent↗
PubMed1980

Coronary artery surgery in South Australia: second report.

This is the second report on the results of coronary artery grafting in South Australia. Symptomatic relief after grafting has continued at a high level (at five years, the conditions of 90.3% of surviving patients are improved as assessed by their cardiologists), and, in patients with significant symptoms, the operation can be recommended with a high degree of safety on these grounds alone. In addition, an attempt has been made to ascertain whether grafting alters longevity and, although more information is required on this point, the initial results are most encouraging with the five-year survival rate for operated patients being 92%, a figure which compares favourably with any large, medically treated group of patients. The operative mortality rate has continued to fall and is 2.2% for the entire series.

Adult↗
PubMed1980

Surgery for left main coronary artery disease.

The early and late results of the first 103 patients with left main coronary obstruction submitted to bypass grafting in South Australia are presented. A satisfactory hospital mortality of 2.9% and a surprisingly low late mortality of 2.9% (at an average follow-up time of 30 months), were obtained, and these figures, when taken in conjunction with a symptomatic relief rate of 83% at 24 months, have encouraged us to continue to recommend coronary artery grafting as the treatment of choice of left main stem disease.

Adult↗
PubMed1977

Coronary artery surgery in South Australia 1970-1976.

The South Australian population of approximately 1,245,000 is 9.2% of the total Australian population. The Cardio-Thoracic Surgical Unit of the Royal Adelaide Hospital is the only one such unit in the State which is equipped for open heart surgery, and coronary artery grafting was first undertaken there in December, 1970. From that time until the end of December, 1976, 701 patients underwent coronary artery grafting with an overall hospital mortality of 3.0%, and a late mortality of 3.2%. The principal indication for operation was incapacitating angina, and of the 628 patients who have been followed-up after operation for a minimum period of six months, 78.6% were judged by their cardiologist to be completely relieved of this symptom. A further 8.9% of patients were considered to be significantly improved. Coronary artery surgery has rapidly assumed a dominant role in our Unit so that, in 1976, of the 435 open heart operations which were performed, 267 (61%) were procedures which necessitated coronary artery grafting. The rate of increase has slowed considerably over the past 18 months, and it is expected that, with current operative indications, the proportion of coronary artery cases will not rise much above 60% of the open heart work load of the Unit.

Adult↗
PubMed1977

Cardiac surgery relative to population: pattern of cardiac surgery in South Australia, 1949--75.

The total work load of the sole cardiac surgery unit in South Australia has been analysed by means of a computer-based data retrieval system. The review covers the period 1949--75 inclusive. This study analyses the case-loads year by year, in total, and in different diagnostic categories, and has allowed conclusions to be drawn about surgical needs relative to population figures. From these figures future trends in requirements for cardiac surgical facilities have been deduced. There are many lessons to be learnt by maintaining an easily recoverable set of data for all the surgery performed in any cardiac surgery unit. This type of analysis makes it possible to maintain surveillance of demands on resources and of the results of the surgery performed. Because of the structure and situation of the community of South Australia and the fact that it is served by a single open heart unit, the pattern of this series may truly represent the optimum cardiac surgery case-load for any modern westernised community of comparable size.

Australia↗