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Douglas A Murphy

Publications and source records attributed to Douglas A Murphy.

4 recordsLinked to original sources
PubMed2006

Endoscopic robotic mitral valve surgery.

OBJECTIVE: To determine the safety and efficacy of endoscopic mitral valve surgery using robotic instruments through the lateral right chest. METHODS: We conducted a retrospective review of 127 patients taken to the operating room for endoscopic robotic mitral surgery from December 2002 through November 2005. Mean age was 54 +/- 13 years and 58% were male. Mitral regurgitation was 4+ in 121 patients, 3+ in 4 patients, and 2+ in 2 patients. Nineteen (15%) patients had a left ventricular ejection fraction of 0.50 or less. Surgical approach was through 4 right chest ports with femoral perfusion and endoaortic balloon occlusion. Mean follow-up was 13.7 +/- 8.9 months and was 100% complete. Echocardiographic follow-up was available on 98 patients with a mean of 8.4 +/- 8.1 months. RESULTS: The mitral procedure was completed endoscopically in 121 (95%) patients. Mitral valve repair was performed in 114 patients and mitral valve replacement in 7 patients. Two patients required reoperation on the mitral valve. There was 1 (0.8%) hospital death and 1 late death. Echocardiographic follow-up in 98 survivors of endoscopic mitral repair revealed 0-1+ regurgitation in 95 (96.9%) and 2+ in 3 (3.1%) patients. CONCLUSIONS: Totally endoscopic mitral surgery can be performed safely with robotic instrumentation. A right lateral configuration of the robotic system allows excellent visualization of the valve with minimal distortion and permits two surgical personnel to participate actively in valve instrumentation. In selected patients with mitral valve disease, this surgical approach might promote higher rates of valve repair.

Adult↗
PubMed2006

Interlaboratory comparison of immunohistochemical testing for HER2: results of the 2004 and 2005 College of American Pathologists HER2 Immunohistochemistry Tissue Microarray Survey.

CONTEXT: Correct assessment of human epidermal growth factor receptor 2 (HER2) status is essential in managing patients with invasive breast carcinoma, but few data are available on the accuracy of laboratories performing HER2 testing by immunohistochemistry (IHC). OBJECTIVE: To review the results of the 2004 and 2005 College of American Pathologists HER2 Immunohistochemistry Tissue Microarray Survey. DESIGN: The HER2 survey is designed for laboratories performing immunohistochemical staining and interpretation for HER2. The survey uses tissue microarrays, each consisting of ten 3-mm tissue cores obtained from different invasive breast carcinomas. All cases are also analyzed by fluorescence in situ hybridization. Participants receive 8 tissue microarrays (80 cases) with instructions to perform immunostaining for HER2 using the laboratory's standard procedures. The laboratory interprets the stained slides and returns results to the College of American Pathologists for analysis. In 2004 and 2005, a core was considered "graded" when at least 90% of laboratories agreed on the result--negative (0, 1+) versus positive (2+, 3+). This interlaboratory comparison survey included 102 laboratories in 2004 and 141 laboratories in 2005. RESULTS: Of the 160 cases in both surveys, 111 (69%) achieved 90% consensus (graded). All 43 graded cores scored as IHC-positive were fluorescence in situ hybridization-positive, whereas all but 3 of the 68 IHC-negative graded cores were fluorescence in situ hybridization-negative. Ninety-seven (95%) of 102 laboratories in 2004 and 129 (91%) of 141 laboratories in 2005 correctly scored at least 90% of the graded cores. CONCLUSION: Performance among laboratories performing HER2 IHC in this tissue microarray-based survey was excellent. Cores found to be IHC-positive or IHC-negative by participant consensus can be used as validated benchmarks for interlaboratory comparison, allowing laboratories to assess their performance and determine if improvements are needed.

Breast Neoplasms↗