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Biomedical subjects

E R Kyger

Publications and source records attributed to E R Kyger.

28 records · Page 2Linked to original sources
PubMed1975

The various forms of pulmonary varices. Report of three cases and review of the literature.

Ture pulmonary varices are congenital local dilatations of a pulmonary vein or veins, with normal or collateral transpulmonary drainage into the left atrium. Pulmonary varices do not cause pulmonary venous hypertension, but existing varices can further become dilated by pulmonary venous hypertension due to mitral valve disease. Embryologically, pulmonary varices may represent residual primitive splanchnic venous components incorporated into the pulmonary venous system, or atresia of an individual pulmonary vein which occurred at a time that enable adoption of unobstructed transpulmonary collateral drainage into the left atrium. True pulmonary varices do not produce symptoms, do not change in diameter over the years, and, usually, do not require treatment.

Diagnosis, Differential↗
PubMed1975

Runaway pacemaker in seven patients: a persisting problem.

Runaway pacemaker has been encountered in 7 patients during the past 7 years at the Texas Heart Institute. In this series, 4 patients with fixed-rate pacemakers experienced pacemaker arrhythmias because of battery depletion, and 3 had arrhythmias because of component failure. Battery deterioration was heralded by an increase in cardiac rate. Ventricular tachycardia, rapidly followed by ventricular fibrillation, occurred in 2 patients. Prompt surgical exteriorization of the failing pulse generator and connection to an external pacemaker resulted in prompt recovery in all patients. Elective generator change should be performed routinely after 24 to 30 months unless reliable serial observations of ventricular rates can be attained. This at least will reduce the lethal complications attributed to battery exhaustion. Increasing developments in the design of generators and sources of power, as well as data from pacemaker clinic follow-up and telephone pulse transmittal, are expected to decrease the frequency of this complication.

Adult↗
PubMed1975

[Clinical experinece using tubular grafts in the reconstruction of the right ventricular outflow tract (author's transl)].

Conduit reconstruction of the right ventricular outflow tract is useful in treatment of a variety of congenital cardiac malformations. Seventeen patients underwent conduit reconstruction at the Texas Heart Institute between December 1965 and June 1974. Fifteen patients survived the operation and have significantly improved. Several different conduits were used: allograft aorta with the aortic valve and mitral leaflet attached, a woven Dacron prosthesis containing a prosthetic valve, a prosthesis containing a xenograft (porcine) valve and a valveless Dacron tube graft. Allograft conduits present difficulties with procurement and inventory and tend to calcify with time. Woven Dacron prostheses are favored because of ready availability in a wide range of sizes. In the case of pulmonary hypertension, we use a conduit containing a xenograft (porcine) value. The largest conduit possible must be used. Indications for conduit reconstruction include anomalous coronary arteries, discontinuity between the pulmonary arteries and pulmonary atresia with a VSD. Our current method of management of pulmonary atresia with VSD includes palliative shunt during infancy to permit full development of the pulmonary arteries for total correction at a more optimal age when a larger conduit may be used.

Adolescent↗
PubMedDate not supplied

Surgical versus medical treatment of coronary artery disease: long-term survival.

In an attempt to answer the question as to whether or not aortocoronary bypass (ACB) does increase life expectancy of patients with coronary artery occlusive disease (CAOD), 4,766 consecutive patients undergoing ACB at the Texas Heart Institute from October, 1969 through June, 1975, were reviewed and followed for five and one half years. Overall early mortality was reduced from 9.7 percent during the first full year (1970) of the study to 3.3 percent during the last full year (1974). Early mortality in males (86.5 percent) was reduced to 3 percent during 1975, but in females only to 8.4 percent. However, late mortality in females was only 2.6 percent as compared to 3.4 percent in males. Long-term survival was similar for both males and females at five and one-half years when early mortality was considered. Males also experienced better symptomatic results than females with 90.3 percent of males remaining asymptomatic, while only 86.6 percent of females remained in this category. Early mortality increased as more vessels were bypassed, but late mortality decreased and symptomatic results improved as more complete revascularization was performed. Only 55 percent of late deaths were cardiac related. Actuarial comparison of this surgical series with the most comparable series in the literature of patients treated medically, demonstrated significant (P less than 0.001) increased survival in the surgical group as compared to medically treated patients at every year up to five and one-half years, for patients with double and triple vessel disease and for the entire series. In those patients with single vessel disease, the survival curves were similar to four years, following which survival was increased in the surgical patients at the end of the fifth and sixth reporting years. In summary, these data appear to suggest that surgical treatment of coronary artery occlusive disease does provide a favorable effect upon life expectancy.

Adult↗