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Biomedical subjects

Frank A Baciewicz

Publications and source records attributed to Frank A Baciewicz.

16 recordsLinked to original sources
PubMed2006

Coronary artery revascularization after chest wall reconstruction with rectus abdominis myocutaneous flap.

The standard incision for a cardiac operation is a median sternotomy. In special situations, alternative approaches are needed. We report a 53-year-old woman who required coronary artery bypass grafting 10 days after chest wall reconstruction with a transverse rectus abdominis myocutaneous flap. We describe our technique, which allowed us to preserve the flap and resulted in good functional and aesthetic outcome.

Breast Neoplasms↗
PubMed2004

Coronary artery bypass grafting in a dialysis-dependent Jehovah's Witness.

We present a case of coronary artery bypass grafting in a Jehovah's Witness with dialysis-dependent chronic renal failure and left main coronary artery disease. The preoperative, intraoperative, and postoperative management is reviewed. This patient underwent 2 coronary revascularization operations (1 on-pump and 1 off-pump). Coronary artery bypass grafting can be performed safely in the Jehovah's Witness patient with dialysis-dependent chronic renal failure by performing the operation electively if possible, limiting blood loss through the application of off-pump bypass and autologous transfusion techniques during surgery, increasing hemoglobin during both the pre- and postoperative periods by using erythropoietin and ferrous sulfate, and maintaining oxygen delivery during the postoperative period by the use of inotropic agents.

Coronary Artery Bypass↗
PubMed2003

Repair type I aortic dissection in a patient with human immunodeficiency virus infection.

A 57-year-old man with human immunodeficiency virus (HIV) infection was evaluated in October 1997 with complaints of weakness of the right lower extremity. A chest computerized axial tomographic scan revealed a type I aortic dissection. He underwent surgical repair including resuspension of the aortic valve and placement of a 32-mm interposition graft between the aortic root and the transverse arch. Postoperatively he required abdominal aorta fenestration and stenting for ischemia of the left lower extremity. Follow-up magnetic resonance imaging 3(1)/(2) years postoperatively showed a normal-sized ascending and transverse aorta and the residual dissection in the descending thoracic and abdominal aorta. The thoracic and abdominal aorta diameters have remained stable. Select patients with type I aortic dissection and HIV infection are candidates for surgical repair.

Aortic Dissection↗
PubMed2003

Hyperbaric oxygen as a chemotherapy adjuvant in the treatment of metastatic lung tumors in a rat model.

OBJECTIVES: The objectives of the study were to test the hypothesis that hyperbaric levels of oxygen enhance the sensitivity of a sarcoma cell line to doxorubicin (Adriamycin) both in vitro and in vivo in a rat model of pulmonary metastases and to test the feasibility of arterialization of mixed venous blood by direct injection of aqueous oxygen into the pulmonary artery in a rat model. METHODS: Rat sarcoma (MCA-2) cells were incubated in the presence of increasing concentrations of doxorubicin (0.1-2.0 micromol/L). A dose-dependent toxicity relationship at 12 hours of treatment was examined with and without pretreatment with hyperbaric oxygen (3.7 atm absolute for 1.5-3.5 hours). In vivo, Sprague-Dawley rats (n = 24) were injected intravenously with 10(6) MCA-2 cells, and the lung tumors were allowed to mature for 14 days. At that time the animals were divided into four groups: control (no treatment), doxorubicin at 2 mg/kg, hyperbaric oxygen (oxygen at 2 atm absolute for 30 minutes), and hyperbaric oxygen plus doxorubicin. Seven days after treatment, the numbers of lung nodules were counted and the lung weights were determined. In additional rats (n = 7), aqueous oxygen (1 mL oxygen/g saline solution) was infused into the pulmonary artery to determine whether arterialization of mixed venous blood was comparable to pulmonary artery oxygenation with a hyperbaric chamber (n = 7). RESULTS: Hyperbaric oxygen plus doxorubicin produced significantly greater cytolysis of MCA-2 cells (P <.01) than did doxorubicin alone. Hyperbaric oxygen plus doxorubicin also significantly decreased the number of lung metastases and the lung weight relative to doxorubicin alone (P <.01 and P <.01, respectively). The feasibility of arterialization of mixed venous blood (>100 mm Hg) with aqueous oxygen infusion was demonstrated. CONCLUSIONS: Hyperbaric oxygen enhanced the chemotherapeutic effect of doxorubicin both in cell culture and in the rat model. Aqueous oxygen infusion can be used to oxygenate mixed venous blood at levels similar to those obtained with the use of a hyperbaric chamber.

Animals↗
PubMed2002

Anticoagulation with bivalirudin during cardiopulmonary bypass in cardiac surgery.

Heparin is the standard agent used for systemic anticoagulation during cardiopulmonary bypass in cardiac operations. Alternatives are needed when patients with heparin-induced thrombocytopenia type II are encountered. We present a patient with a clinical picture of heparin-induced thrombocytopenia type II who was effectively anticoagulated with bivalirudin, a direct thrombin inhibitor, during cardiopulmonary bypass for a cardiac operation.

Anticoagulants↗