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Biomedical subjects

H Anner

Publications and source records attributed to H Anner.

42 records · Page 3Linked to original sources

Urgent abdominal aortic aneurysm repair in patients over the age 80.

We present three patients with successful surgical repair of abdominal aortic aneurysms with signs of imminent rupture in octogenarians. The patients presented with evidence of severe left ventricular dysfunction and reduced compliance either before or during surgery. Extremely cautious delivery of fluids and of after-load reducing agents was employed under the guidance of measurements of cardiac output and filling pressures from a pulmonary arterial catheter inserted prior to surgery.

Age Factors↗

Practice and theory of "delayed" embolectomy. A 22-year perspective.

A study was made of delayed embolectomy in 45 patients (55 limbs). In 5 patients (11%) the cause of arterial embolization was rheumatic heart disease, and 40 patients (89%) suffered from atherosclerotic cardiovascular disease. The study was divided into 3 phases: I (1960-1964), II (1965-1974) and III (1975-1981). In phases II and III surgery was carried out using the Fogarty catheter technique. In 5 patients the embolus was located in the upper extremity. Seven patients died and 8 major amputations were performed within 30 days of surgery. Use of the Fogarty catheter technique and persistent anticoagulant therapy effected 71.8% limb salvage in phase II and 91.6% limb salvage in phase III. Successful revascularization was achieved in 70.9% of the limbs in which peripheral emboli had occurred on an average of 2.7 days prior to surgical intervention. A theoretical basis for the late development of the acute embolic onset is presented.

Adult↗

Extrathoracic approach in surgical treatment of subclavian steal.

Between 1979 and 1985 11 selected patients underwent axilloaxillary and carotid-subclavian bypass grafting [dacron or Gore-Tex (USA), 8 mm inner diameter]. Nine patients had lesions in the left subclavian artery and two patients presented with innominate artery obstruction with subclavian-carotid recovery phenomenon. All patients were symptomatic before surgery, and all were relieved of both cerebrovascular and upper extremity ischemic symptoms following surgery. Early graft patency has been excellent. There has been no mortality or serious postoperative complications. Two patients developed late graft thrombosis with recurrent ischemia of the left upper extremity, but there were no neurological symptoms. There has been a follow-up period of up to 6.5 years (mean 38.4 months.) It would appear that the appropriate extrathoracic route of revascularization is the procedure of choice for symptomatic patients with subclavian steal and subclavian-carotid recovery phenomenon.

Adult↗

Arterio-venous fistula in the lower limb in consequence of Fogarty balloon catheter embolectomy. Case report and review of the literature.

Arterio-venous fistula following Fogarty catheter embolectomy is a rare but dangerous complication. The case of a male patient in whom such a fistula was repaired surgically is described. Aggressive approach in the treatment of this severe condition to prevent unnecessary limb loss is advocated. The pertinent literature is reviewed.

Aged↗

"Delayed rupture of the spleen" or delayed diagnosis of the splenic injury?

Splenic rupture is the most frequent intraabdominal injury following blunt abdominal trauma. Massive hemorrhage commonly occurs from injuries to this friable vascular organ. The mortality rate from simple splenic rupture is 1%. Delayed diagnosis of a ruptured spleen increases the rate to 10%. During 1964-79, 293 patients underwent splenectomy for blunt splenic injury, of whom 278 were operated on within 24 h. All had typical signs of splenic lacerations with intraperitoneal bleeding from the time of injury. Fifteen patients were operated on more than 48 h after sustaining the injury. A detailed analysis of these 15 patients revealed that in only three did the evidence support delayed hemorrhage following traumatic rupture of the spleen. In the other 12 patients, there was a delay in recognition of the intraabdominal injury, almost entirely the result of "diagnostic error." Careful clinical inquiry and peritoneal lavage are the mainstays of early diagnosis and therapy and should help to eliminate any delay in the diagnosis of a ruptured spleen.

Adolescent↗

A case of nerves.

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Cervical Plexus↗