Biomedical subjects
Publications and source records attributed to H Garabedian.
A neonate with incessant supraventricular tachycardia refractory to multiple antiarrhythmic medications was referred to our institution for radiofrequency ablation. An unusual accessory pathway between the right atrial appendage and right ventricle was successfully ablated. This case also emphasizes the congenital origin of such an accessory pathway.
We present the first described use of the Gianturco-Grifka Vascular Occlusion Device to close a moderate patent ductus arteriosus associated with the rare congenital condition of right aortic arch with isolation of the left subclavian artery. Left vertebral artery "steal" through the moderate patent ductus arteriosus was eliminated by this transcatheter technique. Cathet. Cardiovasc. Intervent. 47:320-322, 1999.
OBJECTIVE: Whether scheduling of patients for cardiac surgery as dictated by the availability of cardiopulmonary machines (CPBM) may influence postsurgical outcome, thought not to be an issue in the past, is unknown. EXPERIMENTAL DESIGN AND SETTING: Cardiac surgical outcomes were compared between two consecutive 12 months intervals surrounding the acquisition of a second CPBM by our department in a general hospital. PATIENTS: Patients in Group A (n=416) underwent surgery when only 1 CPBM was available (February 1990-January 1991) and in Group B (n=603) when 2 CPBM were used (February 1991 to January 1992). A cohort, Group C, consisted of patients (n=73), found only in Group A, scheduled as a 3rd and 4th operative case in the same day. RESULTS: There were no significant differences in demographic and clinical characteristics, the duration of ICU stay or hospital discharge between groups A and B. The surgical or technical staff did not change, and the nurse to patient ratio remained constant. Median total bypass time was significantly greater in Group B (80 vs 73 min in Group A, p<0.05), but the frequency of mortality within the first 14 postoperative days was nevertheless lower in Group B than in Group A (3.3% vs 4.6%, respectively, p<0.05). Recurrent myocardial infarction, postoperative bleeding, arrhythmia, pulmonary embolism, acute renal failure, and duodenal ulcer were also significantly higher in Group A compared to Group B (p<0.05). The excess in postoperative complications could be attributed mainly to Group C. Overall, the relative risk for morbidity and mortality decreased when a second CPBM was implemented (p<0.001). CONCLUSIONS. Postoperative complications in our unit were significantly reduced by acquisition of a second CPBM permitting two cases to be started concomitantly early in the day. This data may be valuable to guide decision analysis in departments which need to expand resources in order to cope with the demand of expanding clinical case load.
Explore the source record for details and available documents.
An ambient air sampling study was conducted around a municipal waste combustor; a primary goal was to develop procedures and methods to evaluate the emissions of organic mutagens resulting from incomplete combustion of municipal waste. The products of incomplete combustion from incineration include complex mixtures of organics, particularly polycyclic aromatic compounds, which are present after atmospheric dilution and cooling in emissions as semi-volatile or particle bound organic compounds. Combustion emissions are generally recognized as a potential cancer risk since they contain many carcinogenic and mutagenic polycyclic aromatic hydrocarbons. Analyzing such a complex mixture for the presence of even a few selected chemicals is difficult and provides risk information on only a fraction of the chemicals present. Bioassay methods, however, may be directly applied to evaluate the mutagenic and potential carcinogenic activity of the complex organics from combustion emissions. The Salmonella (Ames) assay was used to determine the mutagenicity associated with particles from ambient air collected near a municipal waste combustor. Dose-response data was generated, and mutagenicity concentrations were calculated to demonstrate the utility of bioassay in assessing the potential impact of emissions from municipal waste combustion. This phase of study quantified mutagenicity concentrations in ambient air but did not detect organic mutagens that could be attributed to incinerator emissions.
Two autopsy-proved cases are presented of a rare form of congenital heart disease, anatomically corrected malposition (S, D, L). Anatomically corrected malposition means that despite the abnormal relationship between the great arteries, the aorta arises nonetheless above the anatomically left ventricle and the pulmonary artery originates above the anatomically right ventricle. (S, D. L) briefly indicates the segmental set or combination: situs solitus of viscera and atria (S), ventricular D-loop (D), AND L-MALPOSITION OF THE GREAT ARTERIES (L). These are the first cases of anatomically corrected malposition (ACM) in whom the presence of a subaortic muscular conus only has been documented pathologically. This established that ACM can occur with a subaortic conus, as well as with a bilateral conus. From the diagnostic standpoint, the distributions or epicardial courses of the coronary arteries are recommended as a helpful approach to ventricular identification. This diagnostic method has widespread angiocardiographic and surgical applications. Symbolic terminology, exemplified by anatomically corrected malposition (S, D. L) is brief and accurate. This approach may conveniently be applied to many other forms of comples congenital heart disease, and it considerably facilitates computer data processing.
Explore the source record for details and available documents.
Explore the source record for details and available documents.