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Biomedical subjects

H Meurala

Publications and source records attributed to H Meurala.

30 records · Page 2Linked to original sources
PubMed1981

Human umbilical cord vein as arterial substitute in the dog.

The aim of this study was to compare human umbilical cord vein grafts (HUCV), treated in different ways, as arterial substitutes in the dog. A portion of the infrarenal abdominal aorta was replaced by a fresh HUCV in 18 dogs. Six HUCV grafts were covered with a vascular dacron prosthesis, 4 of them stayed open during a follow-up time of one year, 2 became occluded. Within an interval of 4 weeks, aneurysms developed in the uncovered 12 HUCV grafts. They also thrombosed within 3 months. The infrarenal abdominal aorta was replaced by HUCV grafts treated with glutaraldehyde in 39 dogs. Within a follow-up time of six months, all grafts were patent and no aneurysm formation could be observed. Eight biografts were compared with eight PTFE grafts ileofemoral positions. Six Biografts as well as six PTFE grafts were patent after six weeks.

Animals↗
PubMed1981

Sequential versus single aortocoronary saphenous vein bypass techniques.

Operative techniques for sequential and single aortocoronary saphenous vein bypass are presented and compared. There were 2.1 distal anastomoses per patient in the sequential saphenous vein bypass graft (SVBG) group (36 patients) and 2.0 in the single SVBG group (40 patients). There were no differences in total operating time or in cardiopulmonary bypass time. There was a significant difference (p less than 0.05) in total ischaemic cross-clamping time and in cross-clamping time per anastomosis between the two groups in favour of single SVBG. Graft flow in the sequential SVBG group was superior to that in the single SVBG group (p less than 0.001). The mean total graft flow per heart in the single SVBG group was superior to that in the sequential SVBG group (p less than 0.01).

Adult↗
PubMed1980

Effect of combined cold and pharmacological ischaemic cardioplegia on myocardial intrinsic sympatho-adrenergic system during coronary bypass surgery.

The effect of combined cold and pharmacological ischaemic cardioplegia on the structural integrity and the degree of the functional activity of the inbuilt intrinsic sympatho-adrenergic nervous system was studied by means of fluorescence microscopy of atrial myocardial biopsies obtained in the course of coronary bypass surgery on 8 consecutive patients. The specimens were taken 1) before starting extracorporeal circulation (controls), and 2) at decannulation (i.e. after cold cardioplegic ischaemic asystole and subsequent coronary reperfusion). The cardioplegia was induced by perfusing the coronary arteries via the aortic root with cold "cardioplegic solution" after starting extracorporeal circulation, venting the left ventricle and cross-clamping the ascending aorta. The specimens were processed for semi-quantitative fluorescence histochemical analysis. No changes were observed. Thus, it is concluded that the procedure of the combined cold and pharmacological ischaemic cardioplegia obviously preserves well the neural noradrenalin of the heart, a vital means of compensating for decreasing myocardial contractility. As the clinical parallelism, all patients made a smooth convalescence.

Adult↗
PubMed1980

Lower extremity revascularisation with axillo-femoral bypass grafting in 28 patients.

A subcutaneously tunneled Dacron graft shunt from the axillary to the femoral artery was used to bypass occlusive aortoiliac disease in 19 patients, and to revascularize ischaemic lower limbs after removal of infected aortoiliac prosthesis in 9 patients. Two high risk patients of the former group died postoperatively. Operative mortality was high, 5 of the 9 patients, when treating complications of aortoiliac grafting. Massive bleeding through the axillo-femoral prosthesis resulted in one operative death. In another case, reoperation for graft bleeding was required. The most usual complication of axillo-femoral grafting was thrombosis which occurred in 11 patients. Another late complication was infection of the graft which developed in 4 patients. In two of these, femoral amputation was required. Only 8 of the 28 patients have been free of any complication. At follow-up (mean 9.9 months), 16 of the 19 survivors had a functioning graft (84%). The high complication rate suggests that axillo-femoral bypass should be reserved only for limb salvage in patients with contraindications for conventional aortofemoral surgery.

Aged↗
PubMed1979

Detached pacing electrode tip as a pulmonary embolus.

Forceful extraction of an Elema unipolar endocardial pacing electrode caused accidental detachment of the electrode tip. The tip migrated from the jugular vein into the central venous circulation and after some delay finally passes during the night into a pulmonary artery branch. Transient pleural irritation was the only sequel.

Cardiac Pacing, Artificial↗
PubMed1978

Cardiac disturbances after pneumonectomy--the value of prophylactic digitalization.

The incidence of postoperative cardiac disturbances and the value of prophylactic digitalization were studied retrospectively in 143 patients undergoing pneumonectomy for carcinoma of the lung. Cardiac arrhythmias occurred in 29% and tachycardia episodes in 30% of the patients. The incidence of myocardial infarction was 2%. Operative mortality was 4%. The cardiac disturbances developed more often after left than after right pneumonectomy. The age of the patients, a history of angina pectoris or hypertension did not markedly increase the incidence of cardiac disturbances, neither did operative factors, such as pericardiotomy, left atrial resection, major bleeding nor postoperative empyema. Prophylactic digitalization significantly reduced postoperative cardiac disorders, their frequency being 33% in the group of patients who received prophylactic digitalis compared with 65% in the group that did not.

Adult↗
PubMed1976

Acute coeliac artery occlusion: initial collateral blood flow from the superior mesenteric artery. An experimental study.

The collateral blood flow from the superior mesenteric artery after acute occlusion of the coeliac truck was measured in experiments in dogs. Immediately after clamping of the coeliac axis the collateral flow was about 30 % of the original coeliac blood flow. During an observation time of three hours the collateral flow increased, the corresponding value at the end of experiment being about 50 %. At the same time the blood pressure in the coeliac artery rose from a mean value of 20 mmHg to 35 mmHg. The initial collateral blood flow was evidently not sufficient, since after this short occlusion period ischaemic changes, even necrosis, were observed in the liver and stomach in some of the test animals.

Acute Disease↗
PubMedDate not supplied

The management of non-neoplastic esophageal perforation.

The clinical features, management and prognosis of non-neoplastic esophageal perforation are evaluated in a clinical series of 29 patients. Five of 12 spontaneous ruptures were caused by vomiting after alcoholic intake. There were 12 iatrogenic perforations, five of which were caused by esophageal dilatation, four by diagnostic endoscopy and three by endoscopic removal of foreign bodies. Most cases were diagnosed by esophagogram. The delay in reaching the right diagnosis was less than 12 hours in 11 cases and more than 48 hours in ten cases. Management was surgical in 25 cases and conservative in four cases. The operative procedures used were direct suture closure in 15 cases, drainage in eight cases and esophageal resection in two cases. The overall mortality rate was 24%. Ten out of 11 perforations treated surgically within 12 hours of the perforation were cured and seven of 15 patients treated by primary closure recovered without complications.

Adult↗
PubMedDate not supplied

Prevention of early reocclusion by dipyridamole and ASA in arterial reconstructive surgery.

In this prospective study 364 patients were subjected to different types of arterial reconstructive surgery. The patients were randomly divided into four groups according to the type of antithrombotic medication given. During the hospitalization period there were no reocclusions in the dipyridamole/ASA group of 93 patients compared with 12 reocclusions in the control group of 86 patients. The difference was statistically highly significant. The difference between the control group and the given dipyridamole or ASA was not statistically significant. Dipyridamole and ASA were tolerated well by the patients in this clinical trial. This was the first clinical investigation to prove the effectiveness of dipyridamole and ASA medication in the prevention of reocclusions in arterial reconstructive bypass surgery.

Arterial Occlusive Diseases↗
PubMedDate not supplied

Prevention of deep venous thrombosis and thrombo-embolism by dipyridamole and acetylsalicylic acid after reconstructive arterial surgery.

A series of 400 consecutive patients subjected to reconstructive arterial surgery were randomly allocated into four equal groups in order to study the effect of dipyridamole and acetylsalicylic acid (ASA) in the prevention of deep venous thrombosis and pulmonary embolism. There were 11 drop-outs. In the dipyridamole-ASA group there were no thrombotic complications while in the control group without antithrombotic therapy five cases of deep venous thrombosis and two cases of fatal pulmonary embolism were encountered (p < 0.05). In the groups receiving either dipyridamole or ASA alone two and four cases of deep venous thrombosis, respectively, were found. It is concluded that treatment with dipyridamole and ASA combined is useful in preventing postoperative thrombotic complication after peripheral vascular reconstructive surgery.

Adolescent↗