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Biomedical subjects

I F Tabry

Publications and source records attributed to I F Tabry.

14 recordsLinked to original sources
PubMed2001

Case report: off-pump total myocardial revascularization for dextrocardia and situs inversus.

A 42-year-old man with dextrocardia and situs inversus underwent successful off-pump total myocardial revascularization using the technique popularized by Tector [Tector 1994, Tector 1996]. The free left internal mammary artery (LIMA) was anastomosed to the in-situ right internal mammary artery (RIMA) at the level of the right-sided left atrial appendage, then anastomosed sequentially to the first diagonal branch (D1) of the left anterior descending artery (LAD), and to the LAD. The in-situ RIMA was sequentially anastomosed to the first and the second obtuse marginal branches (OM1 and OM2) of the circumflex coronary artery. A saphenous vein was then anastomosed to a diffusely diseased posterior descending branch (PDA) of the right coronary artery (RCA). The patient was asymptomatic and in excellent condition three months after surgery. In economically depressed regions of the world, such as the Gaza Strip, off-pump complete revascularization is an excellent alternative to cardiopulmonary bypass.

Adult↗
PubMed1979

Successful repair of straddling atrioventricular valve by technique used for septation of univentricular heart.

Straddling atrioventricular valve (SAVV) is a rare anomaly. Only recently have the premortem diagnostic features been elucidated. Repair of the associated ventricular septal defect poses a considerable technical problem. Corrective operations, infrequently reported, have usually involved replacement of the SAVV. This report describes the successful management of a patient with a straddling left atrioventricular valve in whom the valve was preserved by a technique previously used for septation of the univentricular heart. This technique offers a useful alternative to valve replacement in the management of patients with SAVV.

Angiocardiography↗
PubMed1979

Surgical repair of criss-cross heart with straddling atrioventricular valve.

The criss-cross heart is a rare anomaly in which systemic and pulmonary bloodstreams cross at the atrioventricular (AV) level. Although diagnosed now with increasing frequency, successful surgical repair of associated anomalies has been reported only once. Straddling AV valve is another rare cardiac anomaly which only recently is being diagnosed consistently preoperatively and corrected surgically. This is the first report of successful repair of cardiac anomalies in a patient with the combination of straddling AV valve and criss-cross AV relationships. The uneventful postoperative course and good result on follow-up in this patient are gratifying and suggest that this combination of anomalies now can be repaired with results as good as those for less complex forms of congenital heart disease.

Angiocardiography↗
PubMed1979

Surgical management of straddling atrioventricular valve.

Corrective operations were attempted in 10 patients with straddling atrioventricular valve (SAVV), and successful palliative operations were performed in another nine patients. SAVV occurred as a part of five different cardiac complexes, and three anatomic types were encountered. The SAVV was a tricuspid valve in eight patients, right atrioventricular valve (in univentricular hearts) in five, and mitral valve in six. Four types of corrective procedures were used: (1) the Rastelli operation, (2) isolated closure of the universally present ventricular septal defect by a patch deviating around the straddling portion of the SAVV, (3) replacement of the SAVV with or without insertion of an extracardiac conduit, and (4) closure of the SAVV plus right atrium-pulmonary artery anastomosis (modified Fontan procedure). All three hospital deaths occurred in patients managed by replacement of SAVV and extracardiac conduit insertion (technique 3). This experience allows preliminary speculation about preferred methods of surgical management.

Adolescent↗
PubMed1978

Effect of surgery on ventricular tachyarrhythmias associated with coronary arterial occlusive disease.

We studied 51 patients with coronary artery disease over a 32-month period to determine the effect of coronary revascularization or ventricular resection on ventricular tachyarrhythmias. In these patients, whose major indications for operation were tachyarrhythmias, operative mortality was 18% (9/51). Myocardial infarction could not be documented in 16 patients, including four resuscitated from an arrest; 15 underwent coronary grafting, and one had grafting and mitral valve replacement, with one hospital death. Premature ventricular contractions (PVCs) persist in four of the 15 survivors; all those who had an arrest are free of PVCs. The other 35 patients had documented infarction, associated with an arrest in 19. Grafting only was required in 18, with no hospital mortality and two late deaths (congestive failure and ventricular tachyarrhythmia at 7 months, ventricular tachyarrhythmia at 5 months); eight of 16 survivors have PVCs. Acute (< 3 weeks) infarct resection was performed in six patients with three hospital deaths, no late deaths; one survivor has PVCs. Chronic (> 3 weeks) aneurysm resection in four patients (with bypass grafting in three) had no operative mortality, one late death (5 months) from ventricular tachyarrhythmias, and one survivor continues with PVCs. The remaining seven patients, all in cardiogenic shock, required more than two procedures (bypass grafting, LV resection, VSD closure, mitral valve replacement), with five hospital deaths; the two survivors still have PVCs. Thus, ventricular tachyarrhythmia secondary to coronary artery disease is more likely to resolve postoperatively in patients without myocardial infarction, but its postoperative persistence remains substantial and may warrant special efforts to locate and ablate ectopic foci and/or re-entry pathways.

Adult↗
PubMed1978

Surgical management of double-outlet right ventricle associated with atrioventricular discordance.

Twenty corrective operations for this unusual syndrome have been performed since 1965. All but two patients also had pulmonary stenosis; one of the exceptions had had pulmonary arterial banding. Two patients had situs inversus of the atria and viscera. In only three of the 20 patients (15 percent) was the apex of the heart positioned normally. Six patients had an entirely intracardiac repair; two early and two late deaths occurred in this group. The other technique, performed in 14 patients, involved insertion of an extracadiac conduit between a ventriculotomy in the morphologically left ventricle and the distal end of the proximally oversewn pulmonary artery; one operative and two late deaths occurred in this group. Heart block occurred in six patients, including two among the eight who had technically satisfactory intraoperative mapping of the His bundle. The intraventricular course of the bundle was not consistently positioned, being anterior to the septal defect in four and posterior in four. No hospital deaths have occurred in the last 13 operations; all except one of the survivors are in New York Heart Association Class I or II. Thus correction currently provides a good early results but leaves the ventricles in an inverted relationship both functionally and anatomically.

Adolescent↗
PubMed1978

Successful repair of double-outlet right ventricle, complete atrioventricular canal, and atrioventricular discordance associated with dextrocardia and pulmonary stenosis.

The association of complete atrioventricular canal with other complex congenital cardiac anomalies has represented a significant challenge for the cardiac surgion. The combination of double-outlet right ventricle with complete atrioventricular canal has been particularly difficult to correct, with no surgical successes having been reported until recently. This is a report of the first successful repair of double-outlet right ventricle, complete atrioventricular canal, and atrioventricular discordance (ventricular incersion) associated with common atrium, bilateral superior venae cavae, dextrocardia, and pulmonary stenosis. The specialized conduction tissue was identified by intracardiac electrophysiological mapping, and normal sinus rhythm was preserved. Postoperative cardiac catheterization showed excellent hemodynamics. One year postoperatively, the patient was attending school, playing swimming without difficulty, and taking no cardiac medications. This good result lends encouragement for considering total repair for similar patients with the combination of double-outlet right ventricle, complete atrioventricular canal, and other associated congenital cardiac anomalies.

Angiocardiography↗
PubMed1978

Great-vessel switch operation without coronary relocation for transposition of great arteries.

Since its first successful clinical application in 1963, the Mustard operation has been the procedure of choice for most patients with transposition of the great arteries. Based on the principle of transposition of venous return, it produces a functional but not anatomic correction of the defect. Although the Mustard procedure has favorably changed the natural history of transposition, it is associated with various early and late complications that have led to a search for a more anatomic repair. Recently, transposition has been successfully corrected by switching the great vessels, with or without transplanting the coronary arteries. These are the first case reports of early postoperative hemodynamics in patients undergoing an arterial switch procedure without coronary relocation. The early hemodynamic and clinical results of this operation are excellent and they lend encouragement for its further application in suitable patients.

Angiocardiography↗
PubMed1977

One hundred consecutive coarctation resections followed from one to thirteen years.

The technique of operative repair for coarctation of the aorta is now well standardized and the immediate surgical mortality has been lowered to less than 5% in most large series. Long term follow up, however, is only recently being reported. This paper describes the current status of 100 consecutive patients who underwent elective resection from 1--13 yr ago. There was only one operative death. In contrast with other reports, residual systemic hypertension is rare in the 97 survivors. These observations confirm that coarctation of the aorta can be repaired surgically with an acceptable operative mortality; the outlook of the survivors appears excellent.

Adolescent↗
PubMed1975

Cavernous hemangioma of the heart: case report and review of the literature.

A case of diffuse cavernous hemangioma of the heart discovered incidentally during life is reported. Resection of the tumor was impossible at operation. Two similar cases were found in the literature. Radation therapy is suggested, and the importance of a simple blood pool scan in the investigation of paracardiac masses is stressed.

Female↗