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J B García-Bengochea

Publications and source records attributed to J B García-Bengochea.

At least 19 recordsLinked to original sources
PubMed2006

High thoracic epidural blockade increases myocardial oxygen availability in coronary surgery patients.

BACKGROUND: High thoracic epidural techniques are increasingly being used in patients scheduled for cardiothoracic surgery, including coronary artery bypass grafting. In the present study, we evaluated the acute effects of the epidural blockade on myocardial oxygen availability by means of tissue oxygen pressure monitoring in patients submitted for surgical revascularization. METHODS: Fifty adult patients were included in a prospective, randomized, double-blind study. After placement of an epidural catheter in thoracic space T1-T2, and under general anesthesia, 5-10 ml of either normal saline or 0.3% ropivacaine was injected through the epidural catheter. Hemodynamic parameters and the intramyocardial oxygen partial pressure were recorded before and 20 min after the epidural injection. RESULTS: There were no demographic or hemodynamic differences between the groups before intervention. A significant increase in intramyocardial partial oxygen pressure was observed in the ropivacaine group (14.6 mmHg vs. 25.1 mmHg, P < 0.0005). CONCLUSION: High thoracic epidural blockade with 5-10 ml of 0.3% ropivacaine increases myocardial oxygen availability in coronary diseased patients prior to surgical revascularization without deleterious hemodynamic disturbances.

Aged↗
PubMed1982

Clinical experience with the Ionescu-Shiley xenograft valve: four to five-year follow-up.

Between January 1977 and July 1981, 132 Ionescu-Shiley xenografts were implanted in 124 patients. Early and late mortality was 13.7% (17/124) and 9.2% (10/107), respectively. Cumulative survival rates at 4 to 5 years were 76% (aortic) and 84% (mitral). Thromboembolic analysis showed 0.72 episodes per 100 patients per year, without chronic anticoagulation. The thromboembolism free rates were 96.8% (mitral) and 100% (aortic); 75% of the mitral patients were in atrial fibrillation. No primary valve dysfunction was detected. In the aortic position (8 patients with valve stent diameter from 19 to 25 mm), the mean peak systolic gradient pressure was 10 +/- 5.5 mm Hg, and calculated valve surface areas were 1.6 +/- 0.5 cm2 at rest and 2 +/- 0.1 cm2 after exercise. A satisfactory correlation between catheterization-derived valve area (from hemodynamic data) and valve stent diameter was obtained (r = 0.94). In the mitral position, the mean diastolic gradient pressure was 4.7 +/- 3.1 mm Hg at rest and 13.8 +/- 0.9 after exercise with the 27 mm xenograft. The corresponding calculated surface areas were 2.8 +/- 6 cm2 and 3 +/- 0.8 cm2. The present data show minimal thrombogenicity without chronic anticoagulation, even in patients with atrial fibrillation or enlarged left atrium and advantageous hemodynamic characteristics, particularly in those with small aortic annuli.

Journal Article↗
PubMed1982

Cor triatriatum with mitral valve disease in adults.

One 16-year-old boy with cor triatriatum and congenital mitral regurgitation and two women, 35- and 54-years-old, with cor triatriatum and rheumatic mitral stenosis are reported. The regurgitant mitral valve in the boy had three papillary muscles and short chordae tendineae. One of the patients with rheumatic mitral stenosis had a subtotal cor triatriatum with enlargement of the left atrial appendage and without asymmetry in the signs of pulmonary congestion. The mitral regurgitation facilitated the angiographic diagnosis of cor triatriatum. However, neither of the two patients associated with rheumatic mitral stenosis were correctly diagnosed preoperatively. All three patients were operated on with satisfactory results.

Journal Article↗