Biomedical subjects

J C Gilmore

Publications and source records attributed to J C Gilmore.

4 recordsLinked to original sources

PubMed1997

Complete direct mammary harvest for minimally invasive coronary artery bypass.

Minimally invasive coronary artery bypass has primarily involved left internal mammary artery grafting to the left anterior descending coronary artery through a small left anterior thoracotomy incision. Harvesting of the mammary artery has been accomplished completely using a video-assisted thoracoscopic technique or incompletely to the second interspace under direct vision. With a mammary retractor, the mammary artery can be dissected completely under direct vision, thus eliminating any criticism of an incomplete harvest and any increased difficulty or expense associated with the thoracoscopic harvest. In this series, all 17 mammary arteries were successfully harvested completely under direct vision and 16 patients underwent successful minimally invasive coronary bypass.

Adult↗

PubMed1988

Left ventricular aneurysm repair with myocardial revascularization: an analysis of 246 consecutive patients over 15 years.

From 1970 to 1985, 246 consecutive patients with left ventricular (LV) aneurysm underwent repair and concomitant myocardial revascularization at Ochsner Foundation Hospital. The overall incidence of perioperative death was 7.3%. Although the deaths were mainly cardiac related (10/18) with congestive heart failure (CHF) as the leading cause (6/10), 8 deaths were of noncardiac origin. Perioperative mortality increased significantly in patients with mitral regurgitation (MR) (22%; p = 0.0008); perioperative mortality for patients without MR was 4.8%. The overall 5-year survival was 69%. Late deaths were caused most commonly by myocardial infarction (20/32) with only 7 due to CHF. Predictors of long-term survival were related to LV function preoperatively: absence of CHF (p = 0.001); LV end-diastolic pressure less than or equal to 20 mm Hg (p = 0.03); and ejection fraction greater than or equal to 35% (p = 0.02). Factors that did not significantly affect long-term survival were type of aneurysm repair (resection or plication), morphology of left anterior descending coronary artery (occlusion or stenosis), and size of the aneurysm.

Adult↗

PubMed1983

Bronchogenic carcinoma in patients younger than 40 years.

Bronchogenic carcinoma is reported to be more rapidly fatal in young persons than in older persons. We wondered whether young patients experience a more virulent form of lung cancer or whether other factors might contribute to poor survival. We reviewed the records of 113 Mayo Clinic patients younger than 40 years with histologically proven bronchogenic carcinoma diagnosed between 1956 and 1976. One hundred four patients (92%) had symptoms for a mean duration of 4 months before diagnosis. The disease was categorized as Stage I in 9 patients, Stage II in 6, and Stage III in 98. Fifty-six patients underwent thoracotomy. The procedure was curative in 17 and palliative in 14; in 25, the lesion was unresectable. Respective 1-year and 2-year survivals were 71% and 35% after curative resection and 79% and 28% after palliative resection. The 1-year survival was 82% for patients in Stage I, 40% for Stage II, and 26% for Stage III. Without resection, only 16% of patients lived 1 year or longer. Advanced disease at presentation characterized this group of young patients.

Adult↗

PubMed1983

Isolated iliac artery aneurysms.

The records of 50 patients with isolated iliac artery aneurysms seen between January 1970 and January 1982 were reviewed. Forty-seven were men and three were women. Their ages ranged from 41 to 92 years (mean 69.7 years). Aneurysm diameter ranged from 2 to 20 cm (mean 4.7 cm). Seventeen patients had multiple aneurysms. Sixty-two percent of aneurysms were on the right side. Eighty-nine percent were located in the common iliac artery, 10% in the internal iliac artery, and 1% in the external iliac artery. Twelve patients had symptoms; all presented with sudden pain. Rupture occurred in seven patients; only three patients survived. Twenty-four patients had surgical treatment. Aneurysmorrhaphy with graft interposition was the most common procedure. There were no deaths during elective operation. Nineteen patients who did not undergo operation were followed from 0.25 to 11 years (mean 4.9 years). Enlargement occurred in nine patients and rupture in one. We conclude that the natural history of isolated iliac artery aneurysms is similar to that of other atherosclerotic aneurysms. Elective resection and arterial reconstruction are recommended.

Adult↗