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Biomedical subjects

J J Yashar

Publications and source records attributed to J J Yashar.

At least 19 recordsLinked to original sources
PubMed1993

Favorable results of coronary artery bypass and/or valve replacement in octogenarians.

Between October 1987 and July 1990, of 763 patients undergoing open heart surgery, 43 (5.6%) were 80 (mean and median 82) years of age or older. There were 20 men and 23 women. Eighteen patients (42%) were initially assessed using the angina score of the New York Heart Association or Canadian Cardiovascular Association as class IV. Nine procedures (21%) were performed electively and 34 (79%) urgently. A total of 26 patients (60%) underwent coronary bypass surgery, while 11 (26%) had valve replacements and six (14%) had both coronary bypass surgery and valve replacement; 74% of the patients received two or more grafts. The hospital mortality rate of the octogenarian patients was 9% (four of 43), significantly higher (P < 0.05) than the overall hospital mortality rate of 3.6% for patients < or = 79 years of age. A history of myocardial infarction within 2 weeks before the procedure was obtained in nine of 43 patients (21%); 22 (51%) had experienced at least one myocardial infarction before surgery. Ejection fractions were 'normal' in 28 patients (65%), 'fair' in nine (21%) and 'poor' in six (14%). The mean length of hospital stay for the octogenarian patients was 19 (range 8-64) days. Thirty-five of the 39 operative survivors were followed for a mean of 14 (range 3-35) months. The actuarial probability of survival was 86% at the end of this time. A total of 31 patients (79%) assessed using the angina score of the New York Heart Association or Canadian Cardiovascular Association were class I or II. During the follow-up period.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1981

Dacron vs vein for femoropopliteal arterial bypass. Should the saphenous vein be spared?

The increasing need for the saphenous vein to bypass lesions of the coronary and other small arteries prompts a reconsideration of its routine use for femoropopliteal bypass. Evaluation after five years in 124 consecutive patients (135 procedures) demonstrated no significant difference in overall definitive patency between venous grafts (63%) and Dacron prostheses (65%). Dacron prostheses were avoided when below-knee anastomoses were required, but when the distal anastomoses were made above the knee, the five-year patency for veins and Dacron was equal (67%). Although the quality of the distal runoff influenced the long-term patency, effects were similar for veins and for Dacron. The data support the use of Dacron prostheses for femoropopliteal bypass proximal to the knee joint, allowing preservation of the saphenous vein for possible use elsewhere.

Adult↗
PubMed1980

Atrioventricular sequential pacemakers: indications, complications, and long-term follow-up.

Our experience with 32 patients with atrioventricular (AV) sequential pacemakers and an average follow-up of 22 months is presented. The pertinent literature and physiology are reviewed. The indications, advantages, and complications of AV sequential pacemakers are analyzed. Half of the patients required bifocal pacing for control of arrhythmia alone, while half required control of arrhythmia associated with congestive heart failure due primarily to a noncompliant left ventricle. It is anticipated that the hemodynamic improvement occurring as a results of AV sequential pacing will increase the use of this mode of cardiac pacing in selected patients.

Adult↗
PubMed1979

Primary osteogenic sarcoma of the heart.

The clinical course of a 17-year-old boy with primary osteogenic sarcoma of the left atrium with partial obstruction of the mitral valve and the right pulmonary veins is described. After operative removal of the tumor, echocardiography documented its rapid recurrence. Despite two subsequent open-heart operations and adjuvant chemotherapy and radiotherapy, the patient died twenty-one months after the initial symptoms. Previous reports of such tumors are reviewed, and technical difficulties of removal are discussed.

Adolescent↗
PubMed1978

Survival and limb salvage in patients with infected arterial prostheses.

A series of 590 cases with a 2.5% rate of infection of arterial prostheses is presented. When one of the anastomoses was in the inguinal area, the incidence of prosthetic infection was higher. Two infections not involving the anastomotic site healed with conservative management. The three patients with aortoduodenal fistulas died. The long-term survival was 62%, and the amputation rate was 31%. During the last two years, a more aggressive surgical approach of total removal of the infected prosthesis and its replacement with an extraanatomic bypass has been instituted. With this approach, only one death and one amputation has occurred in six patients.

Aged↗
PubMed1978

Failure of Dacron prostheses caused by structural defect.

Intrinsic prosthetic failure is quite uncommon since the advent of Dacron prostheses. Only 24 cases of arterial prosthetic failure have been described in the literature. Our experience consists of two additional failures of knitted Dacron prostheses. The first patient developed aortojejunal fistula due to a defect of the aortic prosthesis 6 years after resection and replacement of an abdominal aortic aneurysm. The analysis of the graft revealed a defect in the form of a dropped stitch, which caused a weak spot where the prosthesis was able to be torn apart longitudinally. The second patient had femoropopliteal bypass and 6 years later developed degeneration with aneurysmal formation of the entire length of the prosthesis. Optical microscopy of this prosthesis exhibited mostly transverse failures which were coincident with valleys of the corrugated prosthesis. This was indicative of a defect that rendered the corrugation root too weak to withstand normal arterial pressures. This presentation emphasizes the seldom and serious complication of prosthetic failure due to defect of the prosthetic material. Details of scanning electron microscopy of the prosthesis, clinical presentation, angiography, and pathological findings with treatment also are discussed.

Aorta, Abdominal↗
PubMed1977

The treatment of patients with recurrent ventricular fibrillation.

During the four year period from 1972 to 1975, eleven patients, eight with recurrent and three with first attacks of ventricular fibrillation, underwent aortocoronary bypass graft and/or resection of ventricular aneurysm. All patients had old myocardial infarction from seven weeks to six years. Left ventricular angiography demonstrated discrete aneurysm of the anterior wall of the left ventricle in nine of the patients and akinesis or hypokinesis of the anterior and posterior wall of the left ventricle in the remaining two. Coronary angiography was carried out in ten patients and revealed significant disease of the left anterior descending and right coronary arteries in ten and nine patients, respectively. There was no operative mortality, and there were two late deaths. Eight patients have improved significantly and have had no further sign of ventricular irritability. The present study indicates that aortocoronary bypass graft and/or resection of ventricular aneurysm is an effective method of therapy for patients with repeacted ventricular fibrillation who have ventricular aneurysm and ischemic heart disease.

Adult↗
PubMed1975

Factors affecting long-term survival of patients with bronchogenic carcinoma.

From January 1963 to December 1968, 148 patients underwent thoracotomy for bronchogenic carcinoma. In 123 patients either lobectomy or pneumonectomy was performed (resectability rate of 84 per cent). The over-all operative mortality was 3.4 per cent. Forty of the patients undergoing resection (34 per cent) are alive and free of cancer five years after surgery. Tumor size, nodal involvement, cell type, location, symptoms, and extent of surgery were studied in relation to the long-term results. Five year survival was directly related to the size of the tumor and the extent of nodal involvement. No patients with mediastinal nodal involvement or with lesions larger than 7 cm in diameter were among the long-term survivors.

Adenocarcinoma↗