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L A Mispireta

Publications and source records attributed to L A Mispireta.

15 recordsLinked to original sources
PubMed1992

Coronary artery bypass without cardiopulmonary bypass.

The purpose of this article is twofold: to describe our technique for performing coronary artery bypass grafting without cardiopulmonary bypass (off pump) and to demonstrate that this operation is safe, in terms of mortality and certain indices of morbidity. Very little has been published in regard to off-bypass operations. From 1985 through 1990, 220 patients underwent operation off bypass; 220 on-pump controls were retrospectively matched for number of grafts, left ventricular function, and date of operation. Groups were compared in terms of mortality and ten indicators of morbidity. The same analysis was performed for ten subgroups. We found no statistically significant difference between groups in mortality (off pump, 1.4% [3/220]; on pump, 2.4% [5/220]), which held across all subgroups. Patients undergoing operation off pump required blood far less often (not transfused: off pump, 72.7% [160/220]; on pump, 54.6% [116/220]; p = 0.005 by Fisher's exact test), and the low output state occurred statistically less frequently off pump (off pump, 5.5% [12/220]; on-pump, 12.7% [28/220]; p = 0.01 by Fisher's exact test). Further research should be directed to which subgroups can be operated on to advantage off pump and which, if any, groups of patients should be confined to on-bypass operations.

Adult↗
PubMed1982

Translumbar selective coronary arteriography.

Translumbar selective coronary arteriography was performed using a preshaped 7 French coronary catheter introduced over the long translumbar needle. The patient had abdominal aortic occlusion, left subclavian artery occlusion, and innominate artery stenosis, which precluded the usual angiographic approaches.

Adult↗
PubMed1981

Reoperation for coronary artery disease.

Forty-two reoperations for myocardial revascularization were done in 40 patients. Seventeen of them (1%) are from our series of 1,700 patients. Average number of grafts per patient was 2.27. Complications occurred in 20 patients. There was no operative or hospital (30-day) mortality. Patients classified as improved or asymptomatic constitute 82.5% of the series. Reoperations within one year were done predominantly for technical cause of failure, whereas reoperations done after more than one year were usually for disease progression. The operative technique is described as are maneuvers to help make a reoperation less hazardous. Reoperations have been accomplished relatively safely with results similar to those of initial operation.

Adult↗
PubMed1976

Surgical management of life-threatening coronary artery disease: experience in 18 consecutive patients with left main trunk or equivalent coronary artery obstruction associated with an obstructed or a nondominant right coronary artery.

Eighteen patients with obstruction of the left main trunk or equivalent coronary artery associated with an obstructed or a nondominant right coronary artery were studied. All patients had coronary artery bypass surgery because of their symptoms and coronary anatomy. Five patients had coronary artery bypass without the use of preoperative elective intra-aortic balloon counterpulsation, and 3 of these patients had cardiac arrest prior to insertion of the grafts. The other 13 patients received elective intra-aortic balloon counterpulsation prior to induction of anesthesia and cannulation. None in this second group of patients developed any hypotensive episodes or cardiac arrest, and all have done well following the bypass operation. This experience suggests that the use of elective preoperative intra-aortic balloon assist in patients who have a very critical coronary artery obstruction is indicated in view of the high incidence of cardiac arrest observed in patients who did not receive the preoperative elective intra-aortic balloon support.

Adult↗