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Biomedical subjects

L Levinsky

Publications and source records attributed to L Levinsky.

At least 37 records · Page 2Linked to original sources
PubMed1980

Cold blood--potassium cardioplegia.

A technique is described for providing myocardial protection utilizing oxygenated blood that is drawn from the pump oxygenator and passed through two disposable cardioplegic cooling coils, which are joined in series and submerged in ice slush. A potassium-containing cardioplegic solution is run into the oxygenated blood at the level of the cooling coils. The amount of blood used in the blood-potassium cardioplegic mixture is controlled using a screw clamp. This method has been used with excellent results in 150 consecutive patients undergoing aortocoronary saphenous vein bypass grafting.

Blood↗
PubMed1980

Refinements in coronary artery surgery contributing to improved survival.

Reviews of the literature and controlled studies of medical versus surgical treatment of coronary artery disease that include surgical results from 3 or 4 years ago may not be pertinent to therapeutic decisions made today. The results in our patients operated during 2 two-year periods (1974--1976, Group I and 1976--1978, Group II) are compared. The Group II patients had more severe coronary artery disease. They had significantly more grafts per patient (p less than .001), their cardiopulmonary bypass time was significantly reduced (p less than .001), they received less inotropic support (p less than .005) and spent less time in the intensive care unit (p less than .001). There was a significant decrease in the overall perioperative mortality (30-day) in the patients of Group II (p less than .055). The second two-year period coincided with the adoption of refinements in the intraoperative preservation of myocardium and also in surgical technique. These refinements are discussed in detail.

Adult↗
PubMed1980

Tubular hypoplasia of the descending thoracic aorta. Surgical treatment with a PTFE bypass graft under moderate total body hypothermia.

An 8 1/2-year-old child presenting with hypertension was noted to have tubular hypoplasia of the descending thoracic aorta without collateral circulation on angiography. Surgical management consisted of bypassing the hypoplastic segment (10 cm) using a 10 mm PTFE graft under total body hypothermia to minimize spinal complications. The patient had an uneventful recovery with normalization of blood pressures postoperatively.

Aorta, Thoracic↗
PubMed1980

Anomalous origin of the left coronary artery from the pulmonary trunk: its clinical spectrum and current surgical management.

An anomalous left coronary artery arising from the pulmonary artery is a rare congenital anomaly which carries a serious prognosis with a high mortality in infants. Our experience in the surgical treatment of 9 patients with this condition during the last 5 years is discussed. The majority of patients were under the age of 2 years and presented with left ventricular failure. Surgical procedures included simple ligation of the left coronary artery, left subclavian to left coronary artery anastomosis, interposition vein graft, and direct reimplantation of the left coronary artery into the aorta. Patients treated by simple ligation survived the procedure but did not show improvement. Results with the subclavian artery to left coronary artery anastomosis were disappointing. Direct reimplantation or interposition of a saphenous vein graft appears to be the method of choice.

Child↗
PubMed1979

The revival of the horseshoe graft (side-to-side saphenous-vein-to-aorta anastomosis).

The technique of the horseshoe graft, side-to-side saphenous-vein-to-aorta anastomosis, using a long saphenous vein harvested from the leg is described in this communication. The lack of valves between the ankle and the knee and the high caliber natural Y distributions make this technique attractive. Constructing a double set of vein graft provides, in particular, unlimited possibilities for the construction of six to eight grafts if this appears anatomically feasible.

Coronary Artery Bypass↗
PubMed1979

Dacron patch enlargement of anterior wall of left ventricle after aneurysmectomy with concomitant infarctectomy.

The basis for left ventricular aneurysmectomy with cardiopulmonary bypass was established 20 years ago. There is a higher risk in patients who undergo operation within 2 months of myocardial infarction. In these patients there may be no clear demarcation between devitalized tissue and residual healthy myocardium. A case is reported in which anterolateral aneurysmectomy with concomitant infarctectomy so compromised left ventricular size that the anterolateral wall of the left ventricle had to be reconstructed with a Dacron patch graft.

Adult↗
PubMed1978

Persistent chylothorax. Treatment by talc pleurodesis.

Two patients with persistent chylothorax resistant to therapy by special diet, thoracenteses, and tube thoracostomy drainage were successfully treated by talc pleurodesis. In one patient with advanced lymphosarcoma involving pleura and mediastinal nodes, the chylothorax was managed by open thoracotomy and talc powder. The other patient developed chylothorax following resection of a thoracic aortic aneurysm. She was successfully treated by talc suspension introduced through a thoracostomy tube. Pleurodesis with talc should be considered only when the chylothorax persists after an adequate period of medical treatment and pleural decompression. Intrapleural instillation of talc through a thoracostomy tube should be successful if the chylothorax can be evacuated and the underlying lung fully expanded.

Chylothorax↗
PubMed1976

Sarcoidosis in Europe: a cooperative study.

The data on the epidemiologic situation of sarcoidosis from 24 countries of Europe have been reviewed. The new facts seem to demonstrate that the differences between the frequency of this disease in the north and south are not real. The actual situation is dependent on the general knowledge of this disease and on the extent and intensity of the active detection of its asymptomatic stage. A new prospective cooperative study of the yearly incidence of all forms of sarcoidosis in the total population of at least some European countries would be desirable.

Adult↗
PubMed1975

Tracheobronchial resection and reconstruction. A report of five cases.

During the past six years, five patients have undergone tracheal or tracheobronchial reconstruction in our Department. In three patients, a segmental tracheal resection was performed because of post-tracheostomy stricture or cylindroma of the trachea. Two patients were treated for a carcinoid type of bronchial adenoma--one by sleeve resection of an intermediate bronchus and one by pneumonectomy with partial resection and reconstruction of part of the trachea. The exact location, length and nature of the lesions were demonstrated by endoscopy, tomography and tracheobronchography. The surgical and anesthetic problems associated with tracheobronchial reconstruction are discussed.

Adenoma↗