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Biomedical subjects

M J Levy

Publications and source records attributed to M J Levy.

At least 73 records · Page 4Linked to original sources
PubMed1984

Calcification of a porcine valve xenograft during pregnancy--a case report and review of the literature.

A 20-year-old woman required urgent replacement of a calcified prosthetic mitral porcine xenograft with a mechanical one during the 32nd week of pregnancy. Five weeks later the patient delivered a normal child. Following delivery the patient refused oral anticoagulant treatment and 7 months later she underwent emergency removal of a prosthetic valve thrombus. Six months later, still refusing anticoagulant treatment, she died of cerebral embolization. We suggest that the replacement of a degenerated biologic valve with another biologic valve should be considered in patients who refuse anticoagulant treatment and that patients with prosthetic xenografts should be kept under close medical follow-up, including echocardiography because of possible accelerated xenograft failure during and/or following pregnancy.

Adolescent↗
PubMed1983

Carcinoma of lung with a solitary cerebral metastasis. Surgical management and review of the literature.

During the years 1975 to 1980, 10 male patients and 1 female, with ages ranging between 40 to 61 years, underwent combined resection of primary lung cancer and solitary brain metastasis. In 8 patients the lung cancer was diagnosed and treated first. In those patients, craniotomy for removal of a solitary brain metastasis was carried out 8 to 60 months (mean, 27 months) after excision of the lung tumor. In 3 patients, brain metastasis was diagnosed and treated first and lung excision followed, 2 to 4 weeks after craniotomy. The most common histologic type of the tumor was adenocarcinoma (63.6%). There were no operative deaths. Three patients survived less than 6 months after surgery and were considered as a failure of surgical treatment. Seven patients lived longer than 1 year and three of them are still alive with a follow-up period between 2 to 3 1/2 years after both operations. One of the patients underwent recently successfully second brain intervention for removal of recurrent histologically identical solitary brain metastasis and is well. Our results and those reported in literature encourage the combined surgical removal of primary lung cancer and a solitary brain metastasis.

Adenocarcinoma↗
PubMed1983

Two years experience with Medtronic-Hall prostheses in 75 patients with special reference to its thrombogenicity and hemolysis.

Seventy-five patients received 80 Medtronic-Hall valve prostheses during a 24-month period at the Beilinson Medical Center. The mean age was 50 years and the majority of patients had rheumatic heart disease. All operations were elective. There were 4 early and 2 late deaths (8%). Four patients needed re-operation for paravalvular leaks, 3 of them survived the second operation and one patient with prosthetic valve endocarditis did not. One patient was re-operated on successfully because of a mycotic aneurysm in the ascending aorta. Mild subclinical hemolysis (elevated SLDH and reduced haptoglobin) was found in the majority of patients. Hemolysis was found to be significantly lower in type D 16 prostheses patients. Mild hemorrhagic complications occurred in 2 patients due to anticoagulant therapy. Three patients suffered from prosthetic valve endocarditis (PVE), 2 of them responded to prompt medical therapy. There were no thromboembolic episodes. Most surviving patients experienced marked postoperative improvement. Within the 24-month follow-up period, the Medtronic-Hall valve compared favorably with other disk or ball prostheses previously and currently used in our department.

Adolescent↗
PubMed1983

Atrial tumors--surgical experience of 9 cases.

Nine patients underwent surgical removal of intracardiac tumor during a 12-year period. The mean age of the five women and four men was 57 years (range 40 to 69). Eight of the nine patients were operated on in the last four years of the study period. The interval from onset of symptoms to surgery averaged 18.3 months. Clinical presentation varied significantly, reflecting mechanical, embolic and constitutional effects of the intracardiac mass. Echocardiography was the noninvasive procedure that contributed most to preoperative diagnosis, confirming presence of an intracardiac tumor in seven of the eight examined patients. Of the nine intracardiac tumors, seven were myxomas (6 left atrial and 1 right atrial), one was a primary left atrial liposarcoma and one a right atrial metastasis from an anaplastic carcinoma of the kidney. No patient died during or immediately after the operation. The two patients with malignant tumor died, two months and two years postoperatively, from progression of the basic disease. In neither case, however, was atrial recurrence of tumor found at autopsy. Of the seven surviving patients, five are symptom-free after observation periods averaging 34 months (range 2 months to 12 years). The other two still have signs of mild congestive heart failure. No recurrence of atrial myxoma has so far been detected.

Adult↗
PubMed1983

Myocardial protection in infant open heart surgery.

Myocardial protection was evaluated in 2 groups of 5 infants each undergoing correction of either tetralogy of Fallot (TOF) or subcristal ventricular septal defect (VSD). In group A, profound hypothermia and total circulatory arrest (PHTCA) was utilized. In group B, profound hypothermia and total circulatory arrest combined with potassium cardioplegia (PHTCA + K) was the method of protection used. The analysis was carried out by sequential measurements of clinical, electrocardiographic, enzymatic (CK-MB) and ultrastructural parameters. There were no operative deaths. One infant had a second operation for recurrent VSD. The average anoxic time was 35.4 min in group A (PHTCA) and 32.6 min in group B (PHTCA + K). Analysis of our data demonstrated that when potassium cardioplegia was added to PHTCA, there was less intraoperative myocardial damage according to physiological, ultrastructural and biochemical parameters than when profound hypothermia and total circulatory arrest was applied alone.

Creatine Kinase↗
PubMed1983

Coarctation of the aorta in infancy.

Twenty-five infants under 1 year of age (mean weight 3.4 kg) underwent repair of coarctation of the aorta between the years 1965 and 1982. Three patients had coarctation only, three had coarctation with patent ductus arteriosus (PDA), and 19 had associated intracardiac anomalies. Eleven patients underwent resection of the aorta and end-to-end anastomosis. Eight had subclavian flap arterioplasty, five had patch graft arterioplasty, and one had subclavian-to-aortic anastomosis. Additional procedures were performed on seven patients: banding of the pulmonary artery on one, repair of total anomalous pulmonary venous drainage on one, mitral valve replacement on one, aortic valvotomy on one, and aortic valvotomy plus pulmonary artery banding on one. Twenty-one survived the operation. All patients who died had associated intracardiac anomalies. The 21 survivors have been followed from 3 months to 13 years, with three late deaths that were associated with intracardiac anomalies. Five of the survivors underwent additional second operations: one had repair of the re-coarctation, one had replacement of the prosthetic mitral valve, one had aortic valvotomy, and two had pulmonary artery debanding and closure of a ventricular septal defect. Two of the 18 surviving patients have mild hypertension associated with a residual gradient. The others are in good health.

Journal Article↗
PubMed1982

Tricuspid stenosis due to intravenous leiomyomatosis--a call for caution: case report and review of the literature.

Extension of a benign intravenous leiomyomatous tumor from the pelvis into the right atrium resulted in severe tricuspid stenosis in a 28-year-old woman. Absence of the Budd-Chiari syndrome and other abdominal manifestations led to a misdiagnosis of a primary right atrial tumor, with a fatal outcome during operation. In our search of the English literature, this was only the second case found in which extensive intravenous leiomyomatosis interfered with the tricuspid valve mechanism. In this report, the clinical picture, etiology, and treatment are discussed, along with the literature on this rare entity.

Journal Article↗
PubMed1982

Aortico-left ventricular tunnel: collective review.

Aortico-left ventricular tunnel (ALVT) is an extremely rare congenital entity in which an abnormal communication between the aorta and the left ventricle bypasses the aortic valve. The condition usually results in gross aortic regurgitation, rapid cardiac decompensation, and death. An additional case of ALVT managed by successful surgical repair is described. The 38 cases reported in the literature are reviewed with emphasis on the clinical and pathological features, diagnosis, natural history, and management. Early operation is recommended to prevent distortion of the aortic valve, dilatation of the left ventricle, and distortion of the aortic anulus.

Adolescent↗
PubMed1981

Retrograde embolization of a detached polyethylene catheter.

The increasing use of intravenous polyethylene catheters has led to a growing incidence of accidental breakage of catheters and migration to the heart. In this communication, we describe a patient in whom the broken fragment of catheter migrated retrogradely from the subclavian vein to the inferior vena cava and left iliac vein. The possible mechanism for such retrograde migration is postulated.

Aged↗