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Biomedical subjects

Mark A J Newman

Publications and source records attributed to Mark A J Newman.

17 recordsLinked to original sources
PubMed2006

Radiological diagnosis and classification of antegrade and retrograde Stanford type A intimal intussusception.

Intimal intussusception is an uncommon variation of aortic dissection, resulting from circumferential detachment and stripping of the intima in the setting of a Stanford type A dissection. The resultant tube of detached intima may prolapse either antegrade into the aortic lumen or retrograde into the left ventricular cavity. We classify these forms of dissection as antegrade and retrograde Stanford type A intimal intussusception. We present two cases with intimal intussusception and a review of the current literature. The majority of previous cases have been reported in the cardiology and cardiothoracic surgical literature, with few previous radiological reports.

Aged↗
PubMed2006

Prosthesis replacement in a calcified mitral annulus with reconstruction of the intervalvular fibrous body: the value of an alternative repair.

A patient with healed prosthetic endocarditis, severe calcification of the mitral annulus, and multiple mitral periprosthetic leaks underwent double-valve replacement, with reconstruction of the intervalvular fibrous body. Placing sutures through healthy autologous tissues from outside the heart enabled secure replacement of the mitral prosthesis. This technique avoids extensive circumferential reconstruction of the mitral annulus.

Calcinosis↗
PubMed2005

Use of a single silastic chest drain following thoracotomy: initial evaluation.

BACKGROUND: It is standard practice to use multiple large bore semi-rigid chest tubes to drain the pleural cavity following thoracic procedures. These can cause pain and discomfort at the insertion site. METHODS: We describe our experience with the use of a single small silastic drain following thoracotomy. From November 2001 to November 2003, size 19-F silastic chest tubes (Blake drains) were used for drainage of the pleural cavity in 37 patients at our institution. The patients ranged in age from 18 to 81 years (mean 65). The operations included 22 lobectomies, two bilobectomies, 10 wedge resections, and three other procedures. RESULTS: Total drainage in each patient ranged from 420 to 5440 mL (mean 1387 mL). Tubes were left in place for an average of 4.3 days (range 1-12). The average postoperative length of stay was 7.6 days (range 3-44, median 5). Three patients required insertion of an additional tube for dislodgement, persistent air leak, and bronchopleural fistula, respectively. These complications occurred among the first 15 patients in the present series. None of the patients had persistent pleural effusion. Subjectively, these tubes were more comfortable for the patients and were easier to remove. SUMMARY: The use of a single, small silastic chest drains following thoracotomy may be safe and effective in draining both fluid and air, though an additional tube may be necessary for persistent leaks.

Adolescent↗
PubMed2004

Retroaortic course of the anomalous left main coronary artery: is it a benign anomaly? A case report and review of literature.

BACKGROUND: Left coronary artery sharing a common origin with the right coronary artery and taking a retroaortic course is a rare coronary anomaly. It has been considered a benign entity. CASE REPORT: We report a 19-year-old man who presented with chest pain. Cardiac enzymes were elevated suggesting myocardial ischaemia. Coronary angiography revealed single origin of the coronary artery in the right coronary sinus. The left main coronary artery followed a retroaortic course before bifurcating. The anomalous left coronary artery was dissected and reimplanted in the left coronary sinus. The patient made an uneventful recovery. One year later, he is well with no recurrence of symptoms. CONCLUSIONS: Surgery to restore the normal anatomic position of the left coronary ostium is advisable whenever this anomaly is discovered.

Journal Article↗
PubMed2002

The effect of preoperative aspirin-free interval on red blood cell transfusion requirements in cardiac surgical patients.

OBJECTIVE: To compare red blood cell transfusion in first-time coronary artery surgery patients who stopped taking aspirin < or = 2 days, 3 to 7 days, or >7 days preoperatively. DESIGN: Observational study. SETTING: University-affiliated teaching hospital. PARTICIPANTS: Adult patients (n = 797) undergoing first-time coronary artery surgery on cardiopulmonary bypass who were not receiving other anticoagulant or antiplatelet drugs before surgery. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Patients were divided into 4 groups based on days since last ingestion of aspirin. Blood products transfused in the groups were (aspirin < or =2 days) (n = 140) 2.2 +/- 4 U of red cell concentrate (RCC) (mean +/- SD), 1.4 +/- 3 U of fresh frozen plasma (FFP), and 2.7 +/- 6 U of platelets; (aspirin 3 to 5 days) (n = 255), 1.5 +/- 2 U of RCC, 0.8 +/- 2 U of FFP, and 1.6 +/- 4 U of platelets; (aspirin 6 to 7 days) (n = 215), 1.6 +/- 3 U of RCC, 0.9 +/- 3 U of FFP, and 1.5 +/- 3 U of platelets; and (aspirin >7 days) (n = 187), 1.3 +/- 2 U of RCC; 0.6 +/- 2 U of FFP, and 0.9 +/- 2 U of platelets. CONCLUSION: Patients who stop taking aspirin < or =2 s preoperatively have increased allogenic red blood cell transfusion requirements perioperatively. Patients who stop taking aspirin 3 to 7 days preoperatively have little or no increased requirement for allogenic red blood cell transfusion.

Aspirin↗