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Biomedical subjects

N Conway

Publications and source records attributed to N Conway.

At least 37 records · Page 2Linked to original sources
PubMed1979

Surgery of the ascending aorta: five years' experience at a regional cardiac centre.

Between 1972 and 1978, 31 patients underwent replacement of the ascending aorta, with or without aortic valve surgery, at the Wessex Regional Cardiac Centre. The commonest indications for operation were aneurysmal dilatation of the ascending aorta causing aortic regurgitation and acute dissection of the ascending aorta. Eleven of the 31 patients had features of Marfan's syndrome. The overall hospital mortality was 19.4%, a figure comparable with those reported in other series; ventricular failure secondary to ischaemia during operation was the commonest cause of death. The long-term symptomatic results were excellent, except in the two patients who underwent resuspension of the aortic valve for aortic regurgiation associated with acute dissections. For aneurysms of the ascending aorta with associated aortic regurgitation, replacement of the valve and ascending aorta with a combined valve prosthesis and synthetic tube graft, with reimplantation of the coronary ostia, is the procedure of choice if the aortic valve ring is diseased. Experience to date indicates that replacement of the ascending aorta and aortic valve with separate prostheses, leaving the coronary ostia undisturbed, is a satisfactory alternative provided the aortic annulus is of suitable size and quality; this is more likely to be the case in dissections than in aneurysmal dilatation of the ascending aorta. Replacement of the ascending aorta may also be indicated in some cases of dilatation of the ascending aorta secondary to aortic valve disease if the aortic wall is unusually thin.

Adult↗
PubMed1978

The cost of cardiac surgery.

A study in Wessex has shown that at 1977 prices, and excluding the cost of equipment already installed in the unit, the cost of replacing a man's aortic valve in this unit is about 1800 pounds. Nevertheless, this seems a small price to pay for return to health and full working capacity, particularly since such patients no longer need to draw social security benefits and their tax contributions will return to normal, thus probably paying for the operation within two years.

Adult↗
PubMed1978

Correction of anomalous origin of left coronary artery using left subclavian artery.

A case of anomalous origin of the left coronary artery from the pulmonary artery is reported in which surgical correction by anastomosis of the left subclavian artery to the left coronary artery was performed at the age of 6 months. There was a dramatic clinical improvement, and at 22 months repeat angiocardiography disclosed a patent graft and remarkable improvement in left ventricular function. It is recommended that this is the operation of choice for infants in whom cardiac catheterisation fails to show a shunt into the pulmonary artery or the shunt is small.

Coronary Vessel Anomalies↗
PubMed1977

Correction of type B interrupted aortic arch with ventricllar septal defect in infancy.

The successful correction of a Type B interrupted aortic arch (IAA) with simultaneous closure of a ventricular septal defect (VSD) in a 6-month-old infant is described. With the use of profound hypothermia and limited cardiopulmonary bypass, a flap of pulmonary artery, together with the persistent ductus arteriosus (PDA), was dissected free and sutured so as to form a tube which then was anastomosed to the ascending aorta. The ventricular septal defect and the pulmonary arteriotomy then were closed. Cardiac catheterization 5 months later demonstrated a satisfactory reconstruction with no gradient between the ascending and descending aorta.

Aorta, Thoracic↗
PubMed1976

Myocardial infarction complicating aortic valve replacement.

One hundred consecutive aortic valve replacements were studied. Fifteen patients had a myocardial infarction as a result of the operation, and four of the five deaths in the series stemmed from this group. In the four deaths from infarction, autopsy revealed occlusion of a main coronary artery. This was attributable to coronary perfusion in three instances. All of the 11 survivors who sustained an infarct were free of angina and left ventricular failure 6 weeks after the operation. Patients with infarcts had longer bypass times and larger aortic systolic gradients than the patients who did not have an infarct. It is suggested that an infarct can occur as the result of occlusion of a main coronary artery; this is a fatal event commonly related to trauma from the coronary perfusion cannula. Alternatively, infarction may result from regional ischemia, perhaps without vessel occlusion, and is associated with long bypass times and with large aortic valve gradients. In such cases the prognosis is good. However, myocardial infarction was the major cause of death in this series.

Adolescent↗
PubMed1975

Simultaneous mitral valve replacement and ligation of persistent ductus arteriosus; a case report.

The successful simultaneous closure of a persistent ductus arteriosus and mitral valve replacement in a 65-year-old woman with pulmonary hypertension is reported. The approach through a left thoracotomy gave good exposure and momentary cessation of cardiopulmonary bypass made ligation of the calcified ductus possible. Although this seems to be a rare association, when mitral valve disease is significant the simultaneous closure of the duct and mitral valve surgery is the treatment of choice.

Aged↗