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Biomedical subjects

N H Baker

Publications and source records attributed to N H Baker.

18 recordsLinked to original sources
PubMed1987

Vascular complications associated with the use of intraaortic balloon pumping.

Our 11-year experience with intraaortic balloon pumping (IABP) was analyzed to determine the incidence and evaluate the management of vascular complications. Between 1973 and 1984, 637 patients were candidates for IABP. In 41 cases, IABP was precluded because peripheral vascular disease inhibited balloon catheter insertion. Of the 596 patients who underwent IABP, 304 (51.0%) survived the hospital period, and late follow-up information was available for 283 (93%) of these. The late results were analyzed with respect to the duration of survival and the presence of lower-extremity claudication. Sixty-six (11.1%) of the 596 patients experienced vascular complications (mainly in the form of limb ischemia). Balloon removal, followed by thromboembolectomy, restored limb viability in the majority of cases. When continued IABP was required, creation of a femoral-femoral bypass to the portion of the limb distal to the balloon allowed viability to be maintained.

Journal Article↗
PubMed1986

Experience with intraaortic balloon counterpulsation.

An eleven-year experience with intraaortic balloon pumping (IABP) or counterpulsation in 637 patients was analyzed with respect to early and late results. Intraaortic balloon pumping was employed for left ventricular pump failure, for coronary insufficiency, and in association with cardiac operations. Late results were analyzed by follow-up of 283 (93%) of the 304 patients leaving the hospital, and were studied with respect to duration of survival, activity status, occupational status, presence of cardiac symptoms, use of cardiac medications, and presence of lower extremity claudication. Early results were analyzed for hospital survival (304/637 [48%]). Patient complications of IABP included wound infection (1/637 or 0.2%), vascular complications (66/637 or 10.4%), and balloon failure (8/637 or 1.3%). No deaths were attributable to complications of IABP. Survival did not correlate with the duration of IABP. Survival was improved in patients who had revascularization in association with IABP.

Adult↗
PubMed1985

Aortocoronary bypass following unsuccessful PTCA: experience in 100 consecutive patients.

This study reviews the experience in a community hospital with aortocoronary bypass in 100 consecutive patients following failed percutaneous transluminal coronary angioplasty (PTCA) in terms of timing of intervention, morbidity, and mortality. Patients undergoing operation within 24 hours of PTCA are defined as the urgent group (68%) and those with intervention at greater than 24 hours, the elective group (32%). Mean interval from PTCA to operation was 43.5 days; among patients with apparently initially successful PTCA and hospital discharge, mean interval to operation was 138 days. Complete revascularization was carried out in all patients using standard techniques. Although the difference was not statistically significant, patients in the urgent group required intraaortic balloon pump support and inotropic infusions more often and experienced greater postoperative blood loss. Significant increases in the use of lidocaine and blood products were noted in the urgent group. The rates of major complications were 54.4% in the urgent group and 18.8% in the elective group. Mortality was 4.4% in the urgent group and 3.1% in the elective group (not significant); all deaths were cardiac related. There were no late deaths among survivors followed for 3 months to 4 years; 86% were in Functional Class I. We conclude that PTCA is a reasonable approach for some patients with ischemic heart disease. However, mandatory urgent aortocoronary bypass in these patients carries an increased morbidity and mortality, and patients should be selected with care.

Adult↗