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Biomedical subjects

N Snow

Publications and source records attributed to N Snow.

41 records · Page 3Linked to original sources

Modification of myocardial test probe for epicardial pacemaker insertion.

Modification of the myocardial test probe has proven valuable in reducing the danger of myocardial laceration and has improved the reliability of epicardial threshold measurements during epicardial pacemaker insertion. Angulation of the stylet to 30 degrees and 60 degrees allows application of the probe at an angle perpendicular to the epicardial surface of the heart, thus reducing readout variation and epicardial trauma.

Electrodes↗

Hemopericardium from retrograde dissection of an abdominal aortic aneurysm.

Atherosclerotic abdominal aortic aneurysms rarely result in significant aortic dissection, and it is even more unusual to see marked proximal extension of such a dissection. We report the case of an 82-year-old man whose fatal dissection and hemopericardium originated in an atherosclerotic abdominal aortic aneurysm. This is apparently the third such case to be reported. Accurate angiographic identification of the site of intimal disruption, whether intrathoracic or intra-abdominal, is essential for planning proper therapy.

Aged↗

Peripheral ischemia due to retroperitoneal fibrosis.

Two patients with retroperitoneal fibrosis demonstrated symptoms of peripheral vascular ischemia. Arteriolysis to free the distal aorta and iliac vessels was successful in both patients. Aortography in the posteroanterior view was equivocal, but the accompanying urologic abnormalities and a history of methysergide ingestion helped establish the etiology of the ischemia. The most direct approach to the treatment of the vascular obstruction caused by retroperitoneal fibrosis is complete arteriolysis. Most previous reports indicate that it is relatively easy to establish a dissection plane between the fibrotic plaque and the vessel wall. We found that the fibrotic process invaded the vessel wall. Accordingly, the surgeon must anticipate a difficult, tedious dissection when performing arteriolysis for the treatment of vascular compression secondary to retroperitoneal fibrosis.

Female↗

Intra-aortic balloon counterpulsation via the ascending aorta.

Twenty-three patients have undergone intra-aortic balloon insertion via the ascending aorta; twenty-one in the operating room and two in the surgical intensive care unit. Direct insertion into the aorta within concentric purse-string sutures was utilized. Repeat exploration and balloon removal was accomplished safely with the added advantage of bypass graft inspection and revision where indicated. Only one patient suffered adverse sequelae from this technique, and thirteen patients are long-term survivors (one month-four years).

Aged↗