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Nelson L Jenkins

Publications and source records attributed to Nelson L Jenkins.

5 recordsLinked to original sources
PubMed2005

Combining robotic mitral valve repair and microwave atrial fibrillation ablation: techniques and initial results.

BACKGROUND: Left atrial microwave ablation for atrial fibrillation has become popular for isolating autonomous atrial foci. Previously, mitral valve repairs (MVP) with atrial fibrillation ablation have been performed through sternotomy. We present a technique that combines robotic MVP with left atrial fibrillation ablation. METHODS: Through a 4-cm right minithoracotomy and using cardiopulmonary bypass, the transverse and oblique sinuses are accessed. A Flex-10 microwave catheter is passed around the pulmonary veins, and after weaning from cardiopulmonary bypass, peripulmonary vein microwave ablations are performed. After cardioplegic arrest, the da Vinci system is used to manipulate the catheter to create endocardial lesions around the left atrial appendage. Another endocardial lesion is made connecting the pulmonary venous line with the mitral annulus near P3. The left atrial appendage is closed, and the MVP performed robotically. Data are expressed as mean +/- standard deviation. RESULTS: Sixteen patients underwent this combined procedure, with 80% returning to a normal sinus rhythm at 6 weeks and 73% remaining in normal sinus rhythm at 6 months. Only 1 patient was in atrial fibrillation at 6 months. The ablation procedure added 42 +/- 16.1 minutes to a robotic MVP. The average length of hospital stay was 6.3 +/- 2.2 days, 1.3 days longer than the mean of the prior 50 consecutive robotic MVP patients without a concomitant ablation. CONCLUSIONS: Robotic microwave ablation during robotic MVP is a safe, effective way to resolve atrial fibrillation. These methods offer a promising prelude to the combined totally endoscopic treatment of atrial arrhythmias and mitral insufficiency.

Aged↗
PubMed2002

Innovative techniques in bony reconstruction to facilitate hand salvage.

Mutilating injuries of the hand and congenital hand anomalies can present challenging reconstructive scenarios for salvage and restoration of function. During a 5-year period from 1993 to 1997, the plastic and reconstructive surgical unit of East Carolina University Medical Center was presented with a series of unique reconstructive challenges as a result of complex hand injuries that resulted in unexpected opportunities for the salvage of distal components. These traumatic injuries were unique in that, although devastating to the hand, they left the opportunity for salvage of distal vascularized and sensate components of the hand. Other unique challenges arose as a result of patients who did not want to pursue alternative reconstructive options such as toe-to-hand transfers or pollicization. These cases are presented to emphasize alternative algorithms to standard hand reconstruction in complex scenarios. Three patients presented with distal viable (vascularized and sensate) phalangeal components with proximal complex bony defects, 1 patient presented with a complex thumb defect and declined standard therapy, and 1 patient presented with a congenital thumb anomaly and declined standard therapy. All flaps survived and all hands were saved. These patients illustrate the clinical feasibility of osteocutaneous and free osseous grafting to provide strut stabilization in metacarpal defects and to preserve an opposable post after thumb amputation or thumb anomaly.

Adult↗