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Biomedical subjects

P K Spanos

Publications and source records attributed to P K Spanos.

At least 19 recordsLinked to original sources
PubMed1977

Repair of atrioventricular canal associated with membranous subaortic stenosis.

The successful repair of associated atrioventricular canal anomaly and membranous subaortic stenosis is reported for the first time in two patients. Although subaortic stenosis associated with atrioventricular canal anomaly has been reported previously, it was caused by anomalous positioning of the atrioventricular valve, so that the discrete membranous type of stenosis in these two patients is the unique feature. Awareness of the possible association of these two deformities should enable accurate preoperative diagnosis and simultaneous correction at operation.

Angiocardiography↗
PubMed1977

The significance of intraoperative ventricular fibrillation during aortic valve replacement.

The effect of the spontaneous occurrence of ventricular fibrillation during aortic valve replacement and coronary arterial perfusion was studied in a consecutive series of 361 such operations. All operations were performed in a standard manner before 1972. One fourth of the patients experienced ventricular fibrillation,and the early mortality rate of this group was significantly (p less than 0.005) higher 7.3 per cent) than in the nonfibrillating group (1.5 per cent). The total mortality rate was 3 per cent. However, late results among survivors of the operations showed no effect of fibrillation. These findings indicate that ventricular fibrillation should be avoided in these patients. Whether or not countershock is advisable if and when fibrillation occurs remains an unanswered question.

Adult↗
PubMed1976

Successful transplantation of ectopic kidneys from living related donors.

Two ectopic pelvic kidneys were transplanted from living donors into well matched recipients. Both kidneys have good function at two and four years post transplantation and there has been no evidence of infection post transplantation. Such kidneys can be utilized when there is no evidence of obstruction or infection in the donor and when the contralateral kidney is normal.

Adult↗
PubMed1976

The management of infected abdominal aortic grafts and graft-enteric fistulas.

Seven cases of infected aortic grafts or aorto-enteric fistulas following resection of an abdominal aortic aneurysm are reviewed. All cases were treated with axillo-femoral bypass and graft removal. Patients had recurrent fever, chills, and abdominal pain (5 patients), or massive gastrointestinal hemorrhage (2 patients). The two patients with massive gastrointestinal hemorrhage died. Three of the 5 long-term survivors had a recurrence of the retroperitoneal abscess after graft removal; one of these died. One axillo-femoral bypass graft required early thrombectomy. There have been no subsequent problems with any of the grafts in the 2.5 to 4 year followup period. Axillo-femoral bypass immediately before graft removal is the treatment of choice for infected or fistulous aortic grafts. Any delay in graft removal after the onset of symptoms should be avoided.

Aged↗
PubMed1976

Pulmonary resection for metastatic osteogenic sarcoma.

A retrospective analysis of thirty patients who underwent pulmonary resection for metastatic osteosarcoma over a twenty-eight-year period revealed that most were young males with previous amputations for primary lesions of the lower extremity. In each, one to four thoracotomies had been performed, for a total of fifty-two chest operations with resection of 124 pulmonary metastatic lesions. At last follow-up, eleven of the thirty patients were alive and free of disease. At five years 28 per cent had survived: three of them were alive at more than nine years, and one was alive at nearly twenty years. Adverse survival factors identified were short tumor-free interval and multicentricity of pulmonary metastases. Long-term survival was associated with a tumor-free interval of more than two years and one to four thoracotomies at which few foci were present. As a group, patients selected for lung resection had significantly longer suvival than did patients whose pulmonary metastasis was untreated.

Adolescent↗
PubMed1975

Acute prolonged renal arterial infarction. Return of function after thromboendarterectomy.

This report describes a case of complete occlusion of the right renal artery. Arteriography and intravenous pyelography demonstrated no kidney function. The occlusion was treated by endarterectomy, and eleven days later another intravenous pyelogram revealed that renal function had been restored. A review of the literature also suggests that acute occlusion (caused by embolism) or chronic occlusion (caused by atherosclerosis) should be treated surgically to perserve renal function, reserving nephrectomy only if that should fail.

Acute Disease↗
PubMed1975

Successful management of miliary tuberculosis after renal transplantation.

Miliary tuberculosis is the most lethal form of tubercular disease. If dissemination of tubercle bacilli occurs without therapy, death is almost certain. The importance of establishing an etiologic diagnosis as promptly as possible in patients receiving immunosuppressive therapy is self-explanatory. The presence of a life-threatening infection in these patients requires aggressive antimicrobial therapy and discontinuation of the immunosuppressive drugs until the infectious process is under control; the presence of an impaired immunologic response is responsible for the life-threatening infection and the lack of an acute rejection reaction.

Adult↗
PubMed1975

Late ureteropelvic necrosis after transplantation.

Total ureteropelvic necrosis of the transplanted kidney occurred more than one month after transplantation in 5 of 575 consecutive renal transplants performed at the University of Minnesota Hospital since 1963. Necrosis became evident long after normal renal function had been established. Histologic signs of rejection were minimal, but perinephric or periureteral hematomas were found in 3 of 5 patients: post-transplant acute tubular necorsis requiring hemodialysis occurred in all. The pathogenesis of this complication probably involves (1) a primary deficit of blood supply from the renal vessels to the pelvis and ureter, (2) a failure to develop a new ureteral blood supply because of surrounding hematoma, (3) early swelling of the ischemic ureter resulting in oliguria interpreted as acute tubular necrosis, (4) resolution of edema resulting in diuresis, and (5) late patchy ureteral necrosis and fistula formation due to ureteral ischemia.

Acute Kidney Injury↗
PubMed1974

Resection of suprarenal aortic aneurysm with autotransplantation of the kidney.

This is a report of a patient with renovascular hypertension associated with a suprarenal aortic aneurysm that was treated by nephrectomy, resection of the aneurysm and autotransplantation of the kidney. The autografted kidney was preserved on the Mox-100 perfusion-preservation apparatus for over four hours, during which time the aneurysm was resected and replaced with a Dacron bifurcated graft. The authors believe this is the safest method for the management of aneurysms of the suprarenal aorta, especially when associated with renovascular disease, and it deserves wider application in treating major renovascular disease.

Aorta, Abdominal↗