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Biomedical subjects

R Garcia-Rinaldi

Publications and source records attributed to R Garcia-Rinaldi.

At least 19 recordsLinked to original sources
PubMed1990

Carotid patch angioplasty: immediate and long-term results.

To determine the benefit of carotid patch angioplasty, a retrospective study of 1000 consecutive carotid endarterectomies was done. Based on the type of carotid endarterectomy closure, patients were divided into four groups: 250 had primary closure, 250 had expanded polytetrafluoroethylene patch, 250 had Dacron patch, and 250 had saphenous vein patch. On the basis of operative technique or type of carotid artery closure, no statistical difference was found in the incidence of postoperative stroke (p greater than 0.25): primary closure 1.6% (4), expanded polytetrafluoroethylene 2.0% (5), Dacron patch 1.6% (4), and saphenous vein patch (0). Postoperative carotid patency was determined by B-mode ultrasonography, and 717 patients were evaluated in follow-up extending to 6 years (mean 37.8 months). Based on the method of carotid endarterectomy closure, no significant difference (p greater than 0.25) was found in the incidence of significant restenosis (greater than 50% diameter reduction): primary closure 4.0% (7), expanded polytetrafluoroethylene 4.0% (6), Dacron 5.4% (9), and saphenous vein 1.0% (2). Significant restenosis was most frequent in habitual smokers (93%, 25/28) and females (78%, 22/28) despite the method of carotid endarterectomy closure. No statistical difference was found in the incidence of late ipsilateral stroke either (p greater than 0.25): primary closure 2.9% (5), expanded polytetrafluoroethylene 2% (3), Dacron 5% (3), and saphenous vein 0%. These results indicate that the incidence of postoperative stroke, regardless of method of arterial closure, was not statistically different. The method of carotid closure did not appear to affect the occurrence of late ipsilateral stroke or restenosis; however, patch angioplasty with saphenous vein appears appropriate in habitual smokers, and likely in patients with small internal carotid arteries.

Blood Vessel Prosthesis↗
PubMed1989

A technique for spot application of fibrin glue during open heart operations.

Several techniques have been described for preparing and applying fibrin glue to control surgical bleeding. However, these methods tend to be cumbersome, expensive, or messy. Furthermore, commercial kits have not been approved by the Food and Drug Administration because of the potential risk of hepatitis contamination. Therefore, we have devised a modified, simpler technique that enables the precise, pinpoint application of fibrin glue. The risk of hepatitis transmission is substantially reduced by using cryoprecipitate plasma instead of fibrinogen from pooled donors. This technique is especially well suited for anastomoses of small vessels or for sealing suture holes in nonporous grafts.

Aprotinin↗
PubMed1989

Generation of chordae tendineae with polytetrafluoroethylene stents. Results of mitral valve chordal replacement in sheep.

Surgical repair of ruptured or elongated chordae tendineae of the mitral valve is one of the most complex reconstructive techniques in cardiac surgery. Various surgical procedures have been described to repair chordal abnormalities of the anterior leaflet of the mitral valve with unpredictable results. Mitral valve replacement is usually recommended in that situation. This report describes a simple repair technique that we have devised. We resected one or two marginal chordae of the anterior leaflet of the mitral valve in 35 sheep and replaced them with a double-armed, pledget-supported, expanded polytetrafluoroethylene suture. The 30 surviving animals were studied hemodynamically and were electively put to death 3, 6, 9, 18, and 24 months after the operation. Mitral insufficiency did not develop in any of the sheep. All specimens had a normal mitral valve without thrombosis. The polytetrafluoroethylene suture remained pliable and was incorporated into the anterior leaflet and papillary muscle. Scanning and transmission electron microscopy showed that the suture was completely covered by a sheath of tissue with a collagen structure remarkably similar to that of a native chorda. Calcification was not detected in the new chordae. This reproducible and safe technique may considerably simplify the difficult repair of chordal abnormalities.

Animals↗
PubMed1987

Cardioplegia.

Explore the source record for details and available documents.

Heart Arrest, Induced↗
PubMed1985

Mersilene ribbon closure of the median sternotomy: an improvement over wire closure.

With the increased utilization of median sternotomy in thoracic surgery, some difficulties have arisen with closure of the sternum. This article presents a simple, easy-to-perform method of sternal closure utilizing reinforcement of the sternal halves with a material that is less likely to cut through the sternum and that is readily available.

Cardiac Surgical Procedures↗
PubMed1985

Implantation of pericardial substitutes.

Pericardial substitutes have been shown to decrease the formation of pericardial adhesions. For a pericardial substitute to be properly implanted, it must lie over the heart smoothly without buckling and prevent the accumulation of blood under its surface. The technique we describe prevents buckling of the pericardial substitute and consequently reduces the formation of pericardial adhesions.

Humans↗
PubMed1979

The anatomic basis for the occasional failure of transfemoral balloon catheter thromboembolectomy.

A Fogarty balloon catheter was advanced from the common femoral artery through the popliteal artery and its branches in 15 cadavers. The catheter passed into the peroneal branch 89% of the time. In all 15 cadavers, the peroneal artery was the direct continuation of the popliteal artery and the arterior tibial and posterior tibial arteries branched off at varying angles from the popliteal. This provides an anatomic explanation for the occasional failure of transfemoral Fogarty catheter embolectomy of the leg. Our study suggests that if the patient's foot does not improve after Fogarty embolectomy, the popliteal artery should be exposed and the catheter directed into the shank arteries using vascular forceps.

Catheterization↗
PubMed1978

Intestinal obstruction due to phytobezoars. Observations in two patients with hypothyroidism and previous gastric surgery.

Two patients had small-bowel obstruction due to phytobezoars. Both patients were hypothyroid. One patient had undergone a previous pyloroplasty for pyloric stenosis and the other a truncal vagotomy and a pyloroplasty for a duodenal ulcer. Similarities and differences between the two cases and the possible predisposing factors in the formation of the phytobezoars are discussed. The recognition of high-risk patients, and their education to prevent phytobezoars are emphasized.

Aged↗
PubMed1978

Suspecting thoracic aortic transection.

Deceleration accidents produce a complex of potentially fatal thoracic injuries. Because early detection is the key to successful management of blunt trauma to the great vessels, emergency physicians must be knowledgeable of signs indicative of these complex injuries. Among more than 10,000 patients presenting to the Ben Taub Emergency Center over an 11-year period with thoracic injuries, 100 had clinical or radiographic clues suggestive of blunt trauma decelerative injury to the great vessels. Of these 100 patients, 23 had transection of the descending thoracic aorta and five had avulsion of the innominate artery. One patient had a double transection. Six patients died in the Emergency Center before proximal control could be achieved.

Adolescent↗