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R PIFARRE

Publications and source records attributed to R PIFARRE.

10 recordsLinked to original sources
PubMed1964

COMBINED INTERNAL MAMMARY ARTERY IMPLANTATION AND FREE OMENTAL GRAFT OPERATION: A HIGHLY EFFECTIVE REVASCULARIZATION PROCEDURE (A STUDY OF 17 CASES).

One hundred and forty patients with coronary artery disease treated by internal mammary artery implantation were followed up from six months to 13 years. The mortality rate was 3%; improvement was obtained in 70%. Occlusive disease of all three major coronary arteries, however, requires more blood than can be supplied by the implant procedure, and the free omental graft operation was developed for the management of selected patients with this condition. Normally in animals triple coronary artery ameroid constriction results in 100% mortality. When the free omental graft operation, with or without internal mammary artery implantation, was performed, 80% of such animals survived. The free omental graft forms capillary anastomoses in three days and arteriolar vessels in eight days, which leave the base of the aorta, enter the omentum, thence to the myocardium. A combined internal mammary artery implantation and free omental graft operation was performed in 17 patients with triple coronary artery disease as shown by cine coronary arteriography. There was no operative mortality, and 12 of the patients are free of pain and have returned to work.

Animals↗
PubMed1962

Apparent reversion to trophism of a free omental graft: a preliminary report.

In a previous paper we reported evidence which suggested that a free omental graft has trophic characteristics similar to those of the chorionic epithelium of the early embryo, through which it establishes arteriolar or larger connections with aorta, heart and pericardium within 10 days after it has been placed in contact with the denuded surfaces of each structure. The theory of omental trophism was tested by dropping pieces of omentum completely detached into the pleural and peritoneal cavities of white rats. When examined 25 or more days later a percentage of omental grafts appeared healthy and were attached to pleura, lung, heart and to various structures in the peritoneal cavity. In the pleural grafts, histological sections revealed a continuity between the omental grafts and the sub-pleural tissues. A blood-hungry free omental graft appears to seek out its own blood supply. Neither pleura nor serosa was able to repel its primitive probing for a new blood supply.

Animals↗
PubMed1962

The effect of persantin on intercoronary collateral circulation and survival during gradual experimental coronary occlusion. A preliminary report.

Twenty-five dogs were exposed to gradual coronary occlusion by placing Ameroid constrictors around the origins of the left circumflex and anterior descending coronary arteries. Previous experiments have demonstrated that these constrictors absorb water and, over a period of three weeks, narrow the cross-sectional area of the two arteries to 50% or less, and consequently cause the death of 80% of the experimental animals. Twelve of the 25 animals were fed 50 mg. of Persantin three times a day by mouth commencing one day before the operative procedure. Determinations of the concentration of the drug in the blood revealed a level consistent with that obtained in humans after the administration of therapeutic doses. Eleven of the 13 control animals died in the three-month experimental period while only six of the 12 treated animals expired. Injections of Schlesinger mass in all animals dying or killed following the experimental period demonstrated that Persantin significantly accelerated the development of intercoronary anastomoses in the treated group, and in the surviving animals produced a rich anastomotic network much in excess of that seen in the surviving animals in the control series that were exposed to hypoxia alone. On the basis of these experimental findings, it is suggested that Persantin may favourably alter the prognosis of many patients with coronary artery disease.

Animals↗
PubMed1962

An operation designed to promote the growth of new coronary arteris, using a detached omental graft: a preliminary report.

The human greater omentum exhibits a marked affinity for inflamed surfaces, to which it supplies numerous blood vessels. To achieve myocardial revascularization by omental graft the root of the aorta, the epicardium over both ventricles and the serosal layer of the pericardium were removed in 17 animals. A piece of greater omentum was removed from the abdomen, unfolded and wrapped around the entire heart, and fixed by interrupted sutures to the base of the aorta. Myocardial ischemia was created at the time of operation by ameroid constriction of coronary arteries. Vessels, arteriolar or larger, were found to grow from the root of the aorta, the myocardium and the pericardium into the detached free omental graft, which apparently acted as a conveyer for new vessels, including new coronary arteries, to reach the myocardium.

Animals↗