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S B Colvin

Publications and source records attributed to S B Colvin.

102 records · Page 6Linked to original sources
PubMed1982

Aneurysms of the ascending aorta and transverse arch: surgical experience in 80 patients.

Aneurysms of the ascending aorta and transverse arch constitute formidable surgical challenges. To assess the impact of surgical techniques on operative morbidity and mortality and late results, we reviewed 80 consecutive patients operated from 1976 through 1980. Average age was 52 years and 81% were male. The operative mortality was 17.5% (14 deaths). In patients with aneurysm of the ascending aorta, operative deaths were due to cardiac factors (three patients), neurologic factors (three patients), cardiac factors (two patients), and exsanguination (one patient) accounted for the six operative deaths in patients with transverse arch aneurysms. Two late neurologic deaths occurred in this group. The following conclusions were reached when the surgical techniques were reviewed: Annuloaortic ectasia is best treated by insertion of a conduit with reimplantation of coronary ostia. Dissections are optimally managed by Dacron graft insertion in the ascending aorta and valve replacement. Aortic valve resuspension was done in six patients, with three undergoing subsequent aortic valve replacement for insufficiency. Aneurysms of the transverse arch treated with profound hypothermia and circulatory arrest were associated with fewer neurologic complications, and the operations were more expeditiously completed. Eleven of 80 patients (14%) had or subsequently needed additional surgical procedures on the aortic valve (insufficiency) or the distal aorta.

Adolescent↗
PubMedDate not supplied

Use of saphenous vein allografts for aortopulmonary artery anastomoses in neonates with complex cyanotic congenital heart disease.

A saphenous vein allograft was used to create an aortopulmonary communication in 16 infants with cyanotic congenital heart disease and ductus-dependent pulmonary blood flow. These grafts measured from 3 to 8 mm in diameter and were placed between the aorta and main pulmonary artery in eight patients, between aorta and right pulmonary artery in eight, and between aorta and left pulmonary artery in one (one child had two grafts). Before heparin was used, early in the series, four of these grafts occluded and three of the four infants died during attempted revision. Another infant died early from renal failure. Late mortality has claimed four: one from cerebral hemorrhage, two from hypoxia, and one at open-heart surgery for repair. There are eight late survivors (50%). Most of the allografts were used before small diameter Gore-Tex was available; in more recent patients, 4- to 6-mm Gore-Tex grafts have been used. In our most recent patient, however, the attempt to place a Gore-Tex graft was unsuccessful, but the more pliable saphenous vein graft was readily placed and an adequate shunt obtained. Both the saphenous vein graft and the Gore-Tex have the advantage of providing pulmonary flow without the higher risk of congestive failure or pulmonary hypertension seen in patients with a Waterston or Potts anastomosis. They are easier to perform, require less anesthesia time than the Blalock-Taussig shunt, last as long as the Blalock-Taussig when done under similar conditions, and are easy to take down at the time of total repair.

Aorta↗
PubMedDate not supplied

Aortic dissection complicating cardiac surgery: diagnosis by intraoperative biplane transesophageal echocardiography.

Aortic dissection is a rare but devastating complication of cardiopulmonary bypass. Intraoperative transesophageal echocardiography can be a useful technique to define the anatomy of the dissection, to evaluate its extension and progression, and to detect the presence of aortic insufficiency. We describe two cases in which transesophageal echocardiography helped in making a rapid diagnosis of aortic dissection during cardiac surgery and demonstrate how it may play a role in therapeutic decision making.

Aged↗
PubMedDate not supplied

Metastatic cardiac liposarcoma: diagnosis by transesophageal echocardiography and magnetic resonance imaging.

The most superior portion of the right atrium is not well visualized by transthoracic echocardiography. This limits the ability of the technique to detect intracardiac disease in this area. We describe a 41-year-old man with a history of liposarcoma in whom transthoracic echocardiography was unable to elucidate a right atrial metastasis. Transesophageal echocardiography demonstrated the morphology and extent of the large right atrial mass. These findings were well correlated with both magnetic resonance imaging and surgery.

Adult↗
PubMedDate not supplied

Intraaortic mass after repair of an aortic dissection.

After graft repair of an ascending aortic aneurysm, a patient was seen by us with a chest x-ray film indicating a retained foreign body. Mediastinal exploration had been unrevealing. Transesophageal echocardiography demonstrated the nature and exact location of the foreign body and therefore was instrumental in directing its retrieval.

Aortic Dissection↗
PubMedDate not supplied

Beating-heart coronary artery bypass grafting for left ventricular failure assisted by the Abiomed BVS 5000.

Two cases of postmyocardial infarction cardiogenic shock were treated with left ventricular assist device (LVAD) implantation. With the left ventricular function bypassed, beating-heart coronary artery bypass grafting (CABG) was performed. This technique may be useful in the setting of acute myocardial dysfunction where limited coronary revascularization is required.

Aged↗