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T Spyt

Publications and source records attributed to T Spyt.

14 recordsLinked to original sources
PubMed2000

Endovascular repair of an innominate artery false aneurysm following blunt trauma.

PURPOSE: To describe a case of endovascular graft exclusion of an innominate artery pseudoaneurysm arising from blunt trauma. METHODS AND RESULTS: A 21-year-old patient was admitted following a major road accident. Computed tomography (CT) and aortography on admission disclosed an isolated innominate artery pseudoaneurysm. The lesion was stable, so an elective endoluminal repair was undertaken once the patient was treated for his other injuries. The right carotid artery was exposed and controlled, and the aneurysm was excluded by transluminal implantation of a customized stent-graft consisting of predilated polytetrafluoroethylene graft material covering a balloon-expandable Palmaz stent. A CT scan at 1 month and duplex scans at 6-month intervals documented good stent-graft positioning and aneurysm exclusion over a period of 18 months. CONCLUSIONS: This case illustrates the potential durability of endoluminal repair of innominate artery lesions and highlights the potential role of this minimally invasive alternative to surgery in these clinical situations.

Accidents, Traffic↗
PubMed1997

Unusual presentation of an atrial septal aneurysm with left atrial myxoma: a case report.

A 68-year-old man with coronary artery disease and mitral regurgitation was referred for surgery. Intraoperative transoesophageal echocardiogram revealed mild mitral regurgitation, and an aneurysm of the atrial septum deviating to the right atrial side with mass in the left atrium. During operation the aneurysm of the atrial septum was excised with a small sessile myxoma from base of the atrial septum (2.5 cm X 2 cm X 1.5 cm).

Aged↗
PubMed1997

Role of atrial ischaemia in development of atrial fibrillation following coronary artery bypass surgery.

OBJECTIVE: Atrial fibrillation (AF) is a common complication after coronary artery bypass grafting (CABG) operations, occurring in 5 to 40% of cases. A number of studies have implicated atrial ischaemia in the genesis of this arrhythmia. The aim of this study was to examine the relationship between atrial coronary anatomy and the incidence of post operative atrial fibrillation. METHOD: To investigate a possible anatomical explanation to the onset of AF after CABG, 25 patients with documented AF after CABG were matched and compared to 25 patients which remained in sinus rhythm (SR). All coronary angiograms were reported blindly by a cardiac radiologist with reference to the blood supply of the sino-atrial (SA) node and atrio-ventricular (AV) node before and after surgery. RESULTS: Univariate analysis of risk factors did not identify any significant difference (Fisher exact test, P > 0.05) between the two groups in age, gender, left ventricular function, ischaemic time, number of vessels diseased or grafted, renal dysfunction and withdrawal of beta-blockade. However, significant disease in the SA nodal artery was present in 2 patients of the SR group when compared to 9 in the AF group. Significant disease of AV nodal artery was present in only 4 patients of the SR group when compared to 18 in the AF group. Comparison between the two groups showed a significantly increased incidence of SA or AV nodal artery disease in the AF group, (SA: P = 0.018, AV: P = 0.0001). Mean hospital stay was 8.1 days for the SR group and 9.1 days in the AF group (P = 0.175). CONCLUSION: Obstructive disease in the SA nodal and AV nodal arteries is more common in patients developing atrial fibrillation following coronary artery bypass surgery than those who remain in sinus rhythm. If the incidence of AF could be predicted by the anatomical distribution of arterial disease then targeting prophylaxis to this group may be possible.

Adult↗
PubMed1997

The surgical management of empyema thoracis.

Empyema thoracis remains a common thoracic problem with challenging management strategies. We analysed retrospectively 107 consecutive patients treated for empyema thoracic over a 5-year period. The majority of patients (75%) were male with a mean age of 51 years. Common presenting symptoms were cough, dyspnoea, chest pain and pyrexia. The mean duration of pre-admission symptoms was 7.5 weeks. The causes of empyema were pneumonia, malignancy, iatrogenic injury and trauma. The most frequently isolated organism was Streptococcus milleri. In 71% of patients there was an underlying systemic disorder. Forty-nine patients (46%) underwent an unsuccessful therapeutic procedure prior to admission to the surgical units. In the units, 24 patients received closed intercostal chest tube drainage, 14 of whom required further intervention. Two patients were treated with repeated thoracocentesis. The majority of patients underwent a surgical procedure in the first instance: rib resection and drainage (5), decortication (22), and more extensive procedures (9) with only two patients requiring further surgery. The mean post-operative stay was 16 days and the hospital mortality was 13%. We recommend early referral of all empyema patients to thoracic units, where assessment and definitive procedures can be performed with high chances of success and moderate risk of morbidity and mortality.

Adolescent↗
PubMed1991

Improved biocompatibility of extracorporeal circulation by the use of auto-oxygenation instead of artificial oxygenator in perfusion circuit.

The aim of this study was to determine the biocompatibility of an auto-oxygenation technique of cardiopulmonary bypass. Forty patients undergoing coronary bypass surgery were studied in two groups: A (auto-oxygenation, patients' lungs used in cardiopulmonary bypass) and B (conventional technique of cardiopulmonary bypass with bubble oxygenator). The platelet count decreased to -73% of initial value in group B vs only -27% in group A, P less than 0.001. Platelet aggregation to ADP decreased slightly in group A and hardly at all in group B, P less than 0.001. A transpulmonary leukocyte sequestration was greater in group B: 1.46 +/- 0.5 x 10(3)/mm3 vs only 0.34 +/- 0.2 x 10(3)/mm3 in group A, P less than 0.001. The level of C3a increased in group A from 244 +/- 46 ng/ml to 418 +/- 34 ng/ml and in group B from 268 +/- 46 ng/ml to 521 +/- 65 ng/ml, P less than 0.001, but in group A the levels were significantly less, P less than 0.001. The current study clearly confirms the superior biocompatibility of cardiopulmonary bypass with lung over oxygenator.

Biocompatible Materials↗
PubMed1989

Quantification of extracorporeal platelet deposition in cardiopulmonary bypass: effects of ZK 36374, a prostacyclin analogue.

The degree of extracorporeal platelet sequestration in 32 patients undergoing cardiopulmonary bypass has been assessed using 111In labelled platelets and both a shadow shield whole body monitor and a standard gamma camera. The effects of ZK 36374, a prostacyclin analogue, on deposition of platelets in the oxygenator and atrial line filter were also investigated. Total platelet deposition in the placebo group ranged from 2.2% to 31.7%, mean 13.9 +/- 7.8%; n = 15, and was significantly higher than the deposition in the treatment group, range 0.7% to 9.4%, mean 3.9 +/- 2.6%; n = 16, P less than 0.001. There was also a highly significant correlation between the gamma camera and whole body monitor measurements, r = 0.99, P less than 0.001, with no systematic difference between the techniques. This study demonstrates that accurate quantitative assessment of platelet deposition can be achieved with either the gamma camera or whole body monitor. In addition, significant reduction in platelet sequestration in the extracorporeal circuit can be achieved by using ZK 36374 during the bypass operation.

Adult↗
PubMed1989

CABG in the elderly: the Glasgow experience.

One hundred and eleven patients over the age of 65 years who underwent coronary artery bypass grafting in Glasgow between 1980 and 1985 were compared with 548 younger patients, who had coronary artery bypass surgery over a similar period of time. The elderly group had a higher prevalence of females, pre-operative unstable angina, left main coronary artery disease and depressed left ventricular function. There were no significant differences between the two groups in operative morbidity or mortality and angina was abolished or improved in 93% of the elderly patients at follow-up. Coronary artery surgery has an important role in the management of angina in elderly patients.

Adult↗
PubMed1987

Primary tissue failure in pericardial heart valves.

A number of centers have recorded a significant incidence of primary tissue failure with the standard Ionescu-Shiley pericardial valve. In most cases severe regurgitation was caused by leaflet tears adjacent to the edge of the cloth-covered stent. Our early clinical experience (up to 4 years' follow-up) with two new pericardial valves (Ionescu-Shiley low-profile and Hancock pericardial valves) has shown that primary tissue failure also occurs in these new valves. In vitro accelerated fatigue studies on seven of these valves (size 29 mm) showed that in vitro premature leaflet failure was caused by abrasion of the leaflet on the cloth-covering at the edge of the stent. Clinically, endothelialization and host tissue ingrowth on the cloth and the leaflets at the edge of the frame greatly reduced the amount of abrasion and the incidence of tissue failure. In seven of the eight explanted valves studied, leaflet tears occurred at the top of the stent posts where there was less endothelialization and tissue ingrowth, close to the points where sutures pass through the leaflets. It is likely that both abrasion and stress concentration around these sutures contributed to the tissue failures in the clinical valves.

Adult↗