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Biomedical subjects

Y Bar-El

Publications and source records attributed to Y Bar-El.

27 records · Page 2Linked to original sources

Clamping of the atherosclerotic ascending aorta during coronary artery bypass operations. Its cost in strokes.

In 632 consecutive primary operations for coronary bypass grafting, the effect of instrumentation of the ascending aorta on the prevalence of stroke was evaluated. There were five surgical pathology groups: group A: soft aorta with no palpable disease, 463 patients; group B: distinctly palpable aorta with focal atheromas necessitating minor surgical modifications, 132 patients; group C, unclampable aorta (no plane for crossclamping the aorta without compression of atheromas was present), 16 patients; group D, untouchable aorta, in which the entire ascending aortic wall was involved by atheromatosis (these aortas were not touched), 14 patients; group E, aneurysmal aorta with soft walls, 7 patients. There were four strokes (0.63%), all related to instrumentations of the aorta. There were no cerebrovascular accidents in patients in whom precautions were taken. Of all risk factors studied, age was the only predictive one for major atheromatosis of the aorta (chi 2 test, p less than 0.001). Of the 30 patients in groups C and D, only one was younger than 60 years.

Age Factors↗

Echocardiography in diagnostic assessment of peripheral arterial embolization.

In an attempt to identify a cardiac source of emboli, two-dimensional echocardiography was performed postoperatively in 42 consecutive patients with acute peripheral arterial embolism requiring urgent embolectomy. The patients were divided into four groups. Group 1 included 14 patients with chronic atrial fibrillation, among whom four cases of intracavitary thrombi were detected. Group 2 included 13 patients with acute or previous myocardial infarction, and left ventricular thrombi were detected in three. Group 3 included one patient with a prosthetic mechanical aortic valve and one with mitral valve prolapse; thrombi were not detected in either. Group 4 comprised 13 patients with no clinical evidence of a cardiac source of embolism; in one of them a large left ventricular thrombus was detected. Altogether eight intracavitary thrombi were detected (19%), and only in three (7.1%) were the results of echocardiographic examinations defined as entirely normal. A number of clinically undetected cardiac lesions, such as mitral annular calcification and aortic valve calcification, possibly associated with peripheral arterial embolism, were also detected by postoperative echocardiography. Because of the high percentage of intracavitary thrombi detected and the therapeutic implications thereof, especially if embolism recurred, it is concluded that two-dimensional echocardiographic examination should be recommended for patients with acute peripheral embolism.

Aged↗

Chylopericardium as a complication of mitral valve replacement.

A patient developed chylopericardium after mitral valve replacement. Although there was early relapse with cardiac tamponade it eventually resolved with conservative management consisting of tube drainage initially and a medium chain triglyceride diet for two months.

Adult↗