Biomedical subjects
Publications and source records attributed to Y Caspi.
Aortic regurgitation due to annular aortic ectasia was diagnosed in a 29-year-old woman with heart failure. The primary pathology of this disease is cystic medial necrosis of the ascending aorta with aneurysm formation and dilation of the aortic valve annulus. In successful surgical correction, the ascending aorta was replaced by a dacron prosthesis, the aortic valve by a prosthetic disc valve and the coronary arteries were reimplanted into the aortic graft.
Three hundred sixteen consecutive patients undergoing coronary artery bypass were studied for postoperative electrocardiographic conduction disturbances. Fifty-five of these 316 patients had postoperative bundle branch block (Group 1). This group had a higher incidence of left main coronary stenosis, together with previous inferior myocardial infarction, than patients without postoperative conduction disturbances (Group 2). Perioperative myocardial infarction, low cardiac output, and death were significantly more common in Group 1 than in Group 2: 7.3% versus 1.9% for perioperative myocardial infarction, 16.4% versus 2.7% for low cardiac output, and 5.5% versus 0.8% for death. Analysis of the type of conduction disturbances indicates that the presence of a new complete left bundle branch block postoperatively in a patient undergoing coronary artery bypass is a sign of intraoperative myocardial damage. This damage is potentially lethal, especially in a patient with left main coronary stenosis and previous inferior myocardial infarction.
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Splenic abscess is an uncommon disease that has a high mortality rate if not treated surgically. With the aid of new diagnostic tools, such as ultrasonography, scanning and computerized axial tomography, it is possible to diagnose the entity antemortem. Even though it often has a nontypical clinical course, it may overlap other systemic diseases. We describe an unusual case of splenic abscess with rare complications, the operation and the outcome.
Early repair of acute rupture of the ventricular septum after myocardial infarction is now the procedure of choice accepted by most centers. Rupture of the right ventricular free wall is rare and usually is accompanied by tamponade. The finding of coincidental right ventricular free wall rupture and acute ventricular septal defect following myocardial infarction and their successful repair are discussed in the following report.
Twenty one patients suffering from rupture of the ventricular septum (RVS) following acute myocardial infarction were operated upon between 1982-1985. Eighteen patients were operated upon urgently within 9.3 +/- 2.1 hours following diagnosis of RVS. In all, RVS occurred during the first infarction. None had concomitant myocardial revascularization. There were twelve operative survivors for an operative mortality of 42.5%. Two patients died 6 and 9 months postoperatively. All survivors are in functional class I, during a follow-up period of 14 to 56 months. The need for urgent repair of RVS is stressed and the value of concomitant coronary artery bypass is discussed.