39 results on '"Giacomo A. DeLaria"'
Search Results
2. Evidence for Ozone Formation in Human Atherosclerotic Arteries
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Ralph B. Dilley, Bernard M. Babior, Alan Saven, Kim D. Janda, Paul Wentworth, Cindy Takeuchi, Albert Eschenmoser, Giacomo A. DeLaria, Richard A. Lerner, Roger Galve, Jorge Nieva, and Anita D. Wentworth more...
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Pathology ,medicine.medical_specialty ,Apolipoprotein B ,Arteriosclerosis ,medicine.medical_treatment ,Carotid endarterectomy ,Indigo Carmine ,Lesion ,Pathogenesis ,chemistry.chemical_compound ,Ozone ,Leukocytes ,Humans ,Medicine ,Dimethyl Sulfoxide ,Cytotoxicity ,Inflammation ,Endarterectomy, Carotid ,Multidisciplinary ,Cholestanes ,Singlet Oxygen ,biology ,business.industry ,Vascular disease ,Cholesterol ,Hydrazones ,medicine.disease ,In vitro ,Lipoproteins, LDL ,Sterols ,Carotid Arteries ,chemistry ,biology.protein ,Tetradecanoylphorbol Acetate ,Norsteroids ,medicine.symptom ,business ,Oxidation-Reduction ,Foam Cells - Abstract
Here, we report evidence for the production of ozone in human disease. Signature products unique to cholesterol ozonolysis are present within atherosclerotic tissue at the time of carotid endarterectomy, suggesting that ozone production occurred during lesion development. Furthermore, advanced atherosclerotic plaques generate ozone when the leukocytes within the diseased arteries are activated in vitro. The steroids produced by cholesterol ozonolysis cause effects that are thought to be critical to the pathogenesis of atherosclerosis, including cytotoxicity, lipid-loading in macrophages, and deformation of the apolipoprotein B-100 secondary structure. We propose the trivial designation “atheronals” for this previously unrecognized class of steroids. more...
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- 2003
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Catalog
3. One-year follow-up of direct myocardial gene transfer of vascular endothelial growth factor-2 using naked plasmid deoxyribonucleic acid by way of thoracotomy in no-option patients**Drs. Isner and Schatz are stockholders of Vascular Genetics, Inc., the sponsor of this trial
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Joseph Van Camp, Wayne E. Richenbacher, Giacomo A. DeLaria, R. Jeffrey Snell, Douglas W. Losordo, Timothy D. Henry, Jeffrey M. Isner, Gary L. Schaer, Richard A. Schatz, J. Jeffrey Tyner, James F. Symes, F. David Fortuin, Peter Vale, John J. Lopez, and Robert J. March more...
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medicine.medical_specialty ,business.industry ,Angiogenesis ,medicine.medical_treatment ,Genetic transfer ,Canadian Cardiovascular Society ,Placebo ,medicine.disease ,Vascular endothelial growth factor ,Angina ,chemistry.chemical_compound ,chemistry ,Internal medicine ,Gene expression ,medicine ,Cardiology ,Thoracotomy ,Cardiology and Cardiovascular Medicine ,business - Abstract
This phase I open label, dose-escalating study shows that gene transfer of vascular endothelial growth factor-2 naked deoxyribonucleic acid by direct myocardial injection by way of thoracotomy in patients with Canadian Cardiovascular Society class 3 or 4 angina is feasible and safe. The procedure is well tolerated, with few major adverse cardiac events at 1 year, and without complications directly related to gene expression. In this prospective, nonblinded study, the procedure is associated with clinical improvement; however, there was no angiographic evidence of angiogenesis and there is a great potential for a sham or placebo effect in the study patients. A randomized phase III trial is underway that will help determine the efficacy of vascular endothelial growth factor-2 gene transfer in “no-option” patients. more...
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- 2003
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4. Hemodynamic evaluation of a bioprosthetic venous prosthesis
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Giacomo A. DeLaria, Roger Tu, R. C. Quijano, Kalathi Thyagarajan, Jeff Roy, and Travis J. Phifer
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medicine.medical_specialty ,business.industry ,Chronic venous insufficiency ,medicine.medical_treatment ,Venous circulation ,Thrombogenicity ,Hemodynamics ,Bovine jugular vein ,Valve opening ,medicine.disease ,Prosthesis ,Surgery ,Circulatory system ,medicine ,Cardiology and Cardiovascular Medicine ,business - Abstract
Purpose: A prosthetic venous valve must be biocompatible and nonthrombogenic and function in the venous circulation. Biocompatibility and thrombogenicity of our prosthesis have been examined in prior animal experiments, and 91% of valve conduits including early prototypes are patent at 3 weeks. However, evaluation of valve function is much more difficult in animals; therefore in this study the function of excised valves was evaluated ex vivo. Methods: Nine bovine jugular vein conduits, each with one bileaflet venous valve, were harvested and placed in a venous flow simulator. Flows and pressures were adjusted to mimic human respiratory and hydrostatic variations. Each valve and conduit was tested for variations in valve diameter and sinus expansion in response to flow. Valve opening and closing times and valve competence were measured in response to pressure changes. After testing, each specimen was glutaraldehyde fixed and assessed a second time. Results: Valve orifice area increased in response to flow in both fresh and fixed tissues. Maximum valve orifice area was reduced by fixation (27.7%) at full flows ( p p p Conclusions: Size and availability make the bovine jugular vein valve an ideal venous valve substitute. Glutaraldehyde fixation renders the tissue biocompatible and nonthrombogenic while preserving anatomic integrity and leaflet strength and flexibility. Mounted and stented in a sewing sleeve, this prosthesis could represent the first generally applicable clinical solution to chronic venous insufficiency and venous hypertension. (J VASC SURG 1993;18:577-86.) more...
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- 1993
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5. Deep Venous Thrombosis
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James A. Hunter and Giacomo A. DeLaria
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,medicine.drug_class ,Deep vein ,Anticoagulant ,Atrial fibrillation ,Perioperative ,Critical Care and Intensive Care Medicine ,medicine.disease ,Thrombosis ,Inferior vena cava ,Surgery ,Pulmonary embolism ,Venous thrombosis ,medicine.anatomical_structure ,medicine.vein ,Anesthesia ,Medicine ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,business - Abstract
We reviewed the cases of 10,638 cardiac surgical patients to determine the incidence of deep vein thrombosis (DVT) after open heart surgery (OHS). Seventy-seven patients (0.7 percent) had DVT. Group 1 included 36 patients who had DVT without pulmonary embolism (PE). Occurrence was equal in either leg. Anticoagulation with heparin and warfarin sodium (Coumadin) was employed as treatment. Extension of hospital stay was 10.8 days. Group 2 consisted of 41 patients who experienced PE 9.9 days after OHS. Sixteen patients had known DVT and were receiving heparin. In 25 patients, PE was the first event. Risk factors for PE included perioperative myocardial infarction (16 percent), atrial fibrillation (41 percent), blood type A (70 percent) (p more...
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- 1991
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6. One-year follow-up of direct myocardial gene transfer of vascular endothelial growth factor-2 using naked plasmid deoxyribonucleic acid by way of thoracotomy in no-option patients
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F David, Fortuin, Peter, Vale, Douglas W, Losordo, James, Symes, Giacomo A, DeLaria, J Jeffrey, Tyner, Gary L, Schaer, Robert, March, R Jeffrey, Snell, Timothy D, Henry, Joseph, Van Camp, John J, Lopez, Wayne, Richenbacher, Jeffrey M, Isner, and Richard A, Schatz more...
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Adult ,Vascular Endothelial Growth Factor A ,Lymphokines ,Vascular Endothelial Growth Factors ,Myocardium ,Gene Transfer Techniques ,Myocardial Ischemia ,Neovascularization, Physiologic ,DNA ,Endothelial Growth Factors ,Genetic Therapy ,Middle Aged ,Injections ,Thoracotomy ,Humans ,Intercellular Signaling Peptides and Proteins ,Prospective Studies ,Aged ,Follow-Up Studies - Abstract
This phase I open label, dose-escalating study shows that gene transfer of vascular endothelial growth factor-2 naked deoxyribonucleic acid by direct myocardial injection by way of thoracotomy in patients with Canadian Cardiovascular Society class 3 or 4 angina is feasible and safe. The procedure is well tolerated, with few major adverse cardiac events at 1 year, and without complications directly related to gene expression. In this prospective, nonblinded study, the procedure is associated with clinical improvement; however, there was no angiographic evidence of angiogenesis and there is a great potential for a sham or placebo effect in the study patients. A randomized phase III trial is underway that will help determine the efficacy of vascular endothelial growth factor-2 gene transfer in "no-option" patients. more...
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- 2003
7. Heparin-protamine mismatch. A controllable factor in bleeding after open heart surgery
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Cindy L. Hayes, Bruce W. Armstrong, Giacomo A. DeLaria, and John J. Tyner
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medicine.medical_specialty ,Protamine sulfate ,medicine.drug_class ,Activated clotting time ,Blood Component Transfusion ,Hemorrhage ,Postoperative Complications ,Blood product ,Coagulopathy ,medicine ,Humans ,Protamines ,Cardiac Surgical Procedures ,Coronary Artery Bypass ,Blood coagulation test ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,biology ,business.industry ,Heparin ,Anticoagulant ,Middle Aged ,medicine.disease ,Protamine ,Surgery ,Treatment Outcome ,Anesthesia ,Heart Valve Prosthesis ,biology.protein ,Blood Coagulation Tests ,business ,medicine.drug - Abstract
To test the effect of a new system designed to reduce heparin-protamine mismatch on bleeding after open heart surgery.Nonrandomized but consecutive retrospective review of patients undergoing open heart surgery during a 9-month period.Multispecialty referral center.A total of 150 patients comparable by age, body surface area, and coagulation status undergoing primary open heart surgery for either coronary bypass or heart valve replacement.In the first 75 patients (group 1), heparin sodium was neutralized with protamine sulfate, using a fixed ratio (1 mg of heparin sodium to 1.3 mg of protamine sulfate). An activated clotting time was used to confirm heparin neutralization. For the subsequent 75 patients (group 2), titration of heparin and protamine from defined lots was accomplished using activated clotting times adjusted and matched to drug lots to minimize biologic variability. Groups 1 and 2 had comparable operations, pump times, and cross-clamp times.Doses of heparin and protamine and their effect on blood product transfusion and postoperative bleeding were evaluated in all patients.The average protamine sulfate dose for group 2 patients (287.56 +/- 8.3 mg) was significantly lower than that for group 1 (346.01 +/- 12.6 mg) (P.0005). Less protamine was associated with the transfusion of fewer red blood cells (0.92 +/- 0.15 vs 2.57 +/- 0.38 U) (P.001), platelets (0.72 +/- 0.8 vs 2.96 +/- 0.80 U) (P.01), and fresh-frozen plasma (0.83 +/- 2.0 vs 2.01 +/- 0.48 U) (P.03). No patients in group 2 required reexploration for bleeding, compared with eight patients in group 1.A reduction in protamine dose was associated with significant decreases in blood product use and postoperative bleeding. Excess protamine warrants consideration as both an important and a controllable factor in coagulopathy after open heart surgery. more...
- Published
- 1994
8. Hemodynamic evaluation of a bioprosthetic venous prosthesis
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Linda M. Reilly, Giacomo A. DeLaria, Travis A. Phifer, Jeff A. Roy, Roger A. Tu, and Kalathi A. Thyagarajan
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Adult ,Bioprosthesis ,Macropodidae ,Male ,Sheep ,Surface Properties ,Hemodynamics ,Models, Cardiovascular ,Blood Pressure ,In Vitro Techniques ,Thrombophlebitis ,Prosthesis Design ,Blood Vessel Prosthesis ,Veins ,Evaluation Studies as Topic ,Regional Blood Flow ,Animals ,Humans ,Surgery ,Cattle ,Female ,Horses ,Jugular Veins ,Cardiology and Cardiovascular Medicine - Abstract
A prosthetic venous valve must be biocompatible and nonthrombogenic and function in the venous circulation. Biocompatibility and thrombogenicity of our prosthesis have been examined in prior animal experiments, and 91% of valve conduits including early prototypes are patent at 3 weeks. However, evaluation of valve function is much more difficult in animals; therefore in this study the function of excised valves was evaluated ex vivo.Nine bovine jugular vein conduits, each with one bileaflet venous valve, were harvested and placed in a venous flow simulator. Flows and pressures were adjusted to mimic human respiratory and hydrostatic variations. Each valve and conduit was tested for variations in valve diameter and sinus expansion in response to flow. Valve opening and closing times and valve competence were measured in response to pressure changes. After testing, each specimen was glutaraldehyde fixed and assessed a second time.Valve orifice area increased in response to flow in both fresh and fixed tissues. Maximum valve orifice area was reduced by fixation (27.7%) at full flows (p0.05). Valve sinus dimensions increased in response to increased pressure until maximum expansion was achieved (33 mm Hg). This was reduced 15.3% in fixed tissue (p0.05). Valve opening times (at1 mm Hg gradient) were slightly longer in fixed compared with fresh tissue (0.43 +/- 0.09 vs 0.41 +/- 0.13 second; p0.05). Valve closing times were comparable in both states (0.43 +/- 0.08 vs 0.49 +/- 0.07 second). Three fresh and seven fixed specimens that were subjected to 287 mm Hg back pressure exhibited minimal reflux.Size and availability make the bovine jugular vein valve an ideal venous valve substitute. Glutaraldehyde fixation renders the tissue biocompatible and nonthrombogenic while preserving anatomic integrity and leaflet strength and flexibility. Mounted and stented in a sewing sleeve, this prosthesis could represent the first generally applicable clinical solution to chronic venous insufficiency and venous hypertension. more...
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- 1993
9. Embolic stroke as a sequela of cardiopulmonary bypass
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Robert A. Boyajian, David F Sobel, Giacomo A DeLaria, and Shirley M. Otis
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medicine.medical_specialty ,Infarction ,law.invention ,Neuroimaging ,law ,Internal medicine ,medicine ,Cardiopulmonary bypass ,Humans ,Radiology, Nuclear Medicine and imaging ,Cardiopulmonary Bypass ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Sequela ,medicine.disease ,Magnetic Resonance Imaging ,Pathophysiology ,Embolic stroke ,Stroke ,Embolism ,Intracranial Embolism ,Cardiology ,Neurology (clinical) ,business ,Tomography, X-Ray Computed - Abstract
Tha pathophysiology of brain injury in patients undergoing cardiopulmonary bypass remains unclear despite several decades of inquiry. The advent of noninvasive high-resolution brain and cerebrovascular imaging by magnetic resonance, computed tomography, and pulsed Doppler ultrasonography now permits in vivo assessment of pathophysiological mechanisms. Neuroradiographic and carotid duplex studies were performed in patients who developed neurological deficits following cardiopulmonary bypass. Among 30 symptomatic patients undergoing magnetic resonance or computed tomography brain scans, 18 (60%) had findings of acute ischemic injury. Embolic infarction was evident in 14 (78%) of these 18 patients. Watershed injury was the predominant finding in a single patient, while findings consistent with global anoxia were present in another patient. Carotid atheroemboli were excluded as a possible source of embolism in 11 patients whose carotid duplex studies were unremarkable preoperatively as well as in 3 further patients whose neuroradiographic findings did not correspond with their moderate carotid disease. It is concluded that infarction due to noncarotid embolism is the primary pathophysiology of neurological deterioration following cardiopulmonary bypass. more...
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- 1993
10. Effects of Epidural Anesthesia and Analgesia on Coagulation and Outcome After Major Vascular Surgery
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Robert J. McCarthy, Robert J. March, Rajesh V. Patel, Kenneth J. Tuman, Anthony D. Ivankovich, and Giacomo A. DeLaria
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Anesthesia, Epidural ,Male ,medicine.medical_specialty ,Narcotic ,medicine.medical_treatment ,law.invention ,Postoperative Complications ,Risk Factors ,law ,Diabetes mellitus ,medicine ,Humans ,Myocardial infarction ,Blood Coagulation ,Aged ,Pain, Postoperative ,medicine.diagnostic_test ,business.industry ,Middle Aged ,Vascular surgery ,Prognosis ,medicine.disease ,Intensive care unit ,Thromboelastography ,Surgery ,Analgesia, Epidural ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Heart failure ,Anesthesia ,Female ,business ,Vascular Surgical Procedures ,Artery - Abstract
To examine the interaction of epidural anesthesia, coagulation status, and outcome after lower extremity revascularization, 80 patients with atherosclerotic vascular disease were prospectively randomized to receive general anesthesia combined with postoperative epidural analgesia (GEN-EPI) or general anesthesia with on-demand narcotic analgesia (GEN). Demographics did not differ between groups except that the GEN-EPI group had a higher incidence of diabetes mellitus and of previous myocardial infarction. Coagulation status was monitored using thromboelastography. An additional 40 randomly selected patients without atherosclerotic vascular disease undergoing noncardiovascular procedures served as controls for coagulation status. Vascular surgical patients were hypercoagulable compared with control patients before operation and on the first postoperative day. Postoperatively, this hypercoagulability was attenuated in the GEN-EPI group and was associated with a lower incidence of thrombotic events (peripheral arterial graft coronary artery or deep vein thromboses). The rates of cardiovascular, infectious, and overall postoperative complications, as well as duration of intensive care unit stay, were significantly reduced in the GEN-EPI group. Stepwise logistic regression demonstrated that the only significant predictors of postoperative cardiovascular complications were preoperative congestive heart failure and general anesthesia without epidural analgesia. We conclude that in patients with atherosclerotic vascular disease undergoing arterial reconstructive surgery (a) thromboelastographic evidence of increased platelet-fibrinogen interaction is associated with early postoperative thrombotic events, and (b) epidural anesthesia and analgesia is associated with beneficial effects on coagulation status and postoperative outcome compared with intermittent on-demand opioid analgesia. more...
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- 1991
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11. Thromboelastography as an indicator of post-cardiopulmonary bypass coagulopathies
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Bruce D. Spiess, Anthony D. Ivankovich, Kenneth J. Tuman, Giacomo A. DeLaria, Robert J. McCarthy, and Richard Schillo
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Male ,medicine.medical_specialty ,Whole Blood Coagulation Time ,Activated clotting time ,Hemorrhage ,Critical Care and Intensive Care Medicine ,law.invention ,Postoperative Complications ,Predictive Value of Tests ,law ,Internal medicine ,Cardiopulmonary bypass ,medicine ,Humans ,Cardiac Surgical Procedures ,Intraoperative Complications ,Blood coagulation test ,Cardiopulmonary Bypass ,medicine.diagnostic_test ,business.industry ,General Engineering ,Blood Coagulation Disorders ,Thromboelastography ,Thrombelastography ,Thromboelastometry ,Coagulation ,Anesthesia ,Cardiology ,Blood Coagulation Tests ,business ,Blood sampling - Abstract
Postoperative hemorrhage in patients undergoing open-heart surgery is a major cause of morbidity and mortality. Monitoring of coagulation in these patients has routinely involved the activated clotting time. Thromboelastography is currently used as a monitor of coagulation during liver transplantation. The thromboelastogram, by providing information on the interaction of all the coagulation precursors, gives more clinically useful information on coagulation than that available from the coagulation profile or the activated clotting time alone. This study was done to assess the usefulness of thromboelastography in open-heart surgery. Thirty-eight patients (29 undergoing coronary artery bypass grafting and 9 undergoing valve replacement) were studied with activated clotting time, thromboelastography, and coagulation profiles during three periods: before bypass, during bypass, and after protamine administration. Thromboelastography was a significantly better predictor (87% accuracy) of postoperative hemorrhage and need for reoperation than was the activated clotting time (30%) or coagulation profile (51%). Thromboelastography is easy to use and provides diagnostic data within 30 minutes of blood sampling. more...
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- 1987
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12. The hypertensive balloon
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Eugene F. Bernstein, Ralph Clayman, Giacomo A. DeLaria, and Kaj H. Johansen
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Pulmonary and Respiratory Medicine ,Left ventricular afterload ,medicine.medical_specialty ,Ischemic myocardium ,business.industry ,Ischemia ,medicine.disease ,Balloon ,Surgery ,Coronary occlusion ,Internal medicine ,cardiovascular system ,medicine ,Cardiology ,cardiovascular diseases ,Myocardial infarction ,Cardiology and Cardiovascular Medicine ,business ,Phenylephrine ,Perfusion ,medicine.drug - Abstract
Intra-aortic balloon counterpulsation (IABC) was developed to assist the circulation in pump failure. Its use has recently been suggested to decrease or retard the extent of ischemia in normotensive patients with acute myocardial infarction. In dogs, the combination of IABC and phenylephrine decreased the extent of ischemia after acute coronary occlusion by 76 per cent, far more than IABC alone. The data suggest that increasing coronary perfusion is a more important factor than decreasing left ventricular afterload in this effect of IABC. more...
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- 1974
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13. Surgical Management of Malignant Mesothelioma
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Robert J. Jensik, Giacomo A. DeLaria, L. Penfield Faber, and C. Frederick Kittle
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Adult ,Male ,Mesothelioma ,Pulmonary and Respiratory Medicine ,Extrapleural Pneumonectomy ,medicine.medical_specialty ,Biopsy ,Pleural Neoplasms ,Methods ,medicine ,Humans ,Pneumonectomy ,Aged ,medicine.diagnostic_test ,business.industry ,Middle Aged ,Surgical procedures ,medicine.disease ,Time of death ,Surgery ,Female ,Tumor removal ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
The surgical management of 18 patients diagnosed as having malignant mesothelioma is reviewed. Of these patients, 7 received limited treatment—pleurectomy or biopsy. The mean survival was 10 months, and no patient was disease-free at time of death. The other 11 patients were treated by radical extrapleural pneumonectomy. There were 2 long-term, disease-free survivors at 2 and 4 years. Mean survival for the entire group was 15 months, but most patients received good palliation following tumor removal. Surgical procedures for removal of malignant mesothelioma can be accomplished safely and without major morbidity. When possible, radical extrapleural pneumonectomy affords the best palliation and the only opportunity for cure. more...
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- 1978
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14. Reduction in myocardial ischemia by left ventricular bypass after acute coronary artery occlusion
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Kaj H. Johansen, Eugene F. Bernstein, Giacomo A. DeLaria, and Ira D. Levine
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Coronary artery occlusion ,Myocardial ischemia ,business.industry ,medicine.medical_treatment ,Pulsatile flow ,Electrocardiography in myocardial infarction ,medicine.disease ,Internal medicine ,Cardiology ,medicine ,Surgery ,Myocardial infarction ,Cardiology and Cardiovascular Medicine ,business ,Reduction (orthopedic surgery) - Abstract
With the use of an epicardial ST mapping technique, left ventricular bypass (LVB) was shown to reduce effectively the myocardial ischemia associated with coronary artery occlusion in dogs in proportion to the extent of bypass. Pulsatile flow was equally, but not more, effective. A reduction in cardiac work is proposed as the basis for these benefits. more...
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- 1974
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15. Inferior vena cava interruption with the hunter-sessions balloon: Eighteen years' experience in 191 cases
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Hassan Najafi, Marshall D. Goldin, David O. Monson, Cyrus Serry, Giacomo A. DeLaria, Michael DaValle, and James A. Hunter
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medicine.medical_specialty ,medicine.diagnostic_test ,medicine.drug_class ,business.industry ,Anticoagulant ,Venography ,medicine.disease ,Balloon ,Inferior vena cava ,Surgery ,Pulmonary embolism ,Venous thrombosis ,medicine.vein ,Anesthesia ,medicine ,Thrombus ,Cardiology and Cardiovascular Medicine ,business ,Contraindication - Abstract
Over a period of 18 years, 191 consecutive patients had interruption of the inferior vena cava with the Hunter-Sessions balloon for complications of deep venous thrombosis and pulmonary embolism. Causes of deep venous thrombosis and pulmonary embolism included the postoperative state (33%), cancer (32%), and stroke (11%). There were 93 females and 98 males; ages ranged from 17 to 90 years (average, 57 years). Indications for placement of the Hunter-Sessions balloon were as follows: contraindication to anticoagulants (33%), anticoagulant complications (24%), pulmonary embolism despite anticoagulants (45%), and others including inferior vena cava thrombus (12%). Sixty-eight percent had clinical phlebitis and 36% had positive venography results. Pulmonary embolism had occurred in 165 patients (86%). It was diagnosed by ventilation-perfusion scanning (75%), angiography (23%), or on clinical grounds (2%) in patients with confirmed deep venous thrombosis. At the time of the procedure 52% were in significant cardiopulmonary distress, and 10% were intubated and on respirators. Transjugular placement was done in 188 patients, and transfemoral placement was performed in three. All tolerated inferior vena cava interruption. Thirty patients (15%) died while in the hospital an average of 21 days after balloon placement, which was unrelated to the deaths. Followup was 45 months. Ninety-four patients are dead, 95 are alive, and the status of two patients is unknown. Twenty-nine of 64 patients (45%) who died after they left the hospital died of cancer. At last follow-up, 75% of patients had legs free of edema and 25% had need for elastic stockings. No malfunction or migration has occurred with the device. No patient had a pulmonary embolism while in the hospital after insertion of the Hunter-Sessions balloon, and no patient died of pulmonary embolism. Late minor pulmonary embolism occurred in three patients. (J Vasc Surg 1989;10:450–6.) more...
- Published
- 1989
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16. Sternal wound complications
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Hassan Najafi, Phyllis C. Bleck, Marshall D. Goldin, Cyrus Serry, James A. Hunter, Giacomo A. DeLaria, and Hushang Javid
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Debridement ,Sternum ,business.industry ,medicine.medical_treatment ,Mediastinum ,medicine.disease ,Surgery ,Surgical Wound Dehiscence ,medicine.anatomical_structure ,Median sternotomy ,Cardiothoracic surgery ,Incision and drainage ,medicine ,Cardiology and Cardiovascular Medicine ,Abscess ,business - Abstract
Of 4,124 patients undergoing median sternotomy for cardiac operations, 1.8% had sternal wound complications. These included wound drainage, skin separation, unstable sternum, and sternal dehiscence with or without infection. Septicemia and mediastinal abscess were found in all 19 patients who died. Incision and drainage of skin and subcutaneous tissue with frequent changes of dressing or irrigation (Method A) is recommended for those patients with (I) serosanguineous drainage only or (2) a stable sternum and superficial infection without systemic reaction. Surgical debridement of the sternum and mediastinum with reclosure followed by mediastinal irrigation via drainage tubes with 0.5% povidone-iodine solution (Method B) is recommended for patients with (1) a draining, unstable sternum, (2) infection involving the retrosternal space, or (3) infection causing a systemic reaction unresponsive to Method A. None of the eight patients in the latter group with more serious infections died when managed by Method B, and only one had recurrent infection. In contrast, of 28 patients of the latter group not treated with Method B, 11 died of infection-related causes and 13 returned with recurrent infection. more...
- Published
- 1980
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17. Coronary revascularization in septuagenarians
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Hushang Javid, Richard S. Faro, Milton Weinberg, Marshall D. Golden, David O. Monson, James A. Hunter, Hassan Najafi, Cyrus Serry, and Giacomo A. DeLaria
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Past medical history ,business.industry ,medicine.medical_treatment ,medicine.disease ,Revascularization ,Coronary revascularization ,medicine.anatomical_structure ,Internal medicine ,medicine.artery ,Diabetes mellitus ,Pulmonary artery ,Medicine ,Surgery ,Significant risk ,Operative risk ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
Despite a 15 year experience with the aorta-coronary bypass operation, indications for its use remain unsettled, especially in the elderly. Between January, 1974, and June, 1980, 2,667 patients underwent coronary artery revascularization with an overall mortality of 3.8% (101/2,667). During the last 12 months the mortality has decreased to 1%. There were 2,562 patients below the age of 70, with a mortality of 3.5% (90/2,562), in contrast to 105 patients over the age of 70, with a mortality of 10.5% (11/105) (p = 0.002). In patients less than 70 years of age there was a significant difference between the mortality of men, 3.12% (67/2,146). and that of women, 5.53% (23/416) (p = 0.015). This disparity of operative risk was far more pronounced in patients over 70 years of age: men 6 % (5/84) and women 28.6% (6/21) (p = 0.002). The overall operative mortality of women, 6.6% (29/437), was significantly different from the overall mortality of men, 3.2% (72/2,230) (p = 0.001). An in depth analysis of past medical history, risk factors, and catheterization data is presented in those patients over the age of 70. The average number of vessels bypassed was 2.40: men 2.47 and women 2.09 (p = NS). The ages varied from 70 to 81 years with a mean of 72.5. Smoking (p = 0.012) and diabetes (p = 0.0078) were significant risk factors for coronary disease. Smoking (p = 0.032) and abnormal pulmonary artery pressures (p = 0.0429) were significant variables affecting mortality. A 97.1% follow-up was obtained up to 78 months. Coronary artery revascularization can be performed in men below the age of 70 with acceptable mortality, but there is a twofold increase above the age of 70. Women can undergo revascularization below the age of 70 with a significantly higher risk than males. Those above the age of 70 are at severe risk and should undergo revascularization only after careful selection. more...
- Published
- 1983
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18. Thromboembolism and cancer: Treatment with the Hunter balloon
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Cyrus Serry, Marshall D. Goldin, James A. Hunter, and Giacomo A. DeLaria
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Male ,medicine.medical_specialty ,Lung Neoplasms ,Time Factors ,medicine.medical_treatment ,Breast Neoplasms ,Vena Cava, Inferior ,Balloon ,Inferior vena cava ,Angioplasty ,Neoplasms ,Thromboembolism ,Occlusion ,medicine ,Humans ,Contraindication ,Chemotherapy ,Lung ,business.industry ,Brain Neoplasms ,Cancer ,Middle Aged ,medicine.disease ,Surgery ,medicine.anatomical_structure ,medicine.vein ,cardiovascular system ,Female ,Radiology ,business ,Pulmonary Embolism ,Cardiology and Cardiovascular Medicine ,Angioplasty, Balloon - Abstract
Between 1970 and 1982, 126 inferior vena cava (IVC) balloon occlusions were performed for complications of venous thromboembolism (VTE). Forty, or 32%, were in patients with cancer. There were 20 men and 20 women. The average age was 60.8 +/- 2 years. Cancers of the brain, lung, and breast, along with diffuse metastatic disease with unknown primary disease, were equally common and represented 50% of our cases. Indications for IVC occlusion included pulmonary embolus despite anticoagulation (AC); 50% VTE and contraindication to AC, 38%; and complications of AC, 12%. Three patients died from ongoing complications of previous AC. Eight additional patients died of cancer, for a hospital mortality rate of 28%. Twenty-nine patients were discharged an average of 28.4 +/- 4.3 days after IVC balloon occlusion. Twenty of these patients subsequently died of cancer an average of 13 +/- 4.7 months after hospital discharge. Eight patients remain alive, four for more than 4 years. Pulmonary emboli did not occur after balloon occlusion, and there were no balloon complications. Only 4 of 29 discharged patients had mild leg edema. Hunter balloon occlusion of the IVC represents a safe and effective method for managing complications of VTE in patients with cancer. Early hospital discharge is possible, treatment is permanent, and future chemotherapy is not compromised by the need for long-term anticoagulation. more...
- Published
- 1984
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19. Morphology of blood-surface interaction on intra-aortic balloons
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Eugene F. Bernstein, Frederick J. Schoen, and Giacomo A. DeLaria
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Pulmonary and Respiratory Medicine ,Pathology ,medicine.medical_specialty ,Morphology (linguistics) ,biology ,business.industry ,Scanning electron microscope ,Heparin ,medicine.disease ,Thrombosis ,Fibrin ,medicine ,biology.protein ,Surgery ,Platelet ,Myocardial infarction ,Cardiology and Cardiovascular Medicine ,Cell adhesion ,business ,medicine.drug - Published
- 1973
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20. Effects of Intraaortic Balloon Counterpulsation on the Severity of Myocardial Ischemic Injury following Acute Coronary Occlusion
- Author
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Eugene Braunwald, James W. Covell, Giacomo A. DeLaria, Peter R. Maroko, Peter Libby, Eugene F. Bernstein, and John Ross
- Subjects
medicine.medical_specialty ,Time Factors ,Heart Ventricles ,Myocardial Infarction ,Shock, Cardiogenic ,Coronary Disease ,Anterior Descending Coronary Artery ,Electrocardiography ,Dogs ,Oxygen Consumption ,Heart Rate ,Ischemia ,Coronary Circulation ,Physiology (medical) ,Internal medicine ,Occlusion ,medicine ,Animals ,Humans ,Assisted Circulation ,Myocardial infarction ,Electrodes ,Ligation ,Intraaortic balloon ,business.industry ,Myocardium ,Cardiogenic shock ,Isoproterenol ,Ischemic injury ,medicine.disease ,Coronary Vessels ,Disease Models, Animal ,medicine.anatomical_structure ,Coronary occlusion ,Ventricle ,Acute Disease ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
The effects of intraaortic balloon counterpulsation (IABC) on the magnitude and severity of myocardial ischemic injury were studied in 19 dogs following acute coronary occlusion and in two patients with cardiogenic shock. In the experimental group, epicardial electrocardiograms were taken from 10-14 sites on the anterior surface of the left ventricle following occlusion of the left anterior descending coronary artery or its apical branch. The average S-T-segment elevation ([see Equation in PDF File]) was used as an index of the magnitude of myocardial ischemic injury. In six dogs, two successive 20-min occlusions were performed, and IABC was started prior to the second occlusion. [see Equation in PDF File] 15 min following occlusion decreased from 3.3 ± 0.9 mv after the control occlusion to 1.4 ± 0.4 mv ( P < 0.01) after the occlusion with IABC. In three dogs in which the occlusion was maintained and IABC initiated 30 min later, [see Equation in PDF File] decreased from 1.2 to 0.6 mv. In six dogs in which IABC was started 3 hours after occlusion, it induced a reduction of [see Equation in PDF File] from 4.2 ± 1.1 to 2.8 ± 1.0 mv ( P < 0.01). In four dogs, ischemic injury was augmented by isoproterenol infusion (0.25 µg/kg/min), and while continuing the infusion IABC was initiated. It reduced [see Equation in PDF File] from 8.0 ± 1.9 to 5.7 ± 1.8 mv ( P < 0.05). Thus, IABC reduced the magnitude and extent of myocardial ischemic injury after experimental coronary occlusion, both when IABC was employed prior to, and 3 hours following, coronary occlusion. IABC was also effective in reducing myocardial ischemic injury which had been increased by isoproterenol infusion. Employing a noninvasive technic, which utilizes 35 electrodes on the thorax, the effects of IABC were examined in two patients with cardiogenic shock associated with acute myocardial infarction. Preliminary observations in these patients confirmed the experimental results indicating that IABC reduced myocardial ischemic injury. more...
- Published
- 1972
- Full Text
- View/download PDF
21. Transjugular forceps retrieval of catheter embolus
- Author
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Marshall D. Goldin, Ronald L. Meng, and Giacomo A. DeLaria
- Subjects
Pulmonary and Respiratory Medicine ,Adult ,Male ,medicine.medical_specialty ,Forceps ,Embolism ,Intracardiac injection ,Catheterization ,Bronchoscopy ,Embolus ,Jugular vein ,medicine ,Humans ,Local anesthesia ,cardiovascular diseases ,Heart Atria ,Right internal jugular vein ,medicine.diagnostic_test ,business.industry ,Middle Aged ,Surgery ,Catheter ,cardiovascular system ,Female ,Parenteral Nutrition, Total ,Radiology ,Jugular Veins ,Cardiology and Cardiovascular Medicine ,business - Abstract
Intracardiac migration of an intravenous catheter was treated transvenously in 5 patients successfully. Using local anesthesia and fluoroscopic guidance, a bronchoscopy forceps was passed through the right jugular vein to the right atrium and afforded efficient and safe retrieval of the embolus. The direct route to the right atrium provided by the right internal jugular vein and the precise control offerred by the rigid forceps make this the preferred method of retrieval of a transvenous catheter embolus. more...
- Published
- 1980
22. Seventeen-year experience with routine shunting in carotid artery surgery
- Author
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Cyrus Serry, Ormand C. Julian, Hassan Najafi, Giacomo A. DeLaria, William S. Dye, Hushang Javid, Marshall D. Goldin, and James A. Hunter
- Subjects
Carotid Artery Diseases ,medicine.medical_specialty ,business.industry ,Collateral Circulation ,medicine.disease ,Collateral circulation ,Surgery ,Brain Ischemia ,Shunting ,medicine.anatomical_structure ,Atheroma ,Cerebral blood flow ,Cardiothoracic surgery ,Cerebrovascular Circulation ,cardiovascular system ,medicine ,Methods ,Humans ,Carotid body ,cardiovascular diseases ,Cerebral perfusion pressure ,business ,Stroke - Abstract
Safety of carotid artery surgery depends on proper case selection, meticulous surgical technique, and appropriate protection of the brain during carotid artery cross-clamping. Various methods have been devised to determine the adequacy of collateral circulation, none of which has been proven practical and totally reliable. Attempts at increasing cerebral perfusion to the ischemic portion of the brain by induced hypertension, hypercarbia, and hypocarbia have been ineffective. The purpose of this presentation is to report our experience with routine intraluminal shunting in carotid artery surgery during the past 17 years. Advantages of routine shunting include maintenance of regional cerebral blood flow at the preclamping level and the elimination of any need for monitoring and haste during surgery. Insertion of the tube, properly done, does not injure the arterial wall and should not cause embolization. The presence of the tube within the arterial lumen does not interfere with exposure of the atheroma, yet it facilitates repair of the incision and prevents stricture by faulty suturing technique. Results of carotid artery surgery measured by the incidence of stroke are compared between shunted and nonshunted series. A review of the literature confirms our impression that shunting reverses ischemic changes detected by EEG and regional cerebral blood flow determinations. The usefulness of shunting in the surgical management of internal carotid aneurysm, kinked carotid artery, carotid body tumor, and carotid-subclavian bypass graft is also described. more...
- Published
- 1979
23. Surgical management of combined carotid and coronary occlusive disease
- Author
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Giacomo A. DeLARIA and Hassan Najafi
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Pulmonary and Respiratory Medicine ,Adult ,Male ,medicine.medical_specialty ,Arteriosclerosis ,Carotid arteries ,Occlusive disease ,Coronary Artery Disease ,Coronary artery disease ,Internal medicine ,Monitoring, Intraoperative ,medicine ,Humans ,Anesthesia ,Carotid Stenosis ,Coronary Artery Bypass ,Survival rate ,Internal Mammary-Coronary Artery Anastomosis ,Aged ,Endarterectomy, Carotid ,business.industry ,Internal mammary-coronary artery anastomosis ,Middle Aged ,medicine.disease ,Survival Rate ,Cerebrovascular Disorders ,Carotid Arteries ,Cardiology ,Surgery ,Female ,Cardiology and Cardiovascular Medicine ,business - Published
- 1986
24. Requirements for a method of transvenous inferior vena cava interruption
- Author
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Hushang Javid, Marshall D. Goldin, Giacomo A. DeLaria, Hassan Najafi, James A. Hunter, and Cyrus Serry
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Venography ,Vena Cava, Inferior ,Inferior vena cava ,Thromboembolism ,Complete occlusion ,Inferior vena cava interruption ,medicine ,Methods ,Humans ,Local anesthesia ,Heparin therapy ,Aged ,medicine.diagnostic_test ,business.industry ,Heparin ,Detachable balloon ,Middle Aged ,Surgery ,medicine.vein ,cardiovascular system ,Female ,Radiology ,business ,Tomography, X-Ray Computed ,Vascular Surgical Procedures - Abstract
• Six requirements were defined that would characterize a safe and effective technique of transvenous inferior vena cava (IVC) interruption: (1) the instrument should be placed transjugularly under local anesthesia; (2) the instrument should have "built-in" capability for venography; (3) the technique should produce complete occlusion of the IVC; (4) the occluder must adapt to any variable in IVC diameter; (5) the intracaval device must have no sharp edges, pins, or points; and (6) the technique must permit simultaneous heparin therapy. These specifications were met by a catheter-delivered detachable balloon that could be inflated to any needed diameter. This technique was used in 96 patients, with a follow-up period to ten years. Time and experience confirm the validity of the six requirements for a safe and effective technique. ( Arch Surg 115:1324-1330, 1980) more...
- Published
- 1980
25. Coronary artery bypass surgery in patients less than 40 years of age
- Author
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Michael Kelly, Giacomo A. DeLaria, and Hassan Najafi
- Subjects
Pulmonary and Respiratory Medicine ,Adult ,Male ,medicine.medical_specialty ,Cardiac Catheterization ,medicine.medical_treatment ,Coronary Disease ,Critical Care and Intensive Care Medicine ,Angina Pectoris ,Angina ,Coronary artery bypass surgery ,Postoperative Complications ,Risk Factors ,Diabetes mellitus ,medicine ,Humans ,In patient ,Derivation ,Family history ,Young adult ,Coronary Artery Bypass ,Cardiac catheterization ,business.industry ,Age Factors ,Middle Aged ,medicine.disease ,Surgery ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Coronary bypass patients less than 40 years of age were identified and compared with a control group previously studied at our hospital. In patients less than 40 years, the average age was 35 years. Men comprised 90.1 percent of group 1, and 83.4 percent of group 2. Operative mortality was 2.89 percent for group 1 and 2.1 percent for group 2. Patients less than 40 years were more likely to have positive family history (46.3 percent vs 21.94 percent), elevated cholesterol levels (25.62 vs 11.36 percent), and be smokers (59.09 vs 39.9 percent). Group 1 patients were less likely to have diabetes (4.54 vs 13.37 percent) or hypertension (18.18 vs 31.43 percent). The percentage of late deaths was much higher for younger patients. Postoperative angina and the need for reoperation was higher in group 1. (Chest 1988; 94:1138-41) more...
- Published
- 1988
26. Neurological complications of coronary revascularization
- Author
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Marshall D. Goldin, Robert M. Bojar, Hassan Najafi, Giacomo A. DeLaria, and Cyrus Serry
- Subjects
Pulmonary and Respiratory Medicine ,Coma ,medicine.medical_specialty ,Cerebral infarction ,business.industry ,Arteriosclerosis ,Ischemia ,Perioperative ,medicine.disease ,Air embolism ,Surgery ,Lucid interval ,Anesthesia ,medicine ,Embolism, Air ,Humans ,medicine.symptom ,Coronary Artery Bypass ,Hypotension ,Nervous System Diseases ,Cardiology and Cardiovascular Medicine ,business ,Complication ,Stroke - Abstract
In a series of 3,206 consecutive coronary artery bypass procedures performed between 1976 and 1981, 89 patients died (2.8% mortality) and 32 patients (1%) suffered major neurological syndromes. Among the latter patients, four distinct groups were identified. Group 1 consisted of 10 patients who remained unresponsive after operation. In Group 2 were 10 patients who awakened after operation but had clinical evidence of focal cerebral infarction. Group 3 included 6 patients who were initially intact neurologically but in whom neurological deficits later developed. In Group 4 were 6 patients who had severe mental aberration but no focal neurological deficits. The incidence of coma or focal deficit occurring without a lucid interval (Groups 1 and 2) was 0.62%, and these patients had a 30% mortality. Causative factors were suspected in 70% of the patients in Groups 1 and 2, and included atheromatous embolism, perioperative hypotension, carotid artery occlusive disease and air embolism. The outcome was poor for unresponsive patients, with 70% dying or remaining comatose, but nearly all of the patients with focal deficits or severe mental aberration demonstrated notable improvement. more...
- Published
- 1983
27. Intra-aortic balloon pumping without heparin
- Author
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Emery Nyilas, Eugene F. Bernstein, and Giacomo A. DeLaria
- Subjects
Blood Platelets ,medicine.medical_specialty ,Swine ,Biomedical Engineering ,Biophysics ,Shock, Cardiogenic ,Bioengineering ,Aorta, Thoracic ,Hematocrit ,Intra-Aortic Balloon Pumping ,Thromboplastin ,Biomaterials ,Internal medicine ,medicine.artery ,medicine ,Animals ,Humans ,Platelet ,Assisted Circulation ,Cardiac Surgical Procedures ,Prothrombin time ,Aorta ,medicine.diagnostic_test ,business.industry ,Heparin ,Anticoagulants ,Dextrans ,Thrombosis ,General Medicine ,Blood Cell Count ,Shock (circulatory) ,Cardiology ,Microscopy, Electron, Scanning ,Prothrombin Time ,Cattle ,medicine.symptom ,business ,medicine.drug - Published
- 1972
28. Effect of external counterpulsation in reduction of the myocardial ischemia following coronary artery occlusion
- Author
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Eugene F. Bernstein, Kaj Johansen, and Giacomo A. DeLaria
- Subjects
medicine.medical_specialty ,Coronary artery occlusion ,Myocardial ischemia ,medicine.medical_treatment ,Biomedical Engineering ,Biophysics ,Bioengineering ,Blood Pressure ,Coronary Disease ,Biomaterials ,Electrocardiography ,Dogs ,Ischemia ,Internal medicine ,Methods ,Medicine ,Animals ,Assisted Circulation ,Ligation ,Reduction (orthopedic surgery) ,business.industry ,General Medicine ,Coronary Vessels ,External counterpulsation ,Cardiology ,business - Published
- 1973
29. Quick Reference to Cardiovascular Diseases
- Author
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Giacomo A. DeLaria
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Medicine ,Surgery ,Cardiology and Cardiovascular Medicine ,business ,Intensive care medicine - Published
- 1978
- Full Text
- View/download PDF
30. Intraoperative placement of Swan-Ganz catheter via the left innominate vein
- Author
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Hassan Najafi, Giacomo A. DeLaria, and David M. Shahian
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Internal medicine ,Cardiology ,Medicine ,Surgery ,Cardiology and Cardiovascular Medicine ,business ,Swan Ganz Catheter ,Left Innominate Vein - Published
- 1981
- Full Text
- View/download PDF
31. Prevention of Air Embolism after Mitral Valve Replacement with a Porcine Heterograft Prosthesis
- Author
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Milton Weinberg, David O. Monson, and Giacomo A. DeLaria
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Swine ,medicine.medical_treatment ,Prosthesis ,Air embolism ,Internal medicine ,Methods ,medicine ,Animals ,Embolism, Air ,Humans ,Bioprosthesis ,Prosthetic valve ,business.industry ,Mitral valve replacement ,medicine.disease ,Surgery ,Heart Valve Prosthesis ,cardiovascular system ,Cardiology ,Mitral Valve ,Cardiology and Cardiovascular Medicine ,business ,Suture line - Abstract
The production of prosthetic valve incompetence during atriotomy closure is among the operative maneuvers utilized to prevent air embolism in mitral valve replacement. The leaflets of a porcine bioprosthesis may be retracted safely and effectively, thereby producing temporary valve incompetence, by placing three polypropylene sutures through the valve orifice and around the sewing ring to encircle the leaflets. These traction sutures are easily pulled out through the atriotomy suture line after all air has been displaced from the heart. The technique has been effective, easily accomplished, and without complications. more...
- Published
- 1979
- Full Text
- View/download PDF
32. Cardiac Surgery Safeguards and Pitfally in Operative Technique
- Author
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Giacomo A. Delaria
- Subjects
medicine.medical_specialty ,business.industry ,Internal medicine ,General surgery ,medicine ,Cardiology ,Critical Care and Intensive Care Medicine ,business ,Cardiac surgery - Published
- 1989
- Full Text
- View/download PDF
33. Biologic and Synthetic Vascular Prostheses
- Author
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Giacomo A. DeLaria
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,medicine ,Surgery ,Cardiology and Cardiovascular Medicine ,business - Published
- 1983
- Full Text
- View/download PDF
34. SURGERY OF CORONARY ARTERY DISEASE
- Author
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Giacomo A. DeLaria
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Framingham Risk Score ,business.industry ,Critical Care and Intensive Care Medicine ,medicine.disease ,Surgery ,Coronary artery disease ,Internal medicine ,medicine ,Cardiology ,Myocardial infarction ,Cardiology and Cardiovascular Medicine ,business - Published
- 1987
- Full Text
- View/download PDF
35. Placement of Swan-Ganz catheter: Reply
- Author
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David M. Shahian, Hassan Najafi, and Giacomo A. DeLaria
- Subjects
Pulmonary and Respiratory Medicine ,Surgery ,Cardiology and Cardiovascular Medicine - Published
- 1981
- Full Text
- View/download PDF
36. Textbook of Surgery—Thirteenth Edition. The Biological Basis of Modern Surgical Practice
- Author
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Giacomo A. Delaria
- Subjects
medicine.medical_specialty ,business.industry ,General surgery ,medicine ,Physiology ,Critical Care and Intensive Care Medicine ,business - Published
- 1987
- Full Text
- View/download PDF
37. Surgical Treatment of Aortic Aneurysms
- Author
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Giacomo A. DeLaria
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,medicine ,Surgery ,Cardiology and Cardiovascular Medicine ,Surgical treatment ,business - Published
- 1986
- Full Text
- View/download PDF
38. Patient Care in Cardiac Surgery (3rd ed)
- Author
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Giacomo A. DeLaria
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,medicine ,Surgery ,Cardiology and Cardiovascular Medicine ,Intensive care medicine ,business ,Patient care ,Cardiac surgery - Published
- 1982
- Full Text
- View/download PDF
39. Diseases of the Aorta Including an Atlas of Angiographic Pathology and Surgical Technique
- Author
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Giacomo A. DeLaria
- Subjects
Pulmonary and Respiratory Medicine ,Aorta ,medicine.medical_specialty ,Pathology ,medicine.anatomical_structure ,business.industry ,Atlas (anatomy) ,medicine.artery ,Medicine ,Surgery ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Published
- 1985
- Full Text
- View/download PDF
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