The Experts below are selected from a list of 17388 Experts worldwide ranked by ideXlab platform
Michel Carrier - One of the best experts on this subject based on the ideXlab platform.
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Total gastrectomy in a patient with an in situ Right gastroepiploic artery graft
The Annals of thoracic surgery, 1994Co-Authors: Louis P. Perrault, Marcel J. Rhéault, Michel CarrierAbstract:Abstract A 60-year-old man in whom coronary artery bypass grafting was performed with an in situ Right gastroepiploic artery presented with a gastric adenocarcinoma 22 months after myocardial revascularization. He underwent a total gastrectomy with preservation of the Patent Right gastroepiploic artery graft to the Right coronary artery. Because of the difficulty of abdominal reoperations in patients with in situ Right gastroepiploic artery grafts, surgeons must consider Right gastroepiplcic artery free graft or alternative conduits.
Masatoshi Makuuchi - One of the best experts on this subject based on the ideXlab platform.
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salvage of Right gastroepiploic artery graft before pancreatoduodenectomy
The Journal of Thoracic and Cardiovascular Surgery, 2001Co-Authors: Toshiya Ohtsuka, Yoshihiro Suematsu, Hiroshi Kubota, Shinichi Takamoto, Masatoshi MakuuchiAbstract:A Patent Right gastroepiploic artery (GEA) graft in situ to the coronary artery can create disturbance when upper abdominal operations are carried out. This communication describes a surgical technique for rescue of a functioning GEA graft before pancreatoduodenectomy; saphenous vein grafting from the Right axillary artery to the GEA graft through an intrapleural route. Patient and operation. The patient was a 62-year-old woman who had icterus and anorexia. A diagnosis of bile duct cancer was made, and pancreatoduodenectomy was planned. Five years before, she had undergone a coronary artery bypass operation through a full sternotomy, including the internal thoracic artery and GEA conduits in situ to the left anterior descending and posterior descending coronary arteries and a vein graft from the ascending aorta to the posterolateral branch of the circumflex artery. Preoperative angiography and contrast-enhanced computed tomography demonstrated that the GEA graft from the gastroduodenal artery passed through the antegastric, antehepatic, and transdiaphragmatic route, and its flow extensively covered the inferior wall of the left ventricle. Therefore, before the standard pancreatoduodenectomy, an operation was carried out to salvage the functioning GEA. Electrocardiography, the left radial arterial line, the SwanGanz catheter (Baxter Healthcare Corporation, Edwards Division, Santa Ana, Calif), and transesophageal echocardiography were used for monitoring. A saphenous vein graft was harvested from the Right leg, and a 3-cm Right infraclavicular incision was made to expose the Right axillary artery. An 8-cm median longitudinal incision was made for a partial resternotomy and minilaparotomy. The limited sternotomy was reverse L-shaped, with its transverse cut at the level of the fourth intercostal space. The Right ventricle and atrium were carefully dissected from the sternum just as far as the Right pleural cavity. Through the minilaparotomy, the GEA pedicle on the liver tissue was identified. Eight thousand units of heparin was given, maintaining an activated clotting time of 280 seconds, and an end-to-side anastomosis was created between the vein graft and the axillary artery. Under thoracoscopic guidance, the vein graft was delivered into the Right
Jean Leon Guermonprez - One of the best experts on this subject based on the ideXlab platform.
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revival of the radial artery for coronary artery bypass grafting
The Annals of Thoracic Surgery, 1992Co-Authors: Christophe Acar, Victor A Jebara, Michele Portoghese, Bernard Beyssen, Jean Yves Pagny, Philippe Grare, Juan C Chachques, Jeannoel Fabiani, Alain Deloche, Jean Leon GuermonprezAbstract:Eighteen years after its first introduction for coronary artery revascularization, the radial artery (RA) was reinvestigated because of unexpected good long-term results in the early series. Since July 1989, 104 patients underwent myocardial revascularization using 122 RA grafts (18 patients received two grafts). The left internal mammary artery (IMA) was concomitantly used as a pedicled graft in 100 cases and the Right IMA in 19 cases; a free IMA graft was used in 29 cases and a saphenous vein graft in 24 cases. A mean of 2.8 grafts per patient were performed. Nine patients underwent associated procedures: carotid endarterectomy (3), aortic valve replacement (3), Bigelow procedure (1), and mitral valve repair (2). The target artery receiving the RA was the circumflex (n = 59), diagonal (n = 29), Right coronary (n = 27), and left anterior descending (n = 7). One patient died (0.96%) and 2 had perioperative myocardial infarct. Sternal wound infection was noted in 3 cases of double IMA implantation. No ischemia of the hand was observed. All patients received diltiazem started intraoperatively and continued after discharge. In addition aspirin (100 mg/day) was given at discharge. Early angiographic controls (less than 2 weeks) were obtained in the first 50 consecutive patients and revealed 56 of 56 Patent RA grafts, 48 of 48 Patent left IMA grafts, 11 of 11 Patent Right IMA grafts, 14 of 18 Patent free IMA grafts, and 8 of 9 Patent vein grafts.(ABSTRACT TRUNCATED AT 250 WORDS)
Louis P. Perrault - One of the best experts on this subject based on the ideXlab platform.
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Total gastrectomy in a patient with an in situ Right gastroepiploic artery graft
The Annals of thoracic surgery, 1994Co-Authors: Louis P. Perrault, Marcel J. Rhéault, Michel CarrierAbstract:Abstract A 60-year-old man in whom coronary artery bypass grafting was performed with an in situ Right gastroepiploic artery presented with a gastric adenocarcinoma 22 months after myocardial revascularization. He underwent a total gastrectomy with preservation of the Patent Right gastroepiploic artery graft to the Right coronary artery. Because of the difficulty of abdominal reoperations in patients with in situ Right gastroepiploic artery grafts, surgeons must consider Right gastroepiplcic artery free graft or alternative conduits.
Michael D Clark - One of the best experts on this subject based on the ideXlab platform.
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iliofemoral venous thrombosis caused by compression of an internal iliac artery aneurysm a minimally invasive treatment
Journal of Endovascular Therapy, 1998Co-Authors: David Rosenthal, John H Matsuura, Hilde Jerius, Michael D ClarkAbstract:PURPOSE: To report the success of a minimally invasive treatment for phlegmasia cerulea dolens without gangrene caused by compression from an internal iliac artery aneurysm. METHODS AND RESULTS: An 81-year-old male with a 1-month history of paralysis owing to a hemorrhagic stroke presented with massive edema and skin mottling of the Right lower extremity. Imaging confirmed Right iliofemoral deep vein thrombosis caused by compression from a 4-cm internal iliac artery aneurysm. With thrombolysis ruled out, a minimally invasive treatment plan was undertaken, featuring percutaneous coil embolization of the aneurysm and surgical venous thrombectomy with proximal arteriovenous fistula creation and iliac vein stent placement. Failure of the coils to embolize the iliac aneurysm prompted the use of an endovascular graft to exclude the aneurysm. The patient's symptoms subsided, and he has a Patent Right iliofemoral venous system and internal iliac artery at his latest (16-month) follow-up. CONCLUSIONS: This case demonstrates that minimally invasive endovascular and open techniques can be combined to achieve an optimum outcome in patients at high risk for standard surgical approaches.