Abstract:
:Introduction of the automatic implantable cardioverter defibrillator (AICD) has dramatically affected the surgical treatment of malignant ventricular tachyarrhythmias. The authors continue to perform electrophysiologically directed subendocardial resection (SER) of left ventricular (LV) scars in selected patients, and we revascularize (CABG) those patients undergoing AICD implantation who have significant myocardial ischemia. In an attempt to define the optimal role of each procedure, this report analyzes our 8-year experience with 348 consecutive patients treated surgically for these arrhythmias (SER since 1983 and AICD since 1986). All patients undergoing SER had organized ventricular tachycardia (VT) as a result of myocardial infarction, and most had LV aneurysms; of those undergoing AICD or AICD/CABG, 60% had VT, 15% had ventricular fibrillation, and 25% had both or were noninducible. The thirty-day mortality rate was 1.5% (3/197) for AICD, 5.4% (5/93) for AICD/CABG, and 8.6% (5/58) for SER; these mortality figures are not significant different. Late deaths in all groups were predominantly due to congestive heart failure, and actuarial survival as well as freedom from sudden death was similar between the groups at 4 years. Recurrent VT occurred in 167 of 282 (59%) of long-term survivors of AICD or AICD/CABG during follow-up and in nine of 53 (17%) of those with SER. Forty-eight per cent of survivors of AICD or AICD/CABG required antiarrhythmic medications, whereas only 11% of those with SER required antiarrhythmics. Long-term survival in each group is much higher than that reported for comparable patients with severe LV dysfunction treated medically. In those patients with organized VT and LV aneurysm who are judged able to survive the procedure, SER offers a high likelihood of cure rather than simple prevention of sudden death.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Geha AS,Elefteriades JA,Hsu J,Biblo LA,Hoch DH,Batsford WP,Rosenfeld LE,Carlson MD,Johnson NJ,Waldo ALdoi
10.1097/00000658-199209000-00010subject
Has Abstractpub_date
1992-09-01 00:00:00pages
309-16; discussion 316-7issue
3eissn
0003-4932issn
1528-1140journal_volume
216pub_type
杂志文章abstract:OBJECTIVE:The authors review the general surgical complications of cardiopulmonary bypass, including newer procedures such as heart and lung transplantation, to identify patients at higher risk. SUMMARY BACKGROUND DATA:Although rare, the general surgical complications of cardiopulmonary bypass are associated with high...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199505000-00006
更新日期:1995-05-01 00:00:00
abstract:OBJECTIVE:Metabolic activity of transformed human liver (Hep G2) cells and primary rat hepatocytes were compared during in vitro application of a gel entrapment bioartificial liver. BACKGROUND:Clinical trials of bioartificial liver devices containing either transformed liver cells or primary hepatocytes have been init...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVE:To achieve consensus on the best practices in the management of ventral hernias (VH). BACKGROUND:Management patterns for VH are heterogeneous, often with little supporting evidence or correlation with existing evidence. METHODS:A systematic review identified the highest level of evidence available for each ...
journal_title:Annals of surgery
pub_type: 共识发展会议,杂志文章
doi:10.1097/SLA.0000000000001701
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:This study aimed to explore the impact of a human factors intervention bundle on the quality of ward-based surgical care in a UK hospital. SUMMARY OF BACKGROUND DATA:Improving the culture of a surgical team is a difficult task. Engagement with stakeholders before intervention is key. Studies have shown that ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002089
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:Length of stay (LOS) is an important outcome as a marker of resource consumption. Determining which factors increase LOS may provide information on reducing costs and improving the delivery of care. The purpose of this study was to determine the independent association of intraoperative process of care and po...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199908000-00016
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to assess the effect of Ω3 fatty acids (Ω3FA) on fatty and lean liver in hepatic surgery. BACKGROUND:The global spread of energy-dense diets has led to an endemic rise in fatty liver disease and obesity. Besides metabolic pathologies, steatosis enhances hepatic sensitivity to ischem...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001968
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:FN present a management quandary as they are often benign but may also be aggressive TC. Consensus recommendations have historically advised thyroidectomy for definitive diagnosis. Although MT have robust benefit in hypothetical cost analyses, under current management guidelines a real-time study of their cli...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004130
更新日期:2020-10-01 00:00:00
abstract::Midgestation fetal wound healing is characterized by healing without fibrosis or scar formation. The mechanisms that underlie this remarkable process are mediated in part through a fetal wound extracellular matrix rich in hyaluronic acid. In this study a newly developed assay was used to determine the hyaluronic acid ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199104000-00003
更新日期:1991-04-01 00:00:00
abstract:INTRODUCTION:Intraductal papillary mucinous neoplasms (IPMNs) are being increasingly recognized, and often harbor cancer. Lymph node metastases are an important prognostic factor for patients with invasive intraductal papillary carcinoma (I-IPMC), but the role of lymph node ratio (LNR) in predicting survival after surg...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181cf9155
更新日期:2010-03-01 00:00:00
abstract:PURPOSE:To assess the efficacy of isolated pelvic perfusion (IPP) with tumor necrosis factor (TNF)-α and melphalan in patients with locally advanced cancers in the pelvic and groin area requiring mutilating surgery. METHODS:A total of 27 patients were enrolled (carcinoma, n = 17; sarcoma/melanoma, n = 4; and endocrine...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318242ebe7
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:The study's primary aim was to evaluate the effectiveness of thermal imaging (TI) and its secondary aim was to compare TI and indocyanine green (ICG) fluorescence angiography, with respect to the evaluation of the viability of the gastric conduit. SUMMARY BACKGROUND DATA:The optimal method for evaluating per...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003169
更新日期:2020-06-01 00:00:00
abstract::Intestinal ischemia-reperfusion is a common clinical event associated with both clinical and experimental distant organ injury. In particular, the pulmonary microvasculature appears to be susceptible to injury resulting from systemic inflammatory mediator activation. This study was designed to evaluate the hypothesis ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199301000-00009
更新日期:1993-01-01 00:00:00
abstract::From December 1985 to December 1989, 100 consecutive simultaneous pancreas-kidney (SPK) transplants were performed at the University of Wisconsin Hospital and Clinics. Bladder drainage technique was used for all grafts. One- and three-year patient survival was 93% and 90%; kidney survival, 90% and 85%; and pancreas su...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199112000-00010
更新日期:1991-12-01 00:00:00
abstract:OBJECTIVE:To investigate the role of recombinant bactericidal/permeability-increasing protein (rBPI21) in the attenuation of the sepsis syndrome and acute lung injury associated with lower limb ischemia-reperfusion (I/R) injury. SUMMARY BACKGROUND DATA:Gut-derived endotoxin has been implicated in the conversion of the...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200108000-00014
更新日期:2001-08-01 00:00:00
abstract:OBJECTIVE:To investigate the pattern of nodal metastasis, morbidity, recurrence rates of papillary thyroid carcinoma (PTC), and parathyroid hormone (PTH) responses following neck dissection (ND) plus total thyroidectomy (TT). SUMMARY BACKGROUND DATA:While hypoparathyroidism develops after TT plus ND, little is known o...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000250451.59685.67
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:The study was conducted to determine whether the performance of an extended lymphadenectomy and retroperitoneal soft-tissue clearance in association with a pancreatoduodenal resection improves the long-term survival of patients with a potentially curable adenocarcinoma of the head of the pancreas. SUMMARY BA...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00000658-199810000-00007
更新日期:1998-10-01 00:00:00
abstract::Blunt carotid artery trauma is uncommon but has been associated with severe, permanent neurologic deficits in 42% and mortality in 30% of 96 patients previously reported in the English literature. Since neurologic symptoms characteristically develop only after a latent interval and since physical evidence of significa...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198003000-00014
更新日期:1980-03-01 00:00:00
abstract:OBJECTIVE AND BACKGROUND:Our objective was to determine the fetal in vivo microRNA signature in hypoplastic lungs of human fetuses with severe isolated congenital diaphragmatic hernia (CDH) and changes in tracheal and amniotic fluid of fetuses undergoing fetoscopic endoluminal tracheal occlusion (FETO) to reverse sever...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001054
更新日期:2015-12-01 00:00:00
abstract:SUMMARY BACKGROUND DATA:The extent of hepatectomies is limited by the functional reserve of the remnant liver. The introduction of preoperative portal vein occlusion techniques to induce a preoperative hyperplasia of the future liver remnant has reduced the risk of postoperative liver failure. However, it has remained ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31816a9d7c
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:To develop evidence-based recommendations for safe, effective, and appropriate thyroidectomy. BACKGROUND:Surgical management of thyroid disease has evolved considerably over several decades leading to variability in rendered care. Over 100,000 thyroid operations are performed annually in the US. METHODS:The...
journal_title:Annals of surgery
pub_type: 杂志文章,实务指引
doi:10.1097/SLA.0000000000003580
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Some, but not all, studies using registry data have suggested a small but significant long-term survival advantage following a curative surgical resection of gastric cancer at hospitals where the volume of such surgeries is high. However, because such data may be significantly influenced by the impact of pos...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.sla.0000245469.35088.42
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVE:This study was designed to examine the differential effects of tumor necrosis factor (TNF) and nitric oxide on the acute cardiovascular changes that occur in response to endotoxemia. SUMMARY BACKGROUND DATA:Recent studies have suggested that some, if not all, of the cardiovascular effects of TNF are mediated...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199601000-00009
更新日期:1996-01-01 00:00:00
abstract::In nonfunctioning islet cell tumors of the pancreas, hormone production is not clinically evident. This type of tumor constituted 15% of all islet cell tumors seen at the Mayo Clinic from 1960 through 1978. Although identical to functioning islet cell tumors embryologically and histologically, the nonfunctioning tumor...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198102000-00010
更新日期:1981-02-01 00:00:00
abstract:BACKGROUND:Chest computed tomography (CT) screening of patients with blunt trauma for thoracic aortic injury is controversial. This study was undertaken to determine whether CT could exclude aortic injury and be used to select patients for aortography. METHODS:Computed tomography and aortography were used to evaluate ...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199411000-00015
更新日期:1994-11-01 00:00:00
abstract::Renal scintiphotography with (131)I-hippurate was the primary diagnostic procedure in evaluating renal failure and complications in over 500 transplant patients. This diagnostic test has become our principal method of evaluation and followup of renal transplants, especially in the early post-transplant period. It has ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197409000-00014
更新日期:1974-09-01 00:00:00
abstract:OBJECTIVE:To assess the feasibility of developing a simulated ward environment in which to assess the ward-based care of surgical patients by clinicians of varying levels of experience (construct validation). BACKGROUND:Increasing evidence points to the importance of the postoperative or ward-based phase of surgical c...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318288e1d4
更新日期:2014-02-01 00:00:00
abstract::Nasogastric (NG) decompression after colorectal surgery is practiced commonly. Our aim was to determine whether routine NG decompression benefitted patients undergoing this type of surgery. Five hundred thirty-five patients were randomized prospectively to either NG decompression or no decompression. Stratification wa...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-198906000-00003
更新日期:1989-06-01 00:00:00
abstract:OBJECTIVE:To document the decreased incidence of surgical complications after pancreas transplantation in recent times. SUMMARY BACKGROUND DATA:Compared with other abdominal transplants, pancreas transplants have historically had the highest incidence of surgical complications. However, over the past few years, the au...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200002000-00017
更新日期:2000-02-01 00:00:00
abstract:OBJECTIVE:This study evaluates the effects of mechanical bowel preparation (MBP) on anastomosis below the peritoneal verge and questions the influence of MBP on anastomotic leakage in combination with a diverting ileostomy in lower colorectal surgery. SUMMARY BACKGROUND DATA:In a previous large multicenter randomized ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181c0e75c
更新日期:2010-01-01 00:00:00
abstract::Tissue reaction to sutures was studied in 666 specimens obtained from patients from one day to 23 years after operation. Reaction to catgut depends on the stage of absorption and is mainly histocytic in type. Nonabsorbable sutures are encapsulated by a rim of connective tissue, while near the suture histocytes, giant ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197502000-00003
更新日期:1975-02-01 00:00:00