Cardiac surgery in Wessex: review of 1000 consecutive open-heart procedures.

Ross, John; Monro, James L.; Manners, John M.; Edwards, John C.; Lewis, B; Hyde, I.; Conway, N.; Johnson, Alan M.

doi:10.1136/bmj.2.6050.1485

Cited by 21 publications

(4 citation statements)

References 4 publications

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“…An indication of the operative risk in the various categories into which our patients fell may be obtained from a recent review of our surgical results (Ross et al, 1976).…”

Section: Discussionmentioning

confidence: 99%

“…The Wessex Cardio-Thoracic Unit carries out about 350 open-heart procedures annually (Ross et al, 1976). As a regional unit serving a geo-graphically defined area with a population of 2 7 million in the counties of Hampshire, Dorset, Wiltshire, and the Isle of Wight, it provides the opportunity to study a representative group of patients who have been subjected to open-heart surgery.…”

Section: Methodsmentioning

confidence: 99%

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Wessex cardiac surgery follow-up survey: the quality of life after operation

Ross¹,

Diwell²,

Marsh³

et al. 1978

Thorax

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. (1978). Thorax, 33,[3][4][5][6][7][8][9]. Wessex cardiac surgery follow-up survey: the quality of life after operation. Two hundred consecutive adult patients in all diagnostic categories who had undergone open-heart surgery at the Wessex Regional Cardio-Thoracic Centre were assessed for the subsequent 20 months. They were interviewed, using a standard questionnaire, at the time of referral for surgery and at 2, 8, and 20 months after operation. The questionnaire elicited information on physical activity, employment, dependence on others, leisure activities, mood, and sexual relationships. Patients under 21 were excluded, but there was no upper age limit. Sixty-six per cent were over the age of 50, and many who were close to or over retirement age were included.The results show that 20 months after operation 68% of the survivors denied limitation of normal activity compared with a preoperative figure of 12%, and that there had been a corresponding pattern in return to useful employment. Seventy-four per cent of men of employable age were back at work or capable of gainful employment, and 76% of these had returned to their usual jobs. No correlation was found between the time taken to resume work and the patient's age or diagnosis. There was an equally satisfactory trend in female employment in both full-and part-time jobs, amounting to a 16% increase on the preoperative figure.Decreased dependence upon others was readily identified as a significant gain for 73% of patients at the eight-month follow-up. Throughout the subsequent year the favourable trends in employment statistics, use of leisure time, mood, and sexual relationships point to an overall improvement in the quality of life for the majority of patients.

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“…An indication of the operative risk in the various categories into which our patients fell may be obtained from a recent review of our surgical results (Ross et al, 1976).…”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Wessex cardiac surgery follow-up survey: the quality of life after operation

Ross¹,

Diwell²,

Marsh³

et al. 1978

Thorax

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show abstract

“…Greenwood (1968) reported an incidence of 1 in 200 to 400 operations for mitral valve obstruction. The Wessex Cardiothoracic Centre serves a population of 2-7 million people that may be considered to show a representative distribution of cardiac diseases (Ross et al, 1976). In the past 5 years we have seen 7 atrial myxomata and in the same period have performed 502 operations for isolated mitral valve disease on cardiopulmonary bypass.…”

Section: Discussionmentioning

confidence: 99%

Calcified left atrial myxoma with floppy mitral valve.

Sharratt¹,

Grover²,

Monro³

1979

Heart

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SUMMARY A heavily calcified left atrial myxoma in a man aged 53 was diagnosed from the plain chest xray film and confirmed by echocardiography. There was also moderate mitral regurgitation caused by a floppy mitral valve. Before a systemic embolus is considered to have arisen from a floppy mitral valve, echocardiography must be performed.Myxomata of the left atrium usually present with the features of mitral valve obstruction, systemic emboli, or constitutional symptoms (Goodwin, 1963). Mitral regurgitation is a rare presenting feature (Penny et al., 1967). We report the case of a patient who presented with cerebral embolism and the signs of mitral regurgitation, in whom a calcified left atrial myxoma was found by x-ray film and echocardiography. Case reportA 53-year-old man was referred for consideration of mitral valve replacement for mitral regurgitation. He was thought to have had rheumatic fever as a child and mitral murmurs had been present for at least 20 years. He was seen by a physician in 1971 for dyspepsia and was thought to have mitral regurgitation. He was then in sinus rhythm. Three months before admission to this unit he had been admitted elsewhere with a right hemiparesis which was thought to be caused by a cerebral embolus associated with the onset of atrial fibrillation. He had made a complete neurological recovery but complained of dyspnoea on moderate effort.On examination there was atrial fibrillation, all the peripheral pulses were present and normal, blood pressure 140/80 mmHg. The jugular venous pressure and pulse were normal. There was a moderately increased, dynamic, left ventricular impulse palpable at the anterior axillary line. A grade 2/4 apical pansystolic murmur with late crescendo radiated to the axilla. There was a soft short mitral diastolic murmur. The electrocardiogram confirmed atrial fibrillation and showed unifocal ventricular extrasystoles. The chest x-ray film (Fig. 1) showed a calcified mass within the left atrium. A diagnosis of a moderate mitral regurgitation with a calcified left atrial myxoma or thrombus was made. Echocardiography ( Fig. 2a and 2b) suggested mitral valve prolapse and confirmed a dense mass in the left atrium which did not pass through the mitral valve in diastole. The haemoglobin was 15 1 g/dl and the white blood cell count, platelets, and plasma proteins were normal. The ESR was 33 mm in one hour.Operation was performed without further investigation. The left atrium was found to contain a hard smooth, yellowish tumour measuring 5 cm by 2-5 cm. The mass was attached by a short pedicle to the posterior left atrial wall just below and medial to the right inferior pulmonary vein and 2 cm from the mitral valve. It was excised, together with its )8

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“…The avoidance of bank blood primes for the heart-lung machine (Nahas et al, 1965), the use of filters in the bypass circuit (Hill et al, 1970), and the reduction of bank blood usage in the pc--perfusion period (Ross et al, 1976) may be significant in reducing the accumulation of debris in the pulmonary vascular bed, perhaps of particular importance in the presence of pulmonary hypertension.…”

Section: Discussionmentioning

confidence: 99%