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Charles T. Everson

Bio: Charles T. Everson is an academic researcher from Duke University. The author has contributed to research in topics: Artery & Vein. The author has an hindex of 8, co-authored 10 publications receiving 633 citations.

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Journal ArticleDOI
TL;DR: Analysis of 1735 patients who underwent coronary artery bypass grafting from January 1981 through December 1988 revealed 152 patients with mild, moderate, or severe atherosclerosis of the ascending aorta, a inordinately high incidence of main left coronary disease, significant carotid disease, and abdominal aortic occlusive or aneurysm disease.

242 citations

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TL;DR: Experience with repair of 61 left ventricular aneurysms at West Jefferson Medical Center over a 4 1/2-year period with a 3.3% mortality rate has prompted a change from the standard linear repair to routine use of a modified endoventricular repair.

86 citations

Journal ArticleDOI
TL;DR: Attention is now being turned to the hypercoagulable state as a cause of graft failure, as this has not been previously addressed.
Abstract: Saphenous vein graft failure is one of the primary reasons for coronary artery bypass reoperation. The economic impact alone in this country is staggering in an era of intensive cost cutting. The fact that some vein grafts remain free of disease for years while the sibling vein develops extensive atherosclerosis remains an enigma. Saphenous vein valves have recently attracted interest. Repeated angiograms show that vein graft disease invariably is accentuated around valves. Studies show that the segment of saphenous vein distal to the valves have more accelerated and intense atherosclerosis. Early results of saphenous vein bypass grafting may be predicted with some degree of certainty by saphenous vein graft biopsy. Attention is now being turned to the hypercoagulable state as a cause of graft failure, as this has not been previously addressed. Research into pharmacologic agents for maintaining open grafts has had disappointing results and aspirin alone is still the single drug of choice to promote patency. Preparation of the graft continues to be important because there is direct evidence that surgical injury during preparation leads to neointimal thickening and vascular smooth muscle proliferation. Although there are some exciting new modalities for preventing graft disease, the difficulty in transposing animal data to humans and the uncertainty of the biologic similarities of in vitro and in vivo endothelial cell biochemistry makes any immediate solution unlikely. Therefore an even greater increase in the use of arterial grafts in the near future seems likely, even with their associated problems.

73 citations

Journal ArticleDOI
TL;DR: This study shows that distal right gastroepiploic artery sizes are comparable with sizes of target coronary arteries, however, neither flow nor size is as consistent when compared with internal thoracic artery grafts.

71 citations

Journal ArticleDOI
TL;DR: It is suggested that enflurane administered prior to an ischemic interval enhances postischemic myocardial recovery and may act as aMyocardial protective agent during ischemia.
Abstract: Enflurane is a direct myocardial depressant and may act as a myocardial protective agent during ischemia. The authors studied the effects of enflurane on myocardial high-energy phosphates and tolerance to ischemia in the normothermic, isolated rat heart. After isolation and perfusion with Krebs-Henseleit buffer, the hearts were perfused with either buffer (control) or buffer gassed with 2% enflurane for 10 minutes. Thereafter, hearts were made globally ischemic and elapsed times to initiation of ischemic contracture (IC) were determined. ATP and creatine phosphate (CP) were measured at the conclusion of control and enflurane administration and at IC. Ten hearts per group were reperfused with buffer following IC for 20 min; peak pressure and ATP and CP were determined. Administration of 2% enflurane significantly decreased peak pressure by 20% but did not alter baseline high-energy phosphate levels nor did it prolong time to IC. However, enflurane-treated hearts exhibited significantly greater (P less than 0.01) recovery of function as defined by per cent return of peak pressure (67% +/- 3%) when compared with those hearts not treated with enflurane preischemically (44% +/- 5%). Also, enflurane-treated hearts had significantly higher (P less than 0.01) ATP levels at the conclusion of reperfusion than hearts not perfused with enflurane (12.2 +/- .8 mumol/g dry weight vs. 9.0 +/- 0.8 mumol/g dry weight). These findings suggest that enflurane administered prior to an ischemic interval enhances postischemic myocardial recovery.

67 citations


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TL;DR: A multicenter study to determine the incidence and predictors of — and the use of resources associated with — perioperative adverse neurologic events, including cerebral injury, found patients with adverse cerebral outcomes had higher in-hospital mortality.
Abstract: Background Acute changes in cerebral function after elective coronary bypass surgery are a difficult clinical problem. We carried out a multicenter study to determine the incidence and predictors of — and the use of resources associated with — perioperative adverse neurologic events, including cerebral injury. Methods In a prospective study, we evaluated 2108 patients from 24 U.S. institutions for two general categories of neurologic outcome: type I (focal injury, or stupor or coma at discharge) and type II (deterioration in intellectual function, memory deficit, or seizures). Results Adverse cerebral outcomes occurred in 129 patients (6.1 percent). A total of 3.1 percent had type I neurologic outcomes (8 died of cerebral injury, 55 had nonfatal strokes, 2 had transient ischemic attacks, and 1 had stupor), and 3.0 percent had type II outcomes (55 had deterioration of intellectual function and 8 had seizures). Patients with adverse cerebral outcomes had higher in-hospital mortality (21 percent of patients ...

1,728 citations