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David R. Hockmuth

Bio: David R. Hockmuth is an academic researcher. The author has contributed to research in topics: Aortic valve replacement & Artery. The author has an hindex of 3, co-authored 5 publications receiving 172 citations.

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Journal ArticleDOI
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

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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

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TL;DR: Myocardial temperature measurements, during the course of more complex operations, are useful in choosing the appropriate technique for myocardial protection.
Abstract: New technical challenges involving the delivery of cardioplegia during the course of coronary artery bypass operation continue to be presented to the surgeon. Functioning saphenous grafts at reoperation that are at risk for distal embolization, are managed by altering the standard cardioplegia delivery techniques. Management of patent internal mammary artery (IMA) grafts depends upon the status of the native circulation and coronary collateral. The reoperation may be performed with a fibrillating heart, standard cardioplegia with a clamped mammary graft, or cardioplegia delivered during simultaneous circulatory arrest. Myocardial temperature measurements, during the course of more complex operations, are useful in choosing the appropriate technique for myocardial protection.

13 citations

Journal ArticleDOI
TL;DR: In this paper , the authors evaluated patient-centered metrics in intermediate-surgical-risk aortic stenosis patients enrolled in the SURTAVI (Surgical Replacement and Transcatheter Aortic Valve Implantation) trial treated with self-expanding transcatheter aortric valve replacement (TAVR) or surgery.
Abstract: This study sought to evaluate patient-centered metrics in intermediate-surgical-risk aortic stenosis patients enrolled in the SURTAVI (Surgical Replacement and Transcatheter Aortic Valve Implantation) trial treated with self-expanding transcatheter aortic valve replacement (TAVR) or surgery.Studies have shown TAVR to be an alternative to surgery in patients with severe symptomatic aortic stenosis but have focused on "hard endpoints," including all-cause mortality and stroke, rather than on comparative patient-centered metrics, such as functional status and symptom burden.The study analyzed functional status (6-minute walk test [6MWT]) and symptom burden (Kansas City Cardiomyopathy Questionnaire) in 1,492 patients from the SURTAVI trial at baseline, 30 days, 1 year, and 2 years. Patients were categorized by baseline functional status into tertiles of slow, medium, and fast walkers.Patients with lowest capacity baseline functional status were commonly women, had higher Society of Thoracic Surgeons scores, and had more New York Heart Association functional class III or IV symptoms; reduced baseline functional status was associated with higher aortic valve- and heart failure-related hospitalization at 2 years. There was greater improvement in 6MWT distance in TAVR compared with surgery patients at 30 days (P < 0.001) and 1 year (P = 0.012), but at 2 years, both groups had similar improvement (P = 0.091). The percentage of patients with large improvement in 6MWT was greatest in patients categorized as slow walkers and lowest in fast walkers. Symptom burden improved after TAVR at 30 days and after both procedures at 1 and 2 years.In this substudy of patients from the SURTAVI trial, patients receiving TAVR demonstrated a more rapid improvement in functional status and symptom burden compared with patients undergoing surgery; however, both groups had similar improvements in long-term follow-up. (Safety and Efficacy Study of the Medtronic CoreValve® System in the Treatment of Severe, Symptomatic Aortic Stenosis in Intermediate Risk Subjects Who Need Aortic Valve Replacement [SURTAVI]; NCT01586910).

5 citations

Journal ArticleDOI
TL;DR: To effect a wider use of arterial conduits for coronary bypass grafts, a number of techniques have been devised to use the internal mammary artery and other arterial grafts as free grafts.
Abstract: The use of free arterial grafts has increased since the late patency of free internal mammary artery grafts was found to approach that of pedicle internal mammary artery grafts. An intensified search for other suitable arterial grafts has resulted in reports on the use of free gastroepiploic artery grafts and free inferior epigastric artery grafts. Free arterial heterografts and free homograft saphenous veins have had very disappointing results in general. The lateral costal artery, when available, offers another possible arterial conduit in approximately 10% of patients. To effect a wider use of arterial conduits for coronary bypass grafts, a number of techniques have been devised to use the internal mammary artery and other arterial grafts as free grafts.

3 citations


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Journal ArticleDOI
TL;DR: The American College of Cardiology and the American Heart Association request that the following format be used when citing this document: Ryan TJ, Antman EM, Brooks NH, Califf RM, Hillis LD, Hiratzka LF, Rapaport E, Riegel B, Russell RO, Smith EE III, Weaver WD.

1,325 citations

Journal ArticleDOI
TL;DR: These guidelines are intended for physicians, nurses, and allied healthcare personnel who care for patients with suspected or established acute myocardial infarction and promote rapid identification and treatment of patients with acute MI.
Abstract: Executive Summary andListing of Recommendations These guidelines are intended for physicians, nurses, and allied healthcare personnel who care for patients with suspected or established acute myocardial infarction (MI) These guidelines have been officially endorsed by the American Society of Echocardiography, the American College of Emergency Physicians, and the American Association of Critical-Care Nurses This executive summary and listing of recommendations appears in the November 1, 1996, issue of Circulation The guidelines in their entirety, including the ACC/AHA Class I, II, and III recommendations, are published in the November 1996 issue of the Journal of the American College of Cardiology Beginning with these guidelines, the full text of ACC/AHA guidelines will be published in one journal and the executive summary and listing of recommendations in the other Reprints of both the full text and the executive summary with its listing of recommendations are available from both organizations Each year 900 000 people in the United States experience acute MI Of these, roughly 225 000 die, including 125 000 who die “in the field” before obtaining medical care Most of these deaths are arrhythmic in etiology Because early reperfusion treatment of patients with acute MI improves left ventricular (LV) systolic function and survival, every effort must be made to minimize prehospital delay Indeed, efforts are ongoing to promote rapid identification and treatment of patients with acute MI, including (1) patient education about the symptoms of acute MI and appropriate actions to take and (2) prompt initial care of the patient by the community emergency medical system In treating the patient with chest pain, emergency medical system personnel must act with a sense of urgency When the patient with suspected acute MI reaches the emergency department (ED), evaluation and initial management should take place promptly, because the benefit of reperfusion therapy is greatest if therapy …

370 citations

Journal ArticleDOI
TL;DR: Endoventricular circular patch plasty associated with coronary grafting and cryotherapy, when indicated, provides surviving patients with significant improvement in cardiac function and can be considered as an alternative to heart transplantation in patients with severe left ventricular dysfunction.

339 citations

Journal ArticleDOI
TL;DR: This article reviews bypass graft disease and highlights important aspects of its prevention and management and identifies particularly informative articles on saphenous vein and arterial grafts and on repeat coronary operation.
Abstract: Purpose: To review saphenous vein graft disease and its prevention and management. Data Sources: A MEDLINE search of articles published on saphenous vein and arterial bypass grafts. Study Selection...

176 citations