Author
J G Mudd
Bio: J G Mudd is an academic researcher. The author has contributed to research in topics: Coronary artery disease & Left Main Coronary Artery Stenosis. The author has an hindex of 4, co-authored 5 publications receiving 1634 citations.
Papers
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TL;DR: It is suggested that aneurysmal coronary disease does not represent a distinct clinical entity but is, rather, a variant of coronary atherosclerosis.
Abstract: To examine the clinical and historical features and the natural history of aneurysmal coronary disease, we reviewed the registry data of the Coronary Artery Surgery Study (CASS). Nine hundred seventy-eight patients, representing 4.9% of the total registry population, were identified as having aneurysmal disease. No significant differences were noted between aneurysmal and nonaneurysmal coronary disease patients when features such as hypertension, diabetes, lipid abnormalities, family history, cigarette consumption, incidence of documented myocardial infarction, presence and severity of angina, and presence of peripheral vascular disease were examined. In addition, no difference in 5-year medical survival was noted between these two groups. These findings suggest that aneurysmal coronary disease does not represent a distinct clinical entity but is, rather, a variant of coronary atherosclerosis.
910 citations
TL;DR: Advanced age, female sex, symptoms of heart failure, LMCA stenosis, impaired left ventricular function and nonelective surgery are associated with a higher OM, and these factors should be considered in the selection of patients for coronary artery surgery.
Abstract: Fifteen institutions participating in the Collaborative Study in Coronary Artery Surgery (CASS) have performed isolated coronary artery bypass surgery upon 6630 patients (1061 women and 5569 men) for coronary artery disease. The overall operative mortality (OM) was 2.3% (range 0.3-6.4%). Mortality increased with age, from 0 in the group 20-29 years old to 7.9% in the group 70 years and older. OM was higher for women in each group, ranging from 2.8% for ages 30-39 years to 12.3% for age 70 years and older (0.8% and 5.8% for men). Clinical manifestations of congestive heart failure were associated with increased OM. Mortality was 1.4% in one-vessel, 2.1% in two-vessel and 2.8% in three-vessel disease (diameter narrowing greater than or equal to 70%). Among 1019 patients with left main coronary artery (LMCA) stenosis, OM ranged from 1.6% in patients with mild stenosis and a right-dominant system to 25% in patients with severe (greater than or equal to 90%) stenosis and left dominance. OM varied with ejection fraction (EF) (1.9% for EF greater than or equal to 50% to 6.7% for EF less than 19%) and left ventricular wall motion score (1.7% for least abnormal to 9.1% for most abnormal). For elective surgery, OM was 1.7%, for urgent surgery 3.5%, and for emergency surgery 10.8%. Mortality was 40.0% among 30 patients with severe LMCA stenosis who underwent emergency revascularization. Advanced age, female sex, symptoms of heart failure, LMCA stenosis, impaired left ventricular function and nonelective surgery are associated with a higher OM. These factors should be considered in the selection of patients for coronary artery surgery.
397 citations
TL;DR: There is a strong association of OM with advanced age, female sex, and variables associated with left ventricular dysfunction, and the risk of OM for an individual patient may be estimated with the use of these clinical and angiographic characteristics predictive of OM.
299 citations
TL;DR: Reliability of angiographic assessment of the left main coronary artery segment was evaluated by review of 106 coronary cineangiograms from the Coronary Artery Surgery Study, finding segments that were unusually short, diffusely diseased, or obscured by overlapping vessels were especially difficult to interpret.
Abstract: Reliability of angiographic assessment of the left main coronary artery segment was evaluated by review of 106 coronary cineangiograms from the Coronary Artery Surgery Study. The films were interpreted by three groups of angiographers: those at a clinical site, those at a quality control site, and those on a study census panel. Among the readings of these three groups, there was 41% to 59% agreement on the severity of the lesion, with 80% agreement on whether the lesion was greater or less than 50%. The severity of lesion, its location, or presence of ectasia or calcium did not affect the discrepancy rate, whereas segments that were unusually short, diffusely diseased, or obscured by overlapping vessels were especially difficult to interpret.
101 citations
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TL;DR: A Report of the American College of Cardiology Foundation/AmericanHeart Association Task Force on Practice Guidelines, and the AmericanCollege of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for CardiovascularAngiography and Interventions, and Society of ThorACic Surgeons
Abstract: Jeffrey L. Anderson, MD, FACC, FAHA, Chair
Jonathan L. Halperin, MD, FACC, FAHA, Chair-Elect
Alice K. Jacobs, MD, FACC, FAHA, Immediate Past Chair 2009–2011 [§§][1]
Sidney C. Smith, Jr, MD, FACC, FAHA, Past Chair 2006–2008 [§§][1]
Cynthia D. Adams, MSN, APRN-BC, FAHA[§§][1]
Nancy M
2,469 citations
2,115 citations
TL;DR: The major areas of change reflected in the update of the ACC/AHA Guidelines for Coronary Artery Bypass Graft Surgery are described in a format that can be read and understood as a stand-alone document.
1,805 citations
TL;DR: In this community-based cohort, the incidence ofheart failure has not declined during 2 decades, but survival after onset of heart failure has increased overall, with less improvement among women and elderly persons.
Abstract: ContextThe epidemic of heart failure has yet to be fully investigated, and
data on incidence, survival, and sex-specific temporal trends in community-based
populations are limited.ObjectiveTo test the hypothesis that the incidence of heart failure has declined
and survival after heart failure diagnosis has improved over time but that
secular trends have diverged by sex.Design, Setting, and ParticipantsPopulation-based cohort study using the resources of the Rochester Epidemiology
Project conducted in Olmsted County, Minnesota. Patients were 4537 Olmsted
County residents (57% women; mean [SD] age, 74 [14] years) with a diagnosis
of heart failure between 1979 and 2000. Framingham criteria and clinical criteria
were used to validate the diagnosisMain Outcome MeasuresIncidence of heart failure and survival after heart failure diagnosis.ResultsThe incidence of heart failure was higher among men (378/100 000
persons; 95% confidence interval [CI], 361-395 for men; 289/100 000 persons;
95% CI, 277-300 for women) and did not change over time among men or women.
After a mean follow-up of 4.2 years (range, 0-23.8 years), 3347 deaths occurred,
including 1930 among women and 1417 among men. Survival after heart failure
diagnosis was worse among men than women (relative risk, 1.33; 95% CI, 1.24-1.43)
but overall improved over time (5-year age-adjusted survival, 43% in 1979-1984
vs 52% in 1996-2000, P<.001). However, men and
younger persons experienced larger survival gains, contrasting with less or
no improvement for women and elderly persons.ConclusionIn this community-based cohort, the incidence of heart failure has not
declined during 2 decades, but survival after onset of heart failure has increased
overall, with less improvement among women and elderly persons.
1,474 citations
TL;DR: Acute renal failure was independently associated with early mortality following cardiac surgery, even after adjustment for comorbidity and postoperative complications.
1,201 citations