Noel L. Mills
Bio: Noel L. Mills is an academic researcher from Tulane University. The author has contributed to research in topics: Artery & Vein. The author has an hindex of 11, co-authored 16 publications receiving 767 citations.
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.
TL;DR: The early return of spontaneous partial erections in patients suggests that interposition nerve grafts may enhance the recovery of erectile function when the neurovascular bundles are resected.
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.
TL;DR: There was a high correlation between balloon-measured atrial septal defects and those measured at necropsy in the animals or at operation in the patients, and these measurements aid in determining whether an ostium secundum defect is of proper size and location to be closed transvenously.
Abstract: The size of experimental and clinical secundum atrial septal defects may be accurately measured during cardiac catheterization. The position of the defects in the septum and their distance from the aortic and mitral valves may also be ascertained. A balloon catheter inflated with radiopaque dye is used for the measurement. The volume of dye in the balloon has been correlated with its maximal diameter. Thus, a no. 8-10 French catheter filled with 10 ml of diatrizoate (50 percent) has a diameter of approximately 25 mm and a no. 8-22 French catheter filled with 40 ml of diatrizoate a diameter of approximately 43 mm. Persistent arrhythmias or other adverse effects of the procedure were not observed. There was a high correlation between balloon-measured atrial septal defects and those measured at necropsy in the animals or at operation in the patients. These measurements aid in determining whether an ostium secundum defect is of proper size and location to be closed transvenously and may also prove valuable in physiologic studies of atrial septal defects or other cardiac anomalies.
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.
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.
2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease: Executive summary: A report of the american college of cardiology foundation/american heart association task force on practice guidelines, american association for thoracic surgery, american college of radiology, american stroke association
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 ...
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.