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1.  Surgical treatment of cor triatriatum in a 4½-month-old infant 1 
Thorax  1973;28(2):242-246.
Successful correction of cor triatriatum in a 4½-month-old infant is presented. Altogether six patients with cor triatriatum underwent surgical correction during the last eight years. All but one survived the operation. The clinical features and the surgical treatment are discussed.
PMCID: PMC470022  PMID: 4731121
2.  Coronary artery bypass surgery: current practice in the United Kingdom. 
Thorax  1989;44(9):721-724.
A survey of current clinical practice was carried out among the 84 consultant cardiac surgeons currently performing coronary artery bypass surgery in the United Kingdom. The 80 surgeons who returned the questionnaire performed an estimated total of 17,100 coronary artery bypass graft operations in 1987, a mean case load of 214 operations each. Sixty two of the 80 surgeons regarded the internal mammary artery as the graft conduit of choice, and seven preferred the saphenous vein. The internal mammary artery was used in 73% of bypass grafts to the left anterior descending coronary artery but in only 4% of grafts to the circumflex and right coronary systems. Contraindications to the use of the internal mammary artery included advanced age of the patient (51 surgeons), insufficient flow through the internal mammary artery (49), and endarterectomy (35). Seventy four of the 80 surgeons considered intraoperative damage to the saphenous vein to be a possible cause of vein graft failure, but there was no agreement about how it should be reduced. All surgeons advocated pharmacological measures to enhance graft patency. Dipyridamole and aspirin constituted the most popular regimen (58 surgeons), though only 28 started dipyridamole preoperatively. Warfarin was prescribed postoperatively on occasion by 22 surgeons, but 14 of these used it only after endarterectomy.
PMCID: PMC462052  PMID: 2588208
3.  Fascia lata aortic valve reconstruction: long-term results in 33 patients 
Thorax  1971;26(4):388-391.
Aortic valve reconstruction with autologous fascia lata was performed in 33 patients (mean age 35 years) in 1966 and 1967. Eighty-two per cent had cusp extension rather than replacement, while 33% required additional intracardiac procedures. There were seven hospital deaths (21%) and 11 late deaths (33%), a total mortality of 54% over four years. Six late deaths followed reoperation for recurrent incompetence, and two other patients survived reoperation. Endocarditis (rickettsial, fungal, and bacterial) occurred in five cases, all required reoperation for incompetence, and four died. Sixty-nine per cent of the survivors of operation left hospital with competent valves and did better than the 31% with leaking valves in terms of late deaths, endocarditis, and reoperation for incompetence. Of the 15 patients (45%) still alive, 13 still have their original fascial valve, and of these only two (or perhaps three) have no diastolic murmur. Seven have insignificant murmurs and three have aortic incompetence. These poor results, particularly in the long term, make us sceptical about current enthusiasm for fascia lata heart valves.
PMCID: PMC472315  PMID: 5109420
4.  Stress Ulcers in the Stomach 
British Medical Journal  1959;2(5163):1362-1360.4.
PMCID: PMC1990934  PMID: 13804091
5.  Comparative study of leg wound skin closure in coronary artery bypass graft operations. 
Thorax  1984;39(12):942-945.
A prospective randomised study of four different methods of leg wound skin closure after removal of the long saphenous vein was carried out in 113 patients undergoing coronary artery bypass grafting. These methods were: (1) continuous nylon vertical mattress suture (27 patients); (2) continuous subcuticular absorbable (Dexon) suture (29 patients); (3) metal skin staples (Autosuture) (27 patients); and (4) adhesive sutureless skin closure ("Op-site") (30 patients). All wounds were examined by two independent observers at five, 10, and 45 days after operation. At five days, inflammation, extent of oedema, discharge, and infection were assessed. At 10 days attention was paid to the state of wound healing and at 45 days to the final cosmetic appearance. The use of continuous subcuticular suture resulted in significantly less discharge than did the use of metal staples, nylon vertical mattress suture, or Op-site. The incidence of established wound infection was 4.5% overall, with no infection in the wounds closed with Dexon. Assessment of the healing process showed subcuticular Dexon to be more effective than metal staples or vertical mattress nylon suture. The final cosmetic result showed continuous subcuticular suture to be superior to nylon vertical mattress suture and skin staples but as effective as Op-site sutureless skin closure.
PMCID: PMC459958  PMID: 6096982

Results 1-5 (5)