B. G. Sileshi

Learn More
Since ancient times we have attempted to facilitate hemostasis by application of topical agents. In the last decade, the number of different effective hemostatic agents has increased drastically. In order for the modern surgeon to successfully choose the right agent at the right time, it is essential to understand the mechanism of action, efficacy and(More)
Achieving intraoperative hemostasis is essential for excellent surgical outcomes. A variety of methods, ranging from mechanical tools and energy-based technologies to topical hemostatic agents, are available to the modern surgeon. Given that bleeding develops from different origins, from small discrete bleeding or venous oozing to arterial hemorrhage,(More)
BACKGROUND Aneurysms of the transverse aortic arch, especially those involving the mid to distal arch, are technically challenging to repair with conventional open techniques. We present our results with a combined open/endovascular approach ("hybrid repair") in such patients. METHODS From August 11, 2005, to September 18, 2008, 28 patients underwent(More)
Intraoperative control of bleeding during any surgical procedure is vital for achieving a positive patient outcome. Hemostasis can be achieved through practical and effective systemic or topical approaches. A variety of hemostatic methods can be employed, ranging from simple manual pressure application with one finger to electrical tissue cauterization,(More)
Stroke is the third leading cause of death and long-term disability in the USA. Currently, surgical intervention decisions in asymptomatic patients are based upon the degree of carotid artery stenosis. While there is a clear benefit of endarterectomy for patients with severe (> 70%) stenosis, in those with high/moderate (50-69%) stenosis the evidence is(More)
Implantable and extracorporeal cardiovascular devices are commonly made from titanium (Ti) (e.g. Ti-coated Nitinol stents and mechanical circulatory assist devices). Endothelializing the blood-contacting Ti surfaces of these devices would provide them with an antithrombogenic coating that mimics the native lining of blood vessels and the heart. We evaluated(More)
Clinicians are faced with the challenge of navigating the precarious balance between bleeding and clotting. Bleeding disorders or failure to obtain adequate hemostasis during surgery may lead to severe hemorrhage. However, if thrombotic complications occur (eg, thromboembolic stroke), they may be far more difficult to treat. To achieve a stable equilibrium(More)
To effectively balance bleeding and clotting in surgical patients, the surgeon needs a fundamental knowledge of coagulation biology. The endothelium and activated platelets play crucial roles in coagulation. Activated platelets and damaged endothelial cells provide a platform of negatively charged phospholipids that not only bind coagulation factors and(More)
BACKGROUND Minimally invasive left thoracotomy (MILT) and off-pump implantation strategies have been anecdotally reported for implantation of the HeartWare ventricular assist device (HVAD). We analyzed our experience with off-pump MILT implantation techniques and compared early in-hospital outcomes with conventional on-pump sternotomy (CS) implantation(More)
BACKGROUND Perioperative mortality rate is regarded as a credible quality and safety indicator of perioperative care, but its documentation in low- and middle-income countries is poor. We developed and tested an electronic, provider report-driven method in an East African country. METHODS We deployed a data collection tool in a Kenyan tertiary referral(More)