Troy Downing

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The presence of unrecognized partial anomalous pulmonary venous connection may cause complications of pulmonary infarction and right-to-left shunting in patients undergoing the modified Fontan procedure. These complications can be prevented by identification of any anomalous pulmonary venous connection at preoperative cardiac catheterization.
Six to thirty percent of right ventricular-to-pulmonary arterial (RV-PA) valved conduits in children fail within 5 years. Experience with correction of tetralogy of Fallot has shown that a competent pulmonary valve is not essential for excellent late results in most patients. Between March 1980 and November 1984, 26 patients who were 12.5 +/- 3.3 years old(More)
Tissue-valved prosthetic extracardiac conduits fail in 6% to 30% of patients within 5 years of implantation. Failure is caused both by valve degeneration and by conduit peel formation. This report describes a technique, performed in 16 children, in which an obstructed right ventricle-to-pulmonary artery valved conduit was removed and a new conduit(More)
Intra-aortic balloon pump counterpulsation required as an adjunct during weaning from cardiopulmonary bypass or for circulatory support in the immediate postoperative period was analyzed in 2,498 patients undergoing valve replacement between December, 1972, and September, 1981. A total of 140 successful insertions were performed in 155 attempts. Ninety-five(More)
In an effort to shorten the hospital stay after implantation of a permanent cardiac pacemaker, some physicians have begun performing pacemaker implantation on an ambulatory basis. To assess the potential safety of shortening the duration of hospitalization after pacemaker implantation, we reviewed the complications that occurred in 100 consecutive patients(More)
Although surgeons and anesthesiologists are constantly warned of the danger of hypokalemia following mechanical bowel preparations during the peri- and intraoperative periods, the amount and significance of this problem have not been quantitated. Therefore, the magnitude of the potassium (K+) depletion resulting from three to four days of mechanical bowel(More)
During a 7-year period, intraaortic balloon pumping (IABP) was attempted in 319 cardiac surgical patients. The indications for IABP were stringent and consisted of unsuccessful discontinuation of cardiopulmonary bypass (39%), anticipated failure (40%) to wean from cardiopulmonary bypass, postoperative low cardiac output, or intractable ventricular(More)