Concomitant renal artery revascularization and aortic reconstruction in the adult patient

Concomitant renal artery revascularization and aortic reconstruction in the adult patient are thought to be associated with a high degree of morbidity and mortality. This has been attributed to the diffuse nature of atherosclerosis generally present in these patients and, as a consequence, a poor overall medical condition. Although this series confirms the fragile pre-operative nature of these patients it demonstrates that, with careful surgical management, they can be treated effectively.

Microcomputer database and system of audit for the vascular surgeon

We have set up a vascular database based upon an IBM personal computer in the vascular unit at Repatriation General Hospital, Concord, using 'Dataease'. This is commercially available software that allows the development of a database by users with little or no programming knowledge. The database is menu driven and designed to record details of admissions, indications for surgery, operations, complications and follow-up and has been set up as a prospective project from 1 January 1989 after a pilot study in 1988. Currently, interns, residents and registrars enter data directly onto the computer, providing an excellent teaching and review medium. Unit audit is easy as the program is completely menu driven and there are more than 100 customized reports written, ranging from providing simple complication details to complex reports deriving graft cumulative patency rates. This system also provides for 'instant' discharge letters which have markedly improved communication with the general practitioner.

Upper extremity limb salvage accomplished by in situ vein bypass graft

The need for revascularization procedures in individuals with hand ischemia is uncommon. Previous reports describe the successful utilization of reversed saphenous vein to reconstruct the distal vasculature of the arm. This case report details the use of in situ arm vein to restore perfusion to a threatened hand.

Colonization and sepsis from triple-lumen catheters in critically ill patients

Sepsis from central triple-lumen catheters remains a serious and life-threatening problem. Patients requiring triple-lumen catheter placement frequently have multiorgan failure or very serious illness. Every effort should be made to reduce the incidence of catheter-related sepsis. Earlier recognition of catheter sepsis may allow removal of the offending line before sepsis becomes clinically apparent. These data indicate that line colonization occurs early and frequently after triple-lumen catheter placement, and suggests that early, frequent line changes may reduce the incidence of clinical sepsis.