Mark Hochberg, M.D.

The professionalism curriculum as a cultural change agent in surgical residency education
Hochberg MS; Berman RS; Kalet AL; Zabar SR; Gillespie C; Pachter HL
2011 Jan;203(1):14-20, American journal of surgery
BACKGROUND: Teaching professionalism effectively to fully engaged residents is a significant challenge. A key question is whether the integration of professionalism into residency education leads to a change in resident culture. METHODS: The goal of this study was to assess whether professionalism has taken root in the surgical resident culture 3 years after implementing our professionalism curriculum. Evidence was derived from 3 studies: (1) annual self-assessments of the residents' perceived professionalism abilities to perform 20 defined tasks representing core Accrediting Council on Graduate Medical Education professionalism domains, (2) objective metrics of their demonstrated professionalism skills as rated by standardized patients annually using the objective structure clinical examination tool, and (3) a national survey of the Surgical Professionalism and Interpersonal Communications Education Study Group. RESULTS: Study 1: aggregate perceived professionalism among surgical residents shows a statistically significant positive trend over time (P = .016). Improvements were seen in all 6 domains: accountability, ethics, altruism, excellence, patient sensitivity, and respect. Study 2: the cohort of residents followed up over 3 years showed a marked improvement in their professionalism skills as rated by standardized patients using the objective structure clinical examination tool. Study 3: 41 members of the national Surgical Professionalism and Interpersonal Communications Education Study Group rated their residents' skills in admitting mistakes, delivering bad news, communication, interdisciplinary respect, cultural competence, and handling stress. Twenty-nine of the 41 responses rated their residents as 'slightly better' or 'much better' compared with 5 years ago (P = .001). Thirty-four of the 41 programs characterized their department's leadership view toward professionalism as 'much better' compared with 5 years ago. CONCLUSIONS: All 3 assessment methods suggest that residents feel increasingly prepared to effectively deal with the professionalism challenges they face. Although professionalism seminars may have seemed like an oddity several years ago, residents today recognize their importance and value their professionalism skills. As importantly, department chairpersons report that formal professionalism education for residents is viewed more favorably compared with 5 years ago
— id: 141463, year: 2011, vol: 203, page: 14, stat: Journal Article,

More thoughts about residents' professionalism education in malpractice
Hochberg, Mark S; Kalet, Adina L; Zabar, Sondra R
2011 Oct;86(10):1192-1193, Academic medicine
— id: 137896, year: 2011, vol: 86, page: 1192, stat: Journal Article,

Perspective: Malpractice in an academic medical center: a frequently overlooked aspect of professionalism education
Hochberg, Mark S; Seib, Carolyn D; Berman, Russell S; Kalet, Adina L; Zabar, Sondra R; Pachter, H Leon
2011 Mar;86(3):365-368, Academic medicine
Understanding how medical malpractice occurs and is resolved is important to improving patient safety and preserving the viability of a physician's career in academic medicine. Every physician is likely to be sued by a patient, and how the physician responds can change his or her professional life. However, the principles of medical malpractice are rarely taught or addressed during residency training. In fact, many faculty at academic medical centers know little about malpractice.In this article, the authors propose that information about the inciting causes of malpractice claims and their resolution should be incorporated into residency professionalism curricula both to improve patient safety and to decrease physician anxiety about a crucial aspect of medicine that is not well understood. The authors provide information on national trends in malpractice litigation and residents' understanding of malpractice, then share the results of their in-depth review of surgical malpractice claims filed during 2001-2008 against their academic medical center. The authors incorporated those data into an evidence-driven curriculum for residents, which they propose as a model for helping residents better understand the events that lead to malpractice litigation, as well as its process and prevention
— id: 129319, year: 2011, vol: 86, page: 365, stat: Journal Article,

Can professionalism be taught? Encouraging evidence
Hochberg, Mark S; Kalet, Adina; Zabar, Sondra; Kachur, Elizabeth; Gillespie, Colleen; Berman, Russell S
2010 Jan;199(1):86-93, American journal of surgery
BACKGROUND: Teaching and assessing the Accreditation Council for Graduate Medical Education (ACGME) competencies of Professionalism and Communication have proven to be a challenge for surgical residency training programs. This study used innovative pedagogic approaches and tools in teaching these two competencies. The purpose of this study was to determine whether the learners actually are assimilating and using the concepts and values communicated through this curriculum. METHODS: A six-station Objective Structured Clinical Examination (OSCE) was designed using standardized patients to create varying Professionalism and Communication scenarios. The surgical resident learners were evaluated using these OSCEs as a baseline. The faculty then facilitated a specially designed curriculum consisting of six interactive sessions focusing on information gathering, rapport building, patient education, delivering bad news, responding to emotion, and interdisciplinary respect. At the conclusion of this curriculum, the surgical resident learners took the same six-station OSCE to determine if their professionalism and communication skills had improved. RESULTS: The surgical resident learners were rated by the standardized patients according to a strict task checklist of criteria at both the precurricular and postcurricular OSCEs. Improvement in the competencies of Professionalism and Communication did achieve statistical significance (P = .029 and P = .011, respectively). CONCLUSIONS: This study suggests that the Communication and Professionalism ACGME competencies can be taught to surgical resident learners through a carefully crafted curriculum. Furthermore, these newly learned competencies can affect surgical resident interactions with their patients positively
— id: 106382, year: 2010, vol: 199, page: 86, stat: Journal Article,

The timing of surgery for cholecystitis: a review of 202 consecutive patients at a large municipal hospital
Lee, Ann Y; Carter, Joseph J; Hochberg, Mark S; Stone, Alex M; Cohen, Stuart L; Pachter, H Leon
2008 Apr;195(4):467-470, American journal of surgery
BACKGROUND: Traditionally, cholecystectomy for cholecystitis is performed within 3 days of the onset of symptoms or after 5 weeks, allowing for resolution of the inflammatory response. This study reviewed the outcomes of cholecystectomy performed for patients with gallstone disease in the acute (n = 45), intermediate (n = 55), and delayed (n = 102) periods after the onset of symptoms. METHODS: The medical records of 202 patients who underwent laparoscopic cholecystectomy at a large municipal hospital were reviewed retrospectively. The primary outcomes studied were length of hospital stay, conversion to open cholecystectomy, and complications. RESULTS: There was no significant difference in the conversion rate (acute [18%] vs intermediate [20%] vs delayed [11%]) or complication rate (acute [16%] vs intermediate [9%] vs delayed [7%]) among the 3 groups. The delayed group had a significantly shorter length of hospital stay than the intermediate or acute group (3.1 +/- 3.8 vs 4.3 +/- 3.8 vs 1.7 +/- 2.1, respectively, P < .001). CONCLUSIONS: Patients who present with acute symptoms of cholecystitis should undergo surgery during the same admission, regardless of the duration of symptoms
— id: 76770, year: 2008, vol: 195, page: 467, stat: Journal Article,

Preliminary evaluation of the Web Initiative for Surgical Education (WISE-MD)
Kalet, Adina L; Coady, Sarah H; Hopkins, Mary Ann; Hochberg, Marc S; Riles, Thomas S
2007 Jul;194(1):89-93, American journal of surgery
BACKGROUND: Major changes in health care delivery and financing have negatively impacted students' experience during the surgery clerkship, particularly their exposure to physicians' decision-making processes and to the continuity of patient care. In response to these dilemmas in surgical education, we have developed the Web Initiative for Surgical Education (WISE-MD), a comprehensive surgery clerkship curriculum delivered through multimedia teaching modules and designed to enhance exposure to surgical disease and clinical reasoning. METHODS: As part of the process of creating WISE-MD, we conducted preliminary studies to assess the impact of this computer-assisted approach on students' knowledge, clinical reasoning, and satisfaction. RESULTS: Compared to students who did not view the modules, early data show a trend toward improved knowledge and an improvement in clinical reasoning for students who used the WISE-MD modules. This effect was specific to the clinical content area addressed in the module seen by the students. Most students felt the module was superior to traditional teaching methods and enhanced their understanding of surgical technique and anatomy. CONCLUSIONS: WISE-MD, a theory-driven example of a concerted technology-based approach to surgical education, has the potential to address the myriad problems of today's clinical learning environment.
— id: 73032, year: 2007, vol: 194, page: 89, stat: Journal Article,

Early emergent coronary bypass after failed angioplasty
Hochberg MS; Gregory JJ Jr; McCullough J; Gielchinsky I; Hussain SM; Fuzesi L; Parsonnet V
1993 May;90(5):385-391, New Jersey medicine
Emergency CABG for failed coronary angioplasty was required in 3.3 percent of 1,625 consecutive patients undergoing angioplasties. Twenty-six percent of the patients died in the perioperative period. Efforts must be concentrated on identifying PTCA failure prior to cardiogenic shock
— id: 67168, year: 1993, vol: 90, page: 385, stat: Journal Article,

Early emergent coronary bypass after failed angioplasty
Hochberg, M S; Gregory, J J Jr; McCullough, J; Gielchinsky, I; Hussain, S M; Fuzesi, L; Parsonnet, V
1993 Dec;65(12):775-781, Delaware medical journal
Emergency CABG for failed coronary angioplasty was required in 3.3 percent of 1,625 consecutive patients undergoing angioplasties. Twenty-six percent of the patients died in the perioperative period. Efforts must be concentrated on identifying PTCA failure prior to cardiogenic shock
— id: 70015, year: 1993, vol: 65, page: 775, stat: Journal Article,

Epidermolysis bullosa. A case report
Hochberg, M S; Vazquez-Santiago, I A; Sher, M
1993 Jan;75(1):54-57, Oral surgery, oral medicine, & oral pathology
Epidermolysis bullosa is a group of rare genetic-related skin disorders. It is characterized by bullae and vesicles on the skin and mucosa, that result from friction, trauma, or heat. This article reports a case of Epidermolysis bullosa. With proper diagnosis, the dentist can treat a patient with this type of disorder without causing bullae as a result of treatment
— id: 70016, year: 1993, vol: 75, page: 54, stat: Journal Article,

Coronary angioplasty versus coronary bypass. Three-year follow-up of a matched series of 250 patients
Hochberg MS; Gielchinsky I; Parsonnet V; Hussain SM; Mirsky E; Fisch D
1989 Apr;97(4):496-503, Journal of thoracic & cardiovascular surgery
Two hundred fifty consecutive patients treated for one or two vessel coronary artery disease with either balloon angioplasty or surgical bypass were monitored for 3 years in a study designed to determine the comparative long-term effectiveness of each treatment. The 125 patients having angioplasty were matched with the 125 patients having bypass, so that both groups had a similar number of patients with single or double vessel disease. The two groups did not significantly differ in age, male:female ratio, New York Heart Association class, or risk factors. The ejection fraction was 54 +/- 11 in the angioplasty group and 49 +/- 12 mmHg in the surgical patients (p = 0.0031). Angioplasty was deemed initially successful in 88% (110/125), unsuccessful in 10% (12/125), and in 2% (3/125) the lesion could not be crossed. Emergency bypass was performed in 10% (12/125). Four of the 125 angioplasty patients (3%) died within 30 days. Coronary artery bypass grafting was successfully performed on the matched set of surgical patients with 99% (124/125) discharged well. There was one (1%, 1/125) surgical death. The average hospital stay per patient was 4.8 +/- 3.1 days for angioplasty and 12.1 +/- 4.2 days for bypass grafting (p = 0.0000). Three-year postprocedure follow-up was obtained on 96% (236) of the 245 patients discharged alive. A second angioplasty was required in 18%, and 11 angioplasty patients subsequently required surgical bypass. Overall, 19% (23/121) of the angioplasty patients ultimately required bypass. Four late deaths occurred in the angioplasty group, which brought the early and late mortality rates to 7% (8/121). There were two late surgical deaths, which brought the combined surgical mortality to 2.5% (3/120), p = 0.1263. Patient evaluation reveals that 63% (76/121) of the angioplasty group are alive and in New York Heart Association class I or II 3 years after one or two angioplasty procedures. This figure compares with 92% (110/120) of surgical patients alive and in the same two New York Heart Association classes (p = 0.0000)
— id: 67169, year: 1989, vol: 97, page: 496, stat: Journal Article,

The changing character of coronary artery bypass grafting
Hochberg MS; Gielchinsky I; Parsonnet V; Hussain SM; Fisch D
1988 Mar;85(3):215-220, New Jersey medicine
— id: 67170, year: 1988, vol: 85, page: 215, stat: Journal Article,

Rationale for coronary venous bypass grafting in patients with diffuse coronary artery disease
Hochberg MS
1987 Jun;21(3):200-203, Medical instrumentation
— id: 67171, year: 1987, vol: 21, page: 200, stat: Journal Article,

Pulmonary inactivation of vasopressors following cardiac operations
Hochberg MS; Gielchinsky I; Parsonnet V; Hussain SM; Fisch D
1986 Feb;41(2):200-203, Annals of thoracic surgery
Vasoactive drugs were infused through catheters in the right atrium and then the left atrium of 34 patients who required either vasopressor or vasodilator support following cardiac operation to determine if the route of infusion affected the aortic blood concentration of these agents. Drugs were given through the right atrium for one hour and then the left atrium for an hour. Both central aortic and pulmonary arterial blood were assayed for drug concentrations, and hemodynamic measurements were made. Sixteen patients receiving dopamine hydrochloride through the left atrium had a 36 +/- 12% (+/- standard error of the mean) increase in aortic concentration of the drug (p less than 0.005) and a 37 +/- 14% increase in cardiac index (p less than 0.005) compared with administration through the right atrium. Seven patients receiving epinephrine showed a 59 +/- 21% increase in aortic concentration (p less than 0.05) and a 21 +/- 10% increase in cardiac index (p greater than 0.05, not significant). Eleven patients receiving sodium nitroprusside achieved a 99 +/- 25% increase in aortic concentration (p less than 0.005) and a 20 +/- 7% increase in cardiac index (p less than 0.05). In all instances, significantly higher central aortic blood concentrations were achieved during left atrial (LA) versus right atrial (RA) infusions. Changes in blood concentration of the drug between the pulmonary artery and the aorta during RA infusion suggest removal or inactivation of these drugs in the pulmonary vasculature.(ABSTRACT TRUNCATED AT 250 WORDS)
— id: 67172, year: 1986, vol: 41, page: 200, stat: Journal Article,

Atheroemboli complicating the pre- and postoperative course of aortocoronary bypass (the trash heart): case report with comment
Parsonnet V; Norman JC; Bhatti M; Gielchinsky I; Hochberg MS; Hussain SM
1985 Mar;12(1):87-91, Texas Heart Institute journal
A fatal instance of myocardial atheroembolization is described. Analysis suggests two and perhaps three separate episodes of embolization: the first occurred spontaneously about 2 weeks before admission, the second occurred intraoperatively, and it is possible that a third occurred immediately postoperatively. Intraoperative manipulations were additive to the earlier episode of spontaneous embolization. The descriptive terminology, 'trash heart,' is suggested. Operative techniques to prevent embolization are discussed
— id: 67173, year: 1985, vol: 12, page: 87, stat: Journal Article,

Timing of coronary revascularization after acute myocardial infarction. Early and late results in patients revascularized within seven weeks
Hochberg MS; Parsonnet V; Gielchinsky I; Hussain SM; Fisch DA; Norman JC
1984 Dec;88(6):914-921, Journal of thoracic & cardiovascular surgery
Evidence of ischemia after acute myocardial infarction is a serious complication. If angiography reveals significant coronary artery disease, the precise timing of myocardial revascularization may be of critical importance. From 1978 through 1982, 174 patients underwent myocardial revascularization within 7 weeks of a documented myocardial infarction. The male:female ratio was 138:36, the average age was 58 +/- 1 (SEM) years; and the ejection fractions averaged 41% +/- 1%. Forty-four (25%) patients required preoperative intra-aortic balloon pump support, and an additional 18 (10%) required intra-aortic balloon pumping to be separated from cardiopulmonary bypass. An average of 2.9 +/- 0.1 vessels per patient were bypassed. The hospital mortality for these 174 patients was 16%. When mortalities were categorized according to the postinfarction week in which operation was performed, hospital mortality fell from 46% for those patients operated upon within 1 week of infarction to 6% for those patients operated upon 7 weeks after infarction. Of those patients operated upon within the first week after infarction, 23% were in cardiogenic shock and 62% required preoperative balloon pumping. Clearly the most critically ill patients were operated upon during the early postinfarction period. However, there was a marked difference in survival when patients in each of the seven weekly groups were classified according to ejection fraction. All patients with an ejection fraction greater than or equal to 50% (50 patients) operated upon at any time after infarction survived their hospital course, with only one late death. Conversely, among the 124 patients with an ejection fraction less than 50% operated upon during this 7 week interval, there were 27 (22%) hospital deaths. In this latter group, survival rates steadily improved if revascularization was performed at a time more remote from the infarction. The difference in early and late survival rates of patients operated upon with an ejection fraction greater than or equal to 50% compared to patients with an ejection fraction less than 50% is highly significant (p less than 0.001). We conclude that myocardial revascularization is safe at any time after myocardial infarction for those individuals with an ejection fraction greater than or equal to 50%. However, if the ejection fraction is less than 50%, then operation after myocardial infarction should be delayed at least 4 weeks
— id: 67174, year: 1984, vol: 88, page: 914, stat: Journal Article,

Coronary artery bypass grafting in patients with ejection fractions below forty percent. Early and late results in 466 patients
Hochberg MS; Parsonnet V; Gielchinsky I; Hussain SM
1983 Oct;86(4):519-527, Journal of thoracic & cardiovascular surgery
The outcome of patients undergoing coronary artery bypass grafting with preoperative ejection fractions below 40% was evaluated to determine if a specific level of ventricular dysfunction resulted in unacceptably poor short-term or long-term survival rates. Left ventricular ejection fractions were segregated into groups of five percentage points each starting from 35% to 39% and progressing down to 10% to 14%. In evaluating the six ejection fraction groups between 10% and 39%, we found no significant differences among them with regard to previous myocardial infarctions, left ventricular end-diastolic pressure (LVEDP), age, preoperative New York Heart Association (NYHA) class, or number of vessels bypassed. Eighty-four percent were men and 16% women. From 1976 through 1982, 466 patients were distributed among these groups, all having ejection fractions below 40% (mean 30% +/- 3% SEM). There were significant differences (p = 0.001) in both the hospital and long-term survival (36 months) of patients with preoperative ejection fractions from 20% to 39% (425 patients) as compared to those with preoperative ejection fractions from 10% to 19% (41 patients). Hospital survival rate was 89% for patients with ejection fractions from 20% to 39% but only 63% for patients with ejection fractions below 20%. Similarly, at 3 years, patients with ejection fractions of 20% to 39% had an average survival rate of 60% as compared to an average survival rate of 15% for those with ejection fractions below 20%. Neither the preoperative LVEDP nor the intraoperative ischemic arrest time significantly predicted survival. In all survivors, NYHA class decreased from an average of 3.00 to 1.25 in surviving patients following bypass at a mean follow-up of 29 +/- 5 months. It is concluded that ejection fraction is an excellent predictor of short-term and long-term survival following coronary artery bypass grafting. Patients with ejection fractions of 10% to 19% have a significantly reduced short-term and long-term survival rate as compared to patients with ejection fractions of 20% or more
— id: 67175, year: 1983, vol: 86, page: 519, stat: Journal Article,

Isolated coronary artery bypass grafting in patients seventy years of age and older: early and late results
Hochberg MS; Levine FH; Daggett WM; Akins CW; Austen WG; Buckley MJ
1982 Aug;84(2):219-223, Journal of thoracic & cardiovascular surgery
Increasing longevity makes the consideration of coronary bypass common in elderly patients. Seventy-five patients 70 years of age or older undergoing coronary artery bypass grafting (CABG) for angina pectoris were compared to a control group of 75 patients under 70 years of age. The groups were matched for male:female ratio (46:29), previous infarction (28/75), unstable angina (27/75), and the requirement for preoperative intra-aortic balloon pumping (7/75). Patients under 70 years of age had an average preoperative New York Heart Association (NYHA) class of 3.0 +/- 0.6 (SEM) and an average left ventricular end-diastolic pressure of 15.5 +/- 0.8 mm Hg, compared to 3.3 +/- 0.6 and 12.9 +/- 1.1 mm Hg, respectively, for the older group. Average grafts per patient were 2.7 +/- 0.8 in the younger group and 2.8 +/- 0.1 in the older group. Overall operative mortality for patients under 70 was 4% (3/75) versus 12% (9/75) (p = 0.06) for patients 70 and older. The incidence of chronic stable angina was 2% (1/48) versus 6% (3/48) (p = 0.30). Perioperative infarctions occurred in 7% of those under 70 and 5% of those 70 or older (p = 0.54). Those under 70 averaged 13.8 +/- 0.6 postoperative hospital days versus 18.4 +/- 1.2 hospital days for the older group (p less than 0.05). Follow-up ranged from 2 to 94 months, averaging 22 months for patients under 70 and 24 months for those 70 or older. Late cardiac mortality rates were 4% (3/70) in the younger patients and 3% (2/66) in the older patients (p = 0.53). Current NYHA class was 1.3 +/- 0.7 for those under 70, with 9% reporting angina, and 1.4 +/- 0.7 for those who were 70 or older, with 6% reporting angina. CABG can be performed with acceptable risk in older patients and leads to encouraging symptomatic improvement and late survival
— id: 67176, year: 1982, vol: 84, page: 219, stat: Journal Article,

Selective retrograde coronary venous perfusion
Hochberg MS; Austen WG
1980 Jun;29(6):578-578, Annals of thoracic surgery
The theoretical concept of delivering oxygenated blood to an ischemic myocardium by way of the coronary venous system antedated by many decades the present widespread utilization of coronary artery bypass grafting. Diffuse arterial atherosclerosis has limited the effectiveness of coronary artery bypass grafting in about 15% of patients seen with significant angina pectoris. Consequently, there has been renewed interest in selectively reversing the flow in certain coronary veins through coronary venous bypass grafts. This collective review details the physiology and anatomy of the coronary venous system. It then discusses the early attempts to globally retroperfuse the entire coronary venous system through the coronary sinus. Finally, the current experimental and clinical attempts to selectively retroperfuse just one region of the coronary venous system are presented and reviewed
— id: 67177, year: 1980, vol: 29, page: 578, stat: Journal Article,

Mitral valve replacement in elderly patients: encouraging postoperative clinical and hemodynamic results
Hochberg MS; Derkac WM; Conkle DM; McIntosh CL; Epstein SE; Morrow AG
1979 Mar;77(3):422-426, Journal of thoracic & cardiovascular surgery
— id: 67178, year: 1979, vol: 77, page: 422, stat: Journal Article,

Selective arterialization of the coronary venous system. Encouraging long-term flow evaluation utilizing radioactive microspheres
Hochberg MS; Roberts WC; Morrow AG; Austen WG
1979 Jan;77(1):1-12, Journal of thoracic & cardiovascular surgery
The long-term effectiveness of a retrograde coronary venous bypass graft (CVBG) to an ischemic left ventricle was evaluated in 18 dogs. A saphenous vein was interposed between the aorta and left anterior descending (LAD) vein. The LAD vein was ligated cephalad to the CVBG to prevent an arteriovenous fistula. The LAD artery was ligated at its origin to create anterior wall ischemia. Operative graft flow averaged 53 ml. per minute. The 14 surviving dogs were catheterized 3 to 5 months later. Ten of the 14 CVBG's were patent angiographically. The chests were opened and graft flow now averaged 50 ml. per minute. 141Ce microspheres were injected into the left atrium to measure myocardial flow to the anterior wall. In the 10 dogs with patent grafts, transmural flow was 39 +/- 1 (S.E.M.) ml. per 100 Gm. of tissue per minute. The endocardial/epicardial flow ratio was 1.4/1, indicating that retrograde venous perfusion effectively delivered blood to the subendocardium. After ligation of the CVBG, microsphere measured flow dropped to 15 +/- 1 ml. per 100 Gm. per minute. In 15 control dogs, anterior wall flow was 100 +/- 3 ml. per 100 Gm. per minute, decreasing to 13 +/- 2 ml. 45 minutes after ligation of the LAD artery and vein. None of the eight control dogs with simple ligation of the LAD artery and vein survived more than 5 days. Histologic examination of the anterior wall of the left ventricle, the area served by the CVBG's for 3 to 5 months, disclosed no evidence of venous sclerosis or thrombosis and no evidence of interstitial edema or hemorrhage. Thus a CVBG permitted long-term survival in an otherwise nonviable anatomic preparation. Moreover, restoration of flow with a CVBG was effective because it perfused all layers of the myocardium, especially the subendocardium--the crucial layer of myocardial muscle
— id: 67179, year: 1979, vol: 77, page: 1, stat: Journal Article,

Selective retrograde coronary venous perfusion: an encouraging approach documented by microsphere flow studies
Hochberg MS; Austen WG
1978 ;29:261-262, Surgical forum
— id: 67181, year: 1978, vol: 29, page: 261, stat: Journal Article,

Delayed cardiac tamponade associated with prophylactic anticoagulation in patients undergoing coronary bypass grafting. Early diagnosis with two-dimensional echocardiography
Hochberg MS; Merrill WH; Gruber M; McIntosh CL; Henry WL; Morrow AG
1978 May;75(5):777-781, Journal of thoracic & cardiovascular surgery
Pericardial tamponade occurring late in the hospitalization of a patient who has undergone a heart operation can be life threatening. Recognition of this insidious, but treatable, complication is difficult. Three patients experienced delayed tamponade while receiving warfarin prophylactically following coronary arter bypass. Two-dimensional echocardiography was useful in recognizing the effusion (and thus aided the diagnosis of tamponade) in each patients. The question of whether prophylactic antiocagulatin should be employed for patients undergoing coronary artery bypass procedures is also considered in light of both the present experience and collected reports from the literature
— id: 67180, year: 1978, vol: 75, page: 777, stat: Journal Article,

Results of combined coronary endarterectomy and coronary bypass for diffuse coronary artery disease
Hochberg MS; Merrill WH; Michaelis LL; McIntosh CL
1978 Jan;75(1):38-46, Journal of thoracic & cardiovascular surgery
— id: 67182, year: 1978, vol: 75, page: 38, stat: Journal Article,

Hemodynamic evaluation of selective arterialization of the coronary venous system. An experimental study of myocardial perfusion utilizing radioactive microspheres
Hochberg MS
1977 Nov;74(5):774-783, Journal of thoracic & cardiovascular surgery
— id: 67184, year: 1977, vol: 74, page: 774, stat: Journal Article,

Aortic valve replacement in the elderly. Encouraging postoperative clinical and hemodynamic results
Hochberg MS; Morrow AG; Michaelis LL; McIntosh CL; Redwood DR; Epstein SE
1977 Dec;112(12):1475-1480, Archives of Surgery (Chicago)
Seventy-three patients aged 60 and over and 277 patients under 60 years of age underwent isolated aortic valve replacement (AVR) for aortic stenosis, regurgitation, and mixed disease from 1966 through 1975. Cardiac catheterization was performed five to nine months following operation in 77% of these patients. Follow-up averaged 55 months per patient. The hospital mortality in the elderly group was 2.7%, compared to 5.8% in the younger group. The late cardiac mortality was 21% and 19%, respectively. There was significant improvement (P less than .001) in the left ventricular end-diastolic pressure, cardiac index, and functional class in each of the three disease groups in the younger as well as the elderly patients. More important, the magnitude of improvement in each of these variables in patients over and under 60 years of age was not significantly different. Increasing longevity will make cardiac operations more common in the older population. These findings indicate that AVR carries the same low risk and brings about a similar improvement in left ventricular pump function in patients older and younger than 60
— id: 67183, year: 1977, vol: 112, page: 1475, stat: Journal Article,

Mechanism of size limitation of bacterial colonies
Hochberg, M S; Folkman, J
1972 Dec;126(6):629-635, Journal of infectious diseases
— id: 70017, year: 1972, vol: 126, page: 629, stat: Journal Article,

Cholesterol absorption following eighty per cent small intestinal resection in dogs
Hochberg, M S; Randall, H T
1971 Apr;54(4):208-10 passim, Rhode Island medical journal
— id: 70018, year: 1971, vol: 54, page: 208, stat: Journal Article,