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Biomedical subjects

A Chukwuemeka

Publications and source records attributed to A Chukwuemeka.

14 recordsLinked to original sources

Short-term low-dose propofol anaesthesia associated with severe metabolic acidosis.

Propofol-induced metabolic acidosis is well recognised in the paediatric literature, but the existence of such a syndrome in adults remains contentious. In most reported cases, metabolic acidosis complicated prolonged administration of propofol in critically ill patients. We present a case of severe non-fatal reversible metabolic acidosis, without ventilatory depression or hypoxia, related to short-term propofol infusion in an adult during and after coronary artery bypass grafting. We suggest that lactic acidosis occurred in a genetically susceptible patient with an abnormality of mitochondrial function. This report discusses an unusual adverse effect of propofol anaesthesia and sedation and highlights the need for further investigation to define propofol toxicity.

Acidosis↗

Dystrophic calcification of the radial artery.

The radial artery continues to enjoy resurgence in popularity as a conduit for coronary artery bypass grafting but few studies have examined the prevalence of preexisting disease in this vessel. We highlight a potential, avoidable pitfall when use of the radial artery for coronary artery bypass grafting is proposed.

Aged↗

Modified incision for long saphenous vein harvest.

We describe a modification of the standard open technique of long saphenous vein harvesting that, by avoiding dissection in the region of the medial malleolus, can reduce the incidence of leg wound related complications after coronary artery bypass grafting.

Ankle Joint↗

CT anatomy of the mediastinal structures at the level of the manubriosternal angle.

The mediastinal structures said to lie on a horizontal plane at the level of the manubriosternal joint (manubriosternal plane) in the cadaver include the bifurcation of the trachea, the concavity of the arch of the aorta, and the azygos vein as it arches over the right principal bronchus to enter the superior vena cava. We have reviewed CT scans of the thorax in 51 subjects to determine 1) whether these structures lie consistently at this level in the living thorax and 2) the vertebral level of this plane. We found that the bifurcation of the trachea lay at the plane in 41% of subjects, that the plane passed through the concavity of the arch of the aorta in 49% of subjects, and that, although there was notable individual variation, the manubriosternal plane passed through the upper part of the fifth thoracic vertebra in 53% of cases.

Adult↗

The late post-operative patency rate of aorto-coronary venous grafts.

Long-term aorto-coronary venous graft patency has been examined in a consecutive series of 47 patients (average: 1.6 graft per patient) after a mean follow-up period of 5 years and 9 months (44-108 months) post surgery. Overall patency rate was 71% (52/73 grafts), with the best results for LAD grafts 85% (27/32). Seventy-seven percent of the patients experienced lasting relief from angina. Significant improvement of LV ejection fraction was observed in cases with patent grafts.

Angina Pectoris↗