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Biomedical subjects

A Gooch

Publications and source records attributed to A Gooch.

5 recordsLinked to original sources
PubMed1976

Late thrombosis of the aortic Bjork-Shiley prosthesis. Its clinical recognition and management.

Seven cases of massive thrombosis of an aortic Bjork-Shiley prosthesis were encountered among 433 valvular implants. Four patients died before treatment could be instituted, and three underwent repeat surgery successfully. Anticoagulation therapy was probably well maintained in four, and poorly maintained in three patients. These cases illustrated the need for a high index of suspicion and prompt recognition of this complication in patients with Bjork-Shiley prostheses. The diagnosis of massive thrombosis should be suspected with the rapid onset of (1) signs of congestive heart failure, (2) absence or attenuation of valvular clicks, (3) aortic regurgitation, or (4) hemolytic anemia. Salvage of these patients requires emergency replacement of the thrombosed prosthesis or removal of the thrombus.

Aged↗
PubMed1976

Results of mitral valve replacement with the Beall prosthesis in 209 patients.

In this 3 year study of 209 patients who underwent mitral valve replacement with the newer Beall prostheses (Models 104 and 105) the operative mortality rate was 5.2 per cent. None of these deaths was related to the valve. This prosthesis features a larger frustrum area and a "turtle-neck" sewing ring which permits its rapid insertion with a continuous suture technique. Of the 20 (9.5 per cent) late deaths, two were due to thrombosis of the valve. Among the 178 survivors, 17 developed thromboembolic complications; however, 10 of these patients recovered. Late clinical results have been quite satisfactory in over 90 per cent of the survivors. In the 15 patients who underwent hemodynamic studies postoperatively, the cardiac index and pulmonary artery pressure showed significant improvement; however, they still had transvalvular gradients at rest. The improvement in the design of this prosthesis has been an important factor in lowering the operative risk and improving the late results of mitral valve replacement.

Adult↗
PubMed1975

Iatrogenic arteriovenous fistula: a complication of percutaneous subclavian vein puncture.

A case of iatrogenic subclavian arteriovenous fistula is reported. An intracath had been inserted percutaneously into the left subclavian vein to monitor the central venous pressure during aortic valve surgery. On the second postoperative day a thrill and continuous murmur were detected at the left subclavian region. Left subclavian arteriogram and catheterization studies confirmed the diagnosis of subclavian arteriovenous fistula. The lesion was treated surgically with satisfactory results.

Aortic Valve↗