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Biomedical subjects

A J Clement

Publications and source records attributed to A J Clement.

At least 19 recordsLinked to original sources
PubMed1976

Individual responses to heparinization for extracorporeal circulation.

It has been proposed that wide variations in individual response to heparin lead to deficiencies in popular heparinization protocols for extracorporeal circulation (ECC). Thirty-nine patients undergoing open cardiac operations with ECC were anticoagulated with the heparinization protocol in use at St. Thomas' Hospital. The coagulation state was monitored with the blood activated recalcification time (BART) test. Wide variations in heparin dose-response and heparin activity-decay curves were observed. No patient was underheparinized, but many had markedly prolonged BART's. The total dose of heparin declined because BART monitoring allowed elimination of incremental heparin doses up to 180 minutes of ECC. Adequate reversal with protamine was achieved in all patients regardless of response to herparin. Alternative approaches for heparinization for ECC can be developed with the aid of rapid tests of the intraoperative coagulation state.

Adolescent↗
PubMed1970

Tricuspid valve replacement in rheumatic heart disease.

The diagnosis of tricuspid valve disease is often difficult; the best treatment is not yet established. Twenty patients had tricuspid valve replacements at St. Thomas's Hospital as part of multiple valve replacement procedures. The hospital mortality was 25%, most deaths being due to a low cardiac output causing hepatorenal failure. Preoperative cardiac cachexia had a fatal outcome in all cases. Except in two instances, surviving patients returned to a satisfactory level of activity.

Adolescent↗
PubMed1969

Dental anaesthesia.

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Adrenergic beta-Antagonists↗
PubMed1969

Triple Starr valve replacement.

Of nine patients who have had triple valve replacements for organic rheumatic triple valve disease two died in the postoperative period from inadequate myocardial reserve, and a third died four months later from cerebral embolism originating from clot on the left atrial wall. The remainder are well and, except for one, leading normal lives. Though cardiac transplantation has been recommended and used successfully for triple valve disease by Cooley, it is suggested that the long-term outlook today of triple valve replacement is likely to be better than that of transplantation.

Adult↗