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Biomedical subjects

D J Gillmer

Publications and source records attributed to D J Gillmer.

9 recordsLinked to original sources
PubMed1988

Treatment of ventricular septal defect after myocardial infarction.

Between 1978 and 1984 6 cases of ventricular septal defect after myocardial infarction were referred to this hospital. All 6 patients underwent cardiac catheterisation, had severe pulmonary hypertension and large left-to-right shunts (mean 64%). They were treated with high doses of diuretics and vasodilators, and underwent delayed surgery 6 weeks after rupture. Follow-up is from 1 to 7 years. There has been 1 late, non-cardiac death. The remainder are well. In our experience patients with congestive cardiac failure complicating ventricular septal defect after infarction can be stabilized initially on diuretic and vasodilator therapy, and surgery can safely be deferred until septal fibrosis allows adequate closure.

Adult↗
PubMed1983

Aortic and mitral valve replacement for bacterial endocarditis in pregnancy. A case report.

A 24-weeks pregnant woman presented with bacterial endocarditis due to Streptococcus viridans and severe aortic and mitral valve incompetence. Progressive deterioration in haemodynamic function and the presence of systemic emboli necessitated the urgent performance of aortic and mitral valve replacement; both the patient and the fetus survived. Double valve replacement for infective endocarditis in pregnancy has not previously been reported.

Adult↗
PubMed1981

Valve replacement in active infective endocarditis.

To assess the role of emergency valve replacement in patients with active infective endocarditis (IE), we reviewed 30 patients who underwent valve replacement within 3 months of the diagnosis of IE. Eighteen patients fulfilling the criteria for active IE underwent emergency surgery. The aortic valve was involved in all cases and was previously thought to be normal in 12 (67%). There were 5 early deaths (27,7%), 4 due to circulatory failure and 1 due to rupture of a mycotic cerebral aneurysm. Prosthetic valve dehiscence (paravalvular leak) developed in only 1 patient, and prosthetic valve endocarditis did not occur. The results confirm the place of early valve replacement in otherwise moribund patients with IE. We recommend immediate valve replacement for active IE in the presence of: (i) progressive haemodynamic deterioration; (ii) failure to obtain early control of infection; (iii) significant emboli; and (iv) conduction disturbances.

Adult↗
PubMed1981

Problems encountered during insertion of permanent endocardial pacing electrode.

Case reports of two potential problems arising during permanent endocardial pacemaker electrode insertion are described. They are cannulation of a persistent left-sided superior vena cava, and unsuspected subclavian vein thrombosis. A left-sided superior vena cava may be recognized clinically and avoided; but, if necessary, it can be employed as a route to the right ventricular endocardium. Subclavian vein thrombosis appears to be a complication of previous cephalic vein pacemaker insertion and prohibits further access on the implanted side. It may present with a painful, swollen arm or with the symptoms of multiple pulmonary emboli; occasionally it is not clinically suspected unless abnormal venous distension is sought.

Aged↗
PubMed1980

Insertion of permanent endocardial pacing electrodes via the infraclavicular subclavian vein.

A technique of insertion of permanent endocardial pacing electrodes via the infraclavicular subclavian vein is described. Twenty-eight electrodes have been inserted without a displacement or any of the recognized complications occurring. The method is quicker and more reliable than more conventional approaches. We feel the low displacement rate is the result of the relatively proximal catheter fixation to the fascia pectoralis and the use of tined electrodes.

Electrodes↗
PubMed1980

Primary ('stress') thrombosis of the upper arm associated with multiple pulmonary embolism.

Primary venous thrombosis of the upper arm is an uncommon but distinct syndrome. Although there is a high incidence of residual disability due to failure of the vein to recanalize, pulmonary embolism is unusual, and residual pulmonary symptoms or fatalities have not previously been reported. A case of thrombo-embolic pulmonary hypertension complicating primary thrombosis in the upper arm is described. Prompt recognition and treatment of the condition are recommended.

Adult↗