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Biomedical subjects

G G Hartnell

Publications and source records attributed to G G Hartnell.

At least 19 recordsLinked to original sources
PubMed1992

Diagnosis of acute thoracic aortic dissection using combined echocardiography and computed tomography.

Acute dissection of the thoracic aorta is a life-threatening emergency requiring a diagnosis which is rapid, accurate and safe, and which will distinguish between dissections involving the ascending and descending aorta. In the absence of any general agreement on the best method of making this diagnosis we studied the use of combined echocardiography and contrast-enhanced computed tomography (CT) to diagnose acute aortic dissection. Over a 3 year period 23 patients were investigated in this way. Aortic dissection was demonstrated in 18 cases, involving the ascending aorta in 15, and the descending aorta alone in three. The diagnosis of aortic dissection was confirmed in 13 patients at surgery, in one at aortography and in one at autopsy. Three patients died without surgery or autopsy being performed to confirm the diagnosis and the subsequently which accounted for their symptoms. This combined approach has proved a valuable and safe means of investigating aortic dissection.

Acute Disease↗
PubMed1992

Inflammatory aortic aneurysms: characteristic appearance on magnetic resonance imaging.

Ten to 15% of all aortic aneurysms show inflammatory change. They are characteristically covered on their anterior and lateral sides with thick white fibrous tissue. Peri-aortic fibrosis may spread into the retroperitoneum to encase and obstruct adjacent organs making operative treatment more difficult and increasing the operative morbidity and mortality. Fifteen patients with inflammatory aneurysms and 46 patients with simple non-inflammatory aneurysms were studied prospectively. Each patient underwent magnetic resonance imaging (MRI) using a Picker Vista MR2055 scanner operating at 0.5 tesla. Each scan was reviewed by a radiologist (G.G.H.) preoperatively and a diagnosis of inflammatory or non-inflammatory aneurysm made. At operation, the diagnosis of aneurysm type was made on macroscopic features of inflammatory change, and confirmed histologically using previously published criteria. The radiological diagnosis was found to correspond to the surgical and pathological diagnosis in all cases. In cases of inflammatory aortic aneurysm the aneurysm wall appeared laminated on MRI scan, showing three or more bright, high-signal layers. These appearances of inflammatory change are characteristic, and were present in all 15 patients with such aneurysms. There were no false positives among those patients with simple aneurysms, and no false negatives. Operative specimens of aortic wall were taken from four patients with inflammatory aortic aneurysms and four patients with simple non-inflammatory aortic aneurysms, and subjected to MRI scanning. The characteristic banding appeared only in the inflammatory aneurysm wall samples. Magnetic resonance imaging is a highly sensitive investigative technique for the detection of inflammatory aneurysms, showing characteristic changes. These changes are also seen in in vitro scans of wall samples from inflammatory aneurysms.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

Assessment of the thoracic aorta by spiral CT.

A recently developed technique, spiral CT, allows rapid data acquisition through an entire anatomic region during a single breath-hold. High-quality spiral CT scans of the thoracic region have been obtained with volumes of contrast material that are small relative to those used with conventional CT. This essay illustrates the diseases of the aorta as seen on spiral CT performed with low volumes of contrast material.

Aged↗
PubMed1991

Limitations in the use of five French coronary catheters.

Five french (5F) catheters are being widely promoted for use in patients undergoing day case angiography including coronary angiography. Although there are theoretical advantages to this practice there are also potential disadvantages. We reviewed various performance parameters of four different brands of 5F coronary catheter and compared them with performance of the six (6F) and eight french (8F) coronary catheters used in routine coronary angiography. All the 5F catheters performed significantly less satisfactorily than the 6F and 8F catheters. 5F coronary catheters cannot be recommended for routine transfemoral coronary angiography.

Cardiac Catheterization↗
PubMed1991

The right aortic arch revisited.

The association between congenital cardiac defects and a right-sided aortic arch was assessed in 900 children undergoing cardiac angiography. Some of the associations observed differ from those reported in the established radiological literature. A right arch occurred in 15% of children with truncus arteriosus (up to 50% quoted in the literature), and in only 3% of those with tricuspid atresia (15% quoted in the literature). Anatomically corrected transposition of the great arteries was more strongly associated (18.2%) than has previously been suggested. These differences from previous series may, in part, be due to the improved survival of sick neonates allied with earlier diagnosis and better surgical management.

Abnormalities, Multiple↗
PubMed1991

Complications of direct brachial artery puncture for arteriography: a comparison of techniques.

Direct brachial artery puncture is used increasingly for day-case arteriography and patients with severe aorto-iliac disease. In expert hands low complication rates are reported, but the risks of brachial artery puncture may be higher when it is performed by less experienced operators. Over a 2 year period 49 direct brachial artery punctures were performed for arteriography. In 27 cases catheters were inserted directly over a guide-wire via a variable puncture site. In 22 cases catheters were inserted through an introducer sheath via a high brachial puncture. Significant complications requiring active treatment or surgical intervention occurred in three (11%) cases where direct catheter insertion was used. There were no complications when an introducer sheath was used. Percutaneous high brachial aortography using an introducer sheath is a safer technique when brachial artery puncture is performed infrequently.

Angiography↗
PubMed1990

Coil embolization of pulmonary arteriovenous malformations.

Pulmonary arteriovenous malformations (PAVMs) are uncommon lesions that can be treated by surgery or interventional radiology. Forty-four PAVMs in 11 patients were occluded by transcatheter coil embolization with only one symptomatic complication, deep venous thrombosis, attributable to the procedure. There was a significant improvement in symptoms and a reduction in pulmonary AV shunting in the 9 patients in whom embolization of all visible discrete lesions was successfully completed. Coil embolization is an effective alternative to other methods of treating PAVMs.

Adolescent↗
PubMed1990

Balloon embolisation of a coronary arterial fistula.

Coronary arterial fistulas traditionally are treated surgically. We describe a case in which a fistula between the right coronary artery and right ventricle was treated by balloon embolisation. Coronary arteriography 13 months later showed that the fistula remained occluded, and that the coronary artery had returned to a normal size. In suitable cases, embolisation of coronary arterial fistulas is an effective alternative to surgery, and can restore normal coronary arterial anatomy.

Adolescent↗