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Biomedical subjects

G K Sethi

Publications and source records attributed to G K Sethi.

At least 91 records · Page 5Linked to original sources
PubMed1976

Renovascular hypertension and acute aortic dissection in a patient with renal transplant.

The late results of renal transplantation are very encouraging. Apart from the more common complications, such as the rejection phenomenon and recurrent infections, occasionally renovascular hypertension may occur as a late complication. This is, to our knowledge, the first reported case of acute dissecting aortic aneurysm in a young man who had received a renal transplant six years earlier and later developed renovascular hypertension. All patients with renal transplant who develop severe hypertension which is refractory to medical management should be considered for renal arteriogaphy and correction of stenosis, if it is present.

Adult↗
PubMed1976

Subclavian artery laceration due to migration of a Hagie pin.

Injuries to subclavian artery are infrequent and usually occur due to gunshot or stab wounds and occasionally by blunt trauma to the chest. An early diagnosis and control of hemorrhage is essential to prevent death which may occur due to exsanguinating hemorrhage. A case of injury to the subclavian artery due to migration of a Hagie pin, which was used to treat the acromioclavicular separation, is reported. The subclavian artery was ligated initially, which produced an ischemic and functionless upper extremity. Revascularization of the arm was successfully accomplished by an axilloaxillary bypass grafting procedure. This simple procedure is advocated in situations requiring ligation of the subclavian artery following trauma, when direct reconstruction is not feasible.

Acromioclavicular Joint↗
PubMed1975

Opportunistic endocarditis following open-heart surgery.

The incidence of endocarditis following open-heart operations is declining, but the relative incidence of endocarditis by the opportunistic organisms, both bacterial and fungal, has increased. These "opportunists" require careful identification and sensitivity testing so that appropriate therapy can be planned. In cases of candida endocarditis, a positive precipitin test and elevated candida antibody titer may provide an earlier means of diagnosis than blood cultures. These patients should be treated promptly with adequate dosages of specific antimicrobial or antifungal agents. Reoperation should be considered early if there is evidence of valve dehiscence or embolic phenomena or if drug therapy fails to control the infection.

Adult↗
PubMed1975

False aneurysm of the abdominal aorta due to blunt trauma.

Nonpenetrating trauma to the abdominal aorta is uncommon and the development of a traumatic abdominal aortic aneurysm is even more rare. The victims of blunt trauma to the abdomen should be examined for diminution or absence of femoral pulses, especially if numbness, diminished sensations, or motor weakness appear following trauma. If pulse abnormalities are present, aortography should be performed promptly to exclude aortic disruption or dissection. Immediate surgery should be performed once the diagnosis of aortic disruption is made. To our knowledge, this is the second reported case of successful surgical treatment of a false aneurysm of the abdominal aorta following nonpenetrating trauma.

Aorta, Abdominal↗
PubMed1975

Extrathoracic bypass for stenosis of innominate artery.

Stenosis of the innominate artery usually occurs in older patients in whom the risks of conventional, corrective procedures such as transthoracic endarterectomy or aorto-innominate arterial bypass grafting are quite high. An axillo-axillary bypass procedure was performed in a high-risk patient with innominate arterial stenosis who had repeated episodes of transient cerebral ischemia due to decreased blood flow through the right carotid artery and reversal of blood flow through the right vertebral artery. Postoperatively, he has had dramatic improvement in his symptoms. Because of its simplicity, avoidance of major thoracotomy, avoidance of temporary occlusion of the carotid artery, and excellent late results, axillo-axillary bypass grafting is being proposed as the procedure of choice for stenosis of the innominate artery.

Age Factors↗
PubMed1975

Multiple-plane angiography for more precise evaluation of aortoiliac disease.

In 14 patients an oblique view of the aotoiliac region was obtained in addition to the conventional anteroposterior view. Angiograms in oblique projections are indicated in the following situations: (1) where the symptoms cannot be explained by the findings on the conventional anteroposterior view (2) where the patient has had previous anoroiliac grafts and has redeveloped ischmic symptoms, and (3) where patients with unilateral limb ischemia due to unilateral aotoiliac occlusive disease are being considered for a femororfemoral bypass graft procedure. In six patients appreciation of the true significance of the suspected occlusive lesion was of great value in planning the proper surgical procedure. In the remaining eight, angiographic corroboraion of the absence of significant occlusive disease was equally helpful in managing the patient's condition. Examples of each group are presented.

Angiography↗
PubMed1975

Femorofemoral grafts for unilateral occlusion of aortic bifurcation grafts.

Femorofemoral bypass grafts were performed in 10 patients who developed thrombosis of one of the limbs of previously placed aortoiliac or aortofemoral bifurcation grafts. There were no operative deaths or significant postoperative morbidity, and no amputations had to be performed following the bypass. Nine of the 10 patients have patent grafts from 5 to 70 months (average 33 months) following operation. Of these nine, eight are asymptomatic and one has mild claudication on the side of the unoccluded limb. Because of its simplicity, low operative risk, and encouraging late success rate, we feel that femorofemoral bypass grafting for late unilateral occlusion of a prosthetic bifurcation graft is the procedure of choice.

Aortic Diseases↗
PubMed1975

Femorofemoral bypass graft: choice or compromise?

Thirty-one femorofemoral crossover graft procedures were performed in 27 patients who had unilateral limb ischemia either due to unilateral aortoiliac occlusive disease of due to thrombosis of one of the limbs of a previously placed aortic bifurcation graft. There was no operative mortality, and only two patients required late amputation. There have been two late deaths. Thrombosis of the femorofemoral graft occurred in five patients. Four patients had a second femorofemoral graft, three of whom have long-term patency. Grafts are patent in 23 of 25 surviving patients. The femorofemoral graft procedure is relatively simple and is associated with a low operative mortality and morbidity. Its late patency rates are comparable with those following conventional aortic bifurcation graft procedures. Therefore, we believe the indications for femorofemoral graft should be broadened to include all patients with unilateral aortoiliac occlusive disease where anatomic conditions are favorable and there is unilateral occlusion of an aortic bifurcation graft.

Adult↗