PubMed Health⌕ Search

Biomedical subjects

J L Gibbs

Publications and source records attributed to J L Gibbs.

At least 73 records · Page 4Linked to original sources
PubMed1988

Prevalence of asymptomatic carotid disease: results of duplex scanning in 348 unselected volunteers.

The risk of stroke in patients with asymptomatic carotid disease appears to be related to the presence of a high-grade stenosis. To determine the prevalence of such lesions, duplex scanning was performed on 348 unselected volunteers without symptoms who attended hospital-sponsored health fairs. There were 209 women and 139 men whose ages ranged from 24 to 91 years. Risk factors included hypertension (37%), diabetes (8%), and smoking (23%). One hundred seven subjects (31%) had evidence of extracranial carotid artery disease, 13 (4%) with greater than 50% stenosis, and three (1%) with greater than 80% stenosis of the internal carotid artery. Bilateral disease was present in 50 patients. Disease prevalence and severity were significantly correlated with age (p less than 0.001) and hypertension (p less than 0.01) but not with diabetes or smoking. The incidence of disease was similar in men and women. Although carotid plaques are common in people older than 50 years of age who do not have symptoms, the prevalence of high-grade stenosis--even in the elderly hypertension population--is low, casting doubt on the cost-effectiveness of generalized screening.

Adult↗
PubMed1988

Protein-losing enteropathy caused by baffle obstruction after Mustard's operation.

Three patients developed protein-losing enteropathy caused by intra-atrial obstruction of the systemic venous return after Mustard's operation. The enteropathy resolved in one case after reoperation and in the others after balloon dilatation of the stenosed caval pathways. Protein-losing enteropathy may occur as a complication of Mustard's operation. Balloon dilatation of the obstructed baffle is an effective alternative to reoperation.

Humans↗
PubMed1988

Balloon dilatation of a Waterston aortopulmonary anastomosis.

Percutaneous balloon dilatation of a Waterston anastomosis was performed in a child who had had four shunt operations. Initially, the procedure was apparently successful, but pulmonary oedema developed and he died 12 hours after the procedure. Balloon dilatation of a Waterston anastomosis is technically possible and may prove to be an alternative to reoperation in certain patients. But further experience with the technique is necessary to determine the optimum size of the inflated balloon, and to avoid the risk of producing an excessive increase in pulmonary blood supply.

Adolescent↗
PubMed1988

Neonatal anatomical correction of transposition of the great arteries: non-invasive assessment of haemodynamic function up to four years after operation.

Intracardiac and great artery blood flow velocities were recorded by pulsed and continuous wave Doppler ultrasound in 18 children aged between eight months and four years (mean 25 months) who had undergone anatomical correction of transposition of the great arteries in the first month of life. Postoperative peak flow velocities across the mitral valve and in the ascending aorta were not significantly different from those in an age matched control population, but tricuspid flow velocities were higher than normal. Aortic regurgitation was detected in only one of the eighteen patients, a markedly lower frequency than that reported after two stage anatomical correction. Peak velocities in the pulmonary artery were higher than normal, and in most cases there was some degree of stenosis of the pulmonary artery at the site of anastomosis.

Aorta↗
PubMed1986

Pulmonary balloon valvoplasty in late adult life.

A case of severe valvar pulmonary stenosis in a 60-year-old woman is described. Percutaneous balloon valvoplasty was performed without complication and reduced the right ventricular outflow pressure gradient from 95 mm Hg to 25 mm Hg. Balloon valvoplasty is an effective alternative to surgical valvotomy in adults as well as children.

Angioplasty, Balloon↗
PubMed1986

Doppler echocardiographic characteristics of the Carpentier-Edwards xenograft.

In order to define ranges of normal velocities for the Carpentier-Edwards xenograft, 38 mitral, 24 aortic and 9 tricuspid prostheses were studied with pulsed or continuous wave Doppler at a mean interval of 38 months following surgery. All patients had clinically normal prosthetic valve function and no clinical or radiographic signs of heart failure. Mean peak velocity across aortic prostheses was 244 cm s-1 (SD 48). There was weak correlation (r = 0.54, P less than 0.01) between peak velocity and time since valve implantation, but no significant difference in peak velocity across valves of different size. In the mitral position, mean peak velocity was 164 cm s-1 (SD 24) and mean pressure half time 90 ms (SD 23). There was again no significant difference between valves of different size. There was a weak correlation between pressure half time and time since implantation (r = 0.44, P less than 0.01), but there was no relationship between the latter and peak velocity. In the tricuspid position, mean peak velocity was 150 cm s-1 (SD 12) and mean pressure half time 163 ms (SD 50). The Doppler indices of obstruction to blood flow for prostheses in the mitral and aortic positions showed a significant increase with time after implantation.

Adult↗
PubMed1986

Doppler echocardiography after anatomical correction of transposition of the great arteries.

Nineteen patients who had anatomical correction of transposition of the great arteries between the ages of one week and 10 years were investigated by pulsed and continuous wave Doppler echocardiography 1-98 months after operation. Peak blood flow velocities across the atrioventricular valves were significantly higher than normal, but no pathological regurgitation was seen. Systolic aortic velocities were normal in all but one patient, but mild aortic regurgitation was detected in ten. Increased flow velocities either at pulmonary valve level, at the pulmonary artery bifurcation, or in the left pulmonary artery were detected in 14 patients, the maximum calculated pressure drop being 36 mm Hg. Adequate Doppler sampling of the right pulmonary artery was not achieved in any of the cases, and sampling of the left pulmonary artery was possible in only ten. The principal limitation of the Doppler ultrasound method in this study was the inability to obtain flow velocities from the branch pulmonary arteries in most patients. Doppler echocardiography provides valuable information after the arterial switch operation and may reduce the need for repeat cardiac catheterisation.

Aortic Valve↗
PubMed1985

Diastolic forward blood flow in the pulmonary artery detected by Doppler echocardiography.

The etiology of diastolic motion of the pulmonary valve seen on the M-mode echocardiogram has been the subject of much debate. To further investigate diastolic events in the pulmonary artery, the patterns of diastolic pulmonary artery blood flow velocity were studied using pulsed Doppler echocardiography in patients with a normal heart. Two diastolic waveforms were found, one in early diastole related to passive filling of the right ventricle and one in late diastole related to atrial contraction. These waveforms were also related to the two recognized phases of diastolic pulmonary valve motion detected by M-mode echocardiography. The presence of biphasic diastolic blood flow in the pulmonary artery was confirmed by electromagnetic flow velocimetry in four additional patients with various cardiac diseases and normal right heart pressures. It is concluded that both atrial contraction and passive right ventricular filling produce blood flow in the pulmonary artery.

Adolescent↗
PubMed1985

Mechanism of late failure of the Alvarez disc valve prosthesis.

An Alvarez disc valve prosthesis had been implanted in the mitral and tricuspid positions in 15 patients between 1964 and 1967 in this hospital. Of these 15 patients, only three survived longer than 10 years, all three dying unexpectedly between 16 and 18 years postoperatively. Two deaths were a direct result of disruption of the Alvarez prosthesis. The third patient was not examined at necropsy, but in retrospect the history was highly suggestive of valve malfunction. Cross sectional and pulsed Doppler echocardiography made valuable contributions to the diagnosis in both cases of valve disruption and, when available, should be part of the primary investigation of suspected prosthetic heart valve failure. The Alvarez valve prosthesis is liable to erosive wear which may cause late detachment of the disc from the valve ring with abrupt and catastrophic haemodynamic consequences.

Adult↗
PubMed1985

The heart and tuberous sclerosis. An echocardiographic and electrocardiographic study.

Cross sectional echocardiography, 12 lead electrocardiography, and 24 hour ambulatory electrocardiography were performed in eleven patients with tuberous sclerosis. Echocardiography showed single or multiple intramyocardial masses, most commonly in the ventricular septum, suggestive of rhabdomyomata in seven of the eleven cases. One patient with a normal echocardiogram showed ventricular pre-excitation on electrocardiography, with tachycardias of 180 beats per minute on ambulatory monitoring. Sinus bradycardia, sinus tachycardia, and supraventricular tachycardia were also seen, but their importance is uncertain. Echocardiography and electrocardiography should be routinely performed in the assessment of patients with tuberous sclerosis and ambulatory electrocardiography should be considered in those with seizures that respond poorly to anticonvulsants.

Adolescent↗
PubMed1984

Coronary artery obstruction associated with congenital aortic valve disease.

Abnormal attachment of the aortic valve caused obstruction to left coronary arterial flow in a young girl, who presented with angina of effort. Aortic valve and root replacement resulted in the patient's effort tolerance returning to normal with resolution of the exercise electrocardiographic and angiographic abnormalities. This case emphasises the importance of an awareness of the existence of such defects and their amenability to surgical correction.

Adolescent↗
PubMed1984

Coronary sinus orifice atresia and persistent left superior vena cava. A report of two cases, one associated with atypical coronary artery thrombosis.

Fourteen previously reported cases of atresia of the coronary sinus ostium, in which the coronary venous flow entered the right atrium by a persistent left superior vena cava, the innominate vein, and the right superior vena cava, are reviewed and two new cases reported. The first new case was in a 43 year old woman with atypical chest pains in whom investigations for suspected ischaemic heart disease, including coronary arteriography, yielded normal results. She died suddenly from massive myocardial infarction due to extensive old thrombotic occlusion of a major coronary artery without any appreciable underlying disease of the vessel wall. Exercise testing is considered to be advisable in symptomatic patients with normal coronary angiograms and attention to the venous phase might be informative. The second new case occurred in a child with an atrial septal defect and complete transposition of the great arteries, who died aged 1 month.

Adult↗