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Biomedical subjects

P J Bower

Publications and source records attributed to P J Bower.

12 recordsLinked to original sources
PubMed1978

Echocardiographic diagnosis of double inlet "left" ventricle: indocyanine green contrast studies as an aid to diagnosis.

A 22-year-old woman with double inlet left ventricle had had two systemic-pulmonary shunting procedures for incorrect or incomplete diagnoses. Echocardiography with indocyanine green contrast studies demonstrated a double inlet "left" ventricle. It also localized the bulboventricular septum and infundibular chamber anterior to the two atrioventricular valves, and demonstrated early communication of contrast from the right atrium to the ventricle and infundibular chamber.

Adult↗
PubMed1977

Severe papillary muscle dysfunction substantiated by atrial pacing during cardiac catheterization.

A patient experienced episodic pulmonary edema accompanying nocturnal angina pectoris. The symptoms were provoked at cardiac catheterization by atrial pacing. Simultaneous onset of chest pain, shortness of breath, and sudden appearance of a large V wave in the pulmonary artery wedge pressure contour confirmed acute mitral valve regurgitation. Rapid reversal of these changes after nitroglycerin administration supported "papillary muscle dysfunction" as the explanation for these hemodynamic changes.

Aged↗
PubMed1977

Long-term follow-up of internal mammary artery myocardial implantation.

A study was made of 100 patients who had undergone internal mammary artery myocardial implantation 7 to 10 years previously. Forty-two patients had single implantation with or without a free omental graft, and 54 received double implantations. Four patients had a single internal mammary artery implant plus a single aortocoronary bypass graft. Eleven patients died at operation or within the first month, and 17 died from 1 to 7 years following operation. Two were lost to follow-up, and 15 refused follow-up angiograms. From 7 to 10 years postoperatively, angiographic studies were performed on 55 patients with 73 internal mammary artery implants. Of these 73 implants, 17 (23%) were occluded; 10 (14%) were patent but did not show myocardial filling; 15 (21%) showed myocardial blush or filling of small vessels; and 31 (42%) showed filling of a major coronary artery. The patency rate correlated well with the amount of coronary disease and slightly with the amount of symptomatic improvement. This study shows that the Vineberg operation is physiologically sound; however, the ideal candidates are those patients with coronary arteries of adequate size who could benefit more by direct perfusion.

Adult↗
PubMed1976

Angina pectoris after aortic valve replacement.

Angina pectoris after aortic valve replacement may be due to reduced myocardial blood flow (coronary artery stenosis or valvular dysfunction) or to increased myocardial oxygen demand (idiopathic hypertrophic subaortic stenosis or valvular dysfunction). If a patient does not do well after an aortic valve replacement, causes other than dysfunction of the prosthesis should be sought.

Adult↗
PubMed1975

Coronary artery bypass for acute myocardial infarction.

Coronary artery bypass has been done on 20 patients for acute mmyocardial infarction associated with shock, arrhythmia, and/or cardiac arrest. Twelve had had catheterization before the time of infarction. There were 3 hospital deaths, 2 late deaths, and 15 survivors. Survivors are angina-free and active 4 to 40 months postoperatively. Five patients have been recatheterized since operation, and in 4 all grafts are patent and functioning. Ventricular function was not improved in one patient, has remained the same in one, and improved in 3 patients. Although the time interval from infarction to revascularization is important, success is just as dependent on the patient's existing coronary collateral circulation. Lesions of the left main coronary artery were associated with the highest mortality. The rationale for operation in patients with acute myocardial infarction is to revascularize the marginal myocardium adjacent to the infarct and other underperfused areas when indicated. Chance for survival may thereby be increased by improvement of cardiac pumping or reversal of cardiac arrest or arrhythmia.

Acute Disease↗
PubMed1975

The sick sinus syndrome: treatment by permanent transvenous atrial pacing (a new approach).

"Sick sinus syndrome" is characterized by alternating tachyarrhythmias and bradyarrhythmias, diverse origin, generalized conduction abnormalities, and symptoms of heart failure, systemic embolization, and syncope. Proper treatment requires demand atrial or ventricular pacing. A patient with this syndrome was treated with a new transvenous atrial electrode catheter which has successfully controlled her symptoms for 33 months with unrestricted physical activity and without further paroxysms of atrial arrhythmia.

Aged↗