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Biomedical subjects

R D Lach

Publications and source records attributed to R D Lach.

11 recordsLinked to original sources
PubMed1992

Ventricular standstill complicating left heart catheterization in the presence of uncomplicated right bundle branch block.

We report the unusual occurrence of complete heart block during attempted right coronary artery cannulation in a patient with pre-existing uncomplicated right bundle branch block (RBBB). This complication occurred due to accidental impingement of the Judkin's right coronary catheter on the left bundle when it transiently slipped across the aortic valve. The block resolved without any complication.

Aged↗
PubMed1989

Percutaneous aortic valvuloplasty procedure and implications for nursing.

Percutaneous transluminal aortic balloon valvuloplasty (PTABV) is a procedure performed in the cardiac catheterization laboratory for some patients with severe calcific aortic stenosis. A review of the literature indicated that the procedure was beneficial to elderly patients or those who were poor candidates for surgery. The common complications of PTABV include bleeding at the catheterization site and vagal reactions during groin compression. Nursing implications in the cardiac catheterization laboratory involve ensuring patient comfort, managing the effects of cardiac instrumentation, and monitoring vital signs and vascular integrity. Post-PTABV nursing diagnoses include: (1) potential for injury or hemorrhage, (2) potential for alteration in cardiac output, (3) potential for alteration in tissue perfusion, (4) alteration in comfort, (5) potential for infection, and (6) knowledge deficits.

Aged↗
PubMed1987

Esophageal-atrial fistula.

We report an unusual case of an esophageal-atrial fistula in a patient with CREST (calcinosis, Raynaud's phenomenon, esophagitis, sclerodactyly, telangiectasia) variant of scleroderma. An ulcer in Barrett's esophagus perforated into the left atrium and led to systemic embolization and cerebral abscess. A review of similar reports of esophageal-atrial fistula reveals a symptom complex that includes chronic esophageal pathology, gastrointestinal bleeding, and neurological signs. An antemortem diagnosis has never been made.

Barrett Esophagus↗
PubMed1983

Anomalous right coronary artery arising from left mainstem.

Various coronary artery anomalies occur in both symptomatic and asymptomatic individuals. We have described a unique case of an aberrant right coronary artery arising from the left mainstem, resulting in clinical myocardial infarction in the absence of coronary atherosclerosis. Though different anomalies of the right coronary artery have been described, we feel this case is unique in that the right coronary artery arises from the left mainstem, truly forming a single coronary artery.

Aorta↗