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Biomedical subjects

R R Lower

Publications and source records attributed to R R Lower.

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

Endocarditis due to accidental penetrating foreign bodies.

A 15 year old boy had an eight month history of recurrent fever, malaise and poor appetite. Chest roentgenogram revealed a foreign object overlying the right ventricle. Multiple blood cultures grew Enterobacter cloacae. The patients condition improved and blood cultures became negative following gentamicin and carbenicillin therapy. E. cloacae was isolated from the foreign body (a finishing nail) at surgery. Antimicrobial therapy was continued for a total of 30 days, and the patient made an uneventful recovery.

Adolescent↗
PubMed1976

Congenital tricuspid insufficiency. Definition and review.

Simple congenital tricuspid insufficiency (CTI) has, up to now, been loosely included with the larger Ebstein's anomaly (EA) group. Certain pathologic and clinical features of CTI deserve definition and a place apart from EA. A review of the literature has produced 20 clinical cases for analysis to which we add two cases successfully treated surgically. The high mortality in the neonatal age group (14 of 14) continues to be a formidable challenge, but the older survivors (2 of 8) would appear to have better prospects, based on our limited experience.

Adolescent↗
PubMed1976

Complete repair of tetralogy associated with sickle cell anemia and G-6-PD deficiency.

The case of a 5-year-old black girl with sickle cell anemia and G-6-PD deficiency is described. The child underwent successful repair of tetralogy of Fallot. Open-heart surgery can be safely performed on these patients if certain guidelines are observed, particularly the avoidance of hypoxia, hypothermia, acidosis, and dehydration. The patients should be prepared for the operation with transfusion of normal red cells. Routine preoperative testing for the above hemoglobinopathologic conditions is urged. The pertinent literature is reviewed.

Anemia, Sickle Cell↗
PubMed1976

Rhabdomyoma of the heart: ultrastructural study of three cases.

The electron microscopic features of three primary cardiac rhabdomyomas were studied for the first time. Distinct striated muscle cells arranged in a disorderly fashion are described. The cases demonstrated a spectrum of possible myobibril differentiation with one case having only Z-bands and myosin filaments present while the other two had well formed thick and thin filaments with all of the bands present including Z, I, A, H, and M. Glycogen bodies, numerous mitochondria with tubular cristae, lipid deposits, and peculiar striated structures resembling zebra bodies were also seen. Desmonsomal attachments suggestive of Purkinje-type fibers were seen in all of the cases and were the only types seen in cases 2 and 3. In addition, intercalated discs characteristic of myocardial fibers were noted in case 1. This finding still leaves the exact histogenesis of the lesion uncertain although origin from two types of fibers is possible.

Heart Neoplasms↗
PubMed1975

Advantages of open mind commissurotomy using a triple-orifice technique.

Our experience over an eight-year period with the operative relief of mitral stenosis is reviewed and detailed. Of the 106 patients in the series, 80% had minimal or no calcification, 17% had moderate calcification, and 4% had severe calcium deposits in the valve. Four patients have required reoperation for recurrent stenosis, with valve replacement in 3 and a second commissurotomy in the fourth. Left atrial thrombus was encountered in 16%, and no patient with thrombus experienced embolization in the postoperative period. One postoperative death occurred within 30 days, and a single late death occured 35 days after operation. For the scarred, retracted mitral valve we have utilized a multiple-orifice technique that provides maximal flow without the risk of inducing significant mitral insufficiency.

Adult↗
PubMed1975

Apparent coexistent valvular and subvalvular left ventricular outflow tract obstruction.

A patient is presented in whom coexisting bicuspid valvular aortic stenosis and asymmetrical septal hypertrophy were suggested by echocardiography. A focal area of hypertrophy noted at operation was excised. Subsequent histological examination did not reveal evidence to support the echographic and surgical observations. The necessity for careful intraoperative assessment of the degree and nature of subvalvular muscular hypertrophy is stressed. The absence of classic echographic findings in these patients is noted.

Adult↗
PubMed1975

Associated coarctation of the aorta and mitral valve disease: nine cases with surgical correction of both lesions in three.

Nine cases of the combination of coarctation of the aorta and mitral stenosis were evaluated over a seven-year period. Symptoms did not usually cause distress in infancy, but began subtly with pneumonia or cardiac failure at about 2 years of age. Important clues were differences in blood pressure between the arms and legs, paroxysmal dyspnea, congestive heart failure, right ventricular hypertrophy, and left atrial enlargement. Cardiac catheterization studies showed elevated right ventricular and main pulmonary artery wedge pressures. These features in patients with coarctation of the aorta should suggest associated mitral valve disease. The importance of demonstrating associated valvular lesions, particularly mitral stenosis, is emphasized. Two of our children had successful repair of the coarctation of the aorta and mitral stenosis simultaneously. In a third child, resection of the coarctation was followed in six years by mitral valve replacement.

Aortic Coarctation↗