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Biomedical subjects

Robert D. Leachman

Publications and source records attributed to Robert D. Leachman.

17 recordsLinked to original sources
PubMed1981

Congenital coronary artery-cardiac chamber fistulae: Report of two cases.

Two cases of coronary arteriovenous fistulae are reported. In the first case, the right coronary artery (RCA) drained into the right ventricular outflow tract, and the distal RCA filled through a branch of the left anterior descending coronary artery. In the second case, the RCA drained into the right atrium and filled through a branch of the left circumflex artery. The fistulae were closed with subcoronary mattress sutures that preserved the continuity of the native circulation.

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PubMed1980

Variations in coronary artery anatomy: Normal versus abnormal.

We offer a comprehensive classification of coronary artery anomalies, together with angiographic examples of each entity. Minimal requirements for normality include the following criteria: (1) the dual aortic origin is from right and left coronary ostia; (2) the course of the right coronary artery follows the right atrioventricular groove; (3) the course of the left coronary artery follows the left atrioventricular groove and anterior interventricular groove; (4) the posterior descending branch originates from either the right or left coronary artery; (5) the major coronary branches flow epicardially; and (6) the coronary arteries terminate at the myocardial capillary level. This conception of "normal" coronary arteries has determined the classification of abnormalities presented here. Early and correct diagnosis of anomalies that may compromise the myocardial blood supply is stressed, and possible surgical solutions are offered. Selective coronary angiography is the technique of choice for precise visualization of the coronary artery system.

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PubMed1980

Unusual findings of asymmetrical septal hypertrophy associated with calcification of the interventricular septum: Case report.

A patient with aortic regurgitation, stenosis, and calcification of the septum is reported. Results of echocardiography revealed asymmetrical septal hypertrophy without other features of idiopathic hypertrophic subaortic stenosis. There was no subaortic obstruction evident on cardiac catheterization and angiography. This case serves to emphasize that calcification of the interventricular septum is another possible cause of asymmetrical septal hypertrophy.

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PubMed1980

Recurrent myocardial infarction in a patient with Prinzmetal's angina and normal coronary arteries.

A 55-year-old man was referred for the evaluation of frequent chest pain and syncope. While in the hospital, he experienced severe chest pain accompanied by transient ST segment elevation and a slight elevation of cardiac enzyme levels. Multiple coronary arteriograms were recorded at various times during an interval of 2 months. On one occasion, the results were normal; on another occasion, they showed total occlusion of the left anterior descending, diagonal, and circumflex coronary arteries. The occlusion was completely relieved with sublingual nitroglycerin. Because the patient's clinical condition deteriorated rapidly, double aortocoronary saphenous vein bypass was performed to the left anterior descending and circumflex coronary arteries. During the induction of anesthesia, ventricular fibrillation occurred, and the patient died from refractory recurrent fibrillation 4 hours after surgery. Postmortem examination revealed normal coronary arteries, patent vein grafts, and multiple focal areas of recent and old myocardial fibrosis. Thus, it appears that coronary spasm, in the presence of otherwise normal coronary arteries, can produce myocardial infarction with necrosis, and that medical management may provide a more successful method of treating such patients.

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PubMed1977

TRANSIENT ISCHEMIC EVENTS OF THE HEART (ANGINA PECTORIS).

In an attempt to clarify some of the controversy regarding the concepts of myocardial ischemia, various cardiac pathologies are presented to demonstrate several of the unusual mechanisms involved in the causes of transient ischemic events of the myocardium. A review of the literature is presented, with a discussion of the current approach to managing these unusual clinical conditions.

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PubMed1975

SEGMENTAL AORTITIS AND AORTIC INCOMPETENCE.

An unusual case of a middle-aged male with segmental aortitis and aortic incompetence is described. To our knowledge, only 13 cases have been previously described in the literature, but only two have had anatomopathological confirmation. Aortic incompetence is a rare manifestation of segmental aortitis. Although intrinsic abnormalities of the aortic valve have been proposed, the finding of a normal aortic valve at postmortem examination in 2 of the 3 cases in which the aortic valve was examined, supports the premise that the incompetence is probably secondary to disproportionate dilatation of the aortic root.

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