PROCEDURE: The right groin was prepped and draped in the usual fashion. Seldinger technique was used, and a 6-French sheath was placed in the right femoral artery. A local anesthetic was used and sublingual nitroglycerin was given; no heparin was used. The left and right coronary arteries were selectively opacified in the LAO and RAO projections using manual injections of Optiray. A ventriculogram was done in the RAO projection with the use of a 6-French pigtail catheter. The catheters were then withdrawn, the sheath was removed and VasoSeal applied, and the patient was sent to her room in good condition without complications. PRESSURES: Aorta 117/63, LV 110/2-6…
The catheter data are characteristic of aortic incompetence: there is a wide pulse pressure in the aorta accompanied by a very high left ventricular end-diastolic pressure (LVEDP); a LVEDP greater than 20 mmHg is suggestive of irreversible LV dysfunction. All of the conditions listed are associated with aortic regurgitation. However, the clinical description best fits with Marfan's syndrome. Marfan's syndrome is a connective tissue disease inherited in an autosomal dominant manner. Clinical features include:…
When snow white's hunter used a pig heart to fool the evil queen, he was not totally in the wrong. Pig hearts and human hearts and very similar in structure and function. Pig Valves, however, should not be used in patients. Even though the pig valve heart transplant has been around for over 30 years, it's cons outweigh it's pros. The process of preparation eventually add to the downfall of the method. Pig valves are trimmed then fixed in buffered glutaraldehyde at high pressure. A pig heart valve is comprised of three main components: collagen, elastin, and glycosamino¬glycans (GAGs). Collagen fibers provide strength to the overall structure while elastin molecules give the valve elasticity. Finally, GAGs act as a cushion between the collagen and elastin layers. Glutaraldehyde has been shown to sterilize the tissue and prevent inflammation. The problem is, glutaraldehyde causes faster deterioration of pig valves. Again, pig valves should not be used in transplants.…
Steel's test results, I had reached a diagnosis as to what is likely to be her condition. According to the signs, symptoms, and test results in addition to the family history provided, Mrs. Steel portrays strong indications for having aortic valve stenosis. Generally, the occurrence of valvular stenosis is a result of the flaps stiffening or thickening; therefore, preventing the heart valve from fully opening, which, as a result, reduces the rate of blood flowing through the valve. In this case, stenosis of the aortic valve affects the outflow, diminishing the amount of blood reaching the rest of the body vessels as well as the heart itself. In Mrs. Steel's situation, she may have acquired the disease genetically in addition to having been a smoker for multiple years and taking medication that promotes valvular heart disease. Overall, etiology of aortic valve stenosis includes—but is not limited to-- the following examples: degeneration due to age, rheumatic fever, smoking, bacterial endocarditis, calcium deposits forming on the valve, damage due to atherosclerosis, damage of the heart muscles due to heart attack, medication or drugs that may promote valvular heart disease, radiation therapy,…
Journals JAMA, Stroke, Circulation, Blue Shield of California’s Health Guideline) that identified and matched my relevant, significant medical problems / co-morbidities from MyCHART (attached) with the corresponding major risk factors / complications associated with this planned surgery. (MyCHART is my documented medical record at Scripps Health in San Diego, CA.) The results of this matching process, a significant and truly long list, produced the well-referenced entries below. The Risk Factors / Complication categories of Stroke and Heart Attack, Bleeding at the Catheter Insertion Site, Infection and Death were provided by Blue Shield in their article “Carotid Artery Stenting Treatment Risks.”…
A sternal retractor was used and IMA was harvested and clamped with bulldog. The pericardium was continued to incise and pericardial edges was retracted with sutures to enhance exposure of the heart. The surgeon then identified the affected coronary artery, and coronary anastomotic site stabilizer was then used to reduce the movement of the beating heart and isolate the target coronary artery site for anastomosis (Fig.3). A fine mist of humidified CO2 gas was sprayed over the anastomotic site to clear the bleeding. Vessel loops, or silastic shunts was used to control bleeding. The distal anastomosis of the IMA with coronary artery was then performed side to side anastomoses with fine cardiovascular suture. Since IMA remained attached to the subclavian artery, no proximal aortic anastomosis required (Behny, 2006); the blood flow is restored as soon as the IMA anastomosis is established. If saphenous vein free graft was used during the off pump CABG, the distal end of the vein graft will be performed anastomosis first with the coronary artery, and then the other end of the vein graft will be sewn to the aorta either with the sutureless anastomosis device (Calafiore, et al., 2001) or hand sutured to aorta with the help of Hegar dilator loaded with the saphenous vein (Dikmengil, Ozeren, Aytacoglu, & Sucu, 2005) to minimize manipulation of the aorta . A drain will be…
You are working in the internal medicine clinic of a large teaching hospital. Today your first patient is 70-year-old J.M, a man who has been coming to the clinic for several years for management of CAD and HTN. A cardiac catheterization done a year ago showed 50% stenosis of the circumflex coronary artery. He has had episodes of dizziness for the past 6 months and orthostatic hypotension, shoulder discomfort, and decreased exercise tolerance for the past 2 months. On his last clinic visit 3 weeks ago, a CXR showed cardiomegaly and a 12-lead ECG showed sinus tachycardia with left bundle branch block. You review his morning blood work and initial assessment.…
In cases where the aorta is partially occluded by a C-shaped clamp, the heart is restarted and restoring of the grafts to the aorta is done in this partially occluded section of the aorta while the heart is beating.…
Have you ever imagined raw sewage spewing out of your sink, shower stalls or toilets? With many parts of the country recording high precipitation, such unfortunate occurrences have been experienced by a number of families. These kinds of backflow have their own setbacks. They lead to a damage that will prove a challenge to repair and also lead to massive health hazards.…
An issue that I faced just over two months ago forced me to make a hard and concisions decision. Two months ago, I was told that my fiancé had to have triple bypass surgery. At this point of time my family had just moved to kingwood in a huge home with a major increase in bills. My fiancé wanted to hold off on the surgery to earn more income before the procedure, but I was defiantly against it. My major issue with the surgery was the down time for my fiancé because I need an estimate time of how long bills were going to be an issue.…
Whether a cochlear implant will be beneficial to a person depends on that individual altogether. Age, compatibility, and funding are all important factors that help decide if a cochlear implant will be beneficial or even available. Age is very critical because in human development there is a sensitive period with hearing. A sensitive period is a certain amount of time that is given for a person to be exposed to an experience for it to develop normally. With hearing, this sensitive period is restricted to the age of six. If someone is exposed to sounds by this time there will be very little trouble adjusting to this new experience. However, if this person is exposed to sounds after the age of six, development and success in this new experience may be hindered.…
Imagine giving birth to a beautiful, healthy looking, baby girl and holding her in your arms for the first time. Now imagine a doctor telling you that this little miracle has a possible life threatening congenital heart defect. I can because this happened to me. My daughter suffers from three different congenital heart defects. According to the American Medical Association Family Medical Guide, about 8 out of every 1,000 children are born with heart abnormalities, or congenital heart defects.( AMAFMG p. 389) The 4 most recurring defects are Pulmonary Stenosis, Aortic Stenosis, Atrial Septal Defect and Ventricular Septal Defect. ( Radiologic Technology 2008)…
In percutaneous coronary revascularization, otherwise called angioplasty and stent arrangement, a catheter is embedded into the limited some portion of the artery. An emptied inflatable is gone through the catheter to the influenced territory. At the point when the inflatable is expanded, it packs the fatty deposits against the artery walls. A stent, or mesh tube, might be left in the course to help keep it open. Now and again, the stent discharges a medicine. In coronary bypass surgery, the surgeon uses a blood vessel from another piece of the body to make a graft that can bypass the blocked artery. The graft may originate from the leg or an inner chest-wall artery. Laser surgery includes making a few small gaps in the heart muscle, which…
I think most of them forget that we do not understand the terminology that they use when speaking to us. So having taken some classes in medical terminology and a little knowledge of the different disease of the body, I will do my best to explain things in a fashion that you can explain to your sister so she may be able to understand what is going on with her at this moment. First I will start by explaining to you what an Aortic Aneurysms is. An aortic aneurysm is a weak spot in the wall of the aorta, the primary artery that carries blood from the heart to the head and other extremities. I most cases people with aortic aneurysms in the chest area do not experience symptoms, but can have symptoms if the aneurysm gets bigger or causes pressure on the surrounding organs. You need to explain that she needs to really pay attention to the most common symptoms which are chest pain, back pain, difficulty swallowing, and shortness of breath. Treatment can vary with each patient depending on if the doctor feels you need surgery or not, if you will be able to withstand a major surgery, and if the surgery can be avoided for at least the present time. The treatments that are known for best ways of treating aortic aneurysm are medication such as a beta-blocker. Small aneurysms lest than 5.5 cm that are not at risk of rupturing are generally treated with medicine that is used to treat high blood pressure, but when the aneurysm gets above 5.5 cm to 6.0 cm in size the doctor will most likely recommend surgery. And one that is most important form of treatment for aortic aneurysm is to quit smoking cigarettes if you smoke them. I hope this helps you to understand some of the symptoms that are noticeable with an aneurysm so that you can help your sister to understand too. Also I hope my explanation of the treatments will help your…
This article was taken from the British national daily newspaper The Guardian entitled 'Sarkozy calls…