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Biomedical subjects

F J Macartney

Publications and source records attributed to F J Macartney.

142 records · Page 8Linked to original sources
PubMed1975

New performed catheter for entry into pulmonary artery in complete transposition of great arteries.

A new performed, semi-rigid, polyethylene catheter, with built-in torque control, has been devised for entry to the pulmonary artery in complete transposition of the great arteries. It has been used 19 times in 17 patients: 18 times the pulmonary artery was entered from the right atrium (via the left atrium and ventricle) in a time between 40 s and 15 min (median 5 min); the patients' ages were 2 days to 6 years (median 8 months) and their weights were 3.1 to 13.3 kg (median 6.9 (kg: in the remaining 1 day-old patient, the procedures was terminated because of atrial flutter. The catheter was introduced into the axillary vein in 3 patients and thesaphenous or femoral vein in the remainder. It is suitable for angiocardiography, and the other heart chambers and vessels were easily entered. Thus the catheter has certain advantages over previously described methods for entry to the pulmonary artery, particularly when there is inferior vena caval thrombosis, or when angiocardiography is necessary. Its use does depend on the presence of an interatrial communication, so a method for entry to the pulmonary artery by retrograde catheterization from the axillary artery using a different catheter is also presented; this was successful in 2 patients with ventriculal sepatal defect.

Adult↗
PubMed1975

Visualization and measurement of the main bronchi by tomography as an objective indicator of thoracic situs in congenital heart disease.

When investigating complex congenital heart disease, determination of atrial situs is essential. Pathological studies have demonstrated that the best predictor of atrial situs is thoracic situs. To assess thoracic situs, bronchial tomography was performed in 92 patients with congenital heart disease. Sixty-four of these, without abnormalities of situs or cardiac position, formed 'normal' controls. The lengths of the left and right main bronchi were measured. When these were related to age, and the results analyzed statistically, linear discriminant equations resulted giving a chance of only 0.09% of misclassifying a bronchus of unknown morphology. The lowest ratio between bronchial lengths (BLR) in any individual was 1.71:1. These results were then used to assess thoracic situs in 17 patients with abnormal situs or CARDIAC POSITION. In 7 (2 with situs inversus), abdominal and thoracic situs agreed. Of 6 patients with bilateral left lung, 3 had an interrupted inferior vena cava. Of 4 patients with presumptive asplenia, 2 had bilateral right lung, but two had thoracic lateralization, one solitus and one inversus. The highest BLR in thoracic isomerism was 1.4:1. This emphasizes the complex interrelation of splenic status, thoracic, and abdominal situs, but demonstrates the value of bronchial measurement particularly in apparent situs indeterminatus.

Adolescent↗
PubMed1970

Congenital absence of the pulmonary valve.

The clinical, radiological, electrocardiographic, and haemodynamic findings in 7 patients with the syndrome of congenital absence of the pulmonary valve with ventricular septal defect are reported. Findings included a pansystolic murmur and a low-pitched delayed diastolic murmur at the left sternal border with no pulmonary valve closure sound, an rsR' pattern in V1 on the electrocardiogram, and a chest x-ray showing a large heart and gross dilatation of the main, left or right pulmonary arteries but normal or reduced vascularity of the peripheral lung fields. Cardiac catheterization showed a left-to-right shunt at ventricular level in every case, though in one the shunt was bidirectional. Despite right ventricular systolic pressures at least 75 per cent of systemic level in every patient, the pulmonary artery pressure was invariably normal. Pulmonary stenosis was shown to exist at infundibular level, at valve ring level, or at both. Selective right ventricular angiography was diagnostic: the main and right or left pulmonary arteries were aneurysmally dilated and there was an abrupt transition in calibre between these vessels and their immediate branches; enlargement of the right pulmonary artery caused distortion and downward displacement of the left atrium in 4 patients; in 2 there was a flat ;diaphragm' in the pulmonary valve position.The diagnosis was confirmed in 3 patients by necropsy. The pulmonary valve was represented by at most a rudimentary fringe of tissue. Histological examination of the pulmonary arteries in one patient showed a correlation between the dilatation of the artery and the structure of its wall.

Adolescent↗