Cardiovascular MRI.
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Cardiovascular Diseases↗
Biomedical subjects
G Hartnell
Publications and source records attributed to G Hartnell.
An improved reversal technique from retrograde to antegrade femoral artery cannulation.
Converting retrograde femoral access to antegrade access may be required following diagnostic arteriography to perform an interventional procedure. This technical note describes a modification of a previously described technique that allows reliable catheter reversal which was successful in 27 attempted procedures. There were no complications.
Angioplasty, Balloon↗
Case report: legionella infected thoracic aortic graft.
A case of a thoracic aortic graft in a patient with Marfan's syndrome infected with legionella is presented. The pathogenesis of graft infection and aspects of examination with aortography, gallium scanning, magnetic resonance imaging (MRI), and spiral volumetric computed tomography (CT) are presented, and the pathophysiology and management of thoracic aortic graft infections is briefly discussed.
Aortic Dissection↗
Spiral CT evaluation of coronary artery bypass graft patency.
Spiral CT (SCT) differs from conventional CT in that the entire heart can be rapidly imaged in the axial plane following the peripheral infusion of small quantities of contrast material. As contrast material travels through coronary artery bypass graft segments, good image detail is achieved, allowing visualization of entire coronary artery graft segments during a single injection. The patency of 43 coronary artery bypass grafts in 14 patients on contrast enhanced SCT, with timing tailored to patient-specific transit times, was compared with that obtained by selective graft angiography. With use of 5 or 8 mm/s table feed and 24 s volumetric acquisitions, SCT established graft patency with 85.7% sensitivity and 100% specificity compared to angiographic examination (96.4% sensitivity and 100% specificity). The mean time between angiography and SCT was 2.1 days, with 86% of SCT studies done within 24 h after angiography. The utilization of dynamic scanning to establish the patient-specific time delay prior to initiation of SCT proved crucial in improving the quality and reliability of SCT bypass graft patency assessment. The paired McNemar test indicates no significant difference between angiography and SCT in establishing patency rates.
Aged↗
Behçet's disease complicated by pylephlebitis and hepatic abscesses.
A 22 year old man presented with fever, abdominal pain, weight loss and diarrhea. Past medical history revealed recurrent aseptic meningitis, uveitis, and erythema nodosum. Further inquiry unveiled a prominent history of oral aphthous ulcers; all features of Behçet's disease. Imaging revealed mesenteric arteritis and pylephlebitis, septic thrombophlebitis of the portal vein, a previously unrecognized complication of Behçet's disease, with multiple intrahepatic abscesses. Portal venography demonstrated an extensively diseased, expanded, and obstructed portal venous system. Blood cultures and portal vein aspirate yielded polymicrobial flora. Percutaneous intraportal thrombolytic therapy and mechanical thrombectomy were attempted to restore flow to the portal venous system. This distinctly rare manifestation of Behçet's Disease, pylephlebitis, may result from ischemic injury and structural compromise of the bowel mucosa, resulting from underlying vasculitis.
Adult↗