Biomedical subjects

J B Partridge

Publications and source records attributed to J B Partridge.

27 records · Page 2Linked to original sources

PubMed1981

Clinical cardiovascular experiences with iopamidol: a new non-ionic contrast medium.

Iopamidol, a new non-ionic water-soluble contrast medium, has been compared with standard ionic media in a number of cardiovascular applications. It is stable in aqueous solution, is much less viscous and only slightly more osmolar than metrizamide. Compared to sodium meglumine diatrizoate in a series of 40 coronary arteriograms, it produced a consistent and highly significant decrease in the incidence and severity of hypotension and bradycardia following intracoronary injection. In the same group and in 62 children undergoing ventricular or great vessel angiocardiography, a subjective assessment of patient reaction showed that iopamidol was better tolerated than the ionic medium. There was a very strong patient preference for iopamidol in a group of 20 of the adult patients who had also consented to femoral artery injections of both media. Throughout these series there was no detectable difference in arterial image quality between the media. Venous phase opacification during arterioportography was assessed in 11 cases comparing iopamidol with sodium meglumine iothalamate. No significant difference was found. We conclude that iopamidol is clearly preferable to ionic media for routine cardiovascular applications.

Angiocardiography↗

PubMed1981

Cineangiocardiography in tetralogy of Fallot.

The advantages of angled angiographic projections are demonstrated in a review of 55 cases of tetralogy of Fallot. Particular attention was paid to the origins of the branch pulmonary arteries, whose diameter was measured and compared with that of the descending aorta, showing that in 12 per cent there was narrowing to below 40 per cent of descending aortic diameter. Right aortic arch was present in seven cases (13%) and a major coronary artery anomaly in two (4%).

Angiocardiography↗

PubMed1981

Two chambered left ventricle. Three new varieties.

A short review of two chambered left ventricle is given, and this rare condition is briefly compared and contrasted with the more common condition involving the right ventricle. Three cases are described, each of which presents a new variety of subdivision of the left ventricle; in two of these the condition was first shown by angiocardiography. The first case had left heart hypoplasia with dysplastic stenosis of the mitral and aortic valves and severe endocardial fibroelastosis of the main left ventricular cavity. The second case also showed dysplasia of the left sided valves with pronounced endocardial fibroelastosis, and in addition there was a congenital malformation of the left lung. The third case showed a bizarre ventricular subdivision without other congenital malformations. The role of the intertrabecular myocardial sinusoids in the pathogenesis of some types of two chambered ventricle is discussed and this is considered to have been of significance in the first two cases. The third case possibly represented an intramyocardial aneurysm of obscure aetiology.

Female↗

PubMed1980

Angiocardiography with metrizamide in the neonate and infant.

The non-ionic contrast medium metrizamide was compared with a routine ionic medium (sodium methyl-glucamine diatrizoate) in a series of 16 patients with congenital heart disease, all under 11 kg body weight, undergoing angiocardiography. Despite a higher viscosity, metrizamide yielded images of equal quality to those of the ionic medium, and was clinically better tolerated. Metrizamide produced a significantly lesser effect on plasma osmolality, a parameter closely related to contrast medium toxicity. Other biochemical parameters showed insignificant changes. Metrizamide is therefore a more suitable contrast medium for angiocardiography and despite its cost should be considered for patients with serious congenital heart disease who are in poor clinical condition.

Angiocardiography↗

PubMed1978

The underfilled coronary artery: some pre- and post-operative observations on recipient arterial quality and left ventricular function after coronary artery surgery.

In a series of 141 saphenous vein aortocoronary bypass grafts in 59 patients undergoing routine restudy of the coronary arteries within four weeks of operation, an overall graft occlusion rate of 12% was found. A trend towards a higher occlusion rate was seen in arteries that were small (19%), that had a limited run-off (15%), significant distal disease (24%) or severe atheroma at the graft site (22%). Statistically, these occlusion rates are not significantly different from the overall failure rate and do not give absolute contra-indications to grafting. A particular group of arteries which seemed underfilled in the pre-operative angiogram (1.5 mm or less in diameter but apparently healthy with smooth walls and supplying a larger area of myocardium than would be expected from their apparent size) was identified. These arteries showed a significant increase in diameter in the post-operative angiograms and had a low occlusion rate (1 of 15 grafts; 7%). When all grafts were patent, the mean post-operative left ventricular ejection fraction showed a significant increase over the pre-operative valve, but when one or more grafts were occluded there was no significant change.

Arterial Occlusive Diseases↗

PubMed1977

Coronary arteriography; method of presentation of the arteriogram report and a scoring system.

A coronary arteriographic report presentation consisting of a diagram on which the radiologist draws the coronary arterial anatomy of each individual case is described. The diagram allows a clear visual presentation of all the information gained from the analysis of the original arteriographic study including anatomical variations, the position and importance of each artery in terms of the myocardium it supplies, the sites and severity of obstructions and the presence of collateral pathways. A myocardial scoring system which expresses the severity of left ventricular arterial obstructive disease is also presented. The myocardial score takes into account not only the degree of stenosis of any number of arterial branches, but also their importance in terms of the amount of myocardium supplied.

Angiography↗

PubMed1976

Prognosis in unstable angina.

A retrospective study was made of 158 patients with unstable angina admitted to a coronary care unit over a 4-year period. Twenty patients (13 per cent) had myocardial infarcts while in hospital, and of these 3 died; three others died without preceding evidence of myocardial infarction. There was thus an acute mortality rate of 4 per cent. Patients with persisting angina after the first 24 hours and those without a previous history of myocardial ischaemia were more likely to develop a myocardial infarct or to die in hospital. Follow-up information, ranging from 3 to 7 years, was available in 144 of 152 hospital survivors. Patients older than 60 years (P less than 0-05), with cardiomegaly (P less than 0-01) and with pulmonary venous congestion (P less than 0-05) were found to have significantly increased long-term mortality. Long-term mortality was also found to rise with increasing coronary prognostic index. The average mortality rate for the whole group of hospital survivors was about 5 per cent per annum. Of the 111 patients who were alive at follow-up, 19 (17%) had had a myocardial infarct after leaving hospital, and a similar number had moderate or severe angina.

Age Factors↗

PubMed1976

Common or single ventricle. An angiocardiographic and hemodynamic study of 42 patients.

To correlate anatomy with hemodynamics, the angiocardiographic findings were reviewed in 42 patients with common ventricle (CV). Nine had normally related great arteries (NRGA), 12 d-malposition, 21 l-malposition and 5 a common atrioventricular valve. Selective outlet chamber (OLC) angiocardiograms were available in 14 out of 29 patients with OLCs. OLC position varied from anterior and to the right of the CV to posterior and to the left of it; two categories (anterior and lateral OLC) were delineated by a line 45 degrees to theleft of anterior in the horizontal plane. The OLC was anterior in all patients with NRGA, lateral in most l-malpositions, and almost equally divided between anterior and lateral in d-malposition (P less than 0.05). Complete hemodynamic data were obtained in 29 patients. Complete mixing of venous return occurred in four patients with atresia of one valve. In the remainder complete mixing occurred in 36%, unfavorable streaming in 12% and favorable streaming in 52%. Semilunar valve position and pulmonary stenosis did not affect the nature of mixing. Systemic arterial (SA) minus pulmonary arterial O2 saturation was positive and significantly higher in patients with malposition with lateral OLCs than anterior OLCs (P less than 0.001). However 79% of SA O2 saturation variation could be predicted from pulmonary and systemic blood flow alone.

Adolescent↗

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↗