Search PubMed⌕ Search

Biomedical subjects

K J Grant

Publications and source records attributed to K J Grant.

10 recordsLinked to original sources
PubMed1993

Pneumonectomy for unremitting hemoptysis in unilateral absence of pulmonary artery.

Unilateral absence of pulmonary artery is a rare malformation that can present as an isolated lesion or may be associated with other congenital heart defects. Clinical presentation is subtle when the lesion occurs alone, and may include hemoptysis, which results from rupture of abundant bronchial submucosal vessels perfused by enlarged systemic collaterals that supply the affected lung. Pneumonectomy is recommended as definitive treatment in such an adult patient.

Adult↗
PubMed1989

Interlocking figure-of-8 closure of the sternum.

Sternal dehiscence and mediastinitis are two of the most severe complications of a median sternotomy. A technique of closure is described that appears to provide a more stable sternal approximation without any increase in overall complication rate. Using this technique in 978 consecutive patients, no cases of sternal dehiscence or mediastinitis have been seen.

Adult↗
PubMed1989

A travelers' clinic in an academic setting.

The Department of Family and Community Medicine at the University of Arizona has operated a travelers' clinic since 1983, staffed primarily by faculty and residents from the sections of preventive medicine, occupational medicine, and family medicine. We describe the clinic experience in providing preventive medical services to international travelers. Summer months are the busiest. Destinations of the travelers show a clear predominance of travel to less-developed countries, and this is reflected in the immunizations and prescriptions provided. After their trips, travelers reported a low incidence of diarrhea of generally low severity. The travelers' clinic is also a positive experience for resident physicians who help staff it, particularly those specializing in general preventive medicine.

Adolescent↗
PubMed1988

Contraindications for percutaneous transluminal coronary angioplasty in treatment of unstable angina pectoris.

In recent years, the indications for percutaneous transluminal coronary angioplasty have expanded to include multivessel disease, unstable angina pectoris, stenosis of coronary bypass grafts, and recent total coronary occlusion. To evaluate our experience in using percutaneous transluminal coronary angioplasty to treat unstable angina, we reviewed the records of the patients who underwent this procedure at our hospital between January 1983 and December 1986. Of the 689 patients who underwent balloon angioplasty during the study period, 454 had stable angina and 235 had unstable angina; of the latter group, 34 (14.5%) required emergency coronary artery bypass grafting after balloon angioplasty failed. This outcome was associated with 2 risk factors: previous myocardial infarction and triple-vessel disease. Our data suggest that, in cases of unstable angina pectoris, percutaneous transluminal coronary angioplasty should be reserved for patients with single-vessel disease and no evidence of previous myocardial infarction. They also lend credence to the conclusion that the disease process in unstable angina is different from that in stable angina, and that therapy should be directed towards reducing platelet aggregation and correcting global ischemia, rather than towards balloon angioplasty of "culprit lesions."

Journal Article↗
PubMed1987

Massive chylopericardium after coronary artery bypass surgery.

Massive isolated chylopericardium is a rare postoperative complication of coronary artery bypass surgery. In the following case, massive chylopericardium developed after a coronary artery bypass procedure in which the left internal mammary artery was used for revascularization. The chylopericardium resulted from direct trauma to the thoracic duct during mobilization of the left internal mammary artery to its origin at the subclavian artery. With adequate drainage, the problem was resolved. In cases in which drainage persists, ligation of the thoracic duct may be necessary.

Journal Article↗
PubMed1986

Myocardial revascularization combined with aortic valve replacement.

We reviewed 50 consecutive patients who had undergone complete myocardial revascularization combined with aortic valve replacement during a 5-year interval ending in June 1983. A cold blood cardioplegia technique, utilizing not only the native circulation but also the vein conduits, was used. All patients had greater than 70% stenoses of the major coronary arterial system. No patient had valve replacement alone, and no patient was refused operation. The mean number of arteries grafted was 2.3. There were two hospital deaths. One patient had evidence of perioperative myocardial infarction. There were two late deaths and one non-fatal myocardial infarction during the follow-up period, which averaged 16 months. The technique of hypothermic blood cardioplegia used provides a uniform distribution for myocardial protection, especially in the hypertrophied ventricle, and is superior to previously employed methods. This study indicates that myocardial revascularization combined with aortic valve replacement should be performed in patients with coexisting aortic valvular and coronary disease.

Journal Article↗
PubMed1980

Multiple cardiac lesions from blunt trauma.

Blunt chest trauma may produce a variety of cardiac lesions, which may occur alone or in combination. A case with a ventricular septal defect, left ventricular aneurysm, and coronary arteriovenous fistula with an associated rupture of the thoracic aorta following blunt trauma is presented in order to demonstrate that multiple, life-threatening cardaic lesions may be managed successfully. Surgical repair 32 days postinjury with Teflon patch plus ligation of the fistula were followed by recovery in the patient presented.

Adolescent↗
PubMedDate not supplied

Complete recovery following an unusual cardiac stab wound.

A 17-year-old female was stabbed in the chest and found by paramedics in extremis. She arrived at the receiving hospital with spontaneous respirations and an improved blood pressure. Upon thoracotomy in the operating room, lacerations through the main pulmonary artery and the left atrium were found. The combined efforts of a sophisticated EMS system providing rapid in-field stabilization and transport, a ready in-house trauma team able to quickly assess and provide definitive care, and a prepared operating room team, including cardiopulmonary bypass capability, resulted in a complete and uncomplicated recovery from this rare and lethal injury.

Adolescent↗
PubMedDate not supplied

Gasoline injection.

Injection of petroleum distillates is rare. We recently cared for a man with a long history of drug abuse who attempted intravenous injection with gasoline into a right forearm vein in order to "get high." We believe he accomplished an intramuscular and subcutaneous injection of gasoline which resulted in a severe impairment of the right hand and forearm from damage to the right median, ulnar, and radial nerves.

Adult↗