Surgical complications in children undergoing cancer therapy.
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Biomedical subjects
Publications and source records attributed to M L Murphy.
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Five hundred consecutive coronary arteriograms were reviewed to evaluate left main coronary artery lesions. This entity has been associated with a high incidence of angiographic deaths. Clinical signs claimed to be diagnostic were analyzed together with the value of various projections for making the diagnosis. Pressure damping was a vital sign, and when persistent, it required 3-5 mm to be cut from the catheter's tip for a safe study to be performed. Shallow 10-15 degrees oblique and AP projections were found to be essential for a complete evaluation of the left main trunk. Marked ST depression or hypotension during treadmill exercise testing, as well as the presence of coronary calcification were not statistically significant in anticipating this lesion. The incidence of left main lesions nearly 15% (74/500) in this series is higher than previously reported (2.4-5.9%); however, in 8% (40/500), the stenosis was 75% or greater in degree which more closely approximates to the incidence previously reported in the literature. This may be the result of the additional projections recommended, but is probably also related to the population studied. No complications occurred in this series.
Routine posteroanterior and lateral chest radiographs in 268 patients were analyzed to determine heart size--normal, cardiomegaly, or specific chamber enlargement--using specified radiographic criteria for enlargement. The accuracy of this determination was compared with a specific ventricular mass derived from a postmortem cardiac chamber partition technique. The data indicate that in the majority of cases (greater than 70%) a normal-sized heart or cardiomegaly can be correctly determined from the chest x-ray either by the subjective criteria of chamber enlargement or by measurement of the transverse diameter. The use of the chest x-ray, however, for evaluation of specific ventricular chamber enlargement is a less accurate determination, and results are compromised.