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Biomedical subjects

P R Maggs

Publications and source records attributed to P R Maggs.

16 recordsLinked to original sources
PubMed1991

Misplaced caval filter and subsequent pericardial tamponade.

Use of the Greenfield filter for partial caval interruption is generally accepted as the most reliable mechanical method of pulmonary embolus prophylaxis. However, there have been reports of a variety of (usually nonfatal) complications. We report here the near-fatal complication of acute pericardial tamponade after misplacement of a Greenfield filter. Because of the filter's unusual location, retrieval required cardiopulmonary bypass, profound hyperthermia, and circulatory arrest.

Adult↗
PubMed1988

Review of coronary-subclavian steal following internal mammary artery-coronary artery bypass surgery.

The syndrome of coronary-subclavian steal through an internal mammary artery graft following coronary artery bypass grafting is rare. We are aware of only eight cases reported in the world literature. The cases of these 8 patients are reviewed, and the case of the ninth patient is described. All patients but 1 have been successfully managed by subclavian-carotid artery bypass.

Coronary Artery Bypass↗
PubMed1988

Fatal hypoxemia following mitral valve replacement.

Patency of the foramen ovale is a common condition. In certain clinical settings it permits the development of right-to-left intracardiac shunting. A case is described of sudden, fatal hypoxemia due to shunting through a patent foramen ovale immediately following mitral valve replacement.

Aged↗
PubMed1987

Spontaneous coronary artery dissection.

Spontaneous coronary artery dissection is a rare event that occurs most commonly in young, otherwise healthy women. Approximately 85 cases have been reported in the world literature. Dissection of the left main coronary artery is even less common; only 18 cases have been reported. This review discusses the incidence, presentation, pathogenesis, and management of spontaneous coronary artery dissection. The case of another patient with left main coronary artery dissection is described; to our knowledge, it is the first to be successfully treated by internal mammary artery bypass grafting.

Adult↗
PubMed1983

Intraaortic balloon pump morbidity: a comparative analysis of risk factors between percutaneous and surgical techniques.

We reviewed our concurrent experience with percutaneous insertion versus surgical placement of the intraaortic balloon pump over a two-year period both to compare morbidity and to provide guidelines for the choice of method in particular patient groups and clinical settings. The effects on morbidity of sex, age, emergency placement, coexisting peripheral vascular disease, and duration of counterpulsation were determined. Sex was a highly significant factor, with low complication rates (3/29 or 10.3%) for percutaneous insertion in men and an inordinately high morbidity (12/17 or 70.6%) in women (Fisher exact test: p = 4.611 X 10(-5)). This difference may be due to the smaller size of the femoral artery in women. We conclude that percutaneous insertion is the preferred technique for most men but that direct exposure of the femoral artery should be employed in women. Given the serious morbidity encountered with each technique, there is no justification to broaden the indications for intraaortic balloon counterpulsation.

Assisted Circulation↗
PubMed1979

Effect of left ventricular akinesis on cardiac performance. Experimental study using a new model.

The understanding of left ventricular failure and cardiogenic shock after myocardial infarction has been facilitated by a two-component model proposed by Swan et al. which views the left ventricle as consisting of a clearly defined infarcted portion and a normally functioning remainder. Although appealing, this model is difficult to substantiate experimentally. We describe a new experimental preparation in which the infarct is stimulated by replacing part of the left ventricular wall with an inert patch of Dacron material. In 18 dogs studied after replacing varying amounts of left ventricular contractile mass with noncontractile patches, the left ventricular end-diastolic pressure rose in proportion to the size of the patch. Contractility was unchanged, and overall left ventricular pump function was normal. These data support the conceptual model. The experimental preparation is applicable to other studies of left ventricular akinesis.

Angiocardiography↗
PubMed1978

Coronary artery aneurysm.

The case is presented of a 28-year-old woman with systemic vasculitis, aortic insufficiency, and an aneurysm of the proximal right coronary artery. More than 100 patients with coronary artery aneurysm have been reported, and this represents the twenty-first case treated surgically. Coronary artery aneurysms occur more frequently than previously realized and are seen in approximately 1.5% of patients with coronary artery disease. In addition to arteriosclerotic aneurysm, other common types of coronary aneurysm include those occurring congenitally or from mycosis, dissection, trauma, vasculitis, or periarteritis nodosa. Because of the risk of thrombosis and rupture, aneurysmectomy and saphenous vein bypass grafting are recommended for all but small, diffuse, or multiple aneurysms or dissecting aneurysms.

Adult↗
PubMed1977

Fatal bilateral pneumothoraces complicating subclavian vein catheterization.

Bilateral pneumothoraces complicating attempted bilateral subclavian vein catheterization culminated in the iatrogenic death of the patient. Complications of subclavian vein catheterization are reviewed briefly. This procedure should be limited to patients in whom its use is clearly indicated and should be performed only by individuals who are experienced in the anatomy of the region, who are trained in the technique of subclavian puncture, and who have the means and ability to perform immediate tube thoracostomy should pneumothorax occur.

Carcinoma, Squamous Cell↗