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Biomedical subjects

P Wilde

Publications and source records attributed to P Wilde.

At least 55 records · Page 3Linked to original sources
PubMed1993

Transient cortical blindness after coronary angiography.

Transient visual loss lasting three days developed after transfemoral coronary angiography in a 62 year old man. Computed tomography (CT) showed bilateral leakage of contrast medium into the occipital cortex. A repeat CT scan after his sight recovered showed clearance of contrast with no underlying infarction. A breakdown of the blood-brain barrier with direct neurotoxicity of the contrast media seemed to be the cause of these neurological changes after coronary angiography which apparently have not been reported before.

Blindness↗
PubMed1992

Diagnosis of acute thoracic aortic dissection using combined echocardiography and computed tomography.

Acute dissection of the thoracic aorta is a life-threatening emergency requiring a diagnosis which is rapid, accurate and safe, and which will distinguish between dissections involving the ascending and descending aorta. In the absence of any general agreement on the best method of making this diagnosis we studied the use of combined echocardiography and contrast-enhanced computed tomography (CT) to diagnose acute aortic dissection. Over a 3 year period 23 patients were investigated in this way. Aortic dissection was demonstrated in 18 cases, involving the ascending aorta in 15, and the descending aorta alone in three. The diagnosis of aortic dissection was confirmed in 13 patients at surgery, in one at aortography and in one at autopsy. Three patients died without surgery or autopsy being performed to confirm the diagnosis and the subsequently which accounted for their symptoms. This combined approach has proved a valuable and safe means of investigating aortic dissection.

Acute Disease↗
PubMed1991

Limitations in the use of five French coronary catheters.

Five french (5F) catheters are being widely promoted for use in patients undergoing day case angiography including coronary angiography. Although there are theoretical advantages to this practice there are also potential disadvantages. We reviewed various performance parameters of four different brands of 5F coronary catheter and compared them with performance of the six (6F) and eight french (8F) coronary catheters used in routine coronary angiography. All the 5F catheters performed significantly less satisfactorily than the 6F and 8F catheters. 5F coronary catheters cannot be recommended for routine transfemoral coronary angiography.

Cardiac Catheterization↗
PubMed1989

The current position of cardiac radiology in the United Kingdom.

A questionnaire was sent to 39 hospitals, in the United Kingdom, 38 with a cardiosurgical unit and one with a cardiac radiology department. The object was to ascertain the commitment of consultant radiologists to cardiovascular radiology and cardiac radiology in particular and to evaluate training given to non-consultant radiologists in this subspecialty. Thirty-five (90%) departments responded, 33 of which had a cardiac radiology consultant. All but three of the 63 consultant cardiac radiologists report cine angiography. Of the 63, 26 perform one additional imaging technique and 21 perform two or more additional imaging techniques. The remaining 16 consultants only report on cine angiography. Only nine of 21 departments in which some form of cardiac radiology training was given, had a rotation through the subspecialty at registrar or senior registrar level. Twenty-one departments thought that an additional post in cardiac radiology would be sought if trained people were available.

Cardiology↗
PubMed1989

Fetal echocardiography--four years experience in Bristol.

Fetal echocardiography is described as a reliable method for detecting major structural cardiac abnormalities but relatively few hospitals offer the investigation. We report the results of fetal echocardiography in 110 pregnancies referred to our cardiac ultrasound service. Standard imaging techniques were used and scanning was carried out at 18-24 weeks gestation in the majority. Most referrals were made with a history of congenital heart disease in a sibling or close relative, the remainder followed abnormal routine scans or for other reasons. Four structural cardiac abnormalities were diagnosed in the routine scan abnormality group and one in the positive family history group. Referring clinicians reported no subsequent cardiac abnormality following normal scans. We confirm that provided a careful and systematic technique is used fetal echocardiography is reliable in detecting major structural cardiac defects. Particular attention should be paid to the fetal heart in patients with previously abnormal routine scans as this group accounts for the majority of detected congenital cardiac anomalies.

Echocardiography↗
PubMed1989

Echocardiography of valve disease.

Recent technical developments have led to the combined use of imaging and Doppler modalities in cardiac diagnosis to produce a reliable and non-invasive approach to the accurate assessment of cardiac valve disease. Anatomical detail is visible on two dimensional imaging, accurate measurement and timing can be derived from M-mode studies and Doppler studies give detailed insight into cardiac valve haemodynamics. In the majority of patients valve gradients can be calculated using continuous wave Doppler techniques, while pulsed Doppler techniques (including colour flow mapping) can give accurate information about valve regurgitation. In many cases these techniques provide an adequate substitute for cardiac catheterisation and they can be repeated as often as necessary to monitor progress of disease and treatment.

Blood Flow Velocity↗
PubMed1989

Ventricular fibrillation in coronary angiography: what is the role of contrast medium?

A retrospective review of patients with coronary angiography was undertaken to establish the incidence of ventricular fibrillation and other serious arrhythmias and to identify possible causative factors, in particular whether the use of non-ionic contrast medium increased the risk of a serious arrhythmia. Out of 3660 patients reviewed there were 10 cases of ventricular fibrillation. In all cases, there were identifiable technical factors thought to have accounted for the arrhythmia. There were no cases of ventricular fibrillation complicating a technically satisfactory injection of ionic or non-ionic contrast medium. There was no significant difference in the incidence of serious arrhythmias between patients given ionic and those given non-ionic contrast medium.

Angiocardiography↗
PubMed1989

Management of supracondylar fractures of the femur with Zickel supracondylar nails.

Twenty-one cases of supracondylar fracture of the femur treated at St Vincent's Hospital, Melbourne, during 1983-86, by intramedullary Zickel supracondylar nails were reviewed. The causes were high energy trauma in young patients (six), minor trauma in elderly patients (13), and metastatic malignant fracture (two). The functional results were considered excellent in 10, good in six and poor in five. There were two cases of superficial wound infection. All cases united after 3-6 months. The best functional results were in those patients below 60 years or with pathological fractures. It is concluded that internal fixation of supracondylar fractures of the femur with Zickel supracondylar nails is a successful technique and can be performed by open and closed methods. It is most useful in osteoporotic or pathological bone which is unsuitable for bone plating.

Aged↗
PubMed1988

Left ventricular aneurysm formation: an iatrogenic cause for the third mogul.

Two cases of left ventricular pseudoaneurysm formation developing post-operatively after mitral valve replacement are reported. The chest radiographs showed an abnormal protuberance on the left heart border at the site of the "third mogul". The definitive diagnosis of this protuberance, resulting from the development of a left ventricular aneurysm, was made on angiography in each case. This site is unusual for left ventricular aneurysm formation, with the exception of the annular subvalvular aneurysm described in the negro population. Relevant aetiological factors in the development of these post-operative left ventricular pseudoaneurysms are considered. Since pseudoaneurysms are more prone to rupture than true aneurysms, it is concluded that early diagnosis of development of these left ventricular pseudoaneurysms should be made.

Female↗
PubMed1987

Assessment of percutaneous transluminal coronary angioplasty with 123IODO-heptadecanoic acid.

Ten patients underwent myocardial scintigraphy with 123I-iodo-heptadecanoic acid (HDA), which was injected in the last minute of maximal exercise testing. Six of the patients were rescanned following percutaneous transluminal coronary angioplasty. All ten patients underwent full coronary angiography. There were visible perfusion defects on the static images in 74% of the myocardial areas which were supplied by an artery with a stenosis greater than 75%. The mean half life recorded from areas distal to an arterial stenosis of at least 90% (35.69 min +/- 41.25 min), was longer than the expected normal mean (18.85 min +/- 3.35 min). However, the difference was not statistically significant. The static images changed in some patients following angioplasty, however there was no consistent alteration in the half lives. It was concluded that HDA is a suitable agent for investigating myocardial perfusion, but that the half life cannot be measured adequately for clinical purposes with a planar imaging system.

Angioplasty, Balloon↗
PubMed1987

Prognostic value of 123-IODO-heptadecanoic acid imaging in patients with acute myocardial infarction.

This trial aimed to test if the half life of radioiodinated heptadecanoic acid (HDA) in acutely infarcted myocardium is of prognostic value. Twenty patients had an HDA scan and a MUGA scan within 6 days of acute myocardial infarction, eighteen of these had a visible defect on the HDA images. The mean half life of the areas of acute infarction (15.50 min +/- 7.82 min) was significantly shorter than that of normal myocardium (20.77 min +/- 4.00 min). The MUGA scan was repeated after 6 months in 15 patients. The mean acute infarct half life was longer in patients with an LVEF improvement of at least 5% at 6 months (16.92 min +/- 10.56 min), compared to those with a deterioration of more than 5% (11.75 min +/- 4.03 min), although the difference is not statistically significant. While the results in a few individuals suggested that the half life may be of prognostic significance, the variable response of the group reduced the ability of the half life to act as a prognostic indicator. Improvements in imaging and background subtraction techniques may be necessary before the half life is of practical value.

Clinical Trials as Topic↗
PubMed1987

The measurement of heart size in the antero-posterior chest radiograph.

A computed tomography model was used in eight patients to show how the heart diameter and cardiothoracic ratio might change between antero-posterior and postero-anterior positions. Results were compared with measurements made on erect antero-posterior chest radiographs taken on 103 patients without cardiac failure (controls) and 106 with cardiac failure. An upper limit of cardiothoracic ratio of 55% and of heart diameter of 165 mm in males and 150 mm in females was shown to provide useful discrimination between normal and abnormal heart size.

Female↗