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Biomedical subjects

W C Roberts

Publications and source records attributed to W C Roberts.

At least 379 records · Page 21Linked to original sources
PubMed1984

Comparison of late (62 to 140 months) degenerative changes in simultaneously implanted and explanted porcine (Hancock) bioprostheses in the tricuspid and mitral valve positions in six patients.

A Hancock porcine bioprosthesis (PB) was simultaneously implanted in each of 6 patients aged 30 to 64 years (mean 45) in the tricuspid and mitral valve positions and both PBs were explanted 62 to 140 months (mean 102) later. Cuspal degenerative changes occurred in all 12 PBs. In 5 patients, the changes were more extensive on the PBs in the mitral position than in those in the tricuspid position. Cuspal calcific deposits, as determined by radiographs of the explanted bioprostheses, occurred in 5 PBs in the mitral position and in 3 in the tricuspid position: 1 patient with calcific deposits in the PB in the mitral position had no calcific deposits in the corresponding PB in the tricuspid position; 1 patient had heavy calcific deposits in the PB in the mitral position and only mild deposits in the PB in the tricuspid position; and 3 patients had similar but mild calcific deposits in both PBs. Cuspal tears occurred in 5 of the 6 PBs in the mitral position and in no PB in the tricuspid position. Thrombus was observed on the ventricular aspects of the bioprosthetic cusps in 1 PB in the mitral position and in 4 PBs in the tricuspid position. Thus, in our 6 patients, the degenerative changes were more extensive in the PBs in the mitral position than in those in the tricuspid position. These observations indicate that wear characteristics of simultaneously implanted PBs vary according to the site of implantation.

Adult↗
PubMed1984

Comparison of 7 English-language cardiology journals for 1983.

This article analyzes and compares 7 English-language cardiology journals for the year 1983 in terms of numbers of pages, articles, types of articles, figures and tables published and numbers of authors per article. The 7 journals included the 4 major USA cardiology journals--The American Journal of Cardiology (AJC), Circulation, Journal of the American College of Cardiology (JACC) and American Heart Journal (AHJ)--and 3 non-USA English-language cardiology journals: British Heart Journal (BHJ), European Heart Journal (EHJ) and the International Journal of Cardiology (IJC). Although Circulation published the most total pages (because of its huge abstract issue), the AJC published more total pages for articles, the most articles (in its regular issues, 44% more than Circulation, 48% more than the JACC and 39% more than the AHJ) and the AJC provided the most words per page (its maximal number being 20% higher than the maximal number in Circulation, 16% higher than in the JACC and 26% higher than in the AHJ). Each of the 3 non-USA journals was much smaller in terms of pages and articles published than were any of the 4 USA journals. In types of articles published, several differences among the 7 journals were apparent. Of the articles in Circulation, 24% concerned experimental (nonhuman) studies; this percent was 14 in the JACC, 12 in the AHJ, 8 in the AJC and none or nearly none in the BHJ, EHJ and IJC. Brief reports accounted for 27% of the 392 articles in the AHJ and 13% of the 643 articles in the AJC.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiology↗
PubMed1984

Frequency and significance of M-mode echocardiographic evidence of mitral valve prolapse in clinically isolated pure mitral regurgitation: analysis of 65 patients having mitral valve replacement.

To assess the reliability of M-mode echocardiographic patterns of mitral valve prolapse (MVP) (echo MVP) in detection of morphologic evidence of MVP (morphologic MVP), operatively excised mitral valves and corresponding M-mode echocardiograms from 65 patients with chronic, severe, isolated, pure mitral regurgitation (MR) were studied. Of the 65 patients, 45 (69%) had echo MVP (either holosystolic or mid-to-late systolic prolapse patterns on preoperative M-mode echograms) and 42 (93%) of them had morphologic MVP; of the 3 without morphologic MVP, 2 had ruptured chordae tendineae from infective endocarditis and 1 had papillary muscle dysfunction from atherosclerotic coronary heart disease. Of the 20 patients without echo MVP, 14 (70%) had no morphologic MVP (9 had papillary muscle dysfunction from coronary heart disease, 4 had infective endocarditis on previous normal valves and 1 had rheumatic heart disease). Of the 48 patients with morphologic MVP, 42 (88%) had echo MVP and most had considerably dilated mitral anulae; the other 6 had ruptured chordae tendineae with less degrees of anular dilatation. Of the 17 patients without morphologic MVP, 3 had echo MVP (coronary artery disease in 1 and infective endocarditis on a previous normal valve in 2); of the 14 with neither echo nor morphologic MVP, 9 had papillary muscle dysfunction from coronary artery disease, 4 had infective endocarditis on previously normal valves and 1 had rheumatic heart disease. The patients with very dilated mitral anuli and leaflet areas generally had holosystolic (hammocking) patterns on echo; the patients with small anuli and leaflet areas usually had mid-to-late systolic (buckling) prolapse patterns.

Adult↗
PubMed1984

Relation of level of total serum cholesterol to amount of calcific deposits in operatively excised stenotic mitral valves: analysis of 155 cases.

This report analyzes 155 patients with rheumatic mitral stenosis in whom the operatively excised mitral valve was x-rayed to determine the presence of and extent of calcific deposits and the preoperative level of total serum cholesterol (TC). The amount of mitral calcium was graded 0 to 4+ and the average TC for each of the 5 groups was: 0 deposits--21 patients (14%) (TC = 188 mg/dl); 1+-50 patients (32%) (TC = 196 mg/dl); 2+-22 patients (14%) (TC = 198 mg/dl); 3+-37 patients (24%) (TC = 205 mg/dl), and 4+-25 patients (16%) (TC = 184 mg/dl). These average values of TC and the mean ages of the patients in each of the 5 groups of mitral calcium were not significantly different.

Adult↗
PubMed1984

Amounts of coronary arterial narrowing by atherosclerotic plaques in clinically isolated, chronic, pure aortic regurgitation: analysis of 37 necropsy patients older than 30 years.

The degree of cross-sectional area (XSA) narrowing by atherosclerotic plaque in each of the 4 major epicardial coronary arteries (right, left main, left anterior descending and left circumflex) was determined at necropsy in 37 patients (30 men and 7 women) aged 34 to 77 years (mean 54) with severe, isolated, chronic, pure aortic regurgitation (AR). In 7 patients (19%), greater than or equal to 1 major coronary artery was narrowed 76 to 100% in XSA at some point. Of the 148 major coronary arteries examined in the 37 patients, 12 arteries (8%) were narrowed at some point 76 to 100% in XSA. Each of the 148 major coronary arteries were divided into 5-mm-long segments (average 53 per patient) and a histologic section from each segment was examined. Of the 1,977 segments, 1,087 were narrowed 0 to 25%, 669 (34%) 26 to 50%, 170 (9%) 51 to 75%, 48 (2%) 76 to 95% and 3 (0.001%) 96 to 100%. The average amount of XSA narrowing by atherosclerotic plaque per segment was about 28%. Of the 37 patients, 9 had had angina pectoris, 2 of whom had significant (greater than 75% XSA reduction) coronary narrowing; 2 other patients had had acute myocardial infarction clinically, 1 of whom had significant coronary narrowing at necropsy. Thus, in general, the amount of coronary narrowing in our 37 adults with severe, pure, isolated, chronic AR was relatively mild.

Adult↗
PubMed1984

Comparison at necropsy by age group of amount and distribution of narrowing by atherosclerotic plaque in 2995 five-mm long segments of 240 major coronary arteries in 60 men aged 31 to 70 years with sudden coronary death.

A comparison of the amount and distribution of coronary arterial narrowing by atherosclerotic plaque at necropsy is described in each of four decades (31 to 70 years) of 60 male victims of sudden coronary death (SCD). Of 2995 five-mm segments examined (mena 50 per patient) of the four major (left main [LM], left anterior descending [LAD], left circumflex [LC], and right) coronary arteries, no significant differences were observed in the mean percent of 5 mm long segments narrowed severely (76% to 100% in cross-sectional area [XSA]) in each decade: 33% in the five patients aged 31 to 40 years, 29% in the 27 patients aged 41 to 50 years, 26% in the 18 patients aged 51 to 60 years, and 30% in the 10 patients aged 61 to 70 years. The mean percent of 5 mm segments severely narrowed was significantly (p less than 0.05) greater in the proximal halves than in the distal halves of the LAD, LC, and right coronary arteries in only the two older decades. The mean percent of 5 mm segments minimally (0% to 25%) narrowed, however, was significantly higher in the younger than in the older decades. Thus, as groups, both young and old victims of SCD have similar amounts of severe coronary narrowing, but the younger victims have a greater proportion of their major coronary arteries minimally narrowed.

Adult↗
PubMed1983

The floating heart or the heart too fat to sink: analysis of 55 necropsy patients.

Certain clinical and morphologic findings are described in 55 patients whose hearts at necropsy contained so much fat that they floated in water. The patients were 47 to 89 years old (mean 67). Symptomatic coronary heart disease was present in 28 (51%) and valvular heart disease (mitral stenosis) in 3 (5%). The heart at necropsy was enlarged (greater than 350 g for women and greater than 400 g for men) in 45 patients (82%). The mean heart weight for the 31 women was 470 g and for the 24 men, 515 g. In addition to the severe increase in fat in the atrioventricular sulci and over both ventricles, the amount of fat in the atrial septum was increased in all patients. In 14 patients (25%), the thickness of the atrial septum cephaled to the fossa ovale was greater than or equal to 2 cm. Excessive fat in this location is called "lipomatous hypertrophy of the atrial septum." Of the 16 patients (29%) with fatal acute myocardial infarction, 7 (44%) had rupture of either the left ventricular free wall or ventricular septum. The high frequency of cardiac rupture in these patients supports the contention that rupture during acute myocardial infarction is more common in the fatty than in the non-fatty heart.

Adipose Tissue↗
PubMed1983

Frequency and extent of calcific deposits in purely regurgitant mitral valves: analysis of 108 operatively excised valves.

Operatively excised purely regurgitant mitral valves in 108 patients aged 21 to 73 years (mean 55) (63% men) undergoing isolated mitral valve replacement were examined for calcific deposits. Of the 108 patients, 19 (18%) had leaflet or chordal calcific deposits or both, but in each the deposits were small and did not appear to alter mitral function. Of the 19 patients with mitral calcium, 6 had had active infective endocarditis and the calcium likely represented healed vegetations; in 6 other patients, the leaflet calcium had extended from the mitral anulus in the setting of mitral valve prolapse. The average total serum cholesterol levels were higher in the patients with compared with those without mitral calcium. Thus, calcium deposits are relatively infrequent in adults with clinically isolated pure mitral regurgitation, and when they occur, the deposits are small and in themselves do not appear to contribute to mitral dysfunction.

Adult↗
PubMed1983

Wear of the metallic studs on the composite seat of the 2320 Starr-Edwards aortic valve and its clinical consequences.

The 2320 Starr-Edwards aortic valve has a composite seat with metallic studs that protrude through the cloth. Certain clinical and morphologic findings are described in 6 patients who had this prosthesis in situ for 50 to 144 months (mean 92). Considerable disruption of the cloth covering both struts and base, and varying degrees of wear of the metallic studs that line the luminal side of the prosthetic ring occurred in each. Excessive stud wear resulted in severe disruption of the cloth lining the interior of the prosthetic ring. Cloth disruption may be associated with hemolytic anemia, embolic consequences, or both. Of our 6 patients, 4 had severe hemolytic anemia, 4 had neurologic events compatible with emboli and 1 died suddenly. Stud wear as observed in the 2320 series Starr-Edwards prosthesis also may occur in the models 2310 and 2400 prostheses, which have the same composite seat.

Adult↗