Homograft aortic valve replacement, 1971-1978

Twenty-two patients were subjected to Homograft Aortic Valve Replacement (HAVR) at the University Hospital between 1971 and 1978. The clinical and investigative data, operative morbidity and mortality, and the results in the survivors have been presented. It is concluded that HAVR is a satisfactory operation with acceptable operative morbidity and mortality. (AU)

The development of cardiac catheterization at the University Hospital

Cardiac catheterisation at the University Hospital from 1967 to 1978 has been described, with an outline of its development over the years, the techniques used, the results obtained and the complications encountered. Six hundred and six patients were subjected to cardiac catheterisation. Morbidity was low and there was one death due to malignant hyperthermia complicating general anaesthesia (AU)

Pre and post-operative findings in 18 cases of congenital heart disease treated by open heart surgery and cardiopulmonary bypass - abstract

The main purpose of this paper is to review the results of open heart surgery at the University Hospital of the West Indies in the past three years. 18 patients with congenital heart disease have had corrective surgery performed. The mean age at operation was 14.8 years ranging from 6.8 to 28 years. Seven of the patients were under 12 years and all but two 18 years or under at the same time of surgery: Five patients have had total correction of the Tetralogy of Fallot. Four of them, including a girls of 12 1/2 years who had pulmonary embolus one month after operation, are well at follow-up. One patient, a girl of 11 years, who was operated on in June, 1970, had evidence of right ventricular failure for six months, but when last seen was well although signs of tricuspid incompetence persist. Four patients with atrial septal defect, including one with an ostium primum defect and mitral incompetence, are well at follow-up with no evidence of heart disease. Four patients with ventricular septal defect have had their defect repaired. Two of these had significant pulmonary hypertension pre-operatively and one of these developed a leak post-operatively and has required a second operation. Four cases of pulmonary stenosis (two valvular, one infundibular and one both valvular and infundibular) have been corrected and all these patients are now well and active. A young woman of 27 who was thought on cardiac catheterization to have pulmonary stenosis, was found at operation to have a double outlet right ventricle and infundibular stenosis. Right and left outflow tract reconstruction carried out and although she had a stormy post-operative course was well when last seen. Pre- and post-operative electrocardiographic and radiological data will also be presented (AU)

A methicillin (celbenin) clinical trial at the University Hospital of the West Indies

In a limited clinical trial celbenin was found to be effective against penicillin resistant strains staphylococci and produced no undesirable side-effects (AU)

An analysis of electrocardiographic changes occuring in infantile gastroenteritis and infantile malnutrition in Jamaica

In 84 percent of cases of abnormalities were found in electrocardiograms and those were related to electrolyte disturbances - particularly reflecting low serum levels of magnesium, potassium, sodium and calcium. It was suggested that magnesium should be included in replacement fluids (AU)

Unusual aspects of reticuloses

Tumours of the reticulo-endothelial system appear to be common at the U.C.W.I. Hospital and within the last three years some 80 cases have been seen. 7 of these cases with very unusual initial manifestations were presented in the hope that awareness of the bizarre symptomatology of the reticuloses may lead to earlier diagnosis (AU)

Dilatation and unfolding of the aorta in a Jamaican population

In an analysis of 2085 70 mm. chest X-rays of subjects aged 35-64 from a rural population in Jamaica, 79 of the 1090 women (8.4 percent) showed some degree of aortic dilatation. The clinical examination of these people and age and sex balanced control groups drawn by random methods from the same population revealed three main findings. (1) Arterial pressure levels were consistently higher in the affected, than in the controls. (2) The conditions was associated with aortic regurgitation in 20 percent of men and 7 percent of women. (3) Both aortic dilatation and arterial pressure in these subjects were apparently unrelated to their present serological status. Positive serological reactions were found in about 25 percent of affected and controls. The possible role of syphillis and/or yaws in association with hypertension in producing aortic dilatation is discussed. A relationship between aortic dilatation, often gross, and hypertension has been demonstrated and this combination appears to have a high prevalence in West Indian negroes. Whatever the role of treponemal infection it is apparently not the most important single factor in the production of either the aortic dilatation, the associate hypertension, or the resulting aortic regurgitation. The significance of uncomplicated aortic dilatation, in terms of morbidity and mortality, remains to be determined by follow-up studies of these groups (Summary)