Browsing by Author "Rossouw, J."

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    A collaborative and evolving response to the needs of frontline workers, patients and families during the COVID-19 pandemic at Tygerberg Hospital, Western Cape Province, South Africa
    (Health & Medical Publishing Group, 2021-03-23) Brocker, E.; Louw, K. A.; Hewett, M.; Burger, H.; Felix, R.; De Koker, P.; Rossouw, J.; Seedat, S.
    The global devastation caused by the COVID-19 pandemic and its mental health impact is undeniable. The physical and psychological consequences are wide-ranging – affecting patients fighting the disease, frontline workers in the trenches with them, healthcare staff deployed in high-care settings, and families disconnected from their loved ones in their darkest hours. Within 6 weeks of the COVID-19 outbreak in South Africa, the Department of Psychiatry at Stellenbosch University established the TBH/SU COVID Resiliency Clinic to provide psychological support to frontline workers at Tygerberg Hospital. Identified barriers in healthcare workers accessing mental healthcare resulted in moving towards an on-site visibility to try to remove some of these barriers. This greater on-site presence enabled networking and building of relationships with frontline staff that over time highlighted other frontline needs, such as providing psychosocial and spiritual support to patients and their families. We share challenges, lessons learned and recommendations from two initiatives: the TBH/SU COVID-19 Resiliency Clinic, and an embedded COVID Care Team (CCT). We describe the establishment, roll-out and progress of the Clinic and the subsequent CCT.
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    Rupture of sinus of Valsalva aneurysm into both right atrium and right ventricle : a case report
    (Health and Medical Publishing Group -- HMPG, 1983-04) Przybojewski, J. Z.; Blake, R. S.; De Wet Lubbe, J. J.; Rossouw, J.; Van der Walt, J. J.
    A young man had a congenital sinus of Valsalva aneurysm originating from the right coronary sinus, complicated by fistulas draining into both right atrium and right ventricle, as well as congenitally abnormal aortic valve with mild aortic insufficiency. His dramatic clinical presentation, with the sudden appearance of severe biventricular cardiac failure unresponsive to intensive medical therapy, was an important clue to making the correct pre-operative diagnosis. The use of non-invasive techniques, such as phonocardiography and M-mode and two-dimensional echocardiography, is highlighted. Full cardiac catheterization was employed to define the cardiac pathophysiology. This was one of the few cases documented in which a catheter could be passed from the aorta into the right ventricle via the fistula connecting these two chambers. The fistulas were closed and the aortic valve replaced. Postoperative investigations confirmed the success of corrective surgery. As far as we are aware this is the first documented case of successful repair of a congenital sinus of Valsalva aneurysm rupturing into both the right atrium and right ventricle, accompanied by aortic insufficiency.
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    Rupture of sinus of Valsalva aneurysm into the right ventricle
    (Health and Medical Publishing Group -- HMPG, 1983-07) Przybojewski, J. Z.; Kathrada, F. H.; Rossouw, J.
    A young black woman presented with acute severe right ventricular and moderate left ventricular cardiac failure secondary to rupture of a sinus of Valsalva aneurysm originating from the right coronary sinus. The rupture into the right ventricle was accompanied by severe aortic valve insufficiency. The aortic valve showed congenital myxomatous degeneration with no evidence of infective endocarditis or syphilis. Right ventricular endomyocardial biopsy revealed no evidence of any specific cardiac disease such as amyloidosis. Successful closure of the fistula, together with aortic valve replacement and a De Vega tricuspid annuloplasty, was carried out. M-mode and two dimensional echocardiography delineated the fistula, as well as the most unusual finding of tricuspid valve fluttering, which persisted after operation. Slight insufficiency of the Bjork-Shiley aortic prosthesis was noted at postoperative cardiac catheterization. The patient was discharged from hospital asymptomatic and with no abnormal clinical features.
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    Severe isolated left mainstem coronary artery stenosis : a case report
    (Health and Medical Publishing Group (HMPG), 1986-01) Przybojewski, J. Z.; Rossouw, J.
    A 33-year-old white man had exertional angina pectoris, followed by angina pectoris at rest, and then episodes of ischaemic acute pulmonary oedema associated with angina pectoris. Selective coronary angiography delineated an isolated long-segment stenosis of the left brainstem coronary artery with no other lesions. We believe that the mainstem obstruction was due to coronary artery fibromuscular hyperplasia, a condition rarely affecting the coronary artery circulation. At operation three coronary artery bypass grafts were inserted, one to the left anterior descending artery and two to the left circumflex coronary artery, with a most successful result. The patient's recurrent acute pulmonary oedema was due to severe myocardial ischaemia; the possibility of superadded coronary vasospasm aggravating the obstruction cannot be entirely discounted.