bluuebunny/crossref_metadata_2025 huggingface dataset:
Need for Fast Pathway Ablation in Typical Irregular AV Nodal Reentrant Tachycardia in a Patient with Multiple AV Nodal Pathways
Authors: WEISMÜLLER PETER , OBERGASSEL LUDGER , KATTENBECK KLAUS , LIS WLADISLAW , TRAPPE HANS‐JOACHIM
Published: June 2007

A case of a 60‐year‐old male with irregular AV nodal reentrant tachycardia of the common type is reported. Electrophysiological study revealed multiple antegrade slowly conducting AV nodal pathways and one exclusively retrogradely conducting fast AV nodal pathway. Despite the recommendation for slow pathway ablation as the treatment of choice in patients with AVNRT, first pathway ablation was successfully performed in this case due to the risk of total A V block of ablating the slow pathways. The present report shows that there is the rare patient in whom fast pathway ablation is required for curative treatment of AV nodal reentrant tachycardia.
Coronary Stenting Without Predilatation in Acute Coronary Syndromes
Authors: SCHUTTE DANIEL , POTGIETER LEONI , MOIR KERRY J.
Published: June 2007

We report on the procedural outcome in 30 patients with acute coronary syndromes in whom stent implantation was attempted without predilatation. Elective stent implantation in infarct related coronary arteries after myocardial infarction might be superior to agioptasty alone. We retrospectively analyzed the result from 88 patients who had stent implantation for myocardial infarction or unstable angina. In 30 of these patients we attempted to implant a stem without predilating the vessel. Successful stent deployment was possible in 26 (87%). In four patients where it was not possible to cross the lesion, we could withdraw the stent to predilate the lesion. We did not attempt direct stent implantation if the lesion was calcified, long, involved major side branches or a tortuous proximal segment, or where the length of the lesion and diameter of the distal vessel could not be measured. A low profile, premounted stent was used. Procedural success was 100% in the group of 30 patients with direct stent implantation— not significantly different from the 93% success in the group of 58 patients whose lesions were predilated first but had more complex lesions. The incidence of complications did not differ significantly between the two groups and no instances of stent loss or displacement occurred in the direct implantation group. Stent implantation without predilatation is feasible and not associated with a higher incidence of complications, provided lesions that allow easy positioning of the stent are selected. It can shorten the procedure and duration of ischemic occlusion of the vessel, which would be of particular advantage in unstable patients or where a large area of myocardium is jeopardized.
Recurrent Coronary In‐Stent Restenosis: Potential of Membrane‐Covered Stents
Authors: BALDUS STEPHAN , REIMERS JACOBUS , KÖSTER RALF , KÄHLER JAN , SCHAPS KLAUS‐PETER , BOLTE JOHANN , HAMM CHRISTIAN W.
Published: June 2007

We report a 64‐year‐old patient with single vessel coronary disease who initially underwent PTCA and stent implantation for a complex RCA lesion. The patient was subsequently readmitted for unstable angina pectoris after 2 and 6 months. Coronary angiograms each time revealed subtotal reocclusions of the target vessel due to in‐stent restenosis. At 2 months, the patient underwent rotational atherectomy and additional stent implantation, During the second reintervention at 6 months rotational atherectomy was followed by implantation of two membrane‐covered stent deployed within the conventional stents (stent‐indent). Subsequently, the patient remained asymptomatic. Control angiography after 5 months revealed only minor stent lumen loss not requiring reintervention. Membrane‐covered stents appear to be a promising alternative to reduce the incidence and degree of in‐stent restenosis in selected lesions.
Improved Angiographic Measurement Accuracy with a New Calibration System
Authors: SÖDERBERG BJÖRN , SOLYMAR LASZLO , ERIKSSON PETER , BOSTRÖM HÅKAN
Published: June 2007

During transcatheter interventions, correct distance measurements are mandatory for proper device selection. We present a new calibration procedure in which distance calibration is performed with a high contrast metallic rod placed in the esophagus as a scaling device. Distortion related to differences in Calibration and object planes as well as axial angles were analyzed and appropriate correction factors calculated. A cardiac phantom served to test the accuracy and precision of the new measuring system. The mean measurement error was < 1.7% (range 0.1%–4.9%), and the mean measurement variability 1% (range 0.3%–1.9%). The accuracy of angiographic measurements can be significantly improved using a calibration device in the esophagus in combination with appropiate mathematical corrections.
Successful Coronary Stent Implantation Using Local Nitric Oxide Donor Delivery
Authors: JEONG MYUNG HO , AHN YOUN KEUN , CHO JEONG GWAN , PARK JONG CHUN , NA KOOK JOO , KANG JUNG CHAEE
Published: June 2007

With the introduction of high pressure balloon inflations and antiplatelet therapy, the incidence of stent thrombosis has been markedly reduced, but the incidence of late stent restenosis has not. A new strategy may be local drug delivery, which maintains sustained local concentration and limits systemic complications. To evaluate the efficacy of local nitric oxide (NO) donor delivery on stent thrombosis and complications, local NO donor delivery was performed in stented patients. NO donor (2.0‐mg molsidomine) was delivered (1.0 mL/min > 10 min) using the Dispatch Catheter after predilation of target lesions in 13 patients (6 angina, 7 myocardial infarction, age 53.1 ± 11.4 years). After local NO donor delivery, Palmaz‐Schutz stents were placed using standard methods. Follow‐up coronary angiograms were performed 48 hours and 6 months after stenting. None of the patients had hypotensive effects, ischemic symptoms, or ECG changes during and after local NO donor delivery. APTT and CK values were unchanged at 3 and 24 hours after local NO donor delivery and stenting. Follow‐up coronary angiograms at 48 hours and 6 months showed all stents patent with TIMI III flow and without intrastent thrombus. No target lesion revascularization and 100% event‐free survival were observed during the 6‐month clinical follow‐up period. Intracoronary stenting may be performed safely and effectively by local NO donor delivery prior to stent implantation.
Coronary Thrombo‐Aspiration
Authors: TOUSSAINT MARCEL , FAVEREAU XAVIER , DURUP FLORENCE , FAUCHER JEAN‐NOËL , CORCOS THIERRY , GUERIN YVES
Published: June 2007

Persistence of a thrombus after coronary angioplasty can be treated by transcatheter aspiration. This technique has been used in the right coronary artery of three patients. Coronary arteriography showed the occlusion of the proximal segment in two patients and a stenosis in one. In the two patients with an occlusion, there was no residual stenosis after balloon angioplasty, but a long thrombus remained: in the third patient, the thrombosis of the mid‐segment of the right coronary artery was secondary to a spasm of the proximal and mid‐segments. In all patients, the guiding catheter was gently advanced up to the thrombus that was aspirated with a syringe. The immediate result was excellent, and the control angiogram performed after a delay of 1 to 15 months showed the patency of the artery and the absence of residual stenosis.
Acute Myocardial Infarction in a Discrete Coronary Artery Aneurysm Without Obstruction
Authors: YOSHITOMI YUJI , KOJIMA SHUNICHI , SUGI TOSHIHIKO , MATSUMOTO YUJI , YANO MICHIKO , KURAMOCHI MORIO
Published: June 2007

We report an unusual case of acute myocardial infarction attributable to obstruction of a discrete coronary aneurysm in a 54‐year‐old man. Although coronary angioplasty and thrombolysis were unsuccessful, serial arteriography showed spontaneous recanalization, and no spasm was induced by ergonovine. We discuss its mechanism.
Percutaneous Suture Closure for Management of Large French Size Arterial and Venous Puncture
Authors: FELDMAN TED
Published: June 2007

Aortic valvuloplasty procedures have been limited principally by the occurrence of restenosis in this patient population. Once a decision has been made to proceed with aortic valvuloplasty, one of the next major concerns is management of the femoral artery puncture. For these procedures, 12Fr and 14Fr sheath introducers and prolonged compression with clamps or hemostatic devices have been necessary. Prolonged immobilization is painful for the elderly population in whom aortic valvuloplasty is used. The ability to use percutaneous suture closure to eliminate the need for manual compression, especially for clamp or hemostatic devices, has greatly improved patient tolerance for these procedures. A technique for preloading the suture closure device prior to insertion of a large bore sheath is the technique of choice to make this possible. Mitral valvuloplasty has faced fewer limitations and of course yields results equivalent to surgical commissurotomy in randomized trials. Improved management of the 14Fr femoral venous site has made outpatient treatment simpler. The technical approach necessary for success in the venous system uses contrast injections through the Perclose device marker port to insure that the device is properly positioned prior to deployment of the sutures. More rapid immobilization and simplified postprocedural management can be achieved using percutaneous suture closure for large caliber sheaths after mitral and aortic valvuloplasty.
Simultaneous Assessment of Coronary Flow Reserve and Fractional Flow Reserve with a Novel Pressure‐Based Method
Authors: GRUBERG LUIS , MINTZ GARY S. , FUCHS SHMUEL , SHALMAN EVGENY , BARAK CHEN , DGANY ELHANAN , AHMED JAVED , PICHARD AUGUSTO D. , LEON MARTIN B.
Published: June 2007

Coronary flow reserve (CFR) and fractional flow reserve (FFRmyo) are two guidewire‐based methods currently used to assess the functional severity of coronary artery lesions. Acquiring both measurements simultaneously may provide complementary information, but would require the passage of two different guidewires and complex instrumentation for their calculation. This study assessed the procedural safety and performance of a novel personal computer‐based algorithm, the SmartFlow Intravascular Processor (SFIP), which utilizes a single conventional pressure wire for obtaining simultaneous CFR and FFRmyo measurements for the assessment of coronary artery lesion severity. In 20 consecutive patients with 21 lesions, pressure‐derived CFR, FFRmyo and SFIP‐FFRmyo measurements were obtained during adenosine‐induced hyperemia. Intravascular ultrasound and quantitative coronary angiography lesion analysis was done off‐line at the Washington Core Laboratory. Mean FFRmyo was 0.83 ± 0.11, SFIP‐FFRmyo was 0.86 ± 0.06, and CFR was 1.74 ± 0.46. Pairwise correlation analysis showed excellent correlation between the FFRmyo and the FFRmyo‐SFIP (r2= 0.83, P < 0.0001) and a fair degree of relationship between the CFR and minimal lumen diameter (r2= 0.43, P = 0.07). We could not find a correlation between CFR and FFRmyo (r2= 0.22, P = 0.37), between CFR and FFR‐SFIP (r2= 0.05, P = 0.86), or between the hemodynamic measurements and any of the IVUS‐derived measurements. In conclusion, the SFIP is u novel algorithm for obtaining simultaneous CFR and FFRmyo that may provide valuable information for the assessment of lesion severity and clinical decision making.
A New Temporary Occlusion and Aspiration System for Prevention of Distal Embolization During Percutaneous Transluminal Renal Angioplasty
Authors: EGGEBRECHT HOLGER , HAUDE MICHAEL , BAUMGART DIETRICH , DIRSCH OLAF , OLDENBURG OLAF , HERRMANN JOERG , KRIBBEN ANDREAS , ERBEL RAIMUND
Published: June 2007

Cholesterol embolization has been described as a severe complication of percutaneous transluminal renal angioplasty (PTRA) and may lead to renal insufficiency with the need of transient or permanent hemodialysis. We describe a case of successful angioplasty of a renal artery in‐stent restenosis utilizing a new temporary balloon occlusion and aspiration system for prevention of distal embolization. Histological examination of blood retrieved from the distally occluded vessel showed lipid‐rich macrophages (foam cells) and an amorphic lipoid substance as markers of atherosclerotic plaque debris. Further studies are necessary to evaluate the clinical relevance of atheromatous microembolization and its renal function and clinical course following angioplasty.
Comparative Study Between Various Methods of Percutaneous Transvenous Mitral Commissurotomy Metallic Valvotome, Inoue Balloon, and Double‐Balloon Techniques (VID) Study
Authors: EL‐SAYED MOUSTAFA A. , ANWAR ASHRAF M.
Published: June 2007

The aim of this study was to compare the immediate results of percutaneous mitral commissurotomy using metallic valvotome, Inoue balloon, or double‐balloon techniques. We conducted a randomized trial comparing the immediate results of the three procedures in 150 patients (50 patients in each group) who were rheumatic mitral stenosis candidates for valvuloplasty. The procedures used per group were metallic valvotome (group I), Inoue balloon (group II), and double balloon (group III). The three groups were similar in age, sex, MVA, transmitral PG, LV function, predicted PAP, and presence of mitral re gurgitation. Patients in group I had a higher MV score (>9) than group II and III. The MVA was increased by a similar degree in groups I and III (2.1 ± 0.5 cm2, 2.0 ± 1.2 cm2) but greater than group II (1.87 ± 0.4 cm2) (P = 0.01). Mean transmitral PG was lower in group III (4.3 ± 1.9 mmHg) than in groups I and II (6.3 ± 3.7 mmHg, 6.3 ± 5.3 mmHg), respectively (P = 0.01). Echocardiographic data showed a higher depth score of posterior commissural splitting in groups I and III (0.7 ± 0.3 cm, 0.8 ± 0.3 cm, respectively) than in group II (0.6 ± 0.3) (P = 0.006), while the depth score of anterior commissure splitting was comparable in all groups (0.6 ± 0.3, 0.6 ± 0.3, and 0.7 ± 0.3, respectively) (P = 0.4). Stepwise multivariate regression analysis revealed that the following variables significantly affect the success of valvuloplasty as evidenced by a MVA ≥ 1.5 cm2. (1) techniques, the larger MVA was achieved by valvotome and double balloon (P = 0.0001); (2) MVA before valvuloplasty, the larger the MVA before, the larger the MVA after (P = 0.0008); (3) valve thickness, the more the thickness, the smaller the achieved MVA (P = 0.01); und (4) valve mobility, the more limited mobility, the smaller the MVA (P = 0.007). Small and restrictive ASD was present in 14 (28%) patients in group I, 2 (4%) patients in group II, and 3 (6%) patients in group III. Changes in grade of mitral regurgitation was comparable in all groups as the grade increased by I grade (40% in group I, 36% in group II, and 36% in group III). In contrast to the Inoue balloon technique, the metallic valvotome, and double‐balloon technique produced an excellent and comparable early improvement of MVA associated with minimal complications. However, the good results achieved with patients who had a higher MV score (≥9) by metallic valvotome and lower cost indicate that metallic valvotome should be the treatment of choice for tight mitral stenosis.
The History of Balloon Valvuloplasty
Authors: CHENG TSUNG O.
Published: June 2007

The birth of therapeutic balloon dilation in the management of cardiovascular disease can be traced to Rashkind who in 1966 developed balloon atrial septostomy for palliation of patients with complete transposition of the great vessels. Actually, Dotter and Judkins anteceded Rashkind by coaxial sequential dilation of iliofemoral atherosclerotic obstruction in 1964. However, it was not until the development by Grüntzig in 1978 of a miniaturized flexible balloon catheter for percutaneous transluminal coronary angioplasty that therapeutic balloon dilation began to be applied to stenotic heart valves. The development of percutaneous balloon valvuloplasty was the natural consequence of the early success of surgical mechanical dilation of stenotic heart valves; first the pulmonic valve, then the mitral valve, and finally the aortic valve. The successful relief of valvular stenosis by percutaneous balloon valvuloplasty is a remarkable example of how the pioneering cardiac surgeons paved the way for interventional cardiologists to take over the treatment of heretofore, surgically managed diseases.
Transcatheter Pulmonary and Aortic Valvuloplasty in Congenital Heart Disease
Authors: PIÉCHAUD JEAN‐FRANÇOIS
Published: June 2007

Transcatheter balloon valvuloplasty has been used in pediatric cardiology since the mid‐80s. This procedure requires specific devices and equipment, especially in cases involving newborn infants. The risk is currently low, because of improvements in technology and catheterization laboratory equipment. The results are good enough to make transcatheter dilatation the treatment of choice for congenital stenosis of pulmonary and aortic valves.
Basic Rules of Dosimetry in Endovascular Brachytherapy
Authors: COUCKE PHILIPPE A. , DO HU PHUOC , EECKHOUT ERIC , PICA ALESSIA , PACHE GILBERT , URBAN FILIP
Published: June 2007

Endovascular brachytherapy after percutaneous coronary intervention (PCI), is becoming a standard approach for the treatment and prevention of restenosis. A variety of technical approaches are currently available to deliver ionizing irradiation to the vascular target. Basically two kinds of radioactive isotopes are available that emit gamma radiation (photons) or beta radiation (electrons). The pitfalls and solutions for the optimization of dosimetry are discussed. As might be expected, the inhomogeneous dose distribution across the target volume results in recurrence by underdosage or in complications because of overdosage. Moreover, uniformization of the target definition and reporting of the dose distribution in endovascular brachytherapy is a prerequisite for comparison between the results of the various clinical trials and is absolutely necessary to improve the therapeutic efficacy of this new approach in the prevention of restenosis after coronary angioplasty with or without stenting.
Anatomy of Atrial and Ventricular Septal Defects
Authors: HO SIEW YEN , MCCARTHY KAREN P. , RIGBY MICHAEL
Published: June 2007

The anatomy of atrial and ventricular septal defects is reviewed with reference to the normal cardiac septum. Owing to the limited extent of the atrial septum, true septal defects are confined to the area of the oval fossa. The sinus venosus and coronary sinus defects are interatrial communications being outside the confines of the atrial septum and close to important atrial structures. The description of ventricular septal defects as perimembranous, muscular and doubly committed, and juxtaarte rial defects highlights the anatomy of the margins, the location, and proximity to the conduction system and valvar structures. Malalignment of septal structures can complicate the anatomy of ventricular septal defects producing inlet or outlet obstruction.
The Role of Transesophageal Echocardiography During Catheter Closure of ASD and VSD
Authors: MEIJBOOM FOLKERT J. , WITSENBURG MAARTEN
Published: June 2007

Transcatheter closure has developed into a significant alternative for surgery in the treatment of atrial septal defects (ASDs). Before the choice can be made between the two treatment options, patients should be selected who have a septal defect that is suitable for catheter closure. Transthoracic echocardiography has proven to be unreliable in this respect. Therefore, a diagnostic transesophageal echocardiogram (TEE) is mandatory prior to an intervention session. In adults, this can be done during a routine outpatient clinic visit. In children, a TEE has to be done under general anesthesia. Therefore, it is practical to plan a diagnostic TEE under general anesthesia first, with the possibility of a subsequent catheter intervention in the same session. During the procedure, the role of TEE is to provide additional information to the fluoroscopy images that the interventional cardiologist is used to working with. TEE gives detailed information on the position of the catheter and the device in relation to vital intracardiac structures, like the atrioventricular valves, the pulmonary veins and, most important, the atrial septum itself. Good collaboration between the interventionalist and echocardiographer has proven to be beneficial for successful nonsurgical closure of ASDs. The role of transcatheter closure of ventricular septal defects is limited. Only defects for which surgical treatment is impossible or unattractive are thought to be candidates for transcatheter closure. TEE is helpful also in this procedure.
Coronary Angioplasty and Stent Placement by a Single Operator Without the Assistance of a Second Interventional Cardiologist and Nurse
Authors: ANTONELLIS IOANNIS P. , PATSILINAKOS SOTIRIOS P. , PAMBOUKAS CONSTANDINOS A. , BONOU MARIA , KRANIDIS ATHANASIOS J. , TSILIAS KARMELOS , MARGARIS NIKOLAOS G. , TAVERNARAKIS ANTONIOS G. , ROKAS STYLIANOS G.
Published: June 2007

Traditionally, not only the use of several devices, but plain angioplasty is performed by at least two interventional cardiologists and one specialized nurse. The aim of our study was to investigate the feasibility, effectiveness, and safety of angioplasty with stent implantation by a single operator, without the assistance of a second interventional cardiologist or a nurse. A total of 153 patients participated. Angioplasty with stent implantation was performed in 151 consecutive patients. The angioplasty was performed by a single cardiologist in the presence of a backup operator. Angioplasty and stent placement were successful in 151 of 153 cases (success rate=98.7%). No death occurred and no case of acute stent occlusion was observed. In no case was the backup operator called for assistance. In conclusion, angioplasty with stent placement by a single operator without the assistance of a second interventional cardiologist or a specialized nurse was feasible, effective and safe. (J Interven Cardiol 2000;3‐6)
Cutting Balloon Angioplasty for Ostial Lesions of the Left Anterior Descending Artery
Authors: INOUE TERUO , HOSHI KAZUHIRO , YAGUCHI ISAO , MIYAKE YUMIKO , SHIMIZU MINORU , MOROOKA SHIGENORT
Published: June 2007

We evaluated the effectiveness of Cutting Balloon angioplasty for ostial lesions of the left anterior descending artery compared with conventional balloon angioplasty. Cutting Balloon angioplasty (n = 7) produced larger acute gain (1.70 ± 0.37 vs 0.48 ± 0.25 mm, P < 0.001) and smaller late loss index (0.54 ± 0.55 vs 1.32 ± 0.81, P < 0.05) than conventional balloon angioplasty (n = 7). As a result, late restenosis was seen in only two patients undergoing Cutting Balloon angioplasty, but in all seven patients undergoing conventional balloon angioplasty. Ostial lesions of the left anterior descending artery may be one of the suitable targets of Cutting Balloon angioplasty. (J Interven Cardiol 2000;13:7–14)
Resolution of the “No‐Reflow” Phenomenon with Intracoronary Administration of Adenosine
Authors: TIEDE DANIEL J. , BRADY PETER A. , GARRATT KIRK N. , HOLMES DAVID R.
Published: June 2007

The “no‐reflow” phenomenon results from microcirculatory spasm and has significant hemodynamic and prognostic consequences. Adenosine is an effective microvessel vasodilator. We describe two cases of successful treatment of no‐reflow with intracoronary adenosine after failure of intracoronary calcium channel blockers. (J Interven Cardiol 2000; 13:15–18)
Coronary Pulsed‐Spray: Accelerated Pharmacomechanical Intravascular Thrombolysis in Acute Coronary Events Followed by Immediate Endovascular Therapy
Authors: TORTOLEDO FRANCISCO , FERMÍN ENRIQUE , RODRÍGUEZ VÍCTOR , VÁSQUEZ JOSÉ R.
Published: June 2007

Coronary thrombolysis and percutaneous coronary angioplasty (PTCA) have improved the short— and long‐term prognosis in patients with acute coronary events. This study proposes a rapid approach to lyse the thrombotic material present in the ischemic related vessel (IRV) and immediately apply the most appropriate therapy based on the underlying anatomy. Fifty patients, 24 with myocardial infarction (MI) and 26 with unstable angina (UA), were treated. Once the IRV was identified, a 15 multiple side‐hole infusion catheter was placed across the clot matrix and 25,000 units of urokinase were administered forcefully every 30 seconds in pulses of 1 mL, using a 1‐mL syringe to obtain a spray effect until a total of 1,000,000 units were completed in 20 minutes. Immediate results after the pulsed‐spray thrombolysis (PST): The % stenosis decreased from 96 ± 9 to 49 ± 37 and the flow increased from TIMI 0.06 ± 0.02 to TIMI 2.7 ± 0.6, P < 0.001. Therapeutic procedures immediately after the PST: 30 patients were treated with percutaneous transluminal coronary angioplasty (PTCA) followed by stent deployment, 8 with conventional PTCA, 10 received medical therapy, and 1 underwent elective surgical revascularization. Two patients had minor self‐limited gingival bleeding. One patient had a groin hematoma, and another patient developed a right femoral artery pseudoaneurysm, corrected surgically. One patient with unstable angina died with no‐reflow phenomenon in the circumflex coronary artery. Twenty four patients (48%) have been followed up (11 ± 3.6 months), all in functional Class I–II. Eight (16%) who underwent repeat coronary angiography 4 ± 2.2 months post‐PST, had TIMI 3 flow in the IVR. PST applied to the coronary circulation in acute ischemic events is a method able to lyse the thrombotic material associated with the complicated plaque. This approach allows better selection of an immediate endovascular therapy for each patient based on the underlying anatomy and results in a shorter hospital stay. (J Interven Cardiol 2000; 13:19–26)
Combined Percutaneous Management of an Atrial Septal Defect and Coronary Artery Disease
Authors: CALVER ALISON , DAWKINS KEITH , SALMON ANTHONY
Published: June 2007

A 52‐year‐old female was admitted to the hospital with a 1‐month history of increasing breathlessness, exertional chest tightness, palpitation, and lethargy. Echocardiography revealed a secundum atrial septal defect. Cardiac catheterization confirmed the diagnosis, and the coronary angiogram revealed a critical 90% stenosis in the midright coronary artery (RCA). Under general anaesthesia, two 15‐mm intracoronary stents were placed in the RCA with an excellent angiographic result. The atrial septal defect was then closed percutaneously using the Angel‐Wings atrial septal defect occluder device. Perioperative transesophageal echocardiography confirmed satisfactory positioning of the Angel Wings device and color flow mapping showed no residual shunt across the atrial septum. The patient was discharged home the following day. Percutaneous closure of atrial septal defects offers the chance to replace an open heart surgical procedure with a minimally invasive treatment that allows discharge from the hospital on the day after the closure. To date, adult patients who have concomitant coronary artery disease and an atrial septal defect have undergone surgery even if their coronary lesion was amenable to percutaneous treatment with angioplasty. We describe a patient in whom stenting of the RCA and percutaneous closure of an atrial septal defect were performed concomitantly. (J Interven Cardiol 2000;13:35–38)
Successful Nonsurgical Management of Coronary Artery Perforation Aided by Implantation of a Bare Stent
Authors: RAMAMURTHY S. , MANCHANDA M.D. , K. TALWAR K. , AGARWAL RAJIV , BHARGAVA BALRAM
Published: June 2007

Coronary artery perforation complicating percutaneous transluminal coronary angioplasty (PTCA) is rare but can be potentially fatal. We report a case of coronary artery dissection and perforation during PTCA that was successfully treated by implanting a bare stent with disappearance of angiographic contrast extravasation and performing one‐time pericardiocentesis for unexpected, delayed cardiac tamponade thereby avoiding the need for surgery. The possibility of coronary angiography not detecting a small residual leak from the perforation is also discussed. (J Interven Cardiol 2000; 13:45–50)
Combined Myocardial Free‐Wall and Pericardial Rupture with Hemothorax Complicating Acute Myocardial Infarction
Authors: AZRAK ELIE , KERN MORTON J. , GALAMBOS CSABA
Published: June 2007

Although myocardial rupture is a commonly identified fatal complication of myocardial infarction, the association of myocardial rupture through the pericardium to produce hemothorax without hemopericardium or left ventricular aneurysm has not been reported. We describe this unusual complication of myocardial rupture in a patient 5 days after myocardial infarction.(J Interven Cardiol 2000;13:51–58)
Role of Manual Compression Time and Bed Rest Duration on the Occurrence of Femoral Bleeding Complications After Sheath Retrieval Following 4Fr Left‐Sided Cardiac Catheterization
Authors: THORÉ VÉRONIQUE , BERDER VÉRONIQUE , HOUPLON PHILIPPE , PREISS JEAN P. , SELTON‐SUTY CHRISTINE , JUILLIÈRE YVES
Published: June 2007

To shorten hospital stay or to allow ambulatory procedures, 4Fr catheters for left‐sided cardiac catheterization can be used. These latter parameters may also be influenced by compression time and bed rest duration. The role of these parameters was assessed by prospectively including 130 consecutive patients who underwent 4Fr femoral diagnostic procedures. The patients were randomized into two groups: group 1 consisted of 70 patients undergoing 5‐minute compression and group 2 consisted of 60 patients with 15‐minute compression. In each group, a second randomization was applied to determine the bed rest duration (2–4 hours). More group 1 patients experienced immediate bleeding following manual compression than group 2 patients (12 [17%] vs 3 [5%], P < 0.03, respectively). Compared to group 2, a slight but nonsignificant increase in the total number of hematomas was observed in group 1 (31 vs 22%, NS). No difference existed in terms of local large hematomas at 24 hours (7% in each group) or in terms of benign 10 cm diffuse subcutaneous ecchymosis at 7‐day follow‐up (13 [19%] group 1 patients vs 8 [13%] group 2 patients, NS). However, persistence of diffuse subcutaneous ecchymosis at 7‐day follow‐up appeared to be related to the history of immediate bleeding following manual compression in both groups (group 1: 5/13 vs 7/57 patients [P < 0.04] and group 2: 3/8 vs 0/52 patients [P < 0.002]). In conclusion, 4Fr femoral left‐sided cardiac catheterization is safe and could be performed as an ambulatory procedure. However, it requires 15‐minute duration of manual compression associated with 2‐hour bed rest to decrease local bleeding complications. (J Interven Cardiol 2001;14:7–10)
Y Stenting of a Bifurcation Stenosis Using a New Radiopaque Stent
Authors: JOHNSTON PAUL W. , COHEN ERIC A. , FORT STEPHEN
Published: June 2007

A case of Ystenting using radiopaque stem for a bifurcation stenosis is described. Angiography and intravascular ultrasound demonstrate that in spite of optimal stent placement there is an area of the lesion that is not fully covered by the stents. This may predispose to subacute thrombosis and restenosis. This case illustrates a potential deficiency of this type of bifurcation stenting. (J Interven Cardiol 2001;14:21–25)
Percutaneous Closure of Large Atrial Septal Defects with the Amplatzer Septal Occluder: Technical Overkill or Recommendable Alternative Treatment?
Authors: BERGER FELIX , EWERT PETER , ABDUL‐KHALIQ HASHIM , NÜRNBERG JAN‐HENDRIK , LANGE PETER E.
Published: June 2007

To judge whether an Amplatzer Septal Occluder (ASO) can be used as a safe therapy instead of surgery for closure of large atrial septal defects > 25 mm in diameter, we report our experiences in 45 patients out of a cohort of 467 patients after successful AS0 implantation within a period of 3 years. Median defect diameter was 28 mm (range 25–36), median age was 41.2 years (range 10.1–77.7 years). Body weight ranged from 33.5 to 112.0 kg (median 68 kg). Due to an inevitable reduction of the stent size with increasing distances of the discs fixed at the thicker part of the atrial septum in larger defects, we implanted devices 2–4 mm larger than the measured stretched diameter. Fluoroscopy times ranged from 2.0 to 24.4 minutes, with a median of 10.3 minutes. Follow‐up studies were obtained afer 48 hours and 1, 6, and 12 months, and rhen yearly The median period of follow‐up was 0.82 years (range 0.1–2.6). The complete occlusion rate was 91.1%. A trivial hemodynamically insignificant residual shunt remained in 8.9% of the patients. Three patients showed transient atrial tachyarrhythmias within the first 3 months after implantation and three remained in chronic atrial fibrillation. The excellent results in the short and medium term make Amplatzer device implantation a recommendable safe and effective alternative to surgery, even in selected cases with defects > 25 mm. Final judgement, however, is only possible after long‐term follow‐up. (J Interven Cardiol 2001;14:63–67)
Transcatheter Coil Closure of Muscular Ventricular Septal Defects
Authors: CHAUDHARI MILIND , CHESSA MASSIMO , STUMPER OLIVER , V. DE GIOVANNI JOSEPH
Published: June 2007

We report two patients with small, muscular ventricular septal defects, both of whom had a potential risk of infective endocarditis and underwent transcatheter closure using a detachable Cook coil. We suggest that in selected patients this technique offers a simple and cost‐effective alternative to surgery or double‐disc device procedures. (J Interven Cardiol 2001;14:165–168)
Comparison Between the Safety Profile and Clinical Results of the Cook Detachable and Gianturco Coils for Transcatheter Closure of Patent Ductus Arteriosus in 272 Patients
Authors: OMAR MOHAMMED , BULBUL ZIAD , KAKADEKAR ASHOK , ELELAAH ADB , DE MICHAEL , EL‐OUFI SAUD , SOLYMAR LASZLO , AL‐FADLEY FADEL , FAWZY MOHAMED E.
Published: June 2007

Objectives: We evaluated the occlusion rate and safety of Cook detachable coils versus Gianturco coils in transcatheter closure of patent ductus arteriosus (PDA). Background: The Cook detachable coil recently was introduced in an attempt to improve the safety of transcatheter closure of PDA. Methods: Between January 1994 and September 1998, 272 patients underwent transcatheter PDA closure. Cook detachable coils were used in 137 patients, with a mean age of 43.9 months and weight of 13.8 kg. In 135 patients, Gianturco coils were used, with a mean age of 56.8 months and weight of 17.8 kg. The mean narrowest diameter of the PDA in the Cook detachable coil group was 2.85 mm versus 2.32 mm for the Gianturco coil group. Results: The Cook detachable coil group was younger and weighed less than the Gianturco group (P < 0.05 and 0.02, respectively). Their narrowest PDA diameter was larger (P < 0.01). Embolization rate was significantly lower in the Cook coil group (9 [6.5%] of 137 vs 22 (16.3%) of 135; P = < 0.013). The mean follow‐up for the Cook coil group was significantly shorter (0.55 years) than for the Gianturco coil group (1.18 years; P < 0.001). On an intention‐to‐treat basis, complete occlusion by echocardiography was achieved in 99 (72.3%) of 137 patients in the Cook detachable coil group, which was significantly less than the Gianturco coil group (114 [84.4%] of 135; P = 0.008). Conclusion: Cook detachable coils for transcatheter closures of the PDA are safer than Gianturco coils. Hence, children with large ducti can be treated earlier in life. Short‐term complete occlusion rate was lower in the Cook detachable coil group. This rate can be explained by a shorter follow‐up time, larger ductal diameter, and the different materials used for the detachable coils. (J Interven Cardiol 2001;14:169–178)
Mind the neuron! The role of the single neuron in a theory of mind
Authors: Vickery Richard M.
Published: June 2007

Objective:

To present the argument that the only secure foundation for a theory of behaviour, and ultimately of mind, rests at the level of single neurons, and to assess progress at this level of explanation.

Methods:

Relevant data were obtained by a search of PubMed, last updated in January 2007, focused on implemented models from single-neuron studies.

Results:

Technical limitations on recording neural activity produce trade-offs between temporal and spatial resolution and the ability to track the massively parallel activity of the nervous system. The properties of the single neuron that would need to be measured and the techniques available to obtain the data are described. The concept of a fixed neuronal identity may be impeding progress and should be replaced with the concept of dynamically assigned neuron identity.

Conclusion:

Modern data collection techniques make it possible to obtain data at the single-neuron level on the complete nervous systems of simple organisms. Present models based on this data do not provide an integrated explanation of behaviour. However, there do not appear to be insurmountable theoretical or practical obstacles to building such models in the future or of scaling the data collection up to more complex organisms.
Lygus hesperus (Heteroptera: Miridae) tolerates high concentrations of dietary nickel
Authors: BOYD ROBERT S.
Published: June 2007

Abstract
Nickel hyperaccumulator plants contain unusually elevated levels of Ni (> 1 000 μg Ni/g). Some insect herbivores, including Lygus hesperus (Western tarnished plant bug), have been observed feeding on the California Ni hyperaccumulator Streptanthuspolygaloides. This bug may be able to utilize S. polygaloides as a host either through its feeding behavior or by physiological tolerance of Ni. This experiment determined the Ni tolerance of L. hesperus by offering insects artificial diet amended with 0, 0.4, 1, 2, 4.5, 10, 20 and 40 mmol Ni/L and recording survival. Survival varied due to Ni concentration, with diets containing 10 mmol Ni/L and greater resulting in significantly lower survival compared to the control (0 mmol Ni/L) treatment. Insects tolerated diet containing as much as 4.5 mmol Ni/L, a relatively elevated Ni concentration. I conclude that L. hesperus can feed on S. polygaloides because it is Ni‐tolerant, probably due to physiological mechanisms that provide it with resistance to plant chemical defenses including elemental defenses such as hyperaccumulated Ni.
Impact of habitat diversification on arthropod communities: A study in the fields of Chinese cabbage, Brassica chinensis
Authors: CAI HONG‐JIAO , LI ZHI‐SHENG , YOU MIN‐SHENG
Published: June 2007

Abstract
Field trials were carried out from June to August in 2004 at Wuyishan (Wuyi Mountains), Fujian province, China, to determine the effects of habitat diversification on arthropod communities. Two Chinese cabbage, Brassica chinensis, field 1 (F1) and field 2 (F2) surrounded by diverse vegetable cultivars were selected, while a monoculture of Chinese cabbage served as the control field (CK). The results showed that: (i) when comparing insect abundance of each order between different habitats, significantly higher numbers of lepidopterous insects (39.76% from the each order) and lower densities of Hymenoptera (19.82%) were found in CK than in F1 and F2; (ii) compared with CK, F1 and F2 had a lower percentage of species richness and an abundance of herbivorous insects, but increased richness, abundance and biodiversity of predatory insects; (iii) no differences were observed in neutral insects’guild between different fields; and (iv) the dominant species for each guild depends on the habitat types and sampling dates. This study suggests that intercropping could conceivably be used in these habitats to increase the population of natural predators, thus achieving desirable and ecologically friendly results in vegetable fields.
Monetary remedies for breach of confidence in privacy cases
Authors: Witzleb Normann
Published: June 2007

In Campbell v MGN Ltd, the House of Lords endorsed an expansive interpretation of the breach of confidence action to protect privacy interests. The scope and content of this transformed cause of action have already been subject to considerable judicial consideration and academic discussion. This paper focuses on the remedial consequences of privacy breaches. It undertakes an analysis of the principles which govern awards for pecuniary and non-pecuniary loss, the availability of gain-based relief, in particular an account of profits, and exemplary damages.

Even in its traditional scope, the monetary remedies for breach of confidence raise complex issues, mainly resulting from the fact that this doctrine draws on multiple jurisdictional sources such as equity, contract and property law. The difficulties of determining the appropriate remedial principles are now compounded by the fact that English law also aims to integrate its obligation to protect the right to privacy under Art 8 of the European Convention for the Protection of Human Rights and Fundamental Freedoms 1950 into the conceptual framework of the breach of confidence action.

The analysis provided in this paper supports the contention that not only the scope of the cause of action but also important remedial issues are likely to remain in doubt until the wrong of ‘misuse of private information’ is freed from the constraints of the traditional action for breach of confidence. A separate tort would be able to deal more coherently and comprehensively with all wrongs commonly regarded as privacy breaches.
Ankylosis of tarsometatarsal luxations using external fixation
Authors: McLennan M. J.
Published: June 2007

This report evaluates the suitability of using an external fixator as the sole means of correcting tarsometatarsal luxations. Four dogs were included in this report. Each dog weighed more than 20 kg and had sustained a tarsometatarsal luxation with plantar, medial or lateral instability. The luxations were immobilised with an external fixator for between 12 and 17 weeks. The surgery did not involve soft tissue dissection, debridement of articular cartilage or a cancellous bone graft and no external coaptation was used postoperatively. The result of this treatment was to ankylose the tarsometatarsal luxation and allow the dogs to return to normal function.
When unfairness matters most: supervisory violations of electronic monitoring practices
Authors: Zweig David , Scott Kristyn
Published: June 2007

This study examined the effects of different sources of monitoring information, quality of treatment and quality of decision‐making manipulations on perceptions of fairness and satisfaction with monitoring. Drawing on Blader and Tyler's four‐component model of fairness, participants were asked to rate their perceptions of fairness, satisfaction and intentions to comply with electronic performance‐monitoring policies that originated from formal organisational policies or from their direct supervisors. Results indicated that procedural justice violations originating from the supervisor (vs. formal organisational policy) led to lower perceptions of fairness and satisfaction with monitoring. Furthermore, the effect of procedural justice violations on compliance with monitoring was mediated by perceptions of fairness and satisfaction with monitoring. The present research has theoretical and practical implications for the design, implementation and communication of organisational electronic monitoring practices.
Private equity and HRM in the British business system
Authors: Clark Ian
Published: June 2007

Who owns the firm? Do changes in owner matter? Will change affect the operational and strategic role of the HR function? For some, the answer will be no precisely because mergers and acquisitions, takeovers, buyouts and privatisations are central activities for a British‐based business where short‐term value for shareholders and financial engineering are key management objectives that structure and inform the work of HR professionals. For other readers, the answer may well be yes; ownership and owner strategies do matter, particularly if a firm is acquired by a relatively new actor in the market for corporate control – the private equity firm.
Family Therapy with Black, Disadvantaged Families: Some Observations on Roles, Communication, and Technique
Authors: Foley Vincent D.
Published: June 2007

Within a system concept role delineation and communicational patterns of black, disadvantaged families are evaluated on the basis of 15 years experience. The observations made at best are suggestive and meant to highlight certain features of a black, disadvantaged family system. In the light of these observations some suggestions regarding technique are offered, notably the use of multiple family therapy as a way of increasing therapeutic effectiveness and facilitating movement in the system.
Abstracts
Authors: Sporakowski Michael J.
Published: June 2007

Bernstein, B. E. Lawyer and counselor as an interdisciplinary team: one lawyer's suggestions.

Brandwein, R. A., Brown, C. A. & Fox, E. M. Women and children last: the social situation of divorced women and their families.

Cookerly, J. R. The reduction of psychopathology as measured by the MMPI clinical scales in three forms of marriage counseling.

Denfeld, D. Dropouts from swinging.

Fulton, W. C. Counseling as an insured benefit: perspectives from the insurance industry.

Hurvitz, N. The family therapist as intermediary.

Raths, O. N., Bellville, T. P., Bellville, C. J. & Garetz, F. K. The counter‐phobic mechanism as a force in mate selection and marital stability.

Rolfe, D. J. The financial priorities inventory.

Solomon, M. A. Resistance in family therapy: some conceptual and technical considerations.

Sonne, J. C. On the question of compulsory marriage counseling as a part of divorce proceedings.

Strauss, M. Leveling, civility, and violence in the family.

Weiss, R. L., Birchler, G. R., & Vincent, J. P. Contractual models for negotiation training in marital dyads.
The Treatment of Sexual Disturbance
Authors: Ellis Albert
Published: June 2007

The thesis of this paper is that the highly competent marriage and family therapist had better have good understanding of both general disturbance and sexual disturbance. A case illustration of an individual with a sexual disturbance is given. Editor.
Book Reviews
Authors: Ard Ben N.
Published: June 2007

Book reviewed in this article:

Gottman, John M., & Leiblum, Sandra R. How to do psychotherapy and how to evaluate it: A manual for beginners.

Nichols, William C., Jr., (Editor). Marriage and family therapy: A reader from NCFR journals.

Greenwald, Harold. Direct decision therapy.

Kaufman, Walter. Without guilt and justice: From decidophobia to autonomy
Changing Roles for Women: Implications for Marriage Counselors*
Authors: Humphrey Frederick G.
Published: June 2007

Noting that marriage counselors focus on the male‐female relationship and that changes affecting women also affect men, the author examines changes in womens' roles in American society and draws implications for marriage counselors. Editor.
A Use of Social Exchange Theory in Family Crisis Intervention*
Authors: Brown Arthur H.
Published: June 2007

This paper explores the practical application of social exchange theory in conceptualizing a working hypothesis in family crisis intervention. It is hypothesized that the range of exchange content in a family crisis situation is proportional to the frequency of negative communication. The contention is made that offering specific behavioral exchange equivalents to family members based on need‐response patterns allows for resolution of the family conflict. A case example illustrates support for the hypothesis and implications for future empirical research in family crisis studies are noted.
Setting Up a Rural Private Practice*
Authors: Williams Arthur R.
Published: June 2007

This irreverent, somewhat breezy paper describes the experience of the author in establishing a private practice in an unusual setting and offers some observations for others. Editor.