bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thrombus aspiration in acute myocardial infarction
Authors: Kahn Joel K. , Hartzler Geoffrey O. 
Published: March 2007

AbstractA 57 yr‐old man suffered an in‐hospital inferior myocardial infarction 9 yr following coronary artery bypass surgery. Emergency cardiac catheterization demonstrated a large, occlusive thrombus in the saphenous vein graft to the right coronary artery. Multiple balloon dilitations failed to lyse the thrombus. A guiding catheter was used to aspirate the thrombus from the graft andthere was immediate pain relief.
Coronary artery aneurysm formation following percutaneous transluminal coronary angioplasty: Treatment of associated Restenosis with repeat percutaneous transluminal coronary angioplasty
Authors: Walford Gary D. , Midei Mark G. , Aversano Thomas R. , Gottlieb Sidney O. , Chew Paul H. , Brinker Jeffrey A. 
Published: March 2007

AbstractRestenosis following coronary angioplasty can usually be treated effectively and safely by repeated angioplasty. However, the presence of a complex lesion morphology may bias the clinician away from angioplasty toward either recommending bypass surgery or continuing medical therapy alone in spite of recurrence of the symptoms which were sufficient indication for the initial angioplasty. One type of complex morphology at the site of the restenosis is due to the presence of a focal, eccentric aneurysmal dilatation similar in appearance to a saccular aneurysm. In two previously reported cases in the literature both were referred to bypass surgery. We report eight additional cases including the use of repeat successful angioplasty in six of the cases in spite of the potential problems posed by the complexity of the restenosed lesion.In addition, this case review suggests that this type of complex lesion morphology with restenosis may be more common when the initial angioplasty was associated with deep arterial injury, as in patients whose initial angloplasty was done in an infarct‐related vessel or was associatedwith evidence of a large dissection.
Diagnosis of unexpected atrial septal defect by inspired hydrogen appearance time in adult patients referred for cardiac catheterization
Authors: Schwinger Matthew E. , Tunick Paul A. , Glassman Ephraim , Kronzon Itzhak 
Published: March 2007

AbstractAtrial septal defects may have clinical consequences regardless of their size. We evaluated the incidence of clinically unsuspected atrial septal defects in 4,411 consecutive adult patients referred for cardiac catheterization by the previously validated method of inspired hydrogen appearance time. Oximetry was performed only when an abnormally short inspired hydrogen appearance time was measured. Seventy‐five patients (1.7%) were discovered to have a left‐to‐right shunt by this method. The shunting was at the atrial level in 65 patients. Thirty‐five of these patients (0.8% of all catheterizations) were not suspected of having any form of congenital heart disease by history, physical examination, chest X‐ray, EKG, or echocardiogram. In 19 cases there was no significant oxygen step‐up and the diagnosis would have been missed by oximetry. The atrial septum was explored during open heart surgery in 7 patients. Atrial septal defects were detected and closed in all. Four patients had the finding confirmed by echocardiography after the catheterization. Small atrial septal defects are frequently not detected by clinical evaluation, noninvasive testing, or oximetry and are easily detected by the rapid, safe, and accurate method of inspired hydrogen appearance time.
Assessment of the sensitivity of hydrogen inhalation in the detection of left‐to‐right shunting
Authors: Flores Eduardo D. , Lange Richard A. , Bedotto John B. , Danziger Robert S. , Hillis L. David 
Published: March 2007

AbstractFor the detection of left‐to‐right intracardiac shunting, the oximetric and standard indocyanine green techniques are relatively insensitive, in that neither can reliably detect a shunt with a ratio of pulmonary to systemic flow (Qp/Qs) < 1.3 (percentage shunt, 23%). Although the hydrogen inhalation method is said to be much more sensitive in this regard, no previous study has measured its sensitivity. Accordingly, in 15 patients (4 men, 11 women, aged 38 to 67 years) without intracardiac shunting, hydrogen inhalation was performed 1) without and 2) with an artificially created femoral arteriovenous shunt of known size, and cardiac output was measured by thermodilution. For the 15 subjects with cardiac outputs of 3.64 to 8.10 liter/min, shunts of 22 to 248 ml/min were created, so that the shunts ranged from 0.5% to 3.3%. Hydrogen inhalation detected all shunts ≥ 1.3% (Qp/Qs ≥ 1.01). Of the 10 shunts < 1.3%, it detected 5, with the smallest being 0.7%. Thus, the hydrogen inhalation technique is extremely sensitive in identifying the presence of left‐to‐right shunting, far more sensitive than the oximetric and standard indocyanine green methods.
Orion™, an improved balloon on a wire system: Initial experience
Authors: Corcos Thierry , Favereau Xavier , Poirot Géarard , Souffrant Géarard 
Published: March 2007

AbstractThe OrionTM coronary angioplasty improved balloon on a wire system was used in 42 patients (53 stenoses) including 5 patients with acute myocardial infarction, 18 patients with unstable angina, and 4 patients with kissing balloon angioplasty via a single guiding catheter. All stenoses were crossed successfully and the immediate and in‐hospital success rates were 98 and 93%, respectively. The simple construction, low prcfile, and improved steerability allowed successful and quick angioplasty of high grade stenotic lesions. This balloon catheter represents a significant advance in angioplasty technology.
Reproducible uniform coronary vasomotor tone with nitrocompounds: Prerequisite of quantitative coronary angiographic trials
Authors: Jost Stefan , Rafflenbeul Wolfgang , Rell Gert‐Hinrlch , Gulba Dietrich , Knop Ingo , Hecker Hartmut , Lichtlen Paul R. 
Published: March 2007

AbstractIn quantitative analysis of repeated coronary angiograms, a variable vasomotor tone of the epicardial coronary arteries may influence the accuracy of the results. Therefore, we evaluated the extent and reproducibility of coronary artery dilation with nitrocompounds.In 32 patients with coronary artery disease, the vasodilatory response of angiographically normal coronary segments to different nitrocompounds was analyzed with the computer‐assisted contour detection system CAAS. Twenty patients received 5 mg or 10 mg of isosorbide dinitrate sublingually. After 10 to 15 min, a maximal diameter increase was measured with an average of 16 ± 11% (5 mg: P<0.01) and 28 ± 13% (10 mg:P<0.001) from control. Another 12 patients received 0.025 mg per kg body weight of SIN‐1, the active metabolite of molsidomine, as an intravenous infusion over 5 min. A comparable maximal dilation (29 ± 5%;P<0.001) occurred after 10 to 15 min and could not be enhanced further with 0.8 mg nitroglycerin administered sublingually (28 ± 7%; n.s.). One hour after \documentclass{article}\pagestyle{empty}\begin{document}$\sqrt {Sin-1}$\end{document}, coronary dilation was still 24 ± 8% (P<0.001 compared with control), and 0.8 mg of nitroglycerin sublingually reestablished the previous maximal dilation of 28 ± 8%.We conclude that high doses of nitrocompounds induce a reproducible maximal coronary dilation that eliminates a substantial source of error in quantitative analysis of repeated coronary angiograms. At present, sublingual administrations of either 10 mg isosorbide dinitrate once or 0.8 mg nitroglycerin repeatedly seem to represent the easiest practicable modes to achieve maximal coronary vasodilation for an adequate period.
Coronary artery pseudothrombus: Angiographic filling defects caused by competitive collateral flow
Authors: Weinberg Bradley A. , Bourdillon Patrick D. V. 
Published: March 2007

AbstractTwo cases are described of intraluminal coronary artery filling defects resembling thrombus caused by nonopacifed collateral blood flow mixing with injected contrast just distal to a severe coronary artery stenosis. The term pseudothrombus is ascribed to this appearance to emphasize this differential diagnosis of intraluminal filling defects.
Detection of intramyocardial hemorrhage using high‐field proton (1h) nuclear magnetic resonance imaging
Authors: Lotan Chaim S. , Miller Sandra K. , Bouchard Alain , Cranney Gregory B. , Reeves Russell C. , Bishop Sanford P. , Elgavish Gabriel A. , Pohost Gerald M. 
Published: March 2007

AbstractProton (1H) nuclear magnetic resonance (NMR) imaging has been used to define zones of myocardial infarction (MI), which appear as areas of relatively increased signal intensity (SI). However, zones of decreased SI have been observed within the areas of infarction and have been postulated to result from intramyocardial hemorrhage. To explore this phenomenon further, ex vivo spin‐echo 1H NMR imaging at 1.5 Tesla was performed in 17 dogs after 24 hr (n=9) and after 72 hr (n=8) of coronary artery occlusion.In all dogs, a zone of increased SI (118 ± 9% compared with normal myocardium) was observed in the distribution of the occluded coronary artery. In 12 of the 17 dogs, zones of decreased SI (92 ± 8% compared with normal) were seen within or around the central zone of increased SI. Gross inspection and histological assessment of sliced myocardium usually disclosed hemorrhage in the regions of decreased SI. In three of the five dogs with no apparent zones of decreased SI on NMR. the infarct was small, and only minor hemorrhage was observed by gross inspection, whereas in the remaining two dogs no hemorrhage was seen. Myocardial flow in the hemorrhagic regions was significantly higher than in the necrotic core (59 ± 29% vs. 31 ± 24% compared with control, P< 0.05).Image‐derived calculation of T2 relaxation times in the different infarcted regions revealed a significant shortening of T2 in the infarcted hemorrhagic zones with decreased SI compared with the infarct zones with increased SI (49 ± 8 msec vs. 66±8 msec, P< 0.05). This reduction in T2 in the hemorrhagic zone is consistent with the paramagnetic effects of the deoxyhemoglobin associated with intramyocardial hemorrhage.These observations improve our understanding of the changes in NMR SI within the infarcted regions and provide a noninvasive method for the detection of intramyocardial hemorrhage. This should help to characterize further the myocardium in patients with myocardial infarction and to assess the effect of myocardial hemorrhage following reperfusion therapy.
Guiding catheter exchange during coronary angioplasty
Authors: Warren Stafford G. , Barnett J. Craig 
Published: March 2007

AbstractA new technique to exchange one angioplasty guiding catheter for another with the guide wire in place and across a coronary artery stenosis has been developed to decrease the dangers of having to recross the stenosis with a guide wire. This technique utilizes a regular extended angioplasty guide wire and enables the exchange of guiding catheters during the angioplasty procedure. In 683 consecutive angioplasty procedures by one operator, this technique has been attempted 57 times in 43 patients (6.3%) and has been successful 51 times (90%). The only failures were when the second catheter had a large or open curve (left Amplatz II, 5/22 unsuccessful or multipurpose, 1/3 unsuccessful). There have been no complications. We conclude that exchange of a guiding catheter over a guide wire by the method described is safe and helpful in cases where different guiding catheters are needed for back‐up power once the lesion has been crossed with a guide wire.
Multi‐hospital Eastern Atlantic Restenosis trial: Design, recruitment, and feasibility
Authors: Hill James A. , Macdonald Robert G. , Jugo Ralph , Hirshfeld John W. , Goldberg Sheldon , Savage Michael P. , Vetrovec George , Cowley Michael , Bass Theodore A. , Margolis James R. , Whitworth Hall B. , Taussig Andrew S. , Bove Alfred A. , Pepine Carl J. 
Published: March 2007

AbstractA randomized control trial was set up to examine factors that influence restenosis and determine the effects of corticosteroids on restenosis following successful PTCA. The rationale for the study agent chosen, design, recruitment, and feasibility, as well as initial patient demographic data and initial results are presented.
Klinefelter's syndrome with anomalous origin of left main coronary artery
Authors: Albazzaz Sabah J. 
Published: March 2007

AbstractKlinefelter's syndrome is a rare entity. Even rarer is an anomalous origin of the Left Main Coronary Artery. For both conditions to occur in the same patient is hence exceedingly rare. Reported here is a never previously reported case of a coronary congenital anomaly in a patient with Klinefelter's syndrome together with the proper angiographic approach.
Retrograde Recanalization of an occluded posterior tibial artery by using a posterior tibial cutdown: Two case reports
Authors: Iyer Sriram S. , Dorros Gerald , Zaitoun Rafic , Lewin Ruben F. 
Published: March 2007

AbstractRecanalization of two occluded posterior tibial arteries was successfully achieved by utilizing a retrograde approach via a posterior tibial artery cutdown at the level of the ankle. Both cases were previously unsuccessfully attempted by using an antegrade approach. Thus, the choice of access vessel (arterial entry site) becomes a crucial determinant of angioplasty success.
Percutaneous high‐speed rotational atherectomy (Rotablator™) of a restenosed ostial renal artery: A case report
Authors: Zaitoun Rafic , Dorros Gerald , Iyer Sriram S. , Lewin Ruben F. 
Published: March 2007

AbstractThis case report describes the feasibility and potential benefit of the use of a high‐speed rotational atherectomy device (the Rotablator™) in the treatment of renovascular hypertension in a patient with a recorded restenosis of an ostial renal artery lesion following standard balloon angioplasty.
Systemic heparinization does not prevent clot formation in coil embolization
Authors: Johnson Walter H. , Peterson Robyn K. , Howland Donna F. , Lock James E. 
Published: March 2007

AbstractTherapeutic transcatheter closure with Gianturco‐type steel coils has been applied to a variety of vascular communications in children with congenital heart disease. Vessel closure depends upon successful thrombus formation around the coil. Since systemic anticoagulation with heparin is commonly used during catheterization and cardiac surgery, we studied the effect of systemic heparinization on the efficiency of vessel occlusion by coil emboiization in lambs. Catheters inserted in femoral arteries were used to arteriographically locate and size 36 systemic arteries in 9 lambs weighing 4.2 to 7.4 kg. Twenty‐four vessels were embolized prior to heparinization with 400 u/kg heparin, IV. Effective anticoagulation was demonstrated by post‐heparin activated clotting time (ACT) values greater than 300 sec. Seven vessels (29%) were not successfully coil‐embolized because of inadequate coil position or distant embolization of the coil; 17 (71%) of these vessels were shown to be successfully occluded by arteriography 6 to 77 min later. After a period of systemic heparinization ranging from 71 to 159 min, 9/17 arteries remained occluded, 7/17 could not be examined arteriographically due to early demise of the animal, and only 1/17 showed recanalization. A second group of 12 vessels were embolized after heparinization. Eight (75%) were successfully occluded, and 4 (25%) were not successfully coil‐embolized because of inadequate coil position or coil embolization to distant arteries. We conclude that systemic heparinization had no measurable effect on occlusion rates in coil‐embolized systemic arteries in the lamb. These data support the use of systemic heparinization, when indicated, during or following therapeutic coil embolization in children.
Simplified method for estimating true aortic valve mean gradient from simultaneous left ventricular and peripheral arterial pressure recordings
Authors: Folland Edward D. , Parisi Alfred F. , Comei Cynthia 
Published: March 2007

AbstractEstimation of the aortic valve gradient by simultaneous recording of left ventricular and peripheral arterial pressures is subject to error due to delay and modulation of the arterial pressure contour as it propagates from the ascending aorta. This error can be corrected by averaging the mean gradients derived from unaltered and temporally aligned simultaneous left ventricular‐peripheral arterial pressure tracings. In 26 patients with aortic stenosis and simultaneous recordings of ascending aortic and femoral arterial pressure we compared this method with a simplified approach in which the peripheral arterial pressure is partially aligned by advancing it against the left ventricular pressure by 50% of the time delay of the simultaneously recorded upstrokes. Gradients measured this way predicted the true aortic valve gradients (left ventricular‐ascending aortic) with a mean difference of +1.1 mm Hg (range = +10 to −5 mm Hg). We recommend use of this simplified method of correction because it predicts true aortic valve gradient equally well as the averaging technique (r=0.977 vs. 0.979) and requires half the time and effort.
Experience with the use of coronary autoperfusion catheter during complicated angioplasty
Authors: Saenz Carlos B. , Schwartz Kerry M. , Slysh Sonya J. , Palanca Kim , Charles R. Curry 
Published: March 2007

AbstractBetween February and July of 1989, 22 patients underwent the use of the Stack autoperfusion catheter following acute occlusion or obstructive dissection during coronary angioplasty; in 20 cases conventional balloon was used in an attempt to correct the angiographic appearance followed by the use of Stack catheter when results were sub‐optimal. Only 1 patient (4.5%) required surgical revascularization. Although our study is not prospective or randomized, our observations suggest a significant impact in decreasing the need for emergency surgical revascularization after complicated coronary angioplasty with the use of this approach.
Acquired lutembacher syndrome or mitral stenosis and acquired atrial septal defect after transseptal mitral valvuloplasty
Authors: Sadaniantz Ara , Luttmann Christopher , Shulman Richard S. , Block Peter C. , Schachne Jay , Thompson Paul D. 
Published: March 2007

AbstractCritical mitral stenosis in selected patients may be treated successfully with percutaneous mitral valvuloplasty. Complications of this procedure, particularly an atrial septal defect following transseptal approach, are generally of minor clinical significance.We describe a woman who initially underwent a successful percutaneous double‐balloon mitral valvuloplasty via the transseptal approach. Three months later she presented with right‐sided heart failure. Color Doppler echocardiography and cardiac catheterization demonstrated an atrial septal defect (ASD) as well as restenosis of the mitral valve.We conclude that significant ASDs may occur following transseptal mitral valvuloplasty with appearance of right ventricular failure and that color Doppler imaging aids in the diagnosis of this new variant of the classical Lutembacher syndrome.
Myocarditis simulating acute transmural myocardial infarction
Authors: Chakko Simon , Woska David , de Marchena Eduardo , Morales Azorides R. , Castellanos Agustin 
Published: March 2007

AbstractA patient with cardiogenic shock had typical electrocardiographic findings of acute anterior transmural myocardial infarction. Cardiac catheterization revealed normal coronary arteries and severe biventricular failure. Postmorten examination confirmed normal coronary arteries; acute myocarditis, but no evidence for infarction, was found. Electrocardiographic changes of myocarditis may be indistinguishable from acute transmural infarction. In suspected cases, cardiac catheterization should be considered prior to thrombolytic therapy.
Misplacement of a swan‐Ganz catheter after insertion through the left internal jugular vein
Authors: Unger P. , Stoupel E. , Berkenboom G. 
Published: March 2007

AbstractWe report a case of perforation of the left brachiocephalic vein after insertion through the left internal jugular vein. Entrapment of air in the balloon occurred, possibly due to high surrounding tissue pressure at its base, preventing deflation. We emphasize the potential hazards of catheterization via the left internal jugular vein.
Percutaneous valvuloplasty in a patient with mitral stenosis following surgical annuloplasty
Authors: Saenz Carlos B. , Nocero Michael A. , Weaver Curtis J. 
Published: March 2007

AbstractA case is described in which a patient with a Carpentier‐Edwards annuloplasty ring developed mitral stenosis and was treated with percutaneous mitral valvuloplasty. Possible mechanisms for the development of mitral stenosis are briefly discussed.
Salvage from cardiogenic shock by atherectomy after failed emergency coronary artery angioplasty
Authors: Smucker Mark L. , Sarnat William S. , Kil Diane , Scherb Daniel E. , Howard Paul F. 
Published: March 2007

AbstractIn this case report of a patient undergoing angioplasty for cardiogenic shock during acute myocardial infarction, recurrent occlusion resulted in recurrence of shock. Atherectomy reestablished lasting patency and reversed the patient's hemodynamic collapse. Atherectomy deserves further investigation as a means to salvage vessel patency during unsuccessful coronary angioplasty.
Regression of infundibular pulmonary stenosis after successful balloon pulmonary valvuloplasty in adults
Authors: Fawzy M. E. , Galal O. , Dunn B. , Shaikh A. , Sriram R. , Duran C. M. G. 
Published: March 2007

AbstractBetween July 1985 and March 1988,22 adult patients with congenital pulmonary stenosis underwent balloon pulmonary valvuioplasty. There were 10 males and 12 females aged 16‐45 (average 25 ± 9.9) years. All patients had additional mild to severe infundibular stenosis; 16 were restudied 6‐36 (mean 12.6) months later by repeat Catheterization. Student's t‐test was used for comparison of data.Right ventricular (RV) systolic pressure before dilatation was 84–196 (mean 129 ± 32.3) mm Hg, and the peak pulmonary gradient (PPG) was 60–176 (mean 111 ± 33.2) mm Hg immediately after dilatation. The RV systolic pressure dropped to 32–140 (mean 59.2 ± 27) (P<0.001); and PPG dropped to 10–113 (mean 37.8 ± 26.4) (P<0.001), and the infundibular gradient ranged from 8 to 113 (mean 35.1 ± 25.8) mm Hg. The infundibular diameter, before dilatation, ranged from 2 to 15 (mean 9.5 ± 4) mm Hg. At repeat catheterization, the RV systolic pressure dropped further to 33–66 (mean 42.8 ± 9.7) mm Hg and the PPG was reduced to 0–48 (mean 18.4 ± 10.9) mm Hg (P<0.001). The infundibular gradient regressed to 0–34 (mean 15 ± 8.8) mm Hg (P< 0.001). The infundibular diameter Increased to 8–25 (mean 15.8 rt 5.4) (P<0.001). It is concluded that moderate to severe lnfundibular stenosis, in adults, can regress after successful pulmonary valvuloplasty.
Death at cardiac catheterization: Coronary artery embolization of calcium debris from lonescu‐shiley bioprosthesis
Authors: Walley V. M. , Giannoccaro P. , Beanlands D. S. , Keon W. J. 
Published: March 2007

AbstractThe case described is a death due to emboliration of calcium debris from a bioprosthesis, dislodged at cardiac catheterization. As more bioprosthetic valves are implanted, and more of them fail long‐term with calcification, such complications of the lnvasive study of these valves may be expected.
Percutaneous aspiration of thrombus occluding a saphenous vein graft
Authors: Adatte Jean Jacques , Villavicencio Ramon , Meier Bernhard 
Published: March 2007

AbstractBypass graft occlusion by a thrombus 30 min before elective coronary angiography was treated by percutaneous thrombus aspiration, followed by an angioplasty with a good follow‐up result.