bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of meglumine sodium diatrizoate, lopamidol, and lohexol for coronary angiography and ventriculography
Authors: Murdock Challon J. , Davis Michael J. E. , Ireland Mark A. , Gibbons Fran A. , Cope Geoffrey D. 
Published: March 2007

AbstractMeglumine sodium diatrizoate (Urografin), iopamidol, and iohexol were compared in a double‐blind, randomized study of 287 patients undergoing elective cardiac angiography. Ninety‐six patients received Urografin, 98 received iopamidol, and 92 received iohexol. The groups were similar in all respects. Variables measured before and after contrast injection were left ventricular end‐diastolic pressure (LVEDP), left ventricular systolic pressure (LVSP), systolic arterial pressure (SAP), RR, PR, and QTc intervals, QRS duration, ST segment change greater than 2 mm, arrhythmias, and symptoms. The adequacy of coronary and ventricular opacification was assessed by two experienced observers. Following left ventriculography, small rises in LVEDP occurred with iopamidol and iohexol (mean ± SD: 187 to 21 ± 7 mmHg) and a moderate fall in LVSP with Urografin (150 ± 32 to 133 ± 32 mmHg). Following coronary angiography there was a progressive fall in SAP (130 ± 26 to 117 ± 30 mmHg) and prolongation of RR intervals (900 ± 138 to 1,266 ± 692 msec) and QTc (440 ± 61 to 471 ± 73 msec) and QRS duration (87 ± 25 to 100 ± 27 msec) with Urografin. There was a small fall in SAP with iopamidol(138 ± 25 to 128 ± 27 mmHg) and prolongation of QRS duration with iohexol (85 ± 29 to 90 ± 24 msec). Other parameters were not significantly affected. Frequent bradyarrhythmias (sinus pause 14.5%, asystole 6%) and ST segment depression occurred following Urografin. Urografin was less well tolerated, with 10% of patients experiencing severe nausea or vomiting and 30% of patients experiencing extreme heat sensation. Differences between iohexol and iopamidol were minor. Coronary and left ventricular opacification were satisfactory and not significantly different between the groups. Iopamidol and iohexol have fewer adverse hemodynamic, electrocardiographic, and symptomatic effects, and their use in preference to Urografin is advocated.
Ventricular arrhythmia due to intracoronary papaverine: Analysis of QT intervals and coronary vasodilatory reserve
Authors: Kern Morton J. , Deligonul Ubeydullah , Serota Harvey , Gudipati Chalapathirao , Buckingham Thomas 
Published: March 2007

AbstractIntracoronary papaverine commonly produces striking QT interval prolongation with rare but serious ventricular dysrhythmias reported. Because of 3 cases of severe papaverineinduced dysrhythmia in our laboratory, QT intervals and hemodynamic and intracoronary velocity data collected during intracoronary papaverine administration were retrospectively reviewed in 34 patients; 20 patients with angiographically normal coronary arteries (group 1) and 14 patients (group 2) before and (group 2) after single‐vessel left coronary angioplasty. QT intervals increased from 394 ± 44 to 464 ± 73 msec, 414 ± 47 to 504 ± 95 msec, and 410 ± 41 to 486 ± 75 msec for groups 1 and 2 before and after angioplasty, respectively (all P < 0.01). There was no correlation with hemodynamic, electrocardiographic, or coronary vasodilatory reserve responses and change in QTc interval. In the 3 index patients having significant papaverine‐related arrhythmias, a baseline QT interval was prolonged (after prior papaverine exposure) in only 1 in association with trosade de pointes. These data indicate that QT interval prolongation after papaverine is a common occurrence, but that the production of ventricular dysrhythmia is probably idiosynchratic in origin. In view of these findings, we recommend that appropriate antiarrhythmic preparations be in place for patients receiving intracoronary papaverine.
Platypnea‐orthodeoxia as a cause of unexplained hypoxemia in an 82‐yr‐old female
Authors: Nazzal Sami B. , Bansal Ramesh C. , Fitzmorris Steven J. , Schmidt Carlos A. 
Published: March 2007

AbstractWe describe an 82‐yr‐old patient with platypnea‐orthodeoxia without identifiable lung disease in whom the diagnosis was suspected because of clinical history, echocardiography, and orthostatic measurement of arterial blood gases. Recumbent and upright cardiac catheterization techniques confirmed the presence of orthostatic variation in the degree of right to left shunt across the fossa ovalis. This was successfully treated by surgical closure of the interatrial communication in the region of the fossa ovalis.
New passive perfusion PTCA catheter
Authors: White Christopher J. , Ramee Stephen R. , Banks Alan K. , Ross Terence C. , Berman Michael , Sogard David , Price Herman L. 
Published: March 2007

AbstractPercutaneous coronary angioplasty with a new passive perfusion balloon catheter was compared to a standard angioplasty balloon catheter during prolonged balloon inflations in miniature swine. Inflations with the passive perfusion balloon were alternated with a standard balloon with the initial balloon chosen randomly in 24 coronary arteries. Endpoints for terminating the balloon inflation were the appearance of 2 mm of ST segment deviation from baseline on the electrocardiogram, the occurrence of ventricular fibrillation, or 30 min of balloon inflation. During balloon inflation contrast injections were performed through the guiding catheter and flow distal to the balloon was graded 0–3 using the TIMI scale. The average (±SD) inflation time for the standard balloon was 3.1 ± 2.2 minutes and for the perfusion balloon was 27.2 ± 4.8 min (P < 0.001). Electrocardiographic evidence of 2 mm of ST segment deviation from baseline was seen during 11/13 inflations with the standard balloon and in 3/11 balloon inflations with the perfusion balloon. Ventricular fibrillation occurred during 2/13 of the standard balloon inflations and in none during passive balloon inflations. Distal contrast flow during passive balloon inflations averaged 2.7 ± 0.5 (TIMI scale 0–3) and was absent during inflations with the standard balloon. The perfusion balloon allowed prolonged inflations with excellent distal flow when compared to the standard balloon. The passive perfusion balloon may allow safer, longer inflations in humans while also improving patient comfort. The passive perfusion balloon may also have utility as a bailout catheter to preserve distal flow during abrupt occlusions, and may be useful in conducting prospective trials evaluating the benefits of prolonged balloon inflation during coronary angioplasty in man.
Clinical experience with percutaneous brachial coronary angiography in a “Judkins” laboratory
Authors: Mills Roger M. , Berger Peter , Garber Gary R. , Larosa David , Faxon David P. 
Published: March 2007

AbstractMore than 98% of coronary studies performed in our laboratory are done with the transfemoral approach. In this report, we review our experience with 67 cases in which we used the percutaneous brachial approach as an alternative for patients with peripheral vascular disease. Sixty‐six cases (99%) were completed; one case (1%) was aborted due to cardiogenic shock. No death, stroke, or myocardial infarction occurred. Seven patients (10%) had minor complications; none required surgical intervention. The percutaneous brachial approach with standard preformed catheters offers a simple and satisfactory alternative to transfemoral coronary angiography.
Predictors of increased mitral regurgitation after percutaneous mitral balloon valvotomy
Authors: Roth Robert B. , Block Peter C. , Palacios Igor F. 
Published: March 2007

AbstractLeft ventriculography (LVG) was performed to assess severity of mitral regurgitation (MR) on a scale of 0–4 + in 157 patients before and immediately after percutaneous mitral balloon valvotomy (PMV). There were 129 women and 28 men aged 51 ± 1 (range 13–87) yr. With PMV, mitral valve area increased from 0.9 ± 0.1 cm2 to 2.0 ± 0.1 cm2 (P <.0001). Increase in mitral regurgitation (MR) occurred in 69 patients (44%). Patients were divided into two groups based on increase in MR after PMV. Group A (n = 136) had 0–1 + increase in MR. Group B (n = 20) had ± 2 + increase in MR after PMV. The only predictor of increase in MR≥2+ was the ratio of effective balloon dilating area to body surface area (EBDA/BSA). EBDA/BSA was 4.0 ± 0.1 cm2/m2 in Group A vs. 4.37± 0.2 cm2/m2 in Group B (P =.02).Follow‐up of patients in Group B showed: Four patients remained NYHA Class III and required mitral valve replacement 4.3 ± 1.1 (range 5–21) mo after PMV. One patient who had undergone combined aortic and mitral valvotomy died in the hospital of worsening heart failure. One patient died 1 mo later of sepsis related to a dental abscess. Follow‐up of the remaining 14 patients at 9.5 ± 1.1 (range 2–7) mo showed 10 in NYHA Class I and four in NYHA Class II. Eight of 15 patients (53%) who had repeat left ventriculogram at 9.0 ± 0.8 mo after PMV had a decrease in MR of one grade when compared to LVG immediately after PMV.
Elective supported angioplasty: Initial report of The National Registry
Authors: Vogel Robert A. , Tommaso Carl L. 
Published: March 2007

AbstractA National Registry of 14 centers performing elective supported angioplasty was formed to collate the initial experience with high‐risk patients. Suggested indications were ejection fraction less than 25% and/or target vessels supplying greater than half of the viable myocardium. The data from 105 patients were entered into the Registry during 1988. This group included 30 patients who had dilation of their only patent coronary vessel and 20 patients whose disease was deemed too severe to undergo bypass surgery. Chest pain and ECG changes were uncommonly experienced during balloon inflation. The group experienced a high angioplasty success rate (95%) with an average of 1.7 dilatations per patient. Morbidity was frequently experienced, the majority of which was associated with cannula (18–20F) placement and/or removal. The overall hospital mortality was 7.6%, although half of the deaths occurred in patients who were both over 75 years of age and had left main coronary artery stenosis. Patients under the age of 75 years without left main coronary artery stenosis experienced a hospital mortality rate of 2.6%. Symptomatic improvement occurred in 91% of the patients surviving hospitalization. During the followup period of 1–12 months, three patients died of cardiac complications. This multicenter experience suggests that supported angioplasty can be performed safely in high‐risk patients in several high‐risk subgroups with the expectation of good symptomatic improvement and short‐term survival.
Use of percutaneously inserted cardiopulmonary bypass in the cardiac catheterization laboratory
Authors: Tommaso Carl L. 
Published: March 2007

AbstractA cardiopulmonary bypass system that can be percutaneously inserted is available. In addition to its use in stabilization of severely hemodynamically compromised patients, it has many uses in cardiology including use as an adjunct to high‐risk interventional procedures. The purpose of this report is to communicate our experience with cardiopulmonary bypass in the Catheterization Laboratory and discuss technique, indications, and potential complications.
Angioplasty of a large aortocoronary bypass graft utilizing a single oversized balloon catheter
Authors: Esente Paolo , Giambartolomei Alessandro , Reger Mark J. , Johnson Lewis W. 
Published: March 2007

AbstractAngioplasty of large saphenous vein grafts may present problems because of unavailability of adequately sized balloon dilatation catheters. We report a case of successful PTCA of a left anterior descending graft by using a 5 mm balloon and a standard 8F guiding catheter.
Balloon embolization of latrogenic aortocoronary arteriovenous fistula
Authors: Graeb Douglas A. , Morris D. Christopher , Ricci Donald R. , Tyers G. Frank 
Published: March 2007

AbstractA detachable latex balloon was used to occlude an iatrogenic aortocoronary arteriovenous fistula. The aim of providing retrograde myocardial perfusion was not achieved to any significant degree because of rapid recruitment of collateral venous routes to the coronary sinus. This may have implications for the effectiveness of deliberate grafting of the coronary venous system with proximal venous ligation, as has been recommended when the coronary arterial system is small and diffusely diseased.
Prediction of coronary artery reperfusion after tissue plasminogen activator infusion
Authors: Kinney Evlin L. , Wright Robert J. 
Published: March 2007

AbstractWe investigated whether clinical and laboratory variables can predict perfusion status after t‐PA administration, by using the data from 138 patients who received t‐PA during the Thrombolysis in Myocardial Infarction (TIMI) I study. All clinical and laboratory variables that were collected at baseline or during perfusion for TIMI I were evaluated by the current study. Via stepwise discriminant analysis, 7 variables were closely associated with perfusion status at 90 minutes (listed in the order of their discriminant effect): baseline grade of stenosis in the infarct‐related coronary artery, whether nausea was present during the infusion, baseline aspartate aminotransferase (SGOT) concentration, whether arrhythmias were present during the infusion, baseline fibrinogen concentration, baseline partial thromboplastin time, and baseline diastolic blood pressure. Baseline severity of stenosis and the likelihood of there being reperfusion were inversely related. Eighty‐four percent of patients with adequate perfusion after 90 minutes of t‐PA infusion were classified correctly, but only 50% of those without perfusion at 90 minutes were classified correctly. In addition, since 70% of the TIMI I patients, on average, did achieve perfusion, the use of these 7 variables added little predictive information. Our findings suggest that 1) there is as yet no practical way to predict reperfusion after t‐PA therapy and 2) the severity of coronary stenoses, if known ahead of time, should be considered when selecting patients for thrombolytic therapy.
Monorail™ Piccolino catheter: A new rapid exchagne/ultralow profile coronary angioplasty system
Authors: Mooney Michael R. , Douglas John S. , Mooney Jodi Fishman , Madison James D. , Brandenburg Robert O. , Fernald Rex , Van Tassel Robert A. 
Published: March 2007

AbstractThe MonorailTM Piccolino coronary angioplasty balloon catheter (MBC) was evaluated on 118 patients at two centers. Technical success was achieved in 110 patients (93%). Time for catheter exchange and total fluoroscopy time were significantly lower for the Monorail catheter than with standard equipment (exchange time 97 vs. 170 seconds P <.05 and fluoroscopy time 17 vs. 88 seconds P < 0.001). The advantages of rapid exchange and the ability of utilize 2 Monorail balloon catheters through one 9F guiding catheter for simultaneous inflations allowed for maximal flexibility in treating patients with bifurcation lesions. The double wire approach utilizing one Monorail balloon catheter with a 7F guiding catheter was also technically successful. The MonorailTM Piccolino balloon catheter has unique features that allow for greater ease of operator use, rapid catheter exchange, and optimal angiographic visualization. It is felt that this catheter design provides distinct advantages over standard angioplasty equipment.
Complete atrioventricular block during cardiac catheterization: Two case reports in patients without pre‐existing conduction abnormalities
Authors: Brachfeld Claude , Marshall James , Volosin Kent J. , Groh William C. 
Published: March 2007

AbstractThird‐degree atrioventricular block has been well documented during ventricular catheterization of patients with underlying conduction abnormalities. Two cases reported here describe patients with normal conduction at baseline who sustained complete heart block during ventricular catheterization. Catheterizing physicians should be aware of this risk, which has not been previously reported.
Complete heart block complicating retrograde left heart catheterization
Authors: Feit Alan , Kipperman Robert , Ursell Shantha , Reddy C. V. R. 
Published: March 2007

AbstractThree cases of complete heart block complicating retrograde left heart catheterization are presented. In two of the three cases, electrophysiologic study documented block below the AV (atrial ventricular) node. In the third recurrent complete heart block was fatal. It appears that complete heart block complicating retrograde left sided cardiac catheterization is not simply a pericatheterization event; rather, it appears that there is high risk of recurrent complete heart block and that electrophysiologic study is mandatory.
Pseudo‐aneurysm formation following balloon angioplasty for recurrent coarctation of the aorta
Authors: Joyce Douglas H. , McGrath Lynn B. 
Published: March 2007

AbstractIntraluminal balloon dilatation of re‐stenosis encountered after operative repair of coarctation of the aorta has been recently advocated. A case is presented that demonstrates a potential serious complication of this procedure: rupture of the aortic wall with pseudoaneurysm formation. The operative repair and mechanism of injury are discussed. Balloon dilatation of recurrent coarctation of the aorta can cause a significant morbidity and potential mortality.
Cardiac catheterization in the patient with history of allergy to local anesthetics
Authors: Feldman Ted , Moss Jonathan , Teplinsky Kerry , Carroll John D. 
Published: March 2007

AbstractPatients with a history of allergic reactions to local anesthetic drugs present a difficult problem during evaluation for cardiac catheterization procedures. In the worst cases the procedure may be deferred, or even performed without local anesthesia. In the vast majority of patients an acceptable agent for safe local anesthetic use can be found. Skin testing beginning with very dilute solutions of preservative free local anesthetic agent may be administered easily. This report describes the practical aspects of skin testing and local anesthetic agent selection in patients with a history of allergic reaction to local anesthetic drugs.
Coronary angioplasty for medically refractory unstable angina in patients with prior coronary bypass surgery
Authors: Morrison Douglass A. 
Published: March 2007

AbstractPercutaneous transluminal coronary sngioplasty (PTCA) has been applied with good results to selected patients with unstable angina and to selected patients who have had prior bypass surgery. The population with prior bypass and unstable angina has not been specifically evaluated. This report reviews the results of angioplasty of 45 vessels in 34 patients with medically refractory unstable angina and at least one prior bypass heart surgery. Of these 34 patients, 32 had rest angina; 14 had resting electrocardiographic changes, all 34 were on aspirin 325 mg QD, 31 were on a calcium blocker. 22 were on a beta blocker, 9 were on intravenous nitroglycerin, and 5 required intraaortic balloon counterpulsation for temporary stabilization. Angioplasty of a vein graft was attempted in 17 patients; the left internal mammary was attempted in 4 patients; 24 native coronary arteries in 15 patients were attempted; 3 of the native arteries were protected left main arteries. Of the LIMA angioplasties, 3 were successful; in the 1 unsuccessful case, the occluded anterior descending artery was opened. Of the 17 vein grafts, 16 were successful: 1 had an acute occlusive syndrome and went to surgery with a balloon pump and bail out catheter; his recovery was uneventful. Of the 24 native artery angioplasties, 22 were successful: one patient was technically unsuccessful in the only vessel attempted; he went to semiemergent surgery and recovered uneventfully. In the other, a right coronary lesion was successfully dilated, but an occluded anterior descending artery was not opened. There were no deaths or in‐hospital myocardial infarctions. Of the 32/34 patients with technically successful angioplasty, all 32 had relief of rest angina, and 27 had pre‐discharge exercise testing: 19 were completely asymptomatic and 8 had angina only at maximal exertion. In follow‐up ranging from 6 months to 36 months, 4 patients with vein graft angioplasty, 2 patients with native artery angioplasty, and one of the operated patients, had complications. Two patients with recurrence at 2 months and 14 months, respectively, have undergone successful repeat angioplasty; two patients have had reoperation; 2 patients have had remote myocardial infarctions. Thus far, none of the LIMA have recurred clinically. There have been 2 late deaths in one angioplastied and one operated (the technical failure) patients: one from pulmonary emboli and one from heart failure, both at 6 months after index hospitalization. These data suggest that emergent or semiemergent angioplasty can be performed safely and with good clinical results in patients with unstable angina and prior heart surgery.
Use of femoral artery guiding catheters via the left brachial artery for transluminal coronary angioplasty
Authors: Spaccavento Leo J. , Breisblatt Warren M. 
Published: March 2007

AbstractPercutaneous transluminal coronary angioplasty using the right brachial artery has been described using either a cutdown and arteriotomy or a percutaneous entry (Cohen et al.: American Journal of Cardiology 57:862–864, 1986; Dorros et al.: Catheterization and Cardiovascular Diagnosis 8:233–242, 1982) [1,2]. Each method requires the use of a brachial artery guiding catheter (Sterner guiding catheter; (USCI). This communication reports the use of percutaneous entry of the left brachial artery and coronary angioplasty performed with femoral guiding catheters. In this manner coronary angioplasty has been successfully performed in 42 of 47 patients (90%) without major complications.
Attenuation of pulsus alternans during coronary angiography
Authors: Ring Michael E. , Kern Morton J. , Genovely Harry , Serota Harvey , Vandormael MiChel 
Published: March 2007

AbstractFollowing coronary angiography in a patient with cardiomyopathy and pulsus alternans, we observed a transient but marked attenuation of the alternation in pulse pressure associated with an elevation in pulmonary artery pressure. Attenuation of pulsus alternans has been rarely reported and may represent further deterioration of ventricular function.
Percutaneous double‐balloon valvuloplasty of porcine bioprosthetic valves in the tricuspid position
Authors: Attubato Michael J. , Stroh Jack A. , Bach Richard G. , Slater James , Feit Frederick 
Published: March 2007

AbstractThis is a description of the first two reported cases of double‐balloon valvuloplasty in the treatment of porcine bioprosthetic valve stenosis in the tricuspid position. In both cases, the double‐balloon technique resulted in a better hemodynamic improvement than single‐balloon valvuloplasty and was well tolerated. Double‐balloon valvuloplasty is a reasonable alternative to surgical replacement of a stenotic bioprosthesis in the tricuspid position.