bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hemodynamic abnormalities during coronary angiography: Comparison of hypaque‐76, hexabrix, and omnipaque‐350
Authors: Piao Zhen En , Murdock David K. , Hwang Ming H. , Raymond Richard M. , Scanlon Patrick J. 
Published: March 2007

AbstractThe hemodynamic effects induced by coronary angiography in dogs with low osmolar ionic dimer Hexabrix (HB) and nonionic Omnipaque‐350 (OM) were compared to the standard ionic contrast medium, Hypaque‐76 (H76), both in the normal heart and in one with simulated severe cardiac disease. Left coronary angiography was performed in 12 “normal” closed‐chest dogs with 10‐cc injections of H76, HB, and OM in a randomized, blinded fashion. The maximal change in the left ventricular (LV) systolic pressure (SP), mean aortic pressure (MAP), left ventricular end diastolic pressure (LVEDP), and LV dp/dt were recorded. The LVSP and MAP fell 30 ± 3 mm Hg and 26 ± 4 mm Hg with H76, 22 ± 2 mm Hg and 19 ± 2 mm Hg with HB, and 7 ± 1.5 mm Hg and 5 ± 1 mm Hg with OM (P < .001). The LVEDP increased 4.8 ± 0.5 mm Hg with H76, 3 ± 0.5 mm Hg with HB, but only 0.2 mm Hg with OM (P < .001). The LV dp/dt decreased 392 ± 63 mm Hg/sec with H76 and 235 ± 21 mm Hg/sec with HB, but increased 411 ± 50 mm Hg with OM (P < .001). In eight additional open‐chest dogs, left coronary angiography was performed 1 hr after occlusion of the proximal LAD coronary artery and in the presence of a critical circumflex coronary artery (CX) stenosis. Occlusion of the LAD and the creation of a CX stenosis produced a 22 ± 3 mm Hg decrease in LVSP, a 310 ± 64 mm Hg/sec decrease in LV dp/dt, and a 4.7 ± 0.6 mm Hg increase in the LVEDP; 7 cc H76 produced a further 34 ± 6 mm Hg decrease in LVSP, compared with 13 ± 3 mm Hg with HB and 5.3 ± 1.5 mm Hg with OM (P < .001). The LV dp/dt decreased 505 ± 89 mm Hg/sec with H76, 210 ± 64 mm Hg with HB, but increased 265 ± 31 mm Hg with OM (P .001). The LVEDP increased 5.5 ± 1 mm Hg with H76, compared with 2.8 ± 0.6 mm Hg with HB and 0.37 ± 0.26 mm Hg with OM (P < .001). Thus, both low osmolar contrast media caused significantly less myocardial depression than the standard ionic contrast agents. OM is particularly devoid of myocardial depressive effects and produces less hemodynamic alteration than HB.
Angiographic coronary morphology in postinfarction angina
Authors: Lo Ying‐Sui A. , Abi‐Mansour Pierre , Kaplan Kerry J. , Kramer Barry L. , Hill Irene R. , Meyers Sheridan , Lesch Michael 
Published: March 2007

AbstractTo investigate the pathophysiologic relevance of angiographically irregular coronary stenoses in postinfarction angina (PIA), we analyzed the clinical course and coronary angiograms of 73 patients studied within 30 days of infarction. Coronary lesions were classified as smooth or irregular. Thirty‐six patients had PIA (Group 1) and 37 had an uncomplicated course (Group 2). Irregular lesion(s) in patent infarct‐related arteries were found in 77% of Group 1 vs. 24% of Group 2 patients (P < 0.005). Irregular lesion(s) in any coronary artery were found in 58% of Group 1 versus 19% of Group 2 patients (P < 0.002). Other univariate predictors of PIA included older age, hypertension, angina before myocardial infarct, lower peak creatine kinase, three‐vessel disease, and higher modified Gensini score. Multivariate analysis ranked lesion irregularity as the strongest predictor of PIA. Our data suggests that ruptured atherosclerotic plaques may be important in the pathogenesis of PIA. It is possible that lesion irregularity is associated with an active process and/or a residual thrombus, which may be responsible for postinfarction angina.
Emergency balloon angioplasty and digital subtraction angiography in the management of an acute latrogenic occlusive dissection of a saphenous vein graft
Authors: Roy Paul , Finci Leo , Bopp Pierre , Meier Bernhard 
Published: March 2007

AbstractA 63‐year‐old male with status post quadruple aortocoronary bypass surgery suddenly complained of chest pain and had ST‐segment elevation in lead III during routine coronary angiography. Subsequent selective injections showed occlusion of the bypass graft to the right coronary artery, whereas by digital angiography done 15 min earlier it had been patent. Iatrogenic dissection of the graft was assumed, and balloon recanalization was immediately performed. Chest pain and signs of ischemia rapidly resolved, and no evidence of myocardial infarction was found until hospital discharge.
Local infection after percutaneous transluminal coronary angioplasty: Relation to early repuncture of ipsilateral femoral artery
Authors: Wiener Roy S. , Ong Ling S. 
Published: March 2007

AbstractWe describe two cases of groin infection following repuncture of the femoral artery to perform coronary angioplasty soon after diagnostic coronary arteriography. This serious complication can be avoided by using the contralateral femoral artery in this setting, even if the previously used entry site appears benign.
Power injection of contrast media during percutaneous transluminal coronary artery angioplasty
Authors: Goss Jerome E. , Ramo Barry W. , Raff Gilbert L. , Maddoux Gerry L. , Heuser Richard R. , Shadoff Neal , Leatherman George F. 
Published: March 2007

AbstractVisualization of the coronary arteries during all phases of percutaneous transluminal coronary angioplasty using hand‐held contrast media injection devices is suboptimal. Power injection of contrast media for diagnostic coronary cineangiography has been performed in over 18,000 cases without power injector complication. Here we report our experience with 294 patients using power injection for visualization during all phases of PTCA. It provides optimal visualization of the coronary arteries and has not been associated with complications. It is a safe and efficient system with reduction in both the time and radiation exposure required to perform PTCA and allows determination of the adequacy of the result without unnecessary recrossing of the area of dilatation.
Safety and convenience of a mechanical injector pump for coronary angiography
Authors: Ireland M. A. , Davis M. J. E. , Hockings B. E. F. , Gibbons F. 
Published: March 2007

AbstractCoronary angiography and left ventriculography was performed in 5,887 consecutive patients over a 5‐year period using a mechanical injector pump activated by a foot switch. Five coronary dissections occurred, four of the right coronary artery and one of the left internal mammary artery, which had been grafted to the left anterior descending artery. One patient had angina following an air embolus; there were no significant intramyocardial injections of contrast agent. The pressure generated in the catheter by hand injection of contrast agent was compared with that generated by the injector pump. Contrast agent was injected through a 7F Judkins Right 4 and an 8F Sones catheter by hand at slow, medium, and fast rates by hand and by the injector pump at 2,3, and 4ml/sec; maximum pressure generated was recorded. Although the pressures generated through a Sones catheter were similar using both methods, pressures with hand injection were much more variable. The pressures generated with hand injection through a Judkins catheter were lower than those with pump injection, but again the pressures showed much greater variability with hand injection.The pump was found to be safe, reliable, predictable, and convenient when used for coronary angiography with Sones and Judkins catheters. It eliminates the need for a trained assistant during the procedure of coronary angiography.
Accurate determination of the transaortic valve gradient using simultaneous left ventricular and femoral artery pressures
Authors: Krueger Steven K. , Orme Eric C. , King Charles S. , Barry William H. 
Published: March 2007

AbstractAccurate determination of the transaortic valve gradient has required two catheters, one in the left ventricle and one in the ascending aorta. We now report a new technique for measurement of the transaortic valve gradient from the simultaneous left ventricular (LV) and femoral artery (FA) pressure tracings. This technique was compared with the “true” gradient obtained by measurement of the simultaneous LV and central aortic pressures, and is accurate (R = 0.999) and relatively simple. Other approaches used to determine the mean transaortic valve gradient were less accurate: simultaneous LV‐FA (R = 0.981); aligned LV‐FA (R = 0.974); averaged simultaneous and aligned LV‐FA (R = 0.981); and nonsimultaneous LV‐aorta pullback (R = 0.953). Thus, this new technique provides an accurate transaortic valve gradient without requiring the use of two central catheters.
The potential risk of thrombosis during coronary angiography using nonionic contrast media
Authors: Hwang Ming H. , Piao Zhen En , Murdock David K. , Giardina John J. , Pacold Ivan , Loeb Henry S. , Reyes Cesar V. , Scanlon Patrick J. 
Published: March 2007

AbstractThe influence of contrast media on coagulation has an important association with thromboembolic complication during coronary angiography. In this study, whole blood was methodically mixed with nonionic contrast medium, lohexol (IOH), conventional ionic contrast medium, Hypaque‐76 (H76), and low osmolar ionic dimer Hexabrix (HB) in vitro. The thrombotic propensity of contrast agents can be evaluated by measuring the clot formation of the mixtures. The experiments were repeated with whole blood after systemic heparinization. In the in vitro study, 5 ml of canine (N = 10) and 3 ml of human (N = 11) whole blood was incubated for 30 min in glass tubes with equal volumes of IOH, H76, HB, and 0.9% NaCl before heparinization. Clot formation with IOH and 0.9% NaCl were seen both in dogs (4.0 ± 0.7 gm and 5.6 ± 0.8 gm) and in patients (1.4 ± 0.9 gm and 2.9 ± 1.3 gm), whereas no clot was seen with H76 or XB. Following heparinization, no clot was visualized in any mixture of whole blood with contrast media or 0.9% NaCl. Similar results were observed in the catheter‐syringe system with canine blood (N = 11) mixed with the contrast agents. Blood clots found in 15 min and 30 min of IOH were 0.07 ± 0.08 gm and 0.44 ± 0.20 gm (P < 0.01) and of NaCl were 0.29 ± 0.37 gm and 0.69 ± 0.38 gm (P < 0.01). No clot was present in HB and H76. After heparinization no blood clot was found in any mixtures of the catheter‐syringe system.It is concluded that unlike ionic contrast media, nonionic contrast agents appear to have less inhibitory effects on blood clot formation and, thus, it might be associated with a higher risk of thromboembolic complications during coronary angiography. Since heparin inhibits clotting in the presence of nonionic medium, its use is particularly recommended when this medium is to be used in coronary angiography.
Relation between transpulmonary pressure and right ventricular isovolumetric pressure change during respiratory support
Authors: Jardin François , Brun‐Ney Dominique , Cazaux Pierre , Dubourg Olivier , Hardy Anne , Bourdarias Jean‐Pierre 
Published: March 2007

AbstractSimultaneous recordings of airway pressure, pleural pressure, and right ventricular (RV) pressure were obtained during mechanically controlled ventilation in a group of patients requiring respiratory support. Changes in transpulmonary pressure (calculated as airway pressure minus pleural pressure) were measured at end‐expiration and end‐inspiration during intermittent positive pressure ventilation with or without the application of a positive end‐expiratory pressure, and were related to RV isovolumetric pressure changes at the onset of systole. It was found that any increase in transpulmonary pressure by intermittent positive pressure ventilation, or positive end‐expiratory pressure (PEEP), or both, was associated with a proportional increase in RV isovolumetric pressure change. Moreover, when lung volume was progressively increased by incremental increases in tidal volume or PEEP level, transpulmonary pressure and RV isovolumetric pressure changes were strongly and linearly correlated. These results suggest that: 1) RV isovolumetric pressure change might be used as an index of RV output impedance during respiratory support by mechanically controlled ventilation; and 2) lung inflation resulting from the use of a positive airway pressure during respiratory support can increase RV output impedance and thereby contribute to the decrease in RV stroke output.
Complement activation from protamine sulfate administration after coronary angiography
Authors: Click Roger L. , Homburger Henry A. , Bove Alfred A. 
Published: March 2007

AbstractThe cause of hypotension after reversal of heparin by protamine has not been well defined. In this study we evaluated complement activation (C3a and C4a) by the heparin‐protamine complex in 46 consecutive patients (40 received protamine sulfate to reverse heparin, and six did not) during and after coronary angiography. In patients receiving protamine sulfate, there was a significant increase in C3a over the value before protamine sulfate administration (P<.001) or in patients who did not receive protamine sulfate (P<.05): 807 ± 100 ng/ml vs. 274 ± 75 ng/ml. There were no significant changes in C4a after protamine sulfate administration. These results indicate that the alternate complement pathway is activated when protamine sulfate is administered after coronary angiography. This may induce hypotension as well as platelet aggregation and thrombus formation and may contribute to coronary instability. Therefore, in unstable patients, heparin reversal by protamine should not be done routinely.
Role of intracoronary thrombus in acute complications during percutaneous transluminal coronary angioplasty
Authors: Arora Rohit R. , Platko William P. , Bhadwar Kavita , Simpfendorfer Conrad 
Published: March 2007

AbstractCoronary angiograms from 2,372 consecutive patients who underwent percutaneous transluminal coronary angioplasty (PTCA) were retrospectively reviewed for the presence of intracoronary thrombus (ICT) before dilatation. Patients with evolving acute myocardial infarction and those receiving thrombolytic therapy were excluded from analysis. Coronary artery thrombus was present in 126 patients (6%) (group 1). When compared to 2,246 patients (group 2) without ICT, group 1 had a higher incidence of unstable angina, 74 % vs. 66% (<0.06), previous myocardial infarction, 59% vs. 37% (P < .0001), and history of a recent myocardial infarction, 28% vs. 9% (P < .0001). Patients with predilation intracoronary thrombus had a higher risk for acute occlusion, 6% vs. 2% (P < .002); however, the incidence of emergency coronary bypass surgery and myocardial infarction was similar in both groups. Therefore, the presence of predilatation intracoronary thrombus heralds an increased risk of acute occlusion, but not myocardial infarction or emergency coronary artery bypass surgery.
Survival after myocardial infarction caused by acute left main coronary artery occlusion: Case report and review of the literature
Authors: Cohen Mylan C. , Ferguson David W. 
Published: March 2007

AbstractWe report a 44‐year‐old white male presenting with an acute anterior myocardial infarction. Cardiac catheterization at 2 weeks postinfarction revealed total occlusion of the left main coronary artery. There was a normal dominant right coronary artery supplying moderate collaterals to the left coronary system. The patient was managed with conservative therapy and was N.Y.H.A. functional class II on followup 2 years later. A review of the literature relative to myocardial infarction caused by acute left main coronary artery occlusion is presented, and unique features of these cases are described.
Fracture of a balloon on a wire device during coronary angioplasty
Authors: van den Brand Marcel , de Feyter Pim , Serruys Patrick , Zijlstra Felix , Bos E. 
Published: March 2007

AbstractIn a 61‐year‐old patient with unstable angina an attempt was made to dilate a severe stenosis in a tortuous obtuse marginal branch. The initial attempt with conventional equipment was not successful; although the wire could be advanced distal to the stenosis, a 2.0 balloon did not cross the stenosis. A second attempt with a balloon on a wire device resulted in fracture of this catheter, with the distal 2.8‐cm‐long fragment looped in the left coronary artery. Immediate bypass surgery was performed and the broken fragment was easily removed from the left coronary ostium. The patient made an uneventful recovery.
The probe exchange catheter
Authors: Dorros Gerald , Lewin Ruben F. 
Published: March 2007

AbstractIn order to provide exchange capability to non‐over‐the ‐wire systems (i.e., Probe), an exchange catheter composed of an inner sheath catheter (.039″ external diameter) and a 4 French outer catheter was devised. The system was utillized to exchange between an over‐ to a non‐over‐the‐wire system, different non‐over‐the‐wire systems, and to provide balloon dilatation backup to the soft non‐over‐the‐wire systems in difficult‐to‐engage vein graft takeoff. The system was sccessful utilized in 50 patients without any related complications.
Complications of cardiac catheterization and angiography in patients with valvular heart disease
Authors: Folland Edward D. , Oprian Charles , Giacomini John , Schechter Eliot , Shabetai Ralph , Henderson William G. , Hammermeister Karl E. , Sethi Gulshan ,   The Participants In The Va Cooperative Study On Valvular Heart Disease
Published: March 2007

AbstractComplications were surveyed prospectively in 2,029 catheterizations performed on 1,483 patients from the 13 centers participating in the VA Cooperative Study on Valvular Heart Disease. Complications were reported in 6.9% of 1,559 preoperative procedures of which 2.6% were major and 0.2% fatal. Clinical predictors of complications were hypertension and the precatheterization diagnosis of aortic stenosis. Nevertheless, patients with aortic stenosis successfully tolerated left ventriculography, which was routinely performed regardless of the magnitude of gradient. Procedural predictors of complication were brachial arteriotomy (vascular occlusion) and transseptal catheterization (tamponade). Among the 470 postoperative catheterizations performed solely for research purposes, there were six complications, of which five were bleeding events in patients taking warfarin. Transseptal catheterization was safer in postoperative patients with no cases of tamponade in 125 procedures.
Left ventricular outflow obstruction by a mitral valve prosthesis: Doppler ultrasound and cardiac catheterization findings
Authors: Byrnes Timothy J. , Guillory William R. , Hanley Henry G. 
Published: March 2007

AbstractLeft ventricular outflow tract obstruction by a mitral valve prosthesis was noted several years following surgery when symptoms of congestive heart failure occurred. The diagnosis was made using two‐dimensional echocardiography and Doppler techniques and confirmed at heart catheterization, using micromanometer tipped catheters.
Comparison of the frequency response characteristics of catheter‐mounted piezoelectric and micromanometric phonotransducers
Authors: Garcia Juan C. , Layton Steven A. , Rubal Bernard J. 
Published: March 2007

AbstractThis study compares the frequency response characteristics of catheter‐mounted piezoelectric sound transducers with micromanometric transducers. The tip of a 8F catheter with two piezoelectric transducers and two micromanometers was inserted into a water‐filled chamber that had a speaker fixed at one end. The speaker was driven by a power amplifier and sine wave generator. The outputs of the transducers were connected to a low‐level amplifier. The piezoelectric transducer behaved as a tunable high‐pass filter that could be modified by altering the input impedance of the low level amplifier; the frequency response characteristics were examined at five input impedances ranging from 0.96 to 11.8 megohms. The peak‐to‐peak outputs of the piezoelectric and pressure transducers were recorded at frequency ranges from DC to 1 kHz with a wide‐band oscilloscope. The ratio of the outputs from the piezotransducer and micromanometer (Vph/Vpr) was plotted vs. frequency for each input impedance and analyzed to determine the piezotransducer's output resistance and equivalent capacitance; roll‐off frequencies were then calculated. The equivalent capacitance of the piezo‐element was determined to be 500–700 picofarads. Series capacitance acted with network resistance to produce a predictable frequency‐dependent change in signal amplitude and phase angle. The inherent noise of the pressure transducer was found to be approximately 0.2 mm Hg, while the noise of the piezoelectric transducer was immeasurably low. The piezoelectric phonotransducers were superior to micromanometer transducers in their higher gain and lower noise, suggesting that these transducers may prove useful to physiologic and clinical studies for measuring intravascular sound.
Stenotic anomalous circumflex artery causing myocardial infarction following angioplasty of a right coronary artery stenosis
Authors: Rivitz S. Mitchell , Garratt Kirk N. 
Published: March 2007

AbstractA 68 yr‐old male with evidence of persistent inferior wall ischemia after successful PTCA of a solitary right coronary artery (RCA) lesion was found to have an anomalous left circumflex artery (LCX) arising from the ostium of the RCA. The LCX harbored an atherosclerotic subtotal obstruction, which was then successfully dilated with resolution of the myocardial ischemia. Although not known to have a statistical predisposition to atherosclerotic disease, diseased anomalous coronary arteries can be responsible for myocardial ischemia and infarction. A thorough search for such vessels is warranted in patients with abnormal diagnostic tests and no apparent obstructive lesions in the normally positioned arteries. Similarly, when ischemia does not resolve after successful treatment of a coronary stenosis, anomalous coronary arteries should be sought.
Angiocardiographic evaluation of right ventricular size and morphology in tricuspid atresia
Authors: Boucek Mark M. , Sturtevant Jane E. , Jaffe Richard B. 
Published: March 2007

AbstractThe potential for right ventricular growth and physiological repair in tricuspid atresia may influence the type of Fontan procedure. To evaluate preoperative right ventricular assessment, we compared the right ventricular size and morphology determined by selective right ventricular catheterization with axial left ventricular angiography. In seven consecutive patients with tricuspid atresia and ventriculo‐arterial concordance, the right ventricular volume was 12.8 ± 9.4 cc, with a predicted normal volume (based on body surface area) of 31 ± 16 cc, 43% (range 24–78%) of normal. Right ventricular injection outlined a right ventricular area twice that visualized from an axial left ventricular injection (33.2 vs. 16.5 cm). All patients had a well developed but small trabecular portion of the right ventricle, often unopacified with left ventricular injection. Subinfundibular narrowing adjacent to the ventricular septal defect was invariably present, creating, in effect, a two‐chambered right ventricle. Selective right ventriculography demonstrates the unique morphology of the right ventricle in patients with tricuspid atresia not visualized by axial left ventriculography.
Wearing of caps and masks not necessary during cardiac catheterization
Authors: Laslett Lawrence J. , Sabin Alisa 
Published: March 2007

AbstractAlthough cardiac catheterization‐related infections are rare, caps and masks are often worn to minimize this complication. However, documentation of the value of caps and masks for this purpose is lacking. We, therefore, prospectively evaluated the experience of 504 patients undergoing percutaneous left heart catheterization, seeking evidence of a relationship between whether caps and/or masks were worn by the operators and the incidence of infection. No infections were found in any patient, regardless of whether a cap or mask was used. Thus, we found no evidence that caps or masks need to be worn during percutaneous cardiac catheterization.