bluuebunny/crossref_metadata_2025_split huggingface dataset:
Potential artifact in measurement of left ventricular filling pressure with flow‐directed catheters
Authors: Meister Steven G. , Engel Toby R. , Fischer Herbert A. , Frankl William S. 
Published: February 2007

AbstractArtifactual pulmonary wedge pressure measurements were encountered during bedside use of Swan‐Ganz catheters. These values were higher than pulmonary artery end diastolic pressure and devoid of typical phasic contours. Utilizing fluoroscopy these artifacts were reproduced by advancing the catheter tip 2–4 cm beyond the site of initial wedging and reinflating the balloon. Spurious increases of pulmonary wedge pressure of up to 15 mm Hg were thus obtained.In vitro catheter testing demonstrated overlapping of the catheter tip by the deformed balloon when it was fully inflated in a channel too small to accomodate it.These measurement artifacts are thus attributed to distal migration of the catheter tip into relatively small pulmonary artery branches and to subsequent occlusion of the catheter lumen by the balloon when it is reinflated. This can readily be avoided by routinely inflating the balloon with the minimum volume of air sufficient to yield a pulmonary wedge pressure tracing.
Caliber and distribution of normal coronary arterial anatomya
Authors: Vieweg Cdr. W. V. R. , Alpert L. Cdr. J. S. , Hagan Capt. A. D. 
Published: February 2007

AbstractSelective coronary arteriograms of 125 patients with normal coronary arteries were reviewed to establish the caliber and distribution of normal coronary arterial anatomy. Measurements established the following normal values for coronary arterial caliber in right (R), mixed (M), and left (L) inferior emphasis systems expressed in mm (± SEM):R M L Main left coronary artery 4.7 ± 0.1 5.2 ± 0.2 5.0 ± 0.2 Proximal left anterior descending artery 3.9 ± 0.1 4.1 ± 0.2 3.8 ± 0.2 Mid‐left anterior descending artery 2.3 ± 0.1 2.4 ± 0.1 2.5 ± 0.1 Left circumflex artery 3.2 ± 0.1 3.8 ± 0.2 4.0 ± 0.2 Proximal right coronary artery 4.1 ± 0.1 3.7 ± 0.1 2.7 ± 0.1 Mid‐right coronary artery 3.4 ± 0.1 2.7 ± 0.1 1.9 ± 0.1 S gnificant differences in the caliber of right coronary arterial systems and left circumflex coronary arterial systems validate the separation of coronary arterial anatomy into right, mixed, and left inferior emphasis systems, depending upon the blood supply to the inferior wall of the left ventricle. Classification of the anatomical pattern into right, mixed, and left inferior emphasis systems is useful in the cardiac catheterization laboratory at the time of selective coronary arteriography. If the expected distribution of the coronary vessels is not found, then missing vessels must be sought out. A knowledge of the range of normal size for the coronary arterial tree should be of value in defining the severity of coronary arterial narrowing.
Treatment of angiographically produced cord seizures by intra‐Arterial diazepam
Authors: Gordon David H. , Levin David C. 
Published: February 2007

Abstract10 mg of Diazepam administered into the lumbar artery supplying the artery of Adamkiewicz abolished cord seizures produced by accidental flooding of the cord with a high concentration of contrast material. Selective intra‐arterial Diazepam is a safe and effective method of controlling cord seizures.
A comparison of formulas used to estimate mixed venous saturations
Authors: Iskandrian Abdulmassih , Kimbiris Demetrios , Bemis Charles E. , Mintz Gary 
Published: February 2007

AbstractTrue mixing of venous blood in the absence of shunt occurs in the pulmonary artery. In the presence of left to right shunt at a level proximal to the pulmonary artery, mixed venous blood for oxygen saturation (MVO2) is estimated by using an average of blood samples taken from the chamber proximal to the shunt. In atrial septal defect, the determination of MVO2 is calculated by using blood samples from the superior vena cava (SVC) and the inferior vena cava (IVC). Several formulas have been proposed, utilizing varying combinations of blood samples taken from the SVC and IVC. In the present investigation, 100 patients without evidence of shunt were studied during routine cardiac catheterization. Duplicate blood samples were taken from the pulmonary artery (PA), the SVC, and the IVC, and were analyzed for oxygen‐saturation. If one assumes that the PA blood sample represents true venous blood mixing (TMVO2), the following formulas were used for comparison: (1) PA = SVC; (2) PA = IVC; (3) PA = (SVC + IVC)/2; (4) PA = (2SVC + IVC)/3; (5) PA = (3SVC + IVC)/4; and (6) PA = (2IVC + SVC)/3.When one uses the standard two variable regression equations, this study shows that the 90% confidence limits are wide. The correlation, however, is somewhat better if one uses the formulas (3‐6). Therefore, the error that may be introduced in calculating the TMVO2 may be substantial and can critically alter the estimation of the shunted blood volume.
Effects of adalat (nifedipine) on left ventricular hemodynamics in angina pectoris: Comparative study with propranolol
Authors: Kurita Akira , Ogawa Takeshi , Kanazawa Masakuni , Hamamato Hiromu , Mabuchi Genichi 
Published: February 2007

AbstractThe hemodynamic effects of nifedipine and propranolol administered intravenously were studied in 17 patients with angina pectoris. Nine patients received nifedipine and eight received propranolol. The hemodynamic parameters were compared at rest and during supine bicycle exercise at work loads known to produce angina. Exercise‐induced angina improved in four out of nine patients following nifedipine and in one out of eight patients following propranolol. Nifedipine significantly reduced the increment of left ventricular end‐diastolic pressure and Vmax during exercise. Intravenous propranolol significantly suppressed the increment of heart rate, max dp/dt, tension time index, and Vmax during exercise. Although the exact mode of action of nifedipine remains uncertain, it is suggested that it decreases myocardial oxygen requirements primarily through a reduction of left ventricular volume, whereas propranolol suppresses the positive chronotropic and inotropic responses of the heart muscle to exercise.
Cavernous hemangioma of the right atrium: Presumptive diagnosis by coronary angiography
Authors: Raabe Daniel S. , Fischer John C. , Brandt Ralph L. 
Published: February 2007

AbstractThe angiographic findings in a patient with an interesting vascular tumor of the right atrium are described. The tumor was supplied by vessels from both the right and left coronary arteries and consisted of dilated blood spaces in which contrast material persisted for a prolonged period of time.Since this picture is identical to that described in cavernous hemangioma of other organs, this report presumably represents the first description of the angiographic findings in a cavernous hemangioma of the heart.
Patent ductus arteriosus in adult patients with aortic valvular disease: The importance of routine screening for a left‐to‐right shunt at cardiac catheterization
Authors: Mehl Sydney J. , Kronzon Itzhak , Glassman Ephraim 
Published: February 2007

AbstractTwo patients, catheterized primarily for the preoperative assessment of clinically apparent aortic stenosis and insufficiency, were found to have a patent ductus arteriosus as well at cardiac catheterization. The association of aortic valve disease and patent ductus arteriosus is reviewed, and the importance of making the diagnosis prior to aortic valve replacement is stressed, emphasizing the routine use of the hydrogen‐platinum electrode system.
External counterpulsation: Coronary hemodynamics and use in treatment of patients with stable angina pectoris
Authors: Solignac Alain , Ferguson Ronald J. , Bourassa Martial G. 
Published: February 2007

AbstractExternal pressure counterpulsation (ECP) has been reported to improve the clinical status of patients with angina pectoris. To document the mechanisms for such an improvement left ventricular oxygen consumption and lactate metabolism, coronary sinus blood flow, and cardiac index were studied in 10 patients with angina pectoris 1) prior to and during ECP; and 2) during right atrial pacing before and after 4 consecutive 2‐hour sessions of ECP treatment. During ECP peak early and mean arterial diastolic pressures were significantly raised above control values by 32 and 13% respectively. However, coronary sinus blood flow, left ventricular oxygen consumption and left ventricular lactate extraction, mean systolic arterial pressure and cardiac index were not significantly altered by ECP. Right atrial pacing at 140 beats/min increased coronary sinus blood flow 70% over control values and induced angina and ischemic ST segment changes in 8 patients before and after 4 consecutive treatments of ECP. ECP treatment did not significantly modify the above metabolic and hemodynamic responses at rest or during atrial pacing. Although 5 patients reported improvement in angina symptoms the effect was transitory. No significant improvement over pre ECP‐treatment exercise angina threshold was observed immediately following or at 1 and 3 months post treatment. This method of noninvasive circulatory assistance appears to be of doubtful value in the management of patients with stable angina pectoris.
Effects of propranolol on coronary hemodynamic and metabolic responses to tachycardia stress in patients with and without coronary disease
Authors: Schang Steven J. , Pepine Carl J. 
Published: February 2007

AbstractTo clarify the influence of propranolol—and particularly its heart‐rate effects—on myocardial ischemia, coronary hemodynamics and metabolism were studied in 15 patients utilizing a protocol to control heart rate. Ten patients had significant coronary narrowing (CAD) and 5 were normal. Systemic pressure, coronary sinus blood flow (CSBF), left ventricular oxygen utilization (LVV̇O2), ST Segment depression, and myocardial lactate extraction were measured before and after propranolol (10 mg IV), at rest, and during pacing‐induced tachycardia stress. Propranolol‐related reduction in CSBF and LVV̇O2 at rest was reversed when heart rate was controlled in both patient groups. Propranolol failed to alter heart‐rate threshold, tension‐time index (TTI), CSBF, or LVV̇O2 at angina in the CAD patients. Likewise, ischemic‐type ST depression, decreases in lactate extraction, and coronary resistance were unchanged compared to values observed during tachycardia stress before propranolol. In normal coronary patients, propranolol also produced no significant change in LVV̇O2 or coronary resistance when its heart rate effects were controlled.These data imply that a major coronary and metabolic influence of propranolol relates to changes occurring secondary to its influence on heart rate. Furthermore, this agent's anti‐ischemic effect is not prominent during tachycardia stress suggesting that this stress test may be clinically useful in patients taking propranolol.
Single left pulmonary vein with normal pulmonary venous drainage: Association with partial anomalous pulmonary venous return
Authors: Belott P. H. , Vieweg W. V. R. , Alpert J. S. , Lacovoni V. E. , Francis G. S. , Johnson Allen D. , Hagan A. D. 
Published: February 2007

AbstractAn unusual case of a single left pulmonary vein draining the left lung and joining the left atrium without venous obstruction is reported. This anomaly occurred in association with partial anomalous pulmonary venous return from the upper lobe of the right lung to the superior vena cava. A similar case has been previously reported from our laboratory. The diagnosis of a single left pulmonary vein can be made by routine chest roentgenography because of the charácteristic radiologic appearance of this anomaly. It is important to distinguish this benign entity from more ominous pulmonary radiodensities.
Long‐term survival in preductal atresia of the aortic arch
Authors: Gomes Antoinette S. , Levisman Jorge A. , Grollman J. H. , Eber Leslie M. 
Published: February 2007

AbstractAtresia of the aortic arch is distinguished from complete interruption of the aorta by the presence of a fibrotic strand bridging the 2 discontinuous segments of aorta. Most patients with aortic arch atresia have associated intracardiac defects. There is a high neonatal mortality in this condition, with 95% of the patients dying in the first year of life. The case described herein is the first long‐term survivor with atresia of the aortic arch, a patent ductus arteriosus, and an atrial septal defect to reach adulthood.In this patient an extensive collateral network existed in spite of the presence of a patent ductus arteriosus.
Determination of shunt flow in a case of multiple arteriosystemic connections
Authors: Brewster Hollister P. , Goldschlager Nora , Goldschlager Arnold 
Published: February 2007

AbstractA 64‐year‐old woman presented with acute congestive heart failure and atrial fibrillation, with good response to medical management. Selective coronary and left ventricular cineangiography demonstrated multiple arteriosystemic connections arising from both left and right coronary arteries, but normal (although tortuous) coronary vessels and ventricular contraction pattern. Determination of the magnitude of the shunt flow and concommitant measurement of myocardial lactate extraction suggested that this type of coronary vascular abnormality was an angiographic curiosity without discernible clinical import; however, the etiology of the patient's heart disease remains an enigma.
A historical review of the concept of the left ventricle as a pump
Authors: Cole James S. 
Published: February 2007

AbstractAlthough the concept of the left ventricle as pump has gradually evolved over the past 2000 years, the „modern era”︁ of our understanding began in the 1880's. Studies by Howell and Donaldson, using an isolated heart‐lung preparation, provided insight into the inter‐relationship between preload, afterload and contractility. These concepts were further advanced by Frank, Henderson and Starling, all using isolated heart preparations. The development of new techniques by Wiggers and Hill in the 1920's and 1930's opened up entirely new areas of investigation using intact animal preparations (Wiggers) and isolated muscle segments (Hill). Our debt to these investigators is enormous, and it is perhaps appropriate to reflect on their creative energies as we attempt to define more clearly the mechanical and biochemical functions of heart muscle.
A simple, inexpensive technique to permit the half‐axial projection in laboratories with single plane cineangiography
Authors: Krone Ronald J. , Townsend Richard D. 
Published: February 2007

AbstractA simple inexpensive modification to permit x‐ray beam angulation of a cineradio‐graphic system consisting of a ceiling‐suspended image intensifier and an under‐the‐table x‐ray tube is described. This has permitted the incorporation of the half‐axial projection into the routine evaluation of the proximal left anterior descending artery (LAD) with a minimum of patient discomfort.
A heart model for understanding three‐dimensional cardiac anatomy
Authors: Wolf N. M. , Santamore W. , Kreulen T. H. , Bove A. A. , Spann J. F. 
Published: February 2007

AbstractA simple procedure for making cardiac casts has been described. These casts aid in the understanding of the spacial relationships of the ventricles, valves and coronary arteries as they appear at the time of cardiac angiography.
Specification of angulated projections in coronary arteriography
Authors: Taylor K. W. , McLoughlin M. J. , Aldridge H. E. 
Published: February 2007

AbstractIn coronary arteriography cranial and caudal angulations are combined with oblique angulations to obtain additional views. These angulations are obtained with a variety of equipment rotating about different axes.The planes and axes in and about which the patient and equipment rotate are defined and the equipment is grouped according to the axes about which it rotates. It is shown that a simple definition of the angulation of a projection may be obtained using concepts and terminology consistent with current radiological practice. One group of equipment then gives directly from the rotation of its component parts the angles specifying the projection. For other equipment, the angles specifying the projection are calculated and tabulated for angles of rotation of the equipment from 0 to 90°. Thus, equivalent projections for the different equipment may be found and compared.
High‐frequency pressure fluctuations: Their significance in the documentation of turbulent blood flow
Authors: Sabbah Hani N. , Blick Edward F. , Stein Paul D. 
Published: February 2007

AbstractThe purpose of this report is to indicate the presence of high‐frequency pressure fluctuations that are superimposed upon intra‐arterial pressure curves in man, and to establish their significance as an indication of the presence of turbulent blood flow. Intracardiac pressure was obtained in 23 patients, utilizing catheter‐tip micromanometers. Velocity fluctuations indicative of turbulence were measured in 10 of these patients above the aortic valve. High frequency pressure fluctuations occurred in patients with elevated cardiac output, aortic valvular disease, subaortic stenosis, and atrial septal defect. Patients in whom high frequency velocity fluctuations were measured by hot film anemometry almost always showed high frequency pressure fluctuations on the pressure tracings. This indicated a qualitative relationship between the occurrence of turbulent or disturbed blood flow and the presence of high‐frequency pressure fluctuations. A qualitative relationship between fluctuating pressures and fluctuating velocities was also derived on the basis of fluid dynamic theory. Recognition that high‐frequency pressure fluctuations result from turbulent blood flow may be of value in the localization of turbulent blood flow which, in some instances, may relate to pathological processes.
Closed foramen ovale: A potential entrance to left atrium
Authors: Sweeney Lauren J. , Rosenquist Glenn C. 
Published: February 2007

AbstractThe anatomy of the limbus and its relationship to the fossa ovalis were studied in 90 normal human hearts in an attempt to explain the clinical success of blunt trans‐septal catheterization. Previously reported rates of patent foramen ovale (25–35% of adult specimens) were confirmed, well below the reported rate of success for blunt transseptal catheterization (67–87%). A possible reason for this success is the fragile attachment of the fossa ovalis to its limbus in nearly all hearts without persistent patency.
Aneurysmal dilatation of the right ventricular outflow tract in infancy: Severe form of uhl's anomaly?
Authors: Graham Thomas P. , Smith Clyde W. 
Published: February 2007

AbstractA previously unreported cardiovascular malformation is presented consisting of aneurysmal dilatation of the right ventricular outflow tract associated with a cardiomyopathy, a possible variant of Uhl's anomaly. The patient presented at 8 days of age with mild cyanosis and congestive failure. Cardiac catheterization revealed severe cardiomegaly associated with very poor pump function of both right and left ventricles. The present case is unique in showing 1) severe aneurysmal dilatation of the right ventricular outflow tract, 2) only partially absent right ventricular musculature documented before death by the pressure tracing and cineangiocardiograms, and 3) the first quantitation of both right and left ventricular size and function in this syndrome. A review of previous cases of Uhl's anomaly indicates that this case may represent a variant of that condition and that intrauterine myocarditis or myocardial infarct should be considered in regard to etiology.
Ventricular septal defect following blunt trauma: Spontaneous closure of residual defect after surgical repair
Authors: Krajcer Zvonimir , Cooley Denton A. , Leachman Robert D. 
Published: February 2007

AbstractAs a result of blunt chest trauma a patient developed a large ventricular septal defect (VSD). After surgical closure of the defect a grade 2/6 systolic murmur persisted. One year later findings were the same and left ventriculogram revealed a small residual VSD. Two years after the operation the systolic murmur had disappeared. We postulate that gradual endothelialization and possibly small thrombi (formed around and over the Dacron patch graft) caused the defect to close. This case serves to illustrate some of the complexities in the diagnosis and management of an acquired VSD. To our knowledge this is the first reported spontaneous closure of a VSD occurring after incomplete surgical repair.
Comparison of the performance of pigtail catheters with different number of sideholes
Authors: Schwartz Leonard , Vaughan‐Neil Edward 
Published: February 2007

AbstractThe standard 12 sidehole pigtail catheter is compared with pigtail catheters with 6, 8, and 10 sideholes in 40 patient studies. The catheter with fewer sideholes performed as well as the standard catheter with respect to the quality of left ventricular opacification, lack of catheter recoil during angiography, and absence of complications. An in vitro study confirmed that better flushing of the terminal segment beyond the sideholes is achieved with the 6 sidehole catheter compared to the 12 sidehole catheter. It is anticipated that this feature will decrease the risk of thromboembolism associated with the use of the pigtail catheter.
Percutaneous balloon pulmonary valvuloplasty: State of the art
Authors: Rao P. Syamasundar 
Published: February 2007

AbstractSince the first description of balloon pulmonary valvuloplasty in 1982 by Kan, the procedure has been extensively utilized by several groups of workers for relief of pulmonary valve stenosis. It is generally recommended that the procedure be performed for peak‐to‐peak gradients in excess of 50 mmHg. The technique involves positioning one or more balloon catheters across the stenotic valve, usually over an extra‐stiff guide wire and inflating the balloons with diluted contrast material, thus producing valvotomy. The procedural details are described in this paper. The currently recommended balloon/annulus ratio is 1.2 to 1.25. Immediate reduction of gradient, increase in jet width and free motion of the pulmonary valve leaflets with less doming have been observed following balloon dilatation. Improvement of right ventricular function, tricuspid insufficiency and right‐to‐left shunt has also occurred. Complication can occur, but are rare and minimal. At mid‐term follow‐up, both catheterization measured peak‐to‐peak gradients and Doppler‐measured peak instantaneous gradients remain improved for the group as a whole. However, restenosis, defined as gradient ≥50 mmHg, has been observed in nearly 10% of children. Predictors of restenosis include balloon/annulus ratio <1.2 and immediate post‐valvuloplasty gradient ≥30 mmHg. Small pulmonary valve annulus, earlier study year and post‐surgical complex pulmonary stenosis have also been identified as factors predictive of restenosis. Redilatation with balloons that are larger than those used at the time of initial balloon valvuloplasty produces excellent results and redilatation is the procedure of choice in the management of restenosis after previous balloon pulmonary valvuloplasty. Long‐term follow‐up results are scanty, but the limited data reveal minimal additional restenosis, event‐free rates in mid‐80s and mid‐70s at 10 and 15 years respectively and significant increase in prevalence of pulmonary insufficiency. Balloon pulmonary valvuloplasty is equally successful in neonates as well as in adult subjects. In conclusion, balloon pulmonary valvuloplasty is the treatment of choice for relief of pulmonary valve stenosis. Use of balloons 1.2 to 1.25 times larger than pulmonary valve annulus may produce optimal results. Life‐long follow‐up to identify the significance of residual pulmonary insufficiency is indicated. © 2007 Wiley‐Liss, Inc.