bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multicenter evaluation of a new fixed‐wire coronary angioplasty catheter system: Clinical and angiographic characteristics and results
Authors: Talley J. David , Joseph Abraham , Killeavy Eugene S. , Garratt Kirk N. , Hodes Z. I. , Linnemeier T. J. , Yussman Zoe Ann , Brier Michael E. , Kupersmith Joel 
Published: March 2007

AbstractCoronary angioplasty is increasingly used as an attempt to revascularize patients with severe coronary artery disease. To determine the efficacy of such treatment, a new fixed wire angioplasty catheter was evaluated by a multicenter group in a non‐randomized fashion in 50 patients, average 58 ± 11 years (± 1SD), 58% men. Forty‐four percent had a prior revascularization procedure (28% angioplasty, 16% coronary bypass surgery), 38% had a prior Q‐wave myocardial infarction, 43% had grade 4 angina, and 60% multiple vessel disease. Angioplasty was attempted in 63 lesions which were located in a mid to distal location in 69%, with a proximal tortuosity score of 1.8 (2 = 45–60° entrance angle), and lesion angulation of 1.4 (1 = 45° lesion bend). In 88%, the device was the primary catheter used and in 6%, it was chosen when another system failed. The balloon was able to successfully cross 94% of all lesions attempted. Six lesions were crossed and dilated but significant residual stenoses remained. There were no significant device malfunctions, or angiographic or clinical complications.This feasibility evaluation of this new fixed wire system yielded excellent angiographic results. Although not a comparative study, this analysis suggests that this new generation of angioplasty catheter may improve the safety and efficacy of complex coronary angioplasty.
Coronary angioplasty in octogenarians: Comparisons to coronary bypass surgery
Authors: Myler Richard K. , Webb John G. , Nguyen Khiem P. V. , Shaw Richard E. , Anwar Azam , Schechtmann Norberto S. , Bashour Tali T. , Stertzer Simon H. , Zapolanski Alex 
Published: March 2007

AbstractCoronary angioplasty was performed in 74 patients 80 years of age and older (mean 83±3). Single vessel coronary disease was present in 34% and multivessel coronary disease in 66%. Angioplasty of a single vessel was performed in 51 patients (69%), while 23 (31%) had angioplasty of multiple vessels.Angioplasty was successful in 59 of 74 patients (80%). Angioplasty was unsuccessful but uncomplicated in 12 (16%) due to (unyielding) calcified lesions or (impassable) old occlusions. Of these 12, 8 were discharged on medical therapy and 4 underwent elective uncomplicated bypass surgery prior to discharge. Three (4%) patients required emergency coronary bypass surgery due to abrupt vessel closure during the angioplasty procedure, with one hospital death (1.4%).Follow‐up (mean 24±22 months) was obtained in all patients. Of the 59 successful angioplasty patients, late mortality was 10% (cardiac 7% and non‐cardiac 3%). Survival and survival without myocardial infarction were both 90%; survival without either infarction or bypass surgery was 86%. Actuarial 3‐year survival was 91% and 3‐year freedom from death, infarction or bypass surgery was 87% by life‐table analysis. Repeat angioplasty for restenosis was performed in 7 patients (12%) without complications.
Successful percutaneous closure of a complex coronary‐to‐pulmonary artery fistula using a detachable balloon: Benefits of intra‐procedural physiologic and angiographic assessment
Authors: Doorey Andrew J. , Sullivan Kevin L. , Levin David C. 
Published: March 2007

AbstractA 48‐yr‐old woman presented with a loud continuous precordial murmur and symptoms of fatigue. Color‐flow doppler imaging and nuclear magnetic resonance imaging failed to show the cause of the murmur. Diagnostic catheterization showed a large left anterior descending coronary artery to pulmonary artery fistula with impaired left ventricular wall motion. Two detachable balloons were deployed in the fistula with complete abolition of flow in the main fistula channel. A small parallel channel of the fistula, previously not appreciated due to vessel overlap, remained patent but had trivial flow as assessed by green‐dye and oximetric techniques. The patient had immediate resolution of her symptoms and return of normal ventricular wall motion.
Concurrent double balloon valvotomy for combined rheumatic mitral and tricuspid stenosis
Authors: Sharma Satyavan , Loya Yunus S. , Daxini Bipin V. , Sundaram Usha 
Published: March 2007

AbstractWe expanded the application of percutaneous balloon valvotomy (PBV) to 4 adults (age 14 to 30 years, average 22.2 years) with combined rheumatic mitral and tricuspid stenosis. Double balloon dilatation reduced the transmitral gradient from 17.36 ± 3.54 to 5.52 ± 0.89 (P<0.025) and transtricuspid gradient from 12.65 ± 2.67 to 3.67 ± 0.95 (P<0.025). Mitral and tricuspid valve area increased from 0.73 ± 0.20 to 2.57 ± 0.67 (P<0.005) and from 0.77 ± 0.24 to 2.67 ± 0.24 cm2 (P<0.005), respectively. The procedures were well tolerated, with no significant increase in valvular regurgitation or left to right shunt across the atrial septum. The excellent symptomatic and haemodynamic benefits are sustained at 3–24 months follow‐up.It is concluded that combined dilatation of stenotic valves by double balloon technique can emerge as an alternative to surgery in selected patients with polyvalvar rheumatic heart disease.
A new technique for right heart catheterization with a swan‐ganz balloon catheter via femoral vein in the patient with dilated right heart chambers, utilizing a modified transseptal‐type sheath
Authors: Lee Hongpyo H. , Mahrer Peter R. 
Published: March 2007

AbstractRight heart catheterization with a Swan‐Ganz balloon catheter via femoral vein in the patient with dilated right atrium and ventricle is frequently difficult due to excessive catheter coiling in the dilated atrium. A new technique is described in this situation. By using a modified transseptal‐type sheath positioned counterclockwise in right atrium as an introducing sheath, a balloon catheter can be easily advanced to the distal pulmonary artery by smooth counterclockwise direction and secure support from this sheath.
Simplified formula for the calculation of mitral valve area: Potential inaccuracies in patients with tachycardia
Authors: Brogan Walter C. , Lange Richard A. , Hillis L. David 
Published: March 2007

AbstractA simplified formula (cardiac output/[transvalvular pressure gradient]1/2) has been proposed as an alternative to the Gorlin equation for determining valve area in patients with mitral stenosis. This study was done (a) to assess the relationship between the results of the simplified formula and those of the Gorlin equation in patients with mitral stenosis and (b) to determine the clinical characteristics most likely to be associated with a disparity between the 2 formulae. In 96 patients with mitral stenosis, the disparity between the 2 formulae was>0.2 cm2 in 43 (45%) and ≥ 0.35 cm2 in 21 (22%). The results of the simplified formula were especially likely to be disparate from those of the Gorlin equation in those whose heart rates were>100 beats/minute. Thus, in the patient with mitral stenosis, the simplified formula should be used with caution and cognizance of its potential inaccuracy, particularly if the patient is tachycardic.
Rapid thrombus dissolution by continuous infusion of urokinase through an intracoronary perfusion wire prior to and following PTCA: Results in native coronaries and patent saphenous vein grafts
Authors: Chapekis Anthony T. , George Barry S. , Candela Richard J. 
Published: March 2007

AbstractEven with aspirin and heparin therapy, thrombus present prior to or forming after percutaneous transluminal coronary angioplasty (PTCA) results in significant complications. We report on 33 patients who were treated with continuous infusion of Urokinase through an intracoronary perfusion wire for 24 hr because of visible intracoronary thrombus. Seventeen native vessels (9 pre‐PTCA and 8 post‐PTCA) and sixteen saphenous vein grafts (12 pre‐PTCA and 4 post‐PTCA) were treated. All vessels were patent at the time of perfusion wire placement. Complete thrombus resolution, successful PTCA and sustained patency was seen in 31 of 33 patients. One native vessel treated post PTCA (originally occluded) re‐occluded. One saphenous vein graft treated prior to PTCA showed improvement in thrombus but distal embolization with balloon inflation occurred. No significant complications related to the intracoronary infusion technique were observed.In conclusion, rapid lysis of intra‐coronary thrombus can be accomplish safely using this technique and can result in improved PTCA outcome.
Coronary focal ectasia formation following percutaneous transluminal angioplasty
Authors: Semler Herbert J. 
Published: March 2007

AbstractFocal ectasia of the right coronary artery developed following percutaneous transluminal angioplasty. Operative intervention was not deemed necessary. No restenosis was found on repeat coronary angiography. Five‐yr follow‐up was associated with a benign course.
Congestive heart failure secondary to an arteriovenous fistula from cardiac catheterization and angioplasty
Authors: Sy Alexander O. , Plantholt Stephen 
Published: March 2007

AbstractArteriovenous (AV) fistulae are well known to cause high output cardiac failure. AV fistulae from cardiac catheterization are as rare as 0.01% in the transfemoral approach. We describe here what we believe is the first reported case of high output cardiac failure from an AV fistula due to percutaneous transluminal coronary angioplasty (PTCA). The patient had reversal of the congestive heart failure with surgical correction of the fistula.
Effects of intracoronary administration of contrast media on coronary hemodynamics in a canine post ischemic reperfusion model
Authors: Sheu Sheng H. , Hwang Ming H. , Piao Zhen E. , Hariman Robert J. , Loeb Henry S. , Scanlon Patrick J. 
Published: March 2007

AbstractHemodynamic changes due to intracoronary injections of nonionic contrast medium Omnipaque‐350 (OM), ionic dimer Hexabrix (HB), and ionic contrast medium Renografin‐76 (R76) were compared at baseline and during reperfusion after a 30‐minute left anterior descending coronary artery (LAD) occlusion. In 11 open chest, anesthetized, and atrially paced dogs, 4 ml of either OM, HB, R76, or 0.9% NaCI were injected into the carotid‐LAD bypass system. Coronary blood flow (CBF) and coronary vascular resistance (CVR) were measured before, during and after the intracoronary injection. The maximal hyperemic change (in percentage) from the preinjection value of CBF and CVR were calculated. The results at baseline and during reperfusion for CBF were: 104±14% vs. 85±10% for OM (NS); 76±11% vs. 39±9% for R76 (p<0.05); 57±8% vs. 33±5% for HB (p<0.05); and 30±7% vs. 9±4% for 0.9% NaCI (p<0.05). Consequently, the hyperemic changes of CVR at baseline and during reperfusion were: −49±3 vs. −42±4% for OM (NS); −44±3% vs. −24±6% for R76 (p<0.01); −36±3% vs. −24±4% for HB (p<0.05); and −18±4% vs. −7±3% for 0.9% NaCI (p<0.05). Thus, ischemia and reperfusion significantly dampened the coronary hemodynamic and vascular response to R76, HB, and 0.9% NaCI but not to OM. The preserved coronary vascular reserve with high flow in this canine post‐ischemic reperfusion model may explain the advantage of nonionic over ionic contrast media used in emergency coronary angiography following thrombolysis.
Congenital atresia of left main coronary artery: Proposed mechanism for severe disabling angina in a patient with non‐atherosclerotic single right coronary artery — A case report
Authors: Ruiz Carlos E. , Lau Francis Y. K. 
Published: March 2007

AbstractA patient with progressive disabling angina was found to have a single right coronary artery with atresia of the left main coronary artery, and absence of any obstructive coronary disease. The patient required aortocoronary by‐pass surgical reconstruction of a left main coronary artery to control her angina. Possible mechanisms for the development of her anginal pain are briefly discussed.
Evaluation of a theoretical doppler index to noninvasively estimate peak dp/dt using continuous wave doppler ultrasound of ascending aortic flow in man
Authors: Hunt A. C. , Chow S. L. , Escaned J. , Perry R. A. , Seth Mb A. , Shiu M. F. 
Published: March 2007

AbstractA theoretical formula for calculation of peak dP/dt was derived using parameters obtained from continuous wave Doppler echocardiography signals of aortic blood flow. The direct proportional relationship between the main variables of this formula and invasively measured peak dP/dt was validated in 20 patients undergoing routine diagnostic cardiac catheterization.Doppler signals of aortic flow were obtained simultaneously to invasive pressure recordings with a 2 MHz continuous wave transducer via the suprasternal echocardiographic window. The Doppler signals were recorded on magnetic tape and measurements were made with digital calipers by two independent, blinded observers.The following parameters were measured: peak velocity (V) and time from onset of ejection to peak velocity (T). V2/T, the variable of the derived formula, was calculated for each of the observer's measured parameters and showed a very high interobserver correlation. The two observers' measurements of each parameter were averaged for each patient and the resulting mean was used in calculating the V2/T and mean acceleration.4. A good correlation of V2/T with invasively measured peak dP/dt was obtained. Our derived index of left ventricular function showed a higher correlation with peak dP/dt compared to other Doppler indices of ventricular function. V2/T may provide a noninvasive method for estimating peak dP/dt.
Short and long term outcome of percutaneous transluminal coronary angioplasty in unstable versus stable angina pectoris: A report of the 1985–1986 nhlbi ptca registry
Authors: Bentivoglio Lamberto G. , Holubkov Richard , Kelsey Phd Sheryl F. , Holmes David R. , Sopko George , Cowley Michael J. , Myler Richard K. 
Published: March 2007

AbstractIn a cohort of 1,720 consecutive patients from the National Heart, Lung, and Blood Institute, Percutaneous Transluminal Coronary Angioplasty (PTCA) Registry (August 1985–May 1986), we compared 768 patients (45%) with stable angina and 952 patients (55%) with unstable angina pectoris. Unstable angina patients exhibited at least one of the following characteristics: new onset angina, rapidly progressing angina, angina at rest, angina refractory to medication, variant angina, acute coronary insufficiency, or angina recurring shortly after an acute myocardial infarct.The distribution of single‐ and multi‐vessel disease was similar among stable and unstable angina patients; multi‐vessel disease predominated. Average severity of stenosis and incidence of tubular and diffuse stenosis morphology were higher among patients with unstable angina (both p<0.001). Patient success rates were similar in stable and unstable patients. However, on a per lesion basis, overall angiographic success rate and average reduction of severity of stenosis in successfully dilated lesions were significantly higher among patients with unstable angina (both p<0.001). Incidence of major patient complications (p<0.01) and of emergency coronary bypass surgery (p<0.05) were also higher in patients with unstable angina but consistent with their more precarious clinical condition and stenosis morphology.During a two year follow‐up, the cumulative distributions of death, myocardial infarct, repeat PTCA, and coronary bypass surgery were not significantly different in patients with stable angina compared to patients with unstable angina.Comparison of the current PTCA Registry cohort with the cases reported in the 1979–1982 Registry revealed a 19% higher success rate for both stable and unstable angina patients. Major complication rates decreased between time periods for stable but not for unstable angina patients. Incidence of emergency bypass surgery decreased more for stable than for unstable angina patients.Coronary angioplasty is indicated in properly selected patients with unstable angina and both single‐and‐multi‐vessel coronary disease.
Blade atrial septostomy: Experience with the first 50 procedures
Authors: Khan M. A. Ali , Bricker J. Timothy , Mullins Charles E. , Yousef Saad Al , Nihill Michael R. , Vargo Thomas A. 
Published: March 2007

AbstractWe have performed 50 blade and balloon atrial septostomies in 46 patients with diagnoses of transposition of the great arteries‐32 patients; mitral atresia or stenosis‐10 patients; total anomalous pulmonary venous drainage‐2 patients; tricuspid atresia‐1 patient; and pulmonary valve atresia with hypoplastic right ventricle‐1 patient. The patients' age ranged from 1 day to 72 months (median=8 months) and weights ranged from 2.7 to 14.5 kg. In patients with transposition the systemic saturation increased from an average of 62% to 74.6% (p <0.001) and the inter‐atrial mean pressure gradient was reduced from 7.74 ± 5.3 to 1.4 ± 2.04 mm Hg. Patients with mitral atresia had no significant increase in systemic arterial saturation but a significant decrease in the mean inter‐atrial gradient from 19.6 ± 12.4 to 3.8 ± 5.3 mm Hg. In three patients the blade septostomy was unsuccessful for technical reasons and the condition of the patient. Complications included one death due to atrial laceration, blood loss requiring transfusion in 5 patients, transient CVA in one patient, and failure of the blade to close in one patient. We have found the palliative use of the blade catheter in conjunction with balloon atrial septostomy to be an effective and safe procedure.
Ventricular fibrillation complicating endomyocardial biopsy of a cardiac allograft
Authors: Oldham Nancy , Ott Richard A. , Allen Byron A. , Fopiano Patria , Dwyer Marylynn 
Published: March 2007

AbstractTransvenous endomyocardial biopsy remains the most useful diagnostic aid in assessing rejection in the transplanted heart. Although invasive, the complications associated with endomyocardial biopsy are few, and the procedure is generally regarded as safe. We report a case of apparent ventricular fibrillation complicating transvenous endomyocardial biopsy. Histologic section revealed evidence of moderate acute rejection. This case represents the first report of a life threatening ventricular dysrhythmia following routine endomyocardial biopsy in a cardiac transplant recipient.
Balloon valvuloplasty for mild mitral stenosis
Authors: Pan Manuel , Medina Alfonso , De Lezo Jose Suarez , Romero Miguel , Hernandez Enrique , Segura Jose , Melian Francisco , Pavlovic Djordje , Jimenez Francisco , Vivancos Ricardo , Montero Anastasio , Valles Federico 
Published: March 2007

AbstractOf a total number of 288 patients with mitral stenosis treated by percutaneous balloon valvuloplasty, 21 patients had a basal mitral area equal to or greater than 1.5 cm2, as measured hemodynamically. The immediate hemodynamic results of this particular group of patients with mild mitral stenosis are described, as well as the clinical and echo doppler findings at follow‐up (22 ± 12 mo). Patients with mild mitral stenosis (group I) had more pliable valves (p < 0.01), as assessed by echo, and higher incidence of sinus rhythm (p < 0.02) than that observed in the remaining 267 patients (group II). After valvuloplasty the valve area increased in group I from 1.7 ± 0.2 to 3.1 ± 0.7 cm2 (p < 0.0001). This mean final area was significantly different (p < 0.0001) than that observed in group II (1.98 ± 0.6 cm2). No patients with mild mitral stenosis developed progression of mitral regurgitation, and none had any other major complications. Most of them reached a grade I final functional status. At echo doppler follow‐up studies we did not observe significant changes in the mean mitral gradient as compared with the immediate hemodynamic results.These findings suggest that early mitral balloon valvuloplasty could be an alternative in trying to favorably Influence the natural course of the rheumatic mitral disease in selected patients.
Allograft vasculopathy and death in a cardiac transplant patient with angiographically normal coronary arteries
Authors: Johnson Thomas H. , McDonald Kenneth , Nakhleh Raouf , McGinn Andrew L. , Wilson Robert F. , Olivari Maria Teresa , Kubo Spencer H. 
Published: March 2007

AbstractA cardiac transplant patient died of severe left ventricular dysfunction 2 weeks after coronary anglography demonstrated normal coronary arteries. Post mortem examination showed significant and diffuse allograft vasculopathy. Coronary angiography may have limited sensitivity In detecting allograft vasculopathy.
Early ostial vein graft stenosis: Management by atherectomy
Authors: Kuntz Richard E. , Piana Robert , Schnitt Stuart J. , Johnson Robert G. , Safian Robert D. , Baim Donald S. 
Published: March 2007

AbstractDuring the initial perioperatfve period (1 mo to 1 yr) after saphenous vein coronary grafting, early stenosis and occlusion occurs In 5–8% of grafts due to intimal hyperplasia. We report a patient who developed ostial stenosis within 4 mo of bypass surgery at the aortotomy site of two vein grafts. Balloon angioplasty of the elastic stenoses did not provide significant luminal enlargement, but successful treatment of the lesions was obtained using directional atherectomy. Histological examination demonstrated intimal hyperplasia. Directional atherectomy may be an excellent technique for treatment of elastic ostial vein graft stenoses in lieu of conventional balloon dilatation.
Coronary artery pseudo‐occlusion associated with the use of an active hemoperfusion system during ptca
Authors: Grill Howard P. , Dowger Barbara A. , Brinker Jeffrey A. 
Published: March 2007

AbstractWe describe the phenomenon of coronary artery “pseudo‐occlusion,” which may occur when active hemoperfusion devices are utilized during percutaneous transluminal coronary angioplasty (PTCA). In such cases, contrast injected via the guiding catheter fails to opacity the coronary artery distal to the tip of the dilating catheter, thereby giving the angiographic appearance of coronary occlusion. When active hemoperfusion is terminated, contrast opacifies the vessel in a normal fashion. The cause of this observation is likely multifactorial and includes obstruction to flow by the dilating catheter, high distal pressure delivered by the dilating catheter during hemoperfusion competing with the flow of contrast infected via the guiding catheter, and wash‐out of contrast at the tip of the dilating catheter by non‐contrast containing blood being pumped through the system. This phenomenon must be recognized if potentially deleterious repeat dilatations are to be avoided.