bluuebunny/crossref_metadata_2025_split huggingface dataset:
The value of coronary artery visualization during routine intravenous digital subtraction ventriculography
Authors: Haggman Dale , Detrano Robert , Simpfendorfer Conrad 
Published: March 2007

AbstractRight anterior oblique intravenous digital subtraction ventriculograms and selective coronary angiograms were performed on 71 consecutive patients. The intravenous ventriculograms were reviewed by two blinded observers with close examination of the right and left anterior descending coronary arteries. These were considered abnormal if they failed to opacify or if luminal irregularities suggested > 50% obstruction. Significant (< 50% obstruction) occlusions of the right coronary artery were found in 16 patients according to a blinded reading of the selective angiograms. The observers correctly identified 13 of these on the digital subtraction ventriculograms (sensitivity 81%(. Of the 55 nondiseased right coronary arteries, correct identification was made in 47 (specificity 85%). Likewise, 17 patients had angiographically significant obstructions of the left anterior descending coronary artery and 15 were correctly identified by digital subtraction ventriculography (sensitivity 88%). However, only 20 of the 54 nondiseased left anterior descending coronary arteries were correctly identified (specificity 37%). Nonopacification or visualization of a severe obstruction of the right coronary artery is a useful finding and should be sought during examination of routine intravenous digital subtraction ventriculograms. This technique is not adequate at the present time to replace selective coronary arteriography in the assessment of coronary anatomy.
Flow disturbance due to venous valves: A cause of graft failure
Authors: Singh Ram N. 
Published: March 2007

AbstractLate (greater than 1 year) postoperative angiographic studies in five patients revealed evidence of flow disturbance at the distal valve, when two valves were present in the body of a saphenous vein graft (SVG(. This was associated with delayed clearance of radiopaque dye due to reduced velocity of flow. On follow‐up, occlusion, thrombus formation, or development of atherosclerosis seemed to have occurred in anatomic relation to these valves. All five patients had one additional graft in a good state of preservation; three internal mammary artery (IMA) grafts, and 2 SVGs. The latter had only one venous valve, and the velocity of flow was good.It appears that good velocity of flow is essential to the integrity of coronary bypass grafts. The presence of more than one venous valve in a graft appears to cause flow disturbance and sluggish velocity, factors adversely affecting their integrity.
Detection of atrial septal defect by contrast‐enhanced ultrafast computed tomography
Authors: Skotnicki Robert , Macmillan Robert M. , Rees Michael R. , Maranhao Vladir , Murphy David , Flicker Stephanie , Eldredge W. Jay , Clark Donald L. 
Published: March 2007

AbstractA 53‐year‐old man with previous surgically corrected pulmonic valve stenosis was evaluated for central cyanosis. A right‐to‐left shunt at the atrial level was diagnosed by contrast‐enhanced ultrafast computed tomography. Cardiac catheterization confirmed the CT findings and provided quantitation of the shunt.
Partial left anomalous pulmonary venous return: A diagnostic dilemma
Authors: McGaughey Mark D. , Traill Thomas A. , Brinker Jeffrey A. 
Published: March 2007

AbstractTwo adults were seen with left partial anomalous pulmonary venous return with intact atrial septum. Both cases had remained undiagnosed despite medical attention since childhood, including previous cardiac catheterization in one patient. Noninvasive tests, indocyanine green dye injections, pulmonary artery angiography, and venous sampling for oximetry high in the superior vena cava above the entry of the innominate vein will help establish the diagnosis of this disorder.
Percutaneous transluminal coronary angioplasty in patients over the age of 70 years
Authors: Dorros Gerald , Janke Lynne 
Published: March 2007

AbstractPercutaneous transluminal coronary angioplasty (PTCA) was attempted in 109 patients over the age of 70 years (mean age 75.9). The patients' clinical characteristics showed 55% with multivessel coronary disease, 86% with significant angina pectoris (Class II to IV), 16% with prior bypass surgery, and 2.7% with left ventricular dysfunction. Angioplasty data showed the mean percent diameter stenosis was reduced from 83 ± 12% to 15 ± 16%. One lesion was dilated in 67%, two lesions in 30%, and three lesions in 3% of the patients. A successful dilatation was achieved in 138/148 lesions (89%) with 90/109 patients (83%) clinically improved at hospital discharge. Significant complications were encountered in six patients (5.5%): three transmural infarctions (2.8%), two mortalities (1.8%), and one emergency surgical procedure (0.9%). Follow‐up data (≥1 year) are available in 77 patients: 68 patients (92%) had an improved anginal status {49 patients (65%) had no angina}. During a mean follow‐up of 23 ± 10 months, there were two myocardial infarctions and three deaths. A clinically apparent recurrence occurred in 14 patients (17%). Repeat angioplasty was successfully performed in 13/14 patients. Bypass surgery was performed during the follow‐up in three patients (two of whom had had a recurrence after a second successful angioplasty; one patient died during elective surgery). Transluminal coronary angioplasty can be performed in patients over age 70 with a good success rate, an acceptable complication rate, a relatively low clinically apparent recurrence rate, and should be considered as a therapeutic modality and alternative for the selected geriatric patient.
Percutaneous angioplasty of internal mammary artery graft stenosis using the brachial approach: A case report
Authors: Salinger Michael , Drummer Eric , Furey Kevin , Bott‐Silverman Corinne , Franco Irving 
Published: March 2007

AbstractCannulation of the internal mammary artery (IMA) via the ipsilateral brachial approach offers a complementary alternative to the transfemoral approach for IMA graft angioplasty and can offer potential advantage in terms of catheter stability and ease of IMA cannulation. This report describes successful IMA graft stenosis angioplasty using the ipsilateral brachial approach.
Percutaneous left brachial catheterization usingl 5‐French preformed (Judkins) catheters
Authors: Eugster George S. , Reisig A. Henry , Ugaldea C. Tim 
Published: March 2007

AbstractA method is described combining percutaneous brachial catheterization techniques with the use of 5‐French (F) preformed (Judkins) catheters. This method was used in 50 patients with one unsuccessful attempt to cannulate the brachial artery. There was one lost pulse requiring surgical thrombectomy but no other cardiac, vascular, or neurologic complications. Two moderately large hematomas occurred, which resolved without sequelae. Manipulation of 5‐F Judkins catheters from the left arm was found to be quite acceptable with adequate visualization of the coronary arteries in all cases.We believe this technique to be an excellent alternative to brachial cutdown or transaxillary methods in patients with severe occlusive ileofemoral disease as well as an improved technique for out‐patient catheterization.
Dipyridamole versus intracoronary injection of contrast medium for the evaluation of coronary reserve in man: A comparative study
Authors: Foult Jean‐Marc , Nitenberg Alain 
Published: March 2007

AbstractCoronary reserve can be assessed by the ratio of coronary blood flow after “maximum” vasodilation to control flow. The intravenous infusion of dipyridamole (0.56 mg × kg−1) is considered to elicit maximum coronary vasodilation. The present study was designed to compare coronary flow and resistance responses to intravenous dipyridamole and intracoronary injection of contrast medium (ioxaglate), this latter technique being frequently used in digital radiology to stimulate hyperemia. The comparison was performed in seven normal patients, nine patients with coronary artery disease, and 16 patients with dilated cardiomyopathy. Coronary flow reserve was calculated as the ratio of peak flow after dipyridamole or contrast medium to control flow, and coronary resistance reserve was calculated as the ratio of minimal to control coronary resistance after each stimulus. Although flow reserve after dipyridamole was approximately twice that obtained after contrast medium in the normal group (4.01 ± 0.56 vs 2.02 ± 0.24) there was a close and linear relationship between coronary flow and resistance reserve estimated by both techniques (r = 0.846, p < 0.001 for flow reserve ratios, and r = 0.844 p < 0.001 for resistance reserve ratios). However, contrast‐induced hyperemia identified 13/25 (52%) of patients with coronary artery disease or dilated cardiomyopathy as having a reduced flow reserve, while dipyridamole revealed a restrained coronary flow reserve in 20/25 (80%) of these patients. Similar proportions were obtained when using coronary resistance reserve (56% for contrast vs 80% for dipyridamole). Thus, although contrast medium and dipyridamole provide closely correlated values of coronary flow and resistance reserve, a better separation between normals and patients is achieved after dipyridamole. These results should be considered in the estimation of coronary reserve by means of digital angiography and contrast agents, since the obtention of maximum coronary blood flow appears as a prerequisite for an adequate evaluation of the human coronary circulation functional status.
Relation between left ventricular diastolic function and exercise tolerance in patients with left ventricular dysfunction
Authors: Heo Jaekyeong , Iskandrian Abdulmassih S. , Hakki A‐Hamid 
Published: March 2007

AbstractPrevious studies show no correlation between resting systolic left ventricular performance assessed as the ejection fraction and exercise tolerance. This study examined the relation between left ventricular diastolic performance and exercise tolerance in 63 patients with left ventricular dysfunction (ejection fraction < 50%) due to known or suspected coronary artery disease. The 51 men and 12 women, aged 54 ± 8 years (mean ± standard deviation), underwent symptom‐limited upright exercise testing on a bicycle ergometer. The exercise end‐points were angina (n:5), dyspnea (n:16), and fatigue (n:42). The patients were divided into three groups: group 1 (n:28) with normal exercise tolerance (9.5 ± 2.4 minutes), group 2 (n:18) with mild exercise intolerance (5.8 ± 0.5 minutes), and group 3 (n:17) had severe exercise intolerance (3.7 ± 0.9 minutes). The three groups did not differ in age, ejection fraction, end‐diastolic volume, exercise end‐point, exercise heart rate, and left ventricular peak filling rate at rest. The exercise peak filling rate was, however, significantly higher in group 1 (p = 0.03). Stepwise multivariate discriminant analysis of important variables identified the exercise peak filling rate as the only predictor of exercise tolerance (F = 6.0).Thus, variation in exercise peak filling rate may in part explain the variability of exercise tolerance in patients with left ventricular dysfunction; patients with preserved exercise capacity have higher exercise peak filling rate than those with exercise intolerance.
Intravascular blood velocity in simulated coronary artery stenoses
Authors: Kilpatrick David , Webber Stephen B. 
Published: March 2007

AbstractThe profiles of blood velocity within arterial stenoses have been measured using fiber optic laser Doppler anemometry (FOLDA). The arterial stenoses were created in arteries and tubes of similar size to human coronary arteries and were perfused in vitro at pressures and flows typical of those in the human circulation.At very low flow rates, flow and peak velocity are linearly related, and thus peak velocity measurement can predict internal cross‐sectional areas accurately. With higher flow rates, the intravascular velocities are not linearly related to flow and cannot be used to measure internal cross‐sectional area. This is due to flattening of the velocity profile at both more severe stenoses and higher flow rates.
New triple‐lumen balloon catheter for percutaneous (pulmonary) valvuloplasty
Authors: van den Berg Eduard J. M. , Niemeyer Menco G. , Plokker Thijs W. M. , Ernst Sjef M. P. G. , de Korte Jos 
Published: March 2007

AbstractPercutaneous transluminal balloon pulmonary valvuloplasty has been performed since 1982. In publications, the most critical problems mentioned are severe systemic hypotension and bradycardia due to stasis of blood flow.A triple‐lumen balloon was developed to allow more rapid inflation and deflation and to preserve the preexistent forward blood flow during maximal inflation. Only a slight systemic hypotension and no bradycardia were seen in the first two patients with pulmonary valve stenosis treated with this type of balloon. Thus, the maximal inflation time is not a critical parameter, whereas with the former types of balloon, maximal inflation times were critical, and, if longer than 5 to 10 sec, severe systemic hypotension was registered.We conclude that the triple‐lumen pulmonary valve‐dilatation balloon catheter is superior to the single‐lumen balloon catheter used up to now.
Cigarette smoking during coronary angiography: Diffuse or focal narrowing (spasm) of the coronary arteries in 13 patients with angina at rest and normal coronary angiograms
Authors: Maouad Joseph , Fernandez Francisco , Hebert Jean Louis , Zamani Karen , Barrillon André , Gay Jean 
Published: March 2007

AbstractTo evaluate the acute effects of cigarette smoking on coronary arteries (CA), repeated coronary angiograms were performed in 13 patients with angina at rest and with normal coronary angiograms at basal state, during smoking, and then after methylergometrine (MEM) and after intracoronary nitroglycerin. Smoking induced anginal pain in three patients, triggered spasm (focal narrowing) in six, and/or an abnormal segmental diffuse narrowing (> 30%) in eight. The narrowing of the left CA was on average −21 ± 13% (P < 0.001), with more important narrowing of the mid‐left anterior descending (−29 ± 19%, P < 0.001). The mean of the maximal segmental narrowing by patient was −34 ± 13% (P < 0.001). MEM produced similar effects and induced focal CA spasms in nearly the same patients at the same sites. Cigarette smoking may induce vasoconstrictive effects on CA in patients with rest angina and normal coronary angiograms. This action is not dose‐dependent and may be initiated by less than one cigarette. These observations offer a new perspective for the understanding of the role of smoking in the precipitation of coronary events.
Thrombus formation in the ascending aorta: A complication of angioplasty
Authors: Wang Shih‐Pu , Chiang Benjamin N. 
Published: March 2007

AbstractPercutaneous transluminal coronary angioplasty (PTCA) is recognized as an effective therapeutic procedure for nonsurgical relief of critical coronary stenosis. However, this procedure has the inherent traumatic risk of thromboembolic phenomenon in treated patients. This paper describes a hiterto unreported complication. In two patients a thrombus appeared in the ascending aorta during PTCA performed in the left anterior descending artery (LAD). Mechanisms involved are postulated. It is emphasized that particular attention should be paid to the lateral view in dilatation to treat LAD lesion, especially if the procedure is prolonged.
Early experience with balloon angioplasty of internal iliac arteries for vasculogenic impotence
Authors: Angelini Paolo , Fighali Sayid 
Published: March 2007

AbstractFive patients with vasculogenic impotence underwent balloon angioplasty of internal iliac and/or internal pudendal artery obstructions in an attempt to increase the blood pressure in the dorsalis penis artery and thus improve erectile function. Four patients had bilateral obstructions, and one patient had unilateral iliopudendal arterial disease. Balloon angioplasty was used to dilate bilateral lesions in three patients and unilateral lesions in two patients. Four of the five patients had improvement in erectile function for 2 to 18 months (mean, 12 months) after angioplasty. We conclude that balloon angioplasty is an adequate, expeditious, and relatively inexpensive method for treating subtotal obstruction of the internal iliac and/or internal pudendal arteries in patients with vasculogenic impotence.
Hemodynamic monitoring and pacing with one catheter: A pilot study
Authors: Gessler Carl J. , Jaffe Allan S. 
Published: March 2007

AbstractAttempts to incorporate the monitoring of central pressures and pacing into one catheter have heretofore been unsuccessful. Recently, a new catheter for monitoring central hemodynamic pressures, which has a right ventricular port (Chandler pacing port), has been devised, which has been reported to allow for simultaneous acquisition of hemodynamic data and reliable pacemaker function as well. To assess the reliability of this catheter, we studied ten consecutive Swan‐Ganz catheterizations utilizing this new catheter system. In all instances, hemodynamic monitoring was established without difficulty. In three instances, because of right heart enlargement, fluoroscopy was necessary to position the pacing probe at the right ventricular apex. In all ten instances, a threshold of less than 2.5 mV was obtained. Isolated PVCs and nonsustained ventricular tachycardia were common during insertion. After initial placement, the threshold for sensing and pacing was assessed every 6 hr. Malfunction occurred in three patients. In all, repositioning was accomplished without marked difficulty; in one it required fluoroscopy. In three instances, the Swan‐Ganz pacing catheter system malfunctioned. These data are similar to data utilizing other modalities of temporary pacing and suggest that this catheter may be capable of providing hemodynamic monitoring and pacing from a single percutaneous procedure.
Quantitative validation of cineangiographic axial oblique biplane left ventricular volume measurement
Authors: Pietras Raymond J. , Kondos George T. , Juska Jonas 
Published: March 2007

AbstractAxial oblique left ventriculography allows unique visualization of acquired and congenital cardiac lesions. However, validation of the accuracy of left ventricular (LV) volume with axial oblique projections is limited and clouded by orthogonal violations between biplane projections. Biplane cineradiographic volume measurement of 17 LV casts employing the axial projection 35° right anterior oblique/55° left anterior oblique/30° cranial (35°RAO/55°LAO/30°Cr) was performed and compared to the conventional postero‐anterior/lateral (PA/Lat) and 30° right anterior oblique/60° left anterior oblique (30°RAO/60°LAO) views. LV volume was calculated from biplane cineradiograms by area length and Simpson's rule method. True LV volume by water displacement was 33 ± 28 (mean± S.D.), range 15 to 112 ml. LV cast volume calculated by the area length method from cineradiograms was overestimated (p < 0.002) but no different by Simpson's rule method (pNS). The ideal correlation was best approximated by the 35° RAO/55°LAO/30°Cr biplane view calculated by Simpson's rule, r = 0.99, y = 3.5+ 0.9 ×, and standard error of estimate (SEE) = 4.3 ml. Biplane LV angiography with the axial projection permitted accurate LV volume measurement, and Simpson's rule provided the best representation of true volume.
Thermodilution measurement of the right ventricular ejection fraction
Authors: Morrison Douglass A. , Stovall Ray , Sensecqua James , Friefeld Geoffrey 
Published: March 2007

AbstractThis study addressed the clinical reproducibility and validity of the thermodilution (TD) measurement of the right ventricular ejection fraction (RVEF). Forty‐one patients underwent right heart catheterization, including TD RVEF, within 2 h of gated first pass (GFP) and gated blood pool (GBP) radionuclide ventriculography; 21 had single plane contrast right ventricular angiography (ANGIO) during the same catheterization. Analysis of variance showed no difference among three successive TD RVEF measurements. magnified imageStroke volume by RV ANGIO correlated with Fick (n = 10, r =.86) and thermodilution stroke volume (n= 21, r=.88). It is concluded that although the thermodilution method is an accurate way to measure flow, it is not an accurate way to measure right ventricular ejection fraction, and by inference, ventricular volumes. The most likely explanation for this finding is incomplete mixing as in previous studies of indicator methods of measuring left ventricular volumes.
Left atrial and ventricular transseptal catheterization review: Losing skills?
Authors: Schoonmaker Fred W. , Vijay Nampalli K. , Jantz Richard D. 
Published: March 2007

AbstractTransseptal catheterization has been routinely done at this institution for the past 19 years to evaluate the left heart. Reviewing the last 250 consecutive transseptal heart catheterizations between 1978 and 1986, the left atrium and ventricle were entered in all but six patients. One death occurred with four other major complications. There were 177 males and 73 females ranging from 18 to 84 years of age. Of these 250 studies, 31 were in association with direct left ventricular apical puncture; 42 were in patients with subaortic stenosis; 101 were in aortic stenosis; 26 were in patients with combined aortic and mitral disease; and four were in patients with triple prosthetic valve replacements. No attempts were made to cross the prosthetic mitral valves.A decline in the number of transseptal studies at this institution has been noted over the past 8 years and the technique is no longer taught routinely to Fellows. The reduction is due to increased emphasis on coronary artery anatomy, fewer rheumatic and prosthetic valvular admissions, and improved evaluation by non‐invasive echocardiography and doppler studies. This has resulted in a loss in proficiency among invasive cardiologists.In conclusion, the transseptal technique is potentially hazardous, but continued usage will maintain proficiency and a low major and minor complication rate.
Optimal ECG monitoring during percutaneous transluminal coronary angioplasty of the left anterior descending artery
Authors: Feldman Ted , Childers Rory W. , Chua K. G. 
Published: March 2007

AbstractDuring percutaneous transluminal coronary angioplasty (PTCA) frontal ECG leads are routinely monitored. The detection of ST segment deviation during the procedure is important for decisions regarding guiding catheter seating and the timing of balloon inflation and deflation. ST segment deviation appears on intracoronary electrograms in the absence of changes on the surface ECG in many patients, while the reverse is true in some individuals. When a precordial lead is employed, V5 or V6 is most commonly selected. The surface ECG leads most sensitive for monitoring ischemia during left anterior descending angioplasty are not known. In nine lead surface ECGs recorded during balloon inflation, a small degree of ST segment elevation occurred in leads I, aVL, and V5. Lead V2 demonstrated an increase in ST displacement from 0.0 ± 0.03 mV to 0.29 ± 0.25 mV during coronary occlusion (p<0.01). We conclude that if V5 or V6 is used as a single precordial lead, surface ECG alterations are easily overlooked. During left anterior descending occlusion the most sensitive surface lead is V2. Optimal ECG monitoring during PTCA in some cases should involve surface lead V2 or the intracoronary lead.