bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ergonovine testing for coronary artery spasm in patients with angiographic mitral valve prolapse
Authors: Sabom Michael B. , Curry R. Charles , Pepine Carl J. , Christie Leonard G. , Conti C. Richard 
Published: March 2007

AbstractCoronary artery spasm (CAS) has been postulated to be a pathophysiologic mechanism in the production of ischemic‐like chest pain and ECG changes in patients with idiopathic mitral valve prolapse syndrome. To evaluate the possible role of symptomatic CAS evoked by ergonovine maleate, this agent was administered (0.05 to 0.4 mg IV) to 24 patients with chest pain and mitral valve prolapse who had no significant (<50%) coronary artery obstruction.Symptoms, ECG and blood pressure changes were monitored in all patients following ergonovine administration. No significant changes were observed in heart rate, systolic blood pressure, or double product. Six patients developed their typical chest pain. In two of these six with chest pain, ST segment shifts >1 mm were seen.Post‐ergonovine left ventricular end‐diastolic pressure (LVEDP) and coronary angiographic changes were also studied in a subgroup of 12 of these patients, including five of the six chest pain responders. In the five chest pain responders, pain was associated with a significant rise in LVEDP, whereas no significant change occurred in those patients not experiencing chest pain (p<0.01). Chest pain was also associated with significant CAS (>50% lumen reduction) in two patients, each with ST segment shifts >1 mm.In summary, ergonovine stimulation failed to evoke symptoms, ECG or blood pressure changes in three quarters of mitral valve prolapse patients studied. Six patients developed chest pain. Chest pain was associated with ECG changes characteristic of CAS in two of these patients, each with angiographic CAS. Thus, symptomatic CAS induced by ergonovine was absent in the majority of these 24 patients with idiopathic mitral valve prolapse syndrome.
Echocardiography in the diagnosis of lutembacher syndrome
Authors: Garcia Jorge A. , Krajcer Zvonimir , Pechacek Leonard W. , Leachman Robert D. 
Published: March 2007

AbstractIn two patients with Lutembacher syndrome cardiac catheterization demonstrated a large atrial septal defect but no diastolic gradient across the mitral valve. Echocardiography was compatible with right ventricular volume overload and mitral stenosis. Surgical exploration of the mitral valve at the time of atrial septal defect correction is warranted when the echocardiogram is suggestive of mitral stenosis.
Restrictive cardiomyopathy in an infant with massive biatrial enlargement and normal ventricular size and pump function
Authors: Erath Harold G. , Graham Thomas P. , Smith Clyde W. , Boucek Robert J. 
Published: March 2007

AbstractRestrictive cardiomyopathy in an infant with massive biatrial enlargement and normal ventricular size has been reported only once previously [3]. We now present a 13‐month‐old patient with severe and progressive congestive heart failure who demonstrated normal ventricular cavity size with biatrial enlargement. Ejection fraction and echocardiographic ventricular function studies were normal.
Anomalous origin of the right coronary artery above the left sinus of valsalva
Authors: Yans Javad , Kumar Samuel P. , Kwatra Manmohanlal 
Published: March 2007

AbstractVarious anomalies of coronary arterial origin have been described. These anatomical variations are discovered either by coronary angiography or at autopsy. We are reporting a case of anomalous origin of the right coronary artery above the left sinus of Valsalva. To our knowledge, this anomaly has not been described before. A technique for selectively catheterizing such an aberrant coronary artery is described.
Anomalous origin of the left coronary artery from the right sinus of valsalva
Authors: Sher Ronald F. , Iskandrian Abdulmassih S. , Kimbiris Demetrios , Bemis Charles E. 
Published: March 2007

AbstractWe present the clinical, angiographic and surgical findings in a 63‐year‐old man with anomalous origin of the left main coronary artery from the right sinus of valsalva. The course of the left main artery was abnormal in that it passed between the aorta and the pulmonary artery; in addition, there was obstructive disease involving the left main coronary artery. The association of these two entities in this age group is unusual.
Sudden death in severe aortic stenosis following cardiac catheterization
Authors: Iskandrian Abdulmassih S. , Segal Bernard L. , Wasserman Louis , Kimbiris Demetrios , Bemis Charles E. 
Published: March 2007

AbstractFive patients with critical aortic stenosis (aortic valve area 0.6 cm2 or less) died 2 days to 21 days following cardiac catheterization performed in anticipation of cardiac surgery. A sixth patient was successfully resuscitated for spontaneous ventricular fibrillation, and successful aortic valve replacement was accomplished. Two patients had prior history of syncope; one patient, of ventricular tachycardia; three patients, of pulmonary edema; and three patients, of crescendo angina. One patient had severe hypotension during maintenance hemodialysis for chronic renal failure. The mode of death was sudden but not witnessed in two patients. The terminal cardiac rhythms were slow junctional in one patient, idioventricular in one, ventricular tachycardia in one, and ventricular fibrillation in the fourth patient. We conclude that symptomatic patients with critical aortic stenosis should be monitored after cardiac catheterization, and surgery should be performed as soon as possible since sudden death is not unusual.
Patency of the interatrial septum in children undergoing cardiac catheterization
Authors: Waldman J. D. , Rose G. , Turner S. W. , Pappelbaum S. J. 
Published: March 2007

AbstractCatheter passage into the left atrium from the right atrium greatly facilitates invasive cardiovascular evaluation and reduces the risks attendant on cardiac catheterization studies. We reviewed 371 consecutive cardiac catheterizations to establish the presence of natural interatrial communications. Catheter course, pressure equalization, and left‐to‐right atrial shunt on recirculation angiography were considered to determine intact interatrial septum (IIS), patent foramen ovale (PFO) or atrial septal defect (ASD).During the first year of life, 88% of infants had PFO or ASD; in 12%, the interatrial septum was intact. In children 1–10 years old, 49% had IIS, 27% had PFO, and 24% had ASD. In children 10–21 years old, 24% had PFO, or ASD. Though there seems to be a greater likelihood of ISS in those with left heart obstruction, hemodynamic factors did not completely explain the timing of closure of the foramen ovale.Presence of an interatrial communication allows catheter entrance into all left heart structures including the aorta; therefore, in patients with PFO or ASD, retrograde arterial procedure or transseptal puncture technique can be avoided when performing left heart catheterization. This appears possible in 88% of those under 1 year of age, in 51% of those 1–10 years old, and in 24% of children 10–21 years old.
Tricuspid regurgitation: Clinical and angiographic assessment
Authors: Lingamneni Ramesh , Do Cha Se , Maranhao Vladir , Gooch Alden S. , Goldberg Harry 
Published: March 2007

AbstractBecause previous attempts to diagnose and quantitate tricuspid regurgitation (TR) by angiography have been unreliable, 60 patients with mitral or combined mitral and aortic valve disease had right ventriculography using a special preshaped catheter. A clinical diagnosis of TR was confirmed in 45% of the patients with moderate and severe TR. A pansystolic murmur increasing in intensity with inspiration, a pulsatile liver, and a prominent CV wave in the jugular veins when present together were specific for severe TR but were seen in only 30% of the patients with severe TR (3+ or 4+). Ventricularization of the right atrial pressure contour was specific for severe TR but was seen in only 40% of the patients with severe TR. A normal right atrial mean pressure (RAP) did not exclude TR, but a rise in RAP or an unchanged RAP with deep inspiration was seen in all patients with TR. Similar findings were observed in two patients with severe pulmonary hypertension who had no TR. There was no relation between the magnitude of this rise in RAP, the degree of pulmonary hypertension, and the severity of TR. The use of a special preshaped catheter tends to avoid the induction of premature beats, and right ventriculograms with a preshaped catheter may be useful in diagnosing TR.
The sensitivity of contrast echocardiography in detecting intracardiac shunts
Authors: Pieroni Daniel R. , Varghese P. Jacob , Freedom Robert M. , Rowe Richard D. 
Published: March 2007

AbstractWhile contrast echocardiography has been shown to delineate intracardiac shunts, no information is available concerning the sensitivity of the method. This study establishes the relative sensitivity of the technique in detecting and localizing shunts by comparing the contrast echocardiograms with the simultaneously recorded cardiogreen dye curves in 26 children during cardiac catheterization. The echocardiograms substantiated isolated intracardiac shunting as small as 5%. There were no false‐positive or false‐negative echocardiograms in patients with or without shunt defects.This report demonstrates the contrast echocardiographic technique to be extremely sensitive in detecting intracardiac communications. It reviews the diagnostic patterns necessary for diagnosis and proposes the technique as a sensitive, safe, and accurate alternate method of study in the cardiac catheterization laboratory.
Atrial pacing induced left ventricular dysfunction: Reversibility after aortocoronary bypass surgery
Authors: Hamby Robert I. , Aintablian Agop , Wisoff B. George 
Published: March 2007

AbstractThree patients with angina pectoris were studied before and after aortocoronary bypass surgery. Angiographic studies were performed with and without atrial pacing. Preoperative atrial pacing in all three patients resulted in angina and/or ST segment changes accompanied by regional left ventricular contractile abnormalities, decreased ejection fraction, as well as decreased left ventricular end‐diastolic and stroke volumes. After surgery with all grafts patent, atrial pacing at similar heart rates did not produce an ischemic response. Left ventricular contractile pattern remained normal, and there was no change in ejection fraction, though end‐diastolic and stroke volumes decreased. These studies demonstrate that aortocoronary bypass surgery can abolish both the ischemic response and left ventricular dysfunction that accompany atrial pacing.
The noninvasive assessment of anomalous origin of the left coronary artery from the pulmonary artery
Authors: Wasserman Louis A. , Eshaghpour Eshagh , Takahashi Osahiro , Iskandrian Abdulmassih , Kotler Morris N. 
Published: March 2007

AbstractWe present a patient with anomalous origin of the left main coronary artery from the pulmonary artery. We correlate the findings of echocardiography and myocardial imaging with angiography, and discuss the value of the noninvasive techniques in the diagnosis and in the followup of such patients.
A simple, new system for maintaining measured quantities of saline cold and sterile for thermodilution cardiac output measurement
Authors: Hammermeister K. E. , Vandamme John 
Published: March 2007

AbstractA new, simple system for cooling and maintaining prefilled syringes of injectate in a dry, sterile environment for thermodilution cardiac output using a thermoelectric cold plate is described. Rates and uniformity of cooling were studied. Uniform cooling is achieved in about 60 minutes if refrigerated injectate is used.
Coronary artery‐left ventricular communications: A report of two cases and review of the literature
Authors: Vogelbach Karl‐Heinrich , Allan W. Edmiston , Stenson Robert E. 
Published: March 2007

AbstractTwo patients with chest pain had angiographically‐demonstrated communications between the three coronary arteries and the left ventricular chamber. Communications between coronary arteries and the left ventricle are unusual and communications between all three coronary arteries and the left ventricle are rare. These anomalies are, however, commonly associated with symptoms of chest pain. The presence of left ventricular hypertrophy and a widened pulse pressure may suggest a greater hemo‐dynamic effect of the shunt flow than often suspected angiographically.
Percutaneous cannulation of large pericardial effusions
Authors: Singham K. T. 
Published: March 2007

AbstractA rapid, easy, and safe method of introducing a large cannula into the pericardial space for drainage of large pericardial effusions using conventional catheter introducers and catheters is described. Confirmation of the presence of a sizeable pericardial effusion is essential before insertion of a percutaneous cannula.
Cine‐densitometric measurement of coronary arterial stenoses
Authors: Sandor Tamas , Als Ann V. , Paulin Sven 
Published: March 2007

AbstractComputer‐aided operator‐interactive densitometry has been developed and applied to determine the percent stenosis for obstructive lesions in the coronary arterial tree. Phantom experiments performed to assess system linearity, accuracy of densitometric measurements, nonuniformity in image amplifier response, and the interference of structure noise in measuring precision have been described. Three observers assessed the reproducibility of the method by repeating analyses on 20 stenoses in man recorded on 35‐mm cine angiograms. Calculation of the intra‐ and interobserver errors found that their values significantly decrease with increasing percent stenosis. The reproducibility of the technique was also tested on stenoses that were exposed at multiple angles. The results agreed with those found for the intra‐ and interoperator errors. Limitations of the densitometric approach and desirability of further automation of the measurements are also discussed.
Pulmonary atresia and suprasternal echocardiography
Authors: Sassé; Lewis , Froelich Carla R. , Danielson Gordon K. 
Published: March 2007

AbstractA 54‐year‐old housewife with pulmonary atresia and ventricular septal defect developed increasing cyanosis, dyspnea, weakness, and myocardial ischemia. Initial cardiac catheterizations with angiography, including subtraction techniques, did not definitely indicate main pulmonary artery or right or left pulmonary arteries that would make her amenable to currently available surgical correction. Single‐crystal suprasternal notch echocardiography indicated the presence of a small but definite right pulmonary artery. She subsequently underwent first‐stage surgical correction after angiography and selective catheterization of aortopulmonary shunt vessels, which also revealed the presence of small proximal pulmonary arteries.
Chronic oral vasodilator therapy to control heart failure in postinfarction ventricular septal defect
Authors: Phaneuf Denis C. , Waters David D. , Thé;Roux Pierre , Pelletier Guy , Mizgala Henry F. 
Published: March 2007

AbstractThis report describes a 70‐year‐old woman with biventricular failure following an anteroseptal infarction complicated by interventricular septal rupture. Treatment with nitroprusside followed by oral hydralazine eliminated the failure and reduced the shunt from 2.75 to 1 to 1.7 to 1. She is asymptomatic post‐discharge. Chronic medical therapy including oral vasodilators may be an acceptable alternative to surgery in a small minority of patients with this complication of myocardial infarction.
Congestive cardiomyopathy with segmental wall motion abnormalities and a non‐uniform pattern of fibrosis
Authors: Ritchie James L. , Clarke L. John , Reichenbach Dennis 
Published: March 2007

AbstractA case of congestive cardiomyopathy in a 46‐year‐old smoker with single‐vessel right coronary artery disease is presented. Segmental contraction abnormalities were present in the anterior wall. Pathologic analysis showed diffuse fibrosis consistent with a cardiomyopathy in areas of abnormal contraction and normal muscle in areas of normal contractility. Segmental wall motion abnormalities have been reported but none with microscopic studies of areas of both abnormal and normal contractility.
The risk of sudden death in sickle cell trait: Noninvasive assessment of cardiac response to exercise
Authors: Francis Charles K. , Bleakley Dennis W. 
Published: March 2007

AbstractThe effect of symptom‐limited maximal treadmill exercise was evaluated in 34 patients with sickle cell trait (SCT) and 43 controls. Systolic time intervals were measured before and after exercise in 15 of the sickle cell trait subjects, and in 11 controls. Rate pressure product, degree of ST segment depression and incidence of ventricular arrhythmias in subjects with SCT were not significantly different from similar measurements in the control group. No significant difference in electromechanical systole QS2, left ventricular ejection time (LVET), pre‐ejection period (PEP)/LVET or ejection fraction (EF) were found between the groups. These data indicate that healthy subjects with SCT do not have an increased incidence of exercise‐induced ventricular arrhythmias, myocardial ischemia, or diminished ventricular function compared to normals. Further studies are indicated to elucidate factors that may be operative in the sudden death syndrome.
Percutaneous sheath brachial vein cardiac catheterization in children
Authors: Hesslein Peter S. , Mullins Charles E. , Kugler John D. , Gillette Paul C. 
Published: March 2007

AbstractDuring the past ten years we have performed certain phases of cardiac catheterization on 48 children using a modified percutaneous sheath technique to enter a superficial arm vein. Our patients ranged in age from 15 months to 21 years, with a mean age of 10.0 years. The indications for a superior approach most commonly have included electrophysiologic investigations, femoral vein occlusions, and proximal obstructions of the inferior vena cava. The advantages of a percutaneous sheath technique in the superficial brachial veins include the ease of changing catheters frequently during a case and the preservation of the vessel for possible repeat studies. It is not always possible to enter the heart with this technique, owing to sharp angulation of deep venous confluences in the axilla and occasional venous spasm. When successful, this mode of approach is attended by a very low prevalence of complications. There were no deaths, heart or vein perforations, or systemic infections. One patient developed a superficial phlebitis; this was mild and temporally limited. We have not encountered any case of clinically apparent venous thrombosis. When a superior approach for prograde heart catheterization in children is indicated, we have found that our modified percutaneous sheath technique is a simple, safe, and frequently successful alternative to a cutdown approach.
Anomalous origin of the left coronary artery from the pulmonary artery: A case report with remarkable improvement of myocardial function following subclavian artery—Coronary artery anastomosis
Authors: Yoshida Yoshiro , Emmanouilides Geroge C. , Nelson Ronald J. , Baylen Barry G. , Criley J. Michael 
Published: March 2007

AbstractA 3 2/12‐year‐old boy with anomalous origin of the left coronary artery from the pulmonary artery was successfully treated by anastomosis of the left subclavian artery to the anomalous vessel. A remarkable improvement in left ventricular function and electrocardiogram has occurred postoperatively. This case report supports the postulation that chronically hypoperfused, electrically silent, and minimally contractile myocardial tissue may acquire its electrical activity and function with the establishment of adequate coronary perfusion.
Mid‐Systolic closure of the aortic valve in hypertrophic obstructive cardiomyopathy: A pressure‐Related phenomenon induced by turbulent blood flow
Authors: Sabbah Hani N. , Alam Mohsin , Anbe Daniel T. , Stein Paul D. 
Published: March 2007

AbstractThe purpose of this study was to determine whether mid‐systolic closure and opening of the aortic valve in patients with hypertrophic obstructive cardiomyopathy (HOCM) may reflect dynamic changes of pressure induced by turbulent blood flow in the aorta and left ventricular outflow tract. Five patients with HOCM who had echocardiographic evidence of mid‐systolic closure of the aortic valve and two patients with HOCM who did not have transient mid‐systolic closure of the aortic valve were studied. In patients in whom mid‐systolic closure was present, a transient mid‐systolic drop of pressure was present in the left ventricular outflow tract, distal to the dynamic intraventricular obstruction, 17 ± 3 mm Hg (mean ± SEM) and in the root of the aorta, 16 ± 4 mm Hg. In these patients the mid‐systolic drop of pressure was consistently associated with a high‐intensity intracardiac murmur indicative of turbulence. In the two patients in whom mid‐systolic closure of the aortic valve was absent, the transient mid‐systolic drop of pressure during systole was minimal (average, 3 mm Hg). The transient mid‐systolic drop of pressure distal to the intraventricular obstruction can be explained on the basis of decreased pressure energy of the blood due to turbulence. Since total energy is conserved, increased kinetic energy due to turbulence occurs at the expense of a loss in pressure energy. The transient mid‐systolic reduction of pressure in the turbulent zone during systole may cause a pressure differential across the open valvular leaflets resulting in a transient closure of the aortic valve.
An improved snare system for the nonsurgical retrieval of intravascular foreign bodies
Authors: Hubert John W. , Krone Ronald J. , Shatz Burton A. , Susman Noah 
Published: March 2007

AbstractWe have modified a snare technique originally described for transcolonoscopic removal of colonic polyps for the retrieval of intravascular foreign bodies. The key difference from other snare techniques is the employment of a wire snare with a crimp in its midportion that enables the formation of a loop in a plane perpendicular to the axial direction of the guiding catheter. With this technique we have quickly removed a variety of objects from the right heart and pulmonary arteries in four patients.
Left ventricular outflow obstruction at multiple levels: Occurrence in a single patient
Authors: Morton Brian C. , Troup Wallace J. , Baird Michael G. , Keon Wilbert J. 
Published: March 2007

AbstractCombined forms of left ventricular outflow obstruction are being recognized with increasing frequency. A patient who had coarctation of the aorta, valvular aortic stenosis, and fixed and dynamic subvalvular obstruction is described. The importance of recognizing multiple levels of obstruction in such patients is emphasized.
Cardiac dimensional analysis by use of biplane cineradiography: Description and validation of method
Authors: Lipscomb Kirk 
Published: March 2007

AbstractBiplane cineradiography is a potentially powerful tool for precise measurement of intracardiac dimensions. The most systematic approach to these measurements is the creation of a three‐dimensional coordinate system within the x‐ray field. Using this system, interpoint distances, such as between radiopaque clips or coronary artery bifurcations, can be calculated by use of the Pythagoras theorem. Alternatively, calibration factors can be calculated in order to determine the absolute dimensions of a structure, such as a ventricle or coronary artery. However, cineradiography has two problems that have precluded widespread use of the system. These problems are pincushion distortion and variable image magnification. In this paper, methodology to quantitate and compensate for these variables is presented. The method uses radiopaque beads permanently mounted in the x‐ray field. The position of the bead images on the x‐ray film determine the compensation factors. Using this system, measurements are made with a standard deviation of approximately 1% of the true value.