bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of propranolol for severe dynamic infundibular obstruction prior to balloon pulmonary valvuloplasty (a brief communication)
Authors: Thapar Mohinder K. , Rao P. Syamasundar 
Published: March 2007

AbstractA case of severe pulmonary valvar stenosis and infundibular obstruction has been reported Infundibular obstruction was so severe that no catheter could be advanced into the pulmonary artery. Propranolol, 0.5 mg given intravenously, reduced the obstruction and allowed the balloon dilatation of the pulmonary valve to be carried out without complication. Subsequently oral propranolol helped to remove the infundibular obstruction. We strongly recommend the use of propranolol when infundibular obstruction is present prior or after the balloon pulmonary valvuloplasty.
Experimental argon laser thermal angioplasty as an adjunct to balloon angioplasty in peripheral arteriosclerotic disease
Authors: Stroh Jack A. , Sanborn Timothy A. , Haudenschild Christian C. 
Published: March 2007

AbstractLaser thermal recanalization has been used clinically as an adjunct to balloon angioplasty in the treatment of peripheral arteriosclerotic disease, with improved initial success rates in total peripheral occlusions and greater 1 yr vessel patency suggested, as compared to balloon angioplasty alone. However, the morphological effects of laser‐assisted balloon angioplasty are unknown. Therefore the goals of the present study were to evaluate 1) the angiographic and nistologic effects of laser thermal recanalization followed by balloon angioplasty and 2) the hypothesis that balloon‐catheter‐induced neointimal fracture could be sealed by subsequent laser thermal angioplasty in an experimental rabbit iliac artery atherosclerotic model.In Group 1(7 vessels), a 1.5 mm metal capped argon laser fiberoptic was introduced via femoral arteriotomy and 10 W of thermal power was applied to the iliac artery stenosis for 5 sec while maintaining constant back‐and‐forth motion. Thereafter, balloon angioplasty was performed in the same vessel segment with a 2.5 mm balloon catheter inflated 3 times at 5 atm for 30 sec each. Mean angiographic luminal diameter increased from 1.1 mm to 2.0 mm after both procedures, and mean final post balloon dissection grade was 0.6 on a scale of 0,1 +, and 2 +. Perforation occurred once with the laser probe and once with the balloon catheter. Histologic examination of these vessels was characterized by irregular thermal erosions with minimal reactive thrombosis.In Group 2 (10 vessels), the sequence was reversed, with laser thermal angioplasty following balloon dilation. Mean angiographic luminal diameter improved from 1.2 mm to 1.8 mm after both procedures. The mean post laser thermal angioplasty dissection grade was 1.3, which was twice that of Group 1. Perforation occurred once with the balloon catheter and twice with the laser probe. In only 1 of the 10 vessels was there histologic evidence suggestive of neointimal sealing.In conclusion, laser thermal recanalization prior to balloon angioplasty appears to decrease the degree of angiographic dissection. Histologically, the thermal effect may be eccentric, and thrombosis appears to be limited. However, laser thermal sealing was not found to be feasible with the current 1.5 mm metal‐capped fiberoptic after dilation with a 2.5 mm balloon catheter. This is possibly due to inadequate contact of the probe with the vessel wall. There may also be anincreased tendency towards laser probe perforation following the fracture and dissection which results from balloon dilation.
Left‐sided inferior vena cava draining into the coronary sinus via persistent left superior vena cava: Case report and review of the literature
Authors: Brickner M. Elizabeth , Eichhorn Eric J. , Netto Dymphna , Cigarroa Ricardo G. , Brogan Walter C. , Simonsen Randall L. , Grayburn Paul A. 
Published: March 2007

AbstractA case of a left‐sided Inferior vena cava draining into the coronary sinus via a persistent left superior vena cava is described and the pertinent literature reviewed.
A new complication of coronary arteriography
Authors: Raphael M. J. , Donaldson R. M. 
Published: March 2007

AbstractThe introduction of a sharply angulated catheter through an arterial sheath for percutaneous coronary arteriography was associated in 7 cases with dissection of the iliac arteries; this extended to the lumbar aorta at the level of the coeliac axis. The catheter tip should be introduced gently and preferably straightened out with a good length of guide wire to avoid this complication.
Severe mitral insufficiency post‐balloon valvuloplasty: The late changes found in a disrupted mitral valve
Authors: Black M. D. , Campagna M. , Bedard P. , Marquis J.‐F. , Walley V. M. 
Published: March 2007

AbstractThe case of a 45‐yr‐old woman who had balloon valvuloplasty for rheumatic mltral stenosis is presented. An anterior mitral leaflet tear occurred as a complication of the procedure. Both partlal healing of the anterior mitral leaflet and gradual dilatation of the left atrium occurred which allowed the damaged valve to remain in situ for several months. Some of the late changes which occur after such a complicated valvuloplasty are illustrated here, as this patient eventually required surgery and valve excision for deflnitive repair.
Angioplasty of occluded coronary arteries: Use of thin shaft balloon over‐the‐wire system without pre‐dilatation
Authors: Gilchrist Ian C. , Clemson Barry S. 
Published: March 2007

AbstractA retrospective review was done on 13 consecutive patients who underwent PTCA of totally occluded coronary arteries using a recently released thin shaft balloon over‐the‐wire angioplasty system. Balloon size was determined by the closest fit to the arterial size and used without predilatation techniques. This technique was initially successful in 12 patients with only 2 clinically insignificant episodes of distal embolization and one probable early reclosure. Using thin shaft angioplasty systems, balloon dilatation of totally occluded coronary arteries can be done safely with a single balloon in many caws resulting In simplified procedures and economic benefits.
Percutaneous popliteal approach for angioplasty of superficial femoral artery occlusions
Authors: Zaitoun Rafic , Iyer Sriram S. , Lewin Ruben F. , Dorros Gerald 
Published: March 2007

AbstractAngioplasty using the percutaneous popliteal approach was utilized in 50 patients (PTS) to recanalize 59 occluded superficial femoral arteries which had been unsuccessfully canalized by using the antegrade approach because of either a flush origin occlusion or inability to maintain the guide wire in the true lumen. All PTS had claudication; 8 had rest pain; 3 had non‐healing ulcers. The laser Probe™ was used in 17 cases and the Rotablator™ in 3 cases. Occlusion length varied between 1 and 40 cm: 7 lesions were <10 cm (group 1); 9 were between 10 and 20 cm (group 2); and 43 were >20 cm (group 3). An angiographic success was obtained in 48/59 lesions (81%): 14/16 (87%) in groups 1 and 2 and 34/43 (79%) in group 3. Three PTS needed complementary common femoral endarterectomy and one required percutaneous aspiration of a thromboembolus. Complications included: arterial perforation and/or dissection (without clinical sequelae) in 11 and a popliteal hematoma in 1 PT. One patient with a severely ischemic leg underwent successful emergency vascular surgery, while another limb salvage patient required belowknee amputation. There was no worsening of limb ischemia from any popliteal approach attempt. At discharge, 39 patients (78%) whose outcome would have been unsuccessful with the traditional antegrade approach were clinically improved after utilizing the popliteal approach to achieve a successful angioplasty procedure.
Left ventricular mid‐cavitary obstruction after balloon dilation in isolated aortic valve stenosis in children
Authors: Ludomirsky Achi , O'Laughlin Martin P. , Nihill Michael R. , Mullins Charles E. 
Published: March 2007

AbstractA hyperdynamic left ventricle can lead to post‐dilation mid‐cavitary obstruction in the absence of any preballoon mid‐cavitary obstruction in children with aortic valve stenosis. The purpose of this study was to define the incidence and course of post‐dilation midcavitary obstruction. We reviewed the catheterization and echocardiographic data of 35 patients, ages 3 days to 18 years (mean + 7.9 years), with isolated aortic valve stenosis who underwent balloon dilation with a fall in aortic valve gradient to less than 20 mm Hg. Post‐dilation mid‐cavitary obstruction was suspected from post‐dilation left ventricular angiogram and was quantitated by echocardiographic and Doppler examinations performed immediately after dilation and in a 1–3 month follow‐up period. Continuous wave Doppler directed by color flow Doppler was used for evaluation and differentiation of post‐dilation mid‐cavitary obstruction and residual aortic valve stenosis. Three children (3/35 [9%]) all under 2 years of age developed post‐dilation mid‐cavitary obstruction immediately after dilation. The obstruction within the cavity resolved spontaneously in all three patients.Conclusions: 1) Post‐dilation left ventricular mid‐cavitary obstruction can occur in children under 2 years of age after balloon dilation of severe aortic valve stenosis, and 2) total regression of post‐dilation mid‐cavitary obstruction occurs spontaneously in all patients.
Determination of the anatomical size of ventricular septal defects on the basis of hemodynamic data and noninvasive assessment of pulmonary to systemic vascular resistance ratio rp/rs by doppler‐echocardiography
Authors: Rupprecht Thomas , Hofbeck Michael , Singer Helmut , Harms Dieter , Deeg Karl‐Heinz , Benson Lee 
Published: March 2007

AbstractThe pulmonary and systemic flow (Qp/Qs) and resistance ratios (RP/Rs) were determined in children with isolated ventricular septal defects (VSD) to derive an “effective defect resistance” (Rd/Rs) representing the ratios of the resistance of the defect to the systemic vascular resistance. The defect size (expressed as the ratio of the area of the defect to the cross‐sectional area of the ascending aorta) was related to the calculated “effective defect resistance,” where a significant (non‐linear) correlation was found. The effective resistance of the defect is a useful aid for estimation of the anatomical size of a ventricular septal defect. The close correlation between anatomical size and the hemodynamic parameter Rd/Rs allows one to calculate the ratio Rp/Rs with this concept using nonin‐vasive Doppler‐ultrasound and echocardiography. This was performed in 21 children with VSD who underwent cardiac catheterisation. The noninvasive calculated flow ratio Qp/Qs and the resistance ratio Rp/Rs showed a close correlation to the values measured at cardiac catheterisation.
Five‐Hour balloon inflation to resolve recurrent reocclusion during coronary angioplasty
Authors: Brenner Alan S. , Browne Kevin F. 
Published: March 2007

AbstractA 63‐year‐old male presented with an acute inferior myocardial infarction with initial clinical reperfusion following thrombolysis. Due to recurrent reocclusion, emergency catheterization was performed, demonstrating a 90% stenosis in the mid right coronary artery. Angioplasty was complicated by multiple reocclusions, ultimately requiring 5‐h autoperfusion balloon inflation to maintain patency.
Arteriovenous fistula as a complication of temporary pacemaker insertion: Treatment with percutaneous embolization
Authors: Cooper Stanley G. , Lewis Jon , Pollak Jeffrey S. , Denny Donald F. 
Published: March 2007

AbstractArteriovenous fistula is a rare complication of central venous catheterization. We present a case of right internal mammary artery‐to‐right innominate vein fistula resulting from emergent insertion of a temporary pacemaker. Percutaneous management is discussed and the literature is reviewed.
Comparison of ionic and non‐ionic contrast agents in cardiac catheterization: The effects of ventriculography and coronary arteriography on hemodynamics, electrocardiography, and serum creatinine
Authors: Wayne Cooper M. , Reed P. J. 
Published: March 2007

AbstractWe compared two nonionic contrast agents (ioxaglate and iohexol) with an ionic agent (Renografin‐76) on the effects of ventriculography and coronary arteriography on the hemodynamics, electrocariography, and serum creatinine in one hundred consecutive patients. Patients were randomized to nonionic or ionic groups and were further evaluated regarding the effect of fluid loading prior to catheterization. The ionic agent more often produced subjective reactions (rash, nausea/vomiting). Following ventriculography, both ionic and non‐ionic agents produced an increase in left ventricular end diastolic pressure and this effect was undetermined by fluid loading. Nonionic agents decreased aortic diastolic pressure following ventriculography and this effect was unaltered by fluid loading. In contrast, the ionic agent produced profound hemodynamic changes (drop in both systolic and diastolic pressures) following coronary arteriography and these effects were blunted by prior fluid loading. The ionic agent produced significantly greater heart rate slowing and prolongation of the QT interval than the nonionic agents, suggesting that the latter are potentially less arrhythmogenic. Comparing the two non‐ionic agents, we found that both decreased aortic diastolic pressure and increased left ventricular end diastolic pressure following ventriculography. Iohexol produced greater heart rate slowing than did ioxagliate, though the increase was minor compared to the ionic agent. Neither nonionic agent appeared to significantly affect serum creatinine. In conclusion, the two nonionic agents appeared to offer significant advantages over the ionic agent in ventriculography and coronary arteriography.
Left main coronary artery aneurysm in association with severe atherosclerosis: A case report and review of the literature
Authors: Lenihan Daniel J. , Zeman Howard S. , Collins Gary J. 
Published: March 2007

AbstractAneurysms of the coronary arteries occur in from 0.3% to 4.9% of angiograms. Only 12 cases of left main artery (LMA) aneurysms have been reported. Of these, seven were associated with atherosclerosis in patients more than 56 years old. This report details the case of a 39‐year‐old patient with a large LMA aneurysm associated with atherosclerosis.
Cerebral ischemia: A complication of right ventricular endomyocardial biopsy
Authors: Adair John C. , Call Gregory K. , O'Connell John B. 
Published: March 2007

AbstractDuring percutaneous transvenous endomyocardial biopsy, two cardiac transplant recipients developed symptoms of focal cerebral ischemia. Cerebrovascular injury has not been previously associated with endomyocardial biopsy. This procedure should be recognized as one of the causes of stroke following heart transplantation.
In vivo thrombus formation on a guidewire during intravascular ultrasound imaging: Evidence for inadequate heparinization
Authors: Grayburn Paul A. , Willard John E. , Brickner M. Elizabeth , Eichhorn Eric J. 
Published: March 2007

AbstractWe present a case in which thrombus formation on a guidewire was visualized during intravascular ultrasound imaging despite the administration of 10,000 units of heparin sulfate prior to the procedure. Gross thrombus formation was confirmed upon removal of the guidewire. The activated clotting time was found to be 191 s, suggesting heparin resistance. This report graphically illustrates the potential thrombogenicity associated with intravascular guidewire manipulation during procedures such as intravascular ultrasound imaging and percutaneous transluminal coronary angioplasty. Moreover, this case suggests that adequate heparinization should be routinely verified by measuring the activated clotting time prior to introducing a guidewire into the arterial system.
Cor triatriatum dexter: Recognition and percutaneous transluminal correction
Authors: Savas Vicky , Samyn Joseph , Schreiber Samyn Facc Theodore L. , Hauser Andrew , O'Neill William W. 
Published: March 2007

AbstractCor triatriatum dexter is a rare congenital anomaly in which an obstructive membrane is located in the right atrium. The detection usually occurs after the sequelae of systemic congestion, coagulopathy, and hepatic dysfunction have set in, leading up to a high surgical risk. A percutaneous balloon correction of cor triatriatum dexter in a patient with advanced right‐sided congestive symptoms and hepatic dysfunction is presented. This efficacious method is an alternative to surgical correction and could be extended to the more common cor triatriatum sinistra.
Long‐term patency of arterialized cephalic vein used as a conduit for coronary artery bypass grafting
Authors: Mehta Sameer , Levine Steven , Margolis James R. , Martin Jose C. , Krauthamer Dan , Traad Ernest 
Published: March 2007

AbstractWe present long‐term angiographic follow‐up of a patient with an arterialized segment of cephalic vein used as a conduit for aortocoronary bypass grafting.
Relationship between coronary blood flow and perfusion pressure during reactive hyperemia: A case report in an awake unanesthetized woman with normal coronary arteries
Authors: Houghton Jan Laws , Carr Albert A. , Frank Martin J. 
Published: March 2007

AbstractThe linear relationship between coronary blood flow and mean arterial pressure during reactive hyperemia is presented for the first time in an awake unanesthetized woman with normal coronary arteries during systemic hypotension induced by pharmacologic vasodilation. This case demonstrates the critical dependence of coronary flow reserve on simultaneous perfusion pressure.
Percutaneous mitral valvuloplasty following surgical repair of sinus venosus atrial septal defect
Authors: Gerber Richard , Sedlis Steven P. , Tunick Paul A. , Chinitz Larry , Altszuler Henry , Gindea Aaron 
Published: March 2007

AbstractMitral valvuloplasty performed 5 y after repair of a sinus venosus ASD was difficult because of a thickened septum, but resulted in improved mitral valve opening and did not lead to ASD. Thus, prior repair of a sinus venosus ASD may not be an absolute contraindication to mitral valvuloplasty.
Brachial rotational atherectomy
Authors: Rosenblum Joseph , Stertzer Simon H. , Schechtmann Norberto S. , Hidalgo Benito , Baciewicz Peter A. , Myler Richard K. 
Published: March 2007

AbstractThe brachial approach adds a new dimension to rotational atherectomy. The two cases presented included a large ectopic right coronary artery and a right internal mammary graft where both outcomes were successful. These cases demonstrate that the brachial approach can facilitate rotational atherectomy when greater guide support is necessary.
Thrombolysis by rotational thrombectomy followed by tissue plasminogen activator: Evaluation by angioscopy
Authors: Johnson Christopher C. , Dewhurst Timothy A. , Vracko Rudolph , Auth David C. , Ritchie James L. 
Published: March 2007

AbstractThrombus removal using percutaneous rotational thrombectomy (PRT), followed by tissue plasminogen activator (t‐PA), was studied by contrast angiography and fiberoptic angioscopy in a canine femoral artery model of thrombosis. After thrombus induction and following each treatment, comparisons were made between angioscopy and angiography for the detection of thrombus and subintimal dissection. Angioscopic images were scored in a blinded fashion for lining, protruding, or occlusive thrombus (class 1, 2, or 3) as well as estimated wall coverage by thrombus. Angiograms were studied for percent diameter stenosis and the presence of flaps.Following external forceps crush Injury of 18 arteries, two hour occlusion, and injection of thrombin, mean angiographic stenosis was 66%, thrombus coverage by angioscopy was 81%, and mean angioscopy class was 2.5. Following PRT, stenosis decreased to 27% (p < 0.008), thrombus coverage was reduced to 49% (p < 0.02), and angioscopy class dropped to 2.0 (p < 0.07). After t‐PA treatment, these values were further reduced to 25% (p = NS), 26% (p < 0.02), and 1.3 (p < 0.008), respectively. In comparison to angiography, subintimal dissection (seen as flaps) and thrombus (lining, protruding, or occlusive) were present significantly more often by angioscopy (p < 0.001).It is concluded that PRT results in significant thrombolysis, apparent by angiography and angioscopy. Follow‐up t‐PA can produce additional, incremental thrombolysis, apparent only by angioscopy. A beneficial role for t‐PA following mechanical thrombolysis is suggested by this model. The superior sensitivity of angioscopy for detection of flaps and thrombus Is underscored by this study.
New option for balloon recanalization of total coronary occlusions
Authors: Hüpp H. W. , Franzen O. , Deutsch H. J. , Kux A. , Hilger H. H. 
Published: March 2007

AbstractIn 9 out of 12 patients with a total coronary occlusion but definite signs of viable myocardium a new approach for the recanalization procedure was successfully employed: Following recanalization using an on‐the‐wire 2.0 or 2.5 mm angioplasty catheter, a standard coronary guidewire was placed along the angioplasty catheter. After withdrawal of the catheter, over‐the‐wire angioplasty with an appropriately sized balloon was performed for final dilatation. Pending further studies in a larger patient population, this new method may offer an alternative approach for revascularization of total coronary occlusions.
Morphologic change in coronary artery stenosis with the medtronic Wiktor™ stent: Initial results from the core laboratory for quantitative angiography
Authors: Serruys Patrick , De Jaegere Peter , Bertrand Michel , Kober Gisbert , Marquis Jean Francois , Piessens Jan , Uebis Rainer , Valeix Bernard , Wiegand Volker 
Published: March 2007

AbstractThe purpose of this study was to assess the early changes in stenosis geometry after implantation of the Medtronic Wiktor™ stent in human coronary arteries. Morphologic changes were evaluated by quantitative coronary angiography using automated edge detection. The hemodynamlc significance of the morphologic changes were assessed by the calculation of the theoretical pressure drop across the dilated and stented stenosis derived from the Poiseuile and turbulent resistances assuming a coronary blood flow of either 0.5, 1, or 3 ml/sec. Fifty patients were studied before and immediately after stent implantation. The stented coronary artery was the left anterior descending artery in 26 patients, the circumflex artery in eight patients, and the right coronary artery in 16 patients. Stent implantation resulted in an additional increase in the minimal lumlnal cross‐sectional area and minimal luminal diameter of the dilated vessel without changing the curvature of the stenosis. Furthermore, there was a significant reduction of the “plaque area.” This was associated with a normalization of the calculated resistances to flow and presure drop across the stenosis. To a minimal extent, recoil (0.1 ± 0.36 mm) was observed after stent implantation.
Bilateral coronary artery to left ventricular fistulas
Authors: Podolsky Leo , Ledley Gary S. , Goldstein Jacob , Kotler Morris N. , Yazdanfar Shahriar , Breall Jeffrey A. , Kim Ducksoo , Baim Donald S. , Skillman John J. , Grossman William 
Published: March 2007

AbstractCongenital coronary artery fistulas are important coronary artery anomalies. Bilateral coronary artery fistulas are very rare and coronary artery to left ventricular communications are even more infrequent. This report describes a patient with bilateral right and left coronary artery fistulas draining into a common channel and emptying into the left ventricular cavity.
Percutaneous transluminal coronary angioplasty through 4 french diagnostic catheters
Authors: Moles V. P. , Meier B. , Urban P. , De La Serna F. , Pande A. K. 
Published: March 2007

AbstractThe use of 4 French (4F) diagnostic catheters as guiding catheters for coronary angio‐plasty using fixed‐wire balloons in 2 patients with a stenosis of the right and left anterior descending coronary artery, respectively, is reported.