bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unsuspected vascular disease: A potential limitation to the use of the intra‐aortic balloon
Authors: Zeldis Steven M. , Wilkens Jaemes M. , Goodman Mark , Delaney Thomas 
Published: March 2007

AbstractSince vascular tortuosity or stenosis may preclude placement of the Intra‐aortic balloon, 63 consecutive patients (37 men) having routine Judkins' cardiac catheterization had an aortogram prior to withdrawal of the last catheter. No patient had a history of claudication, palpable aneurysms, pulse deficit, or bruit. No complications occurred.Significant peripheral vascular disease was found in ten patients: three had aortic, one had iliac, and six had femoral stenosis or tortuosity. All were men. The age of patients with peripheral vascular disease was 61.4 ± 7.7 years, while those without were 56.9 ± 9.3 years (P = NS). No difficulty was encountered entering the femoral artery in any patient; there was difficulty advancing the catheter in five of ten (50%) patients with peripheral vascular disease and in three of 54 (6%) patients without (P < 0.002). Fifteen patients without peripheral vascular disease had normal coronary arteries, while none with peripheral vascular disease was normal. In patients with coronary disease, the number of vessels involved was the same in both groups.Peripheral vascular disease that might preclude placement of the Intra‐aortic balloon occurs in 14% of patients undergoing cardiac catheterization and 18% of patients with coronary artery disease. Aortography may be safely performed and should be considered during routine cardiac catheterization in patients who may require Intra‐aortic balloon placement.
Significance of precordial ST‐segment depression in acute transmural inferior infarction: Coronary angiographic findings
Authors: Haraphongse Mant , Jugdutt Bodh I. , Rossall Richard E. 
Published: March 2007

AbstractCoronary arteriographic findings in patients with acute transmural inferior infarction were studied from 57 patients (51 men and 6 women). Their ages ranged from 28 to 72 years with a mean of 50 years. Twenty‐six patients (Group A) had minimal (less than 0.1 mV) or no precordial ST‐segment depression. Thirty‐one patients (Group B) had precordial ST‐segment depression of 0.1 mV or more. The two groups showed consistent differences in frequency of the left anterior descending artery (LAD) stenosis, multivessel disease, mean peak plasma creatinine phosphokinase (CPK, IU/L), and mean ejection fraction. For Group A vs B, these differences were: LAD stenosis, 31% vs 68%, multivessel disease, 35% vs 81%, mean peak plasma CPK, 1283 versus 1904, and mean ejection fraction, 60.5% vs 45.3%. The incidence of abnormal anterolateral and posterobasal wall motion in Group B was more (p < 0.01 and p < 0.05 respectively) than in Group A. All patients in Group B who had precordial ST‐segment depression of 0.3 mV or greater, had LAD stenosis. There was no relation between the duration of ST‐segment depression and the presence of LAD stenosis. Also, there was no correlation between the presence of collateral circulation and the development of ST‐segment depression. The Group B patients tended to have more complications in the acute phase and in the follow up period (p < 0.05) than did those in Group A.It is concluded that precordial ST‐segment depression in acute inferior wall infarction is probably related to anterior injury due to LAD stenosis and these patients were shown to have more severe coronary artery disease, more depression of their ejection fractions, and more myocardial damage than patients without this finding.The earliest recorded ECG is most valuable in identifying the high risk patients. The presence of LAD stenosis in patients with inferior wall infarction who have precordial ST‐segment depression of 0.3 mV or more are likely.
Exercise radionuclide ventriculography in evaluating successful transluminal coronary angioplasty
Authors: DePuey E. Gordon , Boskovic Dejan , Krajcer Zvonimir , Leatherman Louis , Angelini Paolo , Sonnemaker Robert E. , Burdine John A. , Springer Arthur 
Published: March 2007

AbstractTo evaluate the ability of transluminal coronary angioplasty (TCA) to relieve myocardial ischemia, 44 patients with single vessel disease underwent exercise gated radionuclide ventriculography (GRNV) before and 2.8 ± 1.3 days following angiographically successful TCA. Pre‐TCA GRNV was abnormal in 11 of 14 patients with right coronary artery (RCA) stenosis and 24 of 30 with left anterior descending (LAD) stenosis. Following TCA there was an increase in exercise duration from 500 ± 288 sec to 625 ± 273 sec (P < 0.001), and in maximum double product from (209 ± 69) × 102 to (263 ± 70) × 102 (P < 0.001). The number of patients with stress‐induced ST‐T abnormalities decreased from 13 to 4 (P < 0.05), and the number with chest pain during exercise decreased from 18 to one (P < 0.001). Whereas resting ejection fraction was unchanged (0.58 ± 0.10 vs 0.59 ± 0.11) following TCA, the ejection fraction at peak exercise increased from 0.61 ± 0.13 to 0.66 ± 0.12 (P < 0.001). Of 24 patients with resting abnormalities, regional wall motion improved in 13. In 22 of 31 patients with stress‐induced asynergy, the wall motion response to exercise improved (P < 0.001). Of 19 patients restudied angiographically and with exercise GRNV at 6–12 months, restenosis of ≥ 50% had occurred in six, four of whom had abnormal studies. In six in whom the degree of stenosis of the dilated artery had remained ≥20% the exercise GRNV study remained normal. It is concluded that GRNV is helpful in documenting the improvement in resting left ventricular function and functional reserve in patients with angiographically successful TCA. In the limited number of patients with late follow‐up studies, data suggest that GRNV may be a valuable test to detect restenosis.
Aneurysm of the interatrial septum occurring as an isolated anomaly
Authors: Lazar Anthony V. , Pechacek Leonard W. , Mihalick Michael J. , Decastro Carlos M. , Hall Robert J. 
Published: March 2007

AbstractWe report a case of aneurysm of the atrial septum occurring as an isolated abnormality in a patient with atypical chest pain. Apical two‐dimensional echocardiography demonstrated phasic bulging of the fossa ovalis region of the atrial septum into the right atrium. Biplane cineangiography confirmed the presence of a large septal aneurysm in an otherwise normal heart. The incidence, pathogenesis, and complications of this unusual anomaly are briefly discussed.
Fracture of a polyurethane cardiac catheter in the aortic arch: A complication related to polymer aging
Authors: Schneider Ricky M. , Fornes Raymond E. , Stuckey William C. , Gilbert Richard D. , Peter Robert H. 
Published: March 2007

AbstractAn undated Cordis Ducor polyurethane coronary catheter fractured and separated in the aortic arch during a cardiac catheterization, and was removed with an intravascular retriever. The recovered specimen appeared brittle, prompting an investigation of the effects of aging on the tensile strength of 91 polyurethane catheters manufactured by Cordis and the United States Catheter and Instrument Company (USCI). Cordis catheters have stable tensile strength for five years from manufacture, but then deteriorate substantially by seven years, particularly at the bond between the catheter tip and the stainless steel‐reinforced catheter body. The deterioration is associated with the microscopic appearance of deep cracks in the catheter lumen wall. USCI catheters showed a modest but significant loss of tensile strength by three years after manufacture at the catheter bond. It would seem prudent to place a three‐year expiration date on USCI polyurethane catheters, similar to those already on Cordis catheters.
A catheterization technique for reproduction of a human atherosclerotic lumen within the dog coronary artery in vivo
Authors: Spears J. Richard , Crawford Donald W. , Serur Juan , Grossman William , Paulin Sven 
Published: March 2007

AbstractReproduction of a human atherosclerotic lumen within the arterial lumen of an intact animal would facilitate angiographic and hemodynamic studies of stenoses. Accordingly, a male silicone rubber cast of a human atherosclerotic lumen was obtained from a cadaver artery, and a thin‐walled replicate arterial phantom was constructed from the cast by use of a rapidly polymerizing liquid plastic. The casting properties of both materials were such that the topography of the arterial lumen was duplicated precisely in the phantom with 20 x microscopic detail preserved. The phantom was coated with a banzalkonium‐heparin solution and introduced over a guidewire into an epicardial segment of a coronary lumen of the dog. Similarly, a larger phantom was placed within the dog femoral artery either directly via an arteriotomy or indirectly via a catheterization technique. Since the plastic material used to make a phantom had the same radiographic density of tissue, the angiographic appearance of an intra‐arterial phantom was that of a human stenosis.
Overestimation of mitral valve gradients obtained by phasic pulmonary capillary wedge pressure
Authors: Hosenpud Jeffrey D. , McAnulty John H. , Morton Mark J. 
Published: March 2007

AbstractWe investigated the relationship between left atrial (LA) and pulmonary capillary wedge pressure (PCW) in order to define the clinical settings in which PCW may be used to approximate LA pressure and to determine the cause and significance of difference between LA and PCW pressures. Nineteen patients who at cardiac catheterization had LA, PCW, and left ventricular (LV) pressures recorded, had mitral valve gradients and areas determined. Mean PCW and LA pressures correlated well (r = 0.94). Phasic PCW consistently overestimated the MV gradient and underestimated the MV area compared to LA pressure, (8 ± 4 versus 4 ± 3 mm Hg, p < 0.001, 1.3 ± 0.3 versus 1.6 ± 0.3 cm2, p < 0.005, respectively). Three patients had abnormal MV prosthesis function assessed by PCW pressure but not by LA pressure. Diastolic MV gradients between PCW and LV were caused or increased by a slowed y descent in the PCW tracing. Using the PCW pressure may falsely elevate MV gradients and falsely reduce MV areas and lead to incorrect clinical action.
Coronary artery obstruction due to blunt chest trauma with residual angina pectoris
Authors: Loss David M. , Macmillan Robert M. , Maranhao Vladir 
Published: March 2007

AbstractA 41‐year‐old man developed persistent angina pectoris following blunt trauma to his chest. Three months after the injury coronary angiography demonstrated 80% obstruction of the mid‐left anterior descending coronary artery. There was no evidence of atherosclerosis in the remaining coronary arteries. Therefore the assumption is made that blunt trauma can induce incomplete coronary occlusion resulting in classic angina pectoris in apparently otherwise normal coronary arteries. The suggested mechanism of injury to the coronary vessel is either intimal tear and/or subintimal hemorrhage with incomplete luminal thrombosis.
An improved method for transseptal left ventricular catheterization
Authors: Kawachi Kanji , Kitamura Soichiro , Oyama Choken , Koh Shigeo , Morita Ryuichi , Kawashima Yasunaru 
Published: March 2007

AbstractIt is difficult to perform a retrograde left ventricular catheterization in patients having an aortic valve replacement. An improvement of the conventional transseptal catheterization (Brockenbrough method) led to a better success rate of catheterization. The fulcrum of the improved catheter was located 7 cm from the tip. Its curvature was approximately 270°. Its tip was bent inward to form a pig‐tail shape to prevent myocardial injury. This catheterization was performed 33 times in 32 patients. A 97% success rate was achieved.An exercise loading test was performed with a bicycle ergometer while this catheter was maintained in the left ventricle of a patient placed in a supine position. The catheter was well retained in the left ventricle and produced a minimal number of arrhythmias during exercise. The modification of this catheter has proved to be a better method of left ventricular catheterization in patients with an aortic valve replacement.
A method of maintaining thermal homeostasis during cardiac catheterization in newborns
Authors: Giroud Jorge , Pickoff Arthur S. , Garcia Otto L. , Wolff Grace S. , Tamer Dolores 
Published: March 2007

AbstractThis device has been designed to maintain thermal homeostasis in newborns undergoing cardiac catheterization. It is easily constructed from materials available in any hospital, and it is safe and effective. It consists of a warming coil and a delivery unit made from Plexiglas which encloses the patient. In addition to maintaining a neutral thermal environment, it allows for the selection of any desired oxygen concentration by simply blending the gas mixture before warming and delivery. Since using this device we have had no problems or complications related to thermal stress during catheterization of the neonate.
Cardiac complications in vascular procedures: Comparison of percutaneous angioplasty and surgery
Authors: Mohr Rephael , Smolinsky Aram , Morag Benyamina , Bass Arie , Rubinstein Zalman J. , Adar Raphael 
Published: March 2007

AbstractPercutaneous transluminal angioplasty (PTA) is currently recommended to high risk cardiac patients as a relatively safer procedure compared to reconstructive peripheral vascular surgery (RPVS). In order to evaluate this approach we studied the incidence of cardiac complications in 86 consecutive patients undergoing peripheral vascular procedures. 45 patients (Group I) underwent RPVS and 41 (Group II) PTA. The two groups were comparable regarding age, sex, the location of vascular lesions, the incidence of previous MI (Group I—40%, Group II—46%), and the incidence of angina pectoris (I—25%, II—29%). No special treatment or monitoring was used for patients with ischemic heart disease (IHD) in the PTA group. Successful revascularization was achieved in 36 (80%) of the surgical patients and 25 (61%) of the patients who underwent PTA. There were two anginal attacks, two MIs, and one cardiac death in group I compared to six anginas, three MIs, and one death in Group II. These differences are not statistically significant. It is concluded that PTA carries a definite risk of cardiac complications in patients with known IHD.
An accurate and simplified method to calculate angiographic left ventricular ejection fraction
Authors: Tortoledo Francisco A. , Fernandez Genaro C. , Quinones Miguel A. 
Published: March 2007

AbstractAn accurate and simplified method to calculate left ventricular (LV) ejection fraction (EF) derived from the ellipsoidal formula for LV volume calculation is described. The LV minor axis (D) is obtained from the average of three equidistant LV diameters at end‐diastole (Ded) and end‐systole (Des), and the shortening fraction of D2 (%δD2) calculated as (D2ed – D2es)/D2ed. EF is calculated as EF = [ δD2 + ([1 – δD2] × δL)] × 100, where δL = the shortening fraction of the long axis. The coefficient of correlation between the EF by this method and the EF derived from measurements of LV volumes with the area‐length method was 0.98, SEE = 3.57% (n = 50). No significant over‐ or underestimation was observed according to the regression equation Y = 0.922x + 0.82. Thus, this simplified method allows accurate LVEF calculation without the need for planimetry of LV area.
Comparison of the effects of nitroprusside and nitroglycerin on coronary size
Authors: Feldman Robert L. , Day R. Michael , Hill James A. , Conti C. Richard , Pepine Carl J. 
Published: March 2007

AbstractNitroglycerin and nitroprusside are known to differ in their relative degree of systemic arterial and venous dilation. Nitroglycerin has been shown to be a potent large‐vessel coronary dilator, but the effects of nitroprusside on coronary artery size are unclear. Accordingly, we studied coronary artery angiographic responses to both nitroprusside and nitroglycerin in 12 patients. Diameters of left coronary artery segments were measured by quantitative angiography before and during an intravenous infusion of nitroprusside and after sublingual nitroglycerin when both drugs were administered in doses adjusted to achieve similar reductions in aortic pressure.Dilation of the left coronary artery was observed after nitroprusside and after nitroglycerin. Degrees of dilation were similar in the various left coronary artery segments after either nitroprusside or nitroglycerin. In general, segments located more proximally dilated less than those located more distally after either agent.We conclude that both nitroprusside and nitroglycerin are potent dilators of large epicardial and of smaller intramuscular coronary artery segments. The magnitude of dilation of all measured left coronary artery segments appeared remarkably similar with nitroprusside and nitroglycerin given in doses that produced a similar reduction in aortic pressure.
Diurnal changes and reproducibility of corrected sinus node recovery time
Authors: Thormann Jochen , Schlepper Martin , Kramer Wilfried 
Published: March 2007

AbstractCorrected sinus node recovery time (CSRT) has been found unreliable in identifying all cases of sick sinus syndrome. Since other factors than sinus node dysfunction might add to the pathologic significance of the CSRT, we assessed it in 15 patients (nine group I patients with “prolonged” CSRT max = 3,196 + 2,740 msec and six group II patients with “short” CSRT max = 367 + 79 msec) at 0800, 1100, 1400, 1700, 2000, and 2300 hours with atrial overdrive stimulation rates (AST) of 90, 110, 140, 170, and 200 bpm on three consective days using a loop‐mounted stable atrial electrode. Only with AST ≧ 140 beats per minute (bpm) did all CSRTI values prove prolonged (≧ 560 msec). CSRTI values at corresponding time intervals were reproducible with AST ≧ 140 bpm (day 1 vs 2 vs 3, P > .05), but not at AST 90 bpm and 110 bpm (P < .05); CSRTII results, however, varied from day to day (< .05) due to less scatter of single results. CSRTI results increased progressively with AST 90, 110, and 140 bpm from 301 + 256 msec by 60% for each pacing rate up to 785 + 848 msec. With AST ≧ 140 bpm, the pattern of CSRT changes was inconsistent; this was also reflected by the distribution of the mean maxima of CSRTI: For 0800 hours at AST 140 bpm = 822 + 937 msec; for 1100 hours at AST 200 bpm = 824 + 1446 msec; for 1400 hours at AST 140 bpm = 780 + 814 msec; for 1700 hours at AST 170 bpm = 1,099 + 1,008 msec; for 2000 hours at AST 200 bpm = 1,156 + 1,280 msec; and for 2300 hours at AST 170 bpm = 1,021 + 1,102 msec.We conclude therefore that the optimal diagnostic yield for sick sinus syndrome testing is influenced by the time of the day and the AST used for CSRT testing.
Resting and exercise hemodynamics in constrictive pericarditis and a case of cardiac amyloidosis mimicking constriction
Authors: Robbins Mitchell A. , Pizzarello Roy A. , Stechel Richard P. , Chiaramida Salvatore A. , Gulotta Stephen J. 
Published: March 2007

AbstractThe resting and exercise hemodynamics in seven patients with pericardial constriction and in one patient with cardiac amyloidosis are described. Equalization of left and right heart diastolic filling pressures was observed in all cases, both at rest and during exercise. This hemodynamic response, although typical, should not be considered pathognomonic of pericardial constriction.
Early segmental thinning of the left ventricular wall following regional ischemia
Authors: Sabbah Hani N. , Stein Paul D. 
Published: March 2007

AbstractTo explore possible mechanisms of left ventricular early segmental relaxation, complete occlusion of the left anterior descending coronary artery (LAD) was produced in seven open‐chest dogs and partial occlusion of the LAD was produced in six openchest anesthetized dogs. Regional wall thickness was measured both in an ischemic and a normally perfused zone using implanted ultrasonic crystals. Two to three seconds following complete LAD occlusion, thinning of the ischemic wall occurred prematurely during isovolumic relaxation. The extent of premature thinning became more prominent 5 to 10 sec following LAD occlusion. Early thinning of the ischemic wall preceded thinning of the normally perfused wall by 110 ± 10 msec. Partial occlusion of the LAD produced a 33 ± 6% reduction of coronary flow and a 23 ± 4% reduction of systolic wall thickening in the ischemic region. Systolic thickening of the nonischemic wall was unchanged relative to the preocclusion period. Premature early thinning of the mildly ischemic wall preceded thinning of the normally perfused segment by 90 ± 8 msec. The observation that ischemia can produce segmental early thinning of the ventricular wall may have implications in understanding the mechanism of the angiographic observation of the segmental early relaxation phenomena in patients with coronary artery disease.
Rapid visualization of the right coronary artery with an anterior–inferior ostium
Authors: Loss David M. , Maranhao Vladir , Goldberg Harry 
Published: March 2007

AbstractWe describe an approach for rapid visualization of the right coronary artery (RCA) with an anterior‐inferior ostium. The success rate of this method has been 100% without any complications. It decreases patient discomfort, reduces radiation exposure, and increases safety by decreasing procedure time.
Echocardiographic definition of right pulmonary venous connection at catheterization
Authors: Harris J. Peter , Nanda Navin , Stewart Scott , Alexson Chloe G. , Manning James A. 
Published: March 2007

AbstractTraditional methods of identifying partial anomalous pulmonary venous connection to the right atrium in the presence of an atrial defect are not always reliable. Twenty patients were studied with a new technique in which the catheter is introduced into the right superior pulmonary vein followed by echocardiographic assessment of the catheter position in relation to the left atrium and atrial septum. The insertion site of the right pulmonary veins was detected in every patient and in ten patients has been verified at operation. This approach can be performed rapidly and appears to be accurate as well as reliable.
Validity of contrast hyperemia for clinical assessment of coronary flow reserve: The optimal dose of contrast medium and reproducibility of the technique
Authors: Mishima Masayoshi , Inoue Michitoshi , Hori Masatsugu , Tsujioka Katsuhiko , Kuzuya Tsunehiko , Kodama Kazuhisa , Nanto Shinsuke , Abe Hiroshi 
Published: March 2007

AbstractThe dose‐response relation of contrast medium‐induced hyperemic response in coronary blood flow (contrast hyperemia) was investigated to determine the optimal dose of contrast medium (CM, Urografin‐76®) for the assessment of coronary flow reserve in man. The great cardiac venous flow (GCVF) was determined with the continuous thermodilution method during the contrast hyperemia induced by the intracoronary injection of CM of three different doses, ie, 2, 4, and 6 ml/60 kg of body weight, into left coronary artery.Submaximal coronary vasodilation could be obtained by intracoronary injection of 4 ml of CM with minimal changes in systemic hemodynamics. The contrast hyperemia with this dose of CM was reproducible and also closely correlated with that obtained during pacing‐induced angina. Thus, we conclude that the contrast hyperemic technique with intracoronary injection of 4 ml of Urografin‐76® could be a reliable method to assess the coronary flow reserve.