bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterization of left ventricular chamber distortion: Alterations in cavity shape and orientation in mitral stenosis
Authors: Gault James H. , Gentzlerm Richard D. , Cooper Matthew M. , Reed J. C. 
Published: March 2007

AbstractDistortion of the left ventricular (LV) chamber silhouette was identified in 28 patients with mitral stenosis (MS) by disparity between normally identical chamber volumes calculated independently from the frontal(AP) and lateral (LAT) views of biplane cineangiograms( AP end diastolic volume 157.8 ± 10.0 ml, LAT end diastolic volume 115.6 + 7.2 ml, p <.001). Similar systematic disparity was observed in estimates of end systolic volume in these views. While no directional difference in ejection fraction was found, identical (± 10%) AP and LAT measurements were obtained in only 36% of patients, indicating poor reproducibility of the estimate of LV function between single radiographic views.A technique was also devised for determining the spatial orientation of the LV long axis (mid mitral valve to apex) from biplane cineangiograms; this axis was shown to intercept the frontal plane at an angle of 50.9 ± 2.4° in 12 subjects with normal LV anatomy and 36.1 ± 4.5° in seven patients with MS, indicating that the long axis was rotated posteriorly toward alignment with the frontal plane in the latter group. The presence and magnitude of LV chamber distortion was clearly related to the degree of angiographically estimated right ventricular dilatation. Implications of these observations, particularly with reference to the estimation of single plane LV volume characteristics in patients with MS, are discussed.
Torsades de pointes immediately following right coronary arteriography
Authors: Goldfinger Tedd M. , Hoekenga David E. 
Published: March 2007

AbstractSelective coronary angiography with ionic contrast agents produces delayed myocardial repolarization with prolongation of the QTc interval on EKG. Torsade de Pointes, an unusual polymorphic ventricular tachycardia, has been causally linked to delayed myocardial repolarization. We present a case of Torsade de Pointes resulting from selective right coronary arteriography.
A new catheter design for use in patients with critical aortic stenosis
Authors: Agarwal Jai B. , Klein Lloyd W. 
Published: March 2007

AbstractA new catheter that facilitates catheterization in patients with severe aortic stenosis is described. The catheter design is capable of high‐pressure injections for left ventriculography, but it maintains maneuverability and has an end hole for use with a guide wire in traversing tightly stenotic valves. Experience with this catheter in 23 patients confirmed that good‐quality ventriculograms are obtained after left ventricular entry. Twenty‐two of 23 patients with aortic stenosis were studied entirely with this catheter; in only one case were attempts to cross the valve unsuccessful, both with this and other catheters. In conclusion, this new catheter is recommended for routine use in patients with suspected severe aortic stenosis.
Changing trends of congenital heart disease in adults: A catheterization laboratory perspective
Authors: Flanagan Michael F. , Leatherman George F. , Carls Alexa , Keane John F. , Selwyn Andrew P. , Lock James E. 
Published: March 2007

AbstractAdvances in cardiac surgery now enable many children with congenital heart disease (CHD) to survive to adulthood. The influence of such advances on the frequency of various lesions among adult patients undergoing cardiac Catheterization (CC) has not previously been addressed. This retrospective analysis of 329 adults with CHD undergoing CC at an adult and at a pediatric referral center demonstrates that when compared to 20 years ago, adults with CHD who now undergo CC are more likely to have complex cardiac disease, and more have had prior surgery. In addition, despite more aggressive surgical management, ventricular dysfunction and dysrhythmias are now commonly encountered residua of CHD in adults who require diagnostic CC. Premature coronary artery disease appears uncommon. These changing characteristics of adults with CHD require consideration in the planning of future health care for these patients.
Paucity of subtle myocardial injury after angioplasty delineated with MB CK
Authors: Spadaro James J. , Ludbrook Philip A. , Tiefenbrunn Alan J. , Kurnik Peter B. , Jaffe Allan S. 
Published: March 2007

AbstractTo determine the extent to which PTCA elicits subtle myocardial ischemic injury, 28 patients were studied prospectively. The presence of myocardial injury was assessed by analysis of frequent (q4 hours) serial samples of MB CK, a sensitive and specific marker of myocardial injury. Immediately prior to angioplasty, baseline 12‐lead ECGs and blood samples for evaluation of total CK and MB CK were obtained. Additional ECGs were obtained immediately after the procedure and on the following morning, and serial samples for total and MB CK were obtained at 4‐hour intervals for 24 hours. Patients requiring cardiac surgury within 24 hours after PTCA were excluded. Samples (n = 203) were assayed by the glass bead method. Total CK rose by more than 20 IU/L in only five patients, four of whom had received intramuscular premedication. Mean MB CK was 3.4 77± 6.1 IU/L at 12 hours and 4.1 ± 4.7 IU/L at 24 hours compared to 3.1 ± 1.7 IU/L prior to angioplasty. Only one patient with obvious infarction had a value for MB CK above the normal range. Thus, uncomplicated PTCA is not accompanied by objectively detectable subtle myocardial injury.
Vertical left ventricular angulation assessed by thallium 201 myocardial perfusion imaging in patients with mitral valve prolapse
Authors: Arora Rohit R. , Horowitz Steven F. , Machac Josef , Goldman Martin E. 
Published: March 2007

AbstractMitral valve prolapse has been associated with septal to aortic root angle abnormalities determined by echocardiography. Thallium 201 imaging in the anterior view permits visualization of the left ventricular long axis. In the present study, the vertical angle was defined as the angle formed by the long axis of the left ventricle and a horizontal line. The vertical angle was determined in 25 patients who had 201 TL stress testing and M‐mode echocardiography. Group I (11 patients) had mitral valve prolapse and group II (14 patients) did not have mitral valve prolapse. The vertical angle and ultrasound were read blinded to each other. Height, weight, and body surface area were compared for the two groups, and receiver operator curve analysis performed.Vertical angle measured by TL 201 was significantly more vertical in patients with mitral valve prolapse. Receiver operator curve analysis showed that an angle of >30° successfully identified 9/11 patients with mitral valve prolapse, with a sensitivity of 82% and a specificity of 79%. There were no significant differences in height, weight, or body surface area between the two groups. Thus, patients with mitral valve prolapse have more vertically positioned hearts than patients without mitral valve prolapse, independent of body habitus. The different appearance of a vertically oriented heart may contribute to false‐positive readings of TL 201 images.
Left main coronary artery dissection during percutaneous transluminal coronary angioplasty
Authors: Slack John D. , Pinkerton Cass A. , Vantassel James W. , Orr Charles M. 
Published: March 2007

AbstractAcute dissection of the left main coronary artery during diagnostic cardiac catheterization with selective coronary arteriography is an uncommon but recognized complication of the procedure. That similar dissection may occur during percutaneous transluminal coronary angioplasty is less well recognized. This report describes two cases of left main coronary dissection resulting in acute occlusion that occurred during percutaneous transluminal coronary angioplasty and demonstrates that survival with essentially complete functional recovery may result if immediate surgical intervention is undertaken. Recognition and treatment of this potentially catastrophic complication of angioplasty is described.
Trefoil balloon for percutaneous valvuloplasty
Authors: Meier Bernhard , Friedli Beat , Oberhaensli Ingrid , Belenger Jacques , Finci Leo 
Published: March 2007

AbstractA new balloon (Trefoil balloon) was developed to avoid complete interruption of blood flow during percutaneous balloon valvuloplasty. It consists of three identical 2‐ to 4‐cm‐long angioplasty balloons mounted in a parallel fashion on a single catheter. Filled simultaneously, they assume the cross section of a rosette, allowing for continued blood flow. Trefoil balloons of various sizes were tested in five dogs (aorta and aortic valve). They created a gradient ranging from 5 to 40 mmHg where conventional, single balloons of comparable size were completely obstructive. In three consecutive patients with congenital pulmonary stenosis, Trefoil balloons were used successfully and without significant complications. Continued transvalvular blood flow during the actual dilatation process was documented in all cases. The Trefoil balloon is a promising new device for percutaneous valvuloplasty and, perhaps, coronary angioplasty.
Salvage coronary angioplasty for symptoms refractory to medical therapy
Authors: Feldman Robert L. , Macdonald Robert G. , Hill James A. , Carmichael Michael J. 
Published: March 2007

AbstractCoronary angioplasty was used without surgical back‐up in eight patients with angina refractory to medical therapy. After careful evaluation, none of these patients was felt to be a candidate for elective or emergent bypass surgery. Angloplasty provided a reasonable means of coronary revascularization. In each patient, extenuating clinical circumstances and reduced left ventricular function led to this approach. Angioplasty was angiographically and clinically successful in each patient.
Risk of preangioplasty occlusion and myocardial infarction in one‐vesseldisease patients scheduled for percutaneous transluminal coronary angioplasty
Authors: Robert Jacques , Bourassa Martial G. , Moise Alain , Kouz Simon , Crepeau Jacques , Bonan Raoul , Chaitman Bernard R. , David Paul Robert , Salamon Roger 
Published: March 2007

AbstractCoronary occlusion or myocardial infarction occurred in 50 of 394 (13%) one‐vesseldisease patients awaiting percutaneous transluminal coronary angioplasty (PTCA). To identify risk factors for these events, we first matched the 37 patients whdemonstrated occlusion on the immediate preangioplasty repeat angiogram with 37 patients who did not. Matching was based on the time interval between angiograms, the date of the procedure, and the site of the lesion. Preangioplasty occlusion patients did differ from controls by age (47 ± 11 vs 54 ± 8 years, P< <.01), smoking status (34/37 vs 24/37, P <.01), and angina class (2.6 ± 1.0 vs 2.3 ± 0.7, P < .10) at the time of the first angiogram. Second, we pooled the data of the 37 preangioplasty occlusion patients with those of the 13 patients with preangioplasty myocardial infarction. The 50 cases with complication (coronary occlusion or myocardial infarction) were younger (47 ± 12 vs 54 ± 8 years, P < .01), more often smokers (42/50 vs 24/37, P <.05), and more symptomatic (2.7 ± 0.8 vs 2.3 ± 0.7, P <.05) than the 37 controls. This study suggests that young smokers with severe angina are at high risk of preangioplasty occlusion and/or myocardial infarction; prompt management of these patients, when considered for PTCA, seems advisable.
Papavine: The ideal coronary vasodilator for investigating coronary flow reserve? A study of timing, magnitude, reproducibility, and safety of the coronary hyperemic response after intracoronary papaverine
Authors: Zijlstra F. , Serruys P. W. , Hugenholtz P. G. 
Published: March 2007

AbstractA potent, short‐acting vasodilator that induces a maximal hyperemic response of the coronary vascular bed is needed to determine coronary flow reserve. In 12 patients, we measured coronary sinus blood flow by thermodilution over a period of 2 min during which a bolus of 10 mg papaverine was given into the left main coronary artery. This was repeated after 5 min to assess the reproducibility of the changes. The maximal hyperemic response lasted from 24 until 37 sec after papaverine administration. There was no significant difference between the two consecutive hyperemic responses (Student's t‐test for paired observations). The mean difference between first and second hyperemic responses at 30 sec was 7.0% (SD ± 6.2%).In conclusion, 10 mg of intracoronary papaverine is a short‐lasting and reproducible means of inducing a maximal hyperemic response in the coronary vascular bed and therefore appears to be the ideal agent for investigating coronary flow reserve.
Guidewire snap causing left main coronary occlusion during coronary angioplasty
Authors: Keltai Mátyás , Bartek Iván , Biró Veronika 
Published: March 2007

AbstractThe case of a 34‐year‐old female patient is presented. During attempted left anterior descending coronary angioplasty, the exchange guidewire (0.018 inch, 300 cm) snapped and the distal 20 cm of the wire caused immediate thrombotic occlusion of both the left anterior descending and circumflex arteries. The resulting complication was treated by emergency bypass surgery.
Anomalous origin of the right coronary artery from the left sinus of valsalva: A case report
Authors: Kucera Richard F. , Bowden William D. , Thomas Harry M. , Blue Peter W. 
Published: March 2007

AbstractThe rare anomalous origin of the right coronary artery from the left sinus of Valsalva has recently been shown to be associated with myocardial ischemia and sudden death. A patient is presented with overwhelming evidence of myocardial ischemia corrected by a single‐vessel bypass of the right coronary artery.
Clinical evaluation of soft‐tipped catheters for coronary angiography
Authors: Finci Leo , Meier Bernhard , Steffenino Giuseppe , Rutishauser Wilhelm 
Published: March 2007

AbstractNew soft‐tipped Judkins catheters for coronary angiography were compared with conventional femoral catheters for coronary angiography in a randomized, controlled fashion with cross‐over exchange of catheters when problems occurred. The problems encountered with a first generation of soft‐tipped catheters (n = 113) versus conventional catheters (n = 103) were as follows: difficult introduction 27% versus 1% (p < 0.01), difficult placement 13% versus 8% (not significant), difficult aspiration 4% versus 0% (p < 0.05), wedging 5% versus 0% (p <0.05), spasm 3% versus 0% (not significant), overselectivity 7% versus 2% (not significant), cross‐over necessary and successful 18% versus 1% (p < 0.01). Problems with a second generation of soft‐tipped catheters (n = 200), modified according to the experience gathered from the first generation, versus conventional catheters (n = 194) were as follows: difficult placement 10% versus 7%, difficult aspiration 2% versus 0.5%, wedging 2% versus 1%, spasm 1% versus 0%, overselectivity 3% versus 2%, ventricular fibrillation 1.5% versus 0%, cross‐over necessary and successful 3% versus 2%. None of the differences attained statistical significance. The performance of soft‐tipped catheters for coronary angiography was inferior for the first generation but comparable for the second generation to that of conventional catheters. In terms of safety, soft‐tipped catheters were not superior on the basis of our criteria.
Hemodynamic correlates of arterial compliance
Authors: Ferguson James J. , Randall Otelio S 
Published: March 2007

AbstractThere is at present no good understanding of the exact clinical correlates of arterial compliance. The purpose of this study was to establish which hemodynamic variables are most strongly associated with compliance. Hemodynamic measurements were performed on 41 patients undergoing diagnostic cardiac catheterization. Cardiac outputs were determined by thermodilution, and pressures were measured in the ascending aorta with a catheter‐tip manometer. Compliance was calculated from a mono‐exponential fit of diastolic decay pressures. Pulse pressure(PP), stroke volume(SV), age, systolic blood pressure(SBP), and cardiac output(CO) were significantly related to compliance. The quotient SV/PP was a good estimate of compliance, as was a first‐order function of both SV and PP. There appear to be specific clinical correlates of arterial compliance, as well as ways to estimate arterial compliance on the basis of conventional hemodynamic measurements when direct calculations are not possible.
“Isolength” postextrasystolic potentiation as a predictor of functional restoration following surgical revascularization for myocardial ischemia
Authors: Stanton Michael W , Cooper M. Wayne , Voda Jan , Lust Robert , Lutherer L. O. , Feola Mario 
Published: March 2007

AbstractA previously developed method of programmed postextrasystolic potentiation (PESP) was assessed in eight patients with medically refractory unstable angina, as a predictor of functional restoration resulting from surgical revascularization. Prior to coronary arteriography, left ventricular segmental wall motion was determined during ventricular pacing and the first postextrasystolic beat following an extrasystole. The postextrasystole was induced at an interval calculated to occur at a time where ventricular preioad was identical to the regular paced beat (isolength interval). The left ventricular wall was divided into six segments, each subscribing one area of the ventriculogram, and correction for rotation during systole was made. Of 48 segments, 21 were considered “jeopardized,” due to greater than 70% reduction in cross‐sectional lumen of the serving coronary arteries. Fifteen of these 21 responded to PESP, increasing their segmental area ejection fraction from 44 ± 5 (paced “normal” beat) to 56 ± 6 (postextrasystolic beat) (p < 0.05). Following surgical revascularization, these segments showed an improvement in their baseline area ejection fraction from 44 ± 6 to 58 ± 5 (p < 0.05). Six jeopardized segments that failed to respond to PESP prior to revascularization showed functional deterioration after revascularization. The 27 nonjeopardized segments (which were not revascularized) also showed functional improvement, suggesting improved collateral flow. This study demonstrates that isolength postextrasystolic potentiation obtained with a standardized pacing protocol may be used to predict the potential for improvement in cardiac function following surgical revascularization. Our results also show that lack of PESP predicts loss of left ventricular myocardial function following revascularization.
Coronary artery variation in a native Iraqi population
Authors: Kurjia Huda Z , Chaudhry M. Siddique , Olson Todd R 
Published: March 2007

AbstractThe variation and distribution of the coronary arteries were studied in 119 hearts of individuals, 4 fetal months to 40 years old, who died from noncardiovascular causes. All individuals included in this study were natives of the Mosul area of northern Iraq. The coronary arteries were examined by injection‐corrosion and unaided dissection. Almost all (90%) of the anomalies observed were in the right coronary artery. Nine hearts (8% of total sample) possessed ectopic ostia in the right coronary sinus for the right coronary and conus arteries. The occurrence of a separate conus artery appears to be anomalous rather than ubiquitous as widely reported in the literature. One specimen had separate origins for the left circumflex and anterior descending arteries from the left coronary sinus. The patterns of coronary artery distribution were classified as left (14%) and right (46%) preponderant, and balanced (40%), following Schlesinger [Schlesinger, Arch Pathol 30:403–415, 1940]. The present study adds to the growing body of data on intrapopulation frequencies of coronary artery variants among non‐Europeans and supports the contention that postpartum development may modify the pattern of coronary divergence from the aorta. As the number of non‐Caucasian patients undergoing surgical treatment for ischemic or valvular heart disease increases, additional comparative data on racial, sexual, and ontogenetic variation of the coronary arteries and their aortic ostia are required to improve the care of these patients.
Alterations in myocardial metabolism and function at rest in stable angina pectoris: Relations with the amount of exercise‐induced thallium‐201 perfusion defect
Authors: De Kock Martine , Melin Jacques A 
Published: March 2007

AbstractThe relation between the amount of exercise‐induced ischemia and alterations in left ventricular (LV) function and metabolism at rest was studied in 18 coronary patients with stable angina pectoris. An ischemic defect area score was computed from quantitative exercise thallium‐201 (Tl‐201) scintigraphy; this estimation of the amount of ischemic myocardium was used to classify the patients in group I (n = 8; score < 15%, mean 6.7 ± 2.5%) and II (n = 10; score > 15%; mean 27.2 ± 8.9%). Hemodynamics and metabolism were studied in basal state. No patient had anginal pain during the study, and the extent of anglographic coronary artery disease (CAD) was comparable in the two groups. Heart rate, aortic pressure, coronary blood flow, and myocardial oxygen uptake were also similar in both groups. However, ejection fraction was reduced in group II (51 ± 13 vs 63 ± 5%; p <0.01) and LV relaxation was impaired as shown by the increase in timeconstant of isovolumic pressure fall (55 ± 16 vs 44 ± 6 ms in group I; p <0.05); the LV end‐diastolic pressure was also increased in group II (19 ± 8 vs 10 ± 4 mmHg in group I; p <0.05). Furthermore, in group II, myocardial lactate uptake was reduced (4 ± 19 vs 3C ± 29 μ mole/min in group I; p <0.01) and the productions of alanine and glutamine were augmented (−7.5 ± 4.4 vs −4.6 ± 1.6 μ mole/min in group I; p <0.05). This study shows that in anginal patients with a similar extent of angiographic CAD, an increased size of perfusion defect during exercise is associated with an increased incidence in alterations of LV systclic and diastolic function and with signs of impairments in aerobic metabolism.
Unusual intra‐arterial communication in the normal right coronary tree
Authors: Goldner Branislav 
Published: March 2007

AbstractAmong 136 patients with a history of angina pectoris who underwent selective coronary arteriography, two patients (1.4%) with a normal right coronary artery were found to have angiographically demonstrated communications between the various branches of the same coronary artery. Such findings, unaccompanied by coronary artery disease, have been hitherto unknown and suggest a congenital variation in coronary anatomy rather than a clinically significant condition. The purpose of this report is to demonstrate that the angiographic appearance of the anastomotic vessels in such cases is entirely different from that which obtains in cases of obstructive coronary artery disease. The author notes the rarity of angiographic visualization of homocoronary communications in normal right coronary arteries and emphasizes the necessity of distinguishing these from the homocoronary collaterals found in atherosclerotic coronary artery disease.
Anomalous origin of the posterior descending artery from the first septal perforator
Authors: Errichetti Annmarie , Mills Roger M. , Mercadante Nicholas M , Lingley James F 
Published: March 2007

AbstractWe describe a patient with an unusual coronary anatomic variant in which the first septal perforator gives rise to the posterior descending artery. The angiographic features and clinical recognition of this anomaly are reviewed.
Successful percutaneous removal of retained broken coronary angioplasty guidewire
Authors: Krone Ronald J 
Published: March 2007

AbstractThe use of a pigtail left ventriculography catheter to retrieve a coronary angioplasty guidewire that had become entrapped in a small coronary artery and broken off with the proximal end in the descending thoracic aorta is reported. A pigtail catheter was advanced to the ascending aorta and twirled, winding the wire around it, removing the wire from the small artery.