bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined fluid‐filled and micromanometer‐tip catheter system for high‐fidelity pressure recordings in infants
Authors: Colan Steven D. 
Published: March 2007

AbstractInvestigation of pressure‐derived indices of systolic and diastolic function in infants and young children has been limited, in part due to difficulty in obtaining high‐fidelity pressure recordings. Standard fluid‐filled catheter‐manometer systems have a frequency response which is inadequate for this purpose, whereas high‐frequency response micromanometer‐tip catheters systems are difficult to use in this age group. Therefore, a system was investigated whereby a micromanometer‐tip catheter (Millar) was connected directly to a standard pigtail catheter. The frequency response of this combined system was defined using 3.2 Fr pigtails of 40, 50, and 65 cm, 4.0 Fr pigtails of 50, 65, and 80 cm, and 5.0 Fr pigtails of 80 and 100 cm.In three different catheters of each diameter and length, minimal variation in response was seen. The 3.2 Fr‐40‐cm system demonstrated a flat line (100%) response to 90 Hz with a resonant frequency of 130 Hz. This is certainly adequate for determination of pressure derivatives for heart rates up to 120 beats per minute. The longer 3.2 Fr catheters demonstrated a poorer frequency response. The 4.0‐Fr‐50‐cm system was flat line to 60 Hz, rising to 175% response at the resonant frequency of 85 Hz. This is adequate for determination of pressure derivatives at heart rates up to 120 beats per minute. Increasing the diameter or length of the pigtail catheter resulted in further deterioration of the frequency response. Thus, this system provides high‐fidelity tracings suitable for assessment of pressure‐derived indices of systolic and diastolic function in infants and young children.
The use of pigtail catheters for retrieval of foreign bodies from the cardiovascular system
Authors: Auge J. M. , Oriol A. , Serra C. , Crexells C. 
Published: March 2007

AbstractSnare retrieval of foreign bodies is a common procedure but in certain cases, location of the foreign body requires another system. We present three cases in which only the use of a pigtail catheter gave a good grip for gentle traction and removal or repositioning of the foreign body. A careful review of the world literature up to December 1982 gave rise to two previous similar reports. Both our experience and that found in the literature seem to suggest that in cases where there are no free ends to snare, pigtail catheters may be the first instrument used to start retrieval.
Late progression of an asymptomatic intimal tear to occlusive coronary artery dissection following angioplasty
Authors: Zack Paul M. , Ischinger Thomas 
Published: March 2007

AbstractSymptomatic coronary artery dissection is a recognized complication of coronary angioplasty that is usually associated with immediate adverse consequences. In contrast, the asymptomatic angiographic finding of an “intimal tear” following otherwise successful angioplasty has been considered clinically unimportant. A case is reported of a primarily successful coronary angioplasty with intimal tear that progressed to occlusive coronary artery dissection requiring coronary bypass surgery at 4 weeks postangioplasty. This case demonstrates that an asymptomatic intimal tear following successful coronary angioplasty is not always an innocuous angiographic finding.
Absence of left anterior descending coronary artery associated with anomalous origin of left circumflex coronary artery from the right coronary artery: A case report and review
Authors: Ferguson David W. , Henkle Joseph Q. , Haws Charles W. 
Published: March 2007

AbstractIn this report we present a case of a 30‐year‐old female patient with a single coronary artery, which consisted of a right coronary artery from which there was an anomalous origin of the left circumflex coronary artery. There was no left anterior descending coronary artery. The clinical and other noninvasive diagnostic features of this rare angiographic variant are described and compared to other known varieties of coronary anomalies. The absence of objective evidence of ischemia or left ventricular functional impairment and analysis of the angiographic data suggest that this is another benign variant of coronary anatomy.
Balloon dilatation for superior vena caval obstruction after the senning procedure
Authors: Benson L. N. , Yeatman L. , Laks H. 
Published: March 2007

AbstractA 3‐month‐old infant is presented who developed acute superior vena caval obstruction after atrial surgery for transposition of the great arteries. Balloon dilation angioplasty resulted in a decrease in caval‐atrial gradient. The application of balloon angioplasty in this setting is discussed.
Hemodynamic evaluation of stenotic cardiac valves: II. Modification of the simplified valve formula for mitral and aortic valve area calculation
Authors: Angel Juan , Soler‐Soler J. , Anivarro Inocencio , Domingo Enric 
Published: March 2007

AbstractSince the introduction by Gorlin and Gorlin [1] of the hydraulic formulae for calculating valve area, it has become the best parameter for quantitating valve stenosis. Recently Hakki et al [3] proposed a simplified formula for valve area calculation that does not take into account either heart rate (HR) or left ventricular filling or ejection time. The purpose of this study was to analyze the validity of Hakki's formulae under different physiological conditions and to propose an easy correction to improve its accuracy. Our study suggests: (1) that an easy correction for heart rate in certain cases, dividing by 1.35 when HR < 75 beats per min in mitral stenosis and when HR > 90 beats per min in aortic stenosis, significantly improves the accuracy and validity of Hakki's formulae (p < 0.02 and p < 0.05); (2) the instantaneous valve gradients (peak gradient for aortic stenosis and average of instantaneous early, middle, and late diastolic gradients for mitral stenosis) are as valid as mean planimetric gradients for valve area calculation. Thus the simplified formulae proposed in this study allow mitral and aortic valve area calculations by means of instantaneous gradients, cardiac output, and heart rate.
Factory fixation of an ARC curve into brachial coronary artery catheters of the manipulative type: A new curve for sones' type catheters
Authors: Miller Gordon C. 
Published: March 2007

AbstractAdvantage was found in factory fixing an approximation of the curve that has long been hand‐formed at the tableside by angiographers using the manipulative type brachial‐coronary technique. It consists of a 7 cm arc of a circle of 10 cm diameter. Used in 68 different patients, it was found to definitely facilitate and speed selective cannulation of the coronary artery ostia as compared to previous curves.
Spontaneous regression of coronary artery obstructions: Incidence in 313 consecutive repeat angiograms
Authors: Moise Alain , Goulet Claude , Théroux Pierre , Taeymans Yves , Lespérance Jacques , Bourassa Martial G. 
Published: March 2007

AbstractWe studied the incidence of reversibility of coronary obstructions in a consecutive series of 313 patients with nonoperated coronary artery disease catheterized twice 3 to 118 (mean 38) months apart. Recanalization was observed in three patients and regression from an initial < 100% obstruction in six patients. Progression in a different location occurred in six of the nine patients who demonstrated one recanalized or one regressive lesion. We conclude that true regression is an infrequent event in the natural history of medically treated patients with coronary artery disease; moreover, the pathophysiology and clinical relevance of angiographic regression remain poorly defined.
Resolution of congestive failure, mitral regurgitation, and angina after percutaneous transluminal coronary angioplasty of triple vessel disease
Authors: Reinfeld Howard B , Samet Philip , Hildner Frank J 
Published: March 2007

AbstractCongestive heart failure, unstable angina, and moderate mitral regurgitation improved after double‐vessel angioplasty in a 41‐year‐old woman who was considered inoperable because of high risk of bypass surgery. With the concomitant use of balloon counterpulsation, angioplasty reduced the cross‐sectional stenosis in the left anterior descending coronary artery from 98 to 20% and in the left circumflex coronary artery from 90 to 0%. The right coronary artery was completely occluded and angioplasty was not attempted. The ejection fraction was 17% prior to angioplasty and 50% 2 months later at follow‐up.
Applicability of percutaneous transluminal coronary angioplasty to patients with recombinant tissue plasminogen activator mediated thrombolysis
Authors: Topol Eric J. , Eha Jaan E. , Brin Kenneth P. , Shapiro Edward P. , Weiss James L. , Riegel Mary B. , Gottlieb Sidney O. , Brinker Jeffrey A. 
Published: March 2007

AbstractTo test the utility and safety of percutaneous transluminal coronary angioplasty (PTCA) after recombinant tissue plasminogen activator (t‐PA), we performed the procedure in all suitable candidates with acute myocardial infarction (MI) who had successful t‐PA mediated coronary thrombolysis. Twenty consecutive patients with MI received t‐PA after coronary angiographic conformation of total occlusion. Successful recanalization with t‐PA was achieved in 13 patients, leaving a residual obstruction of 84 ± 6% in the nine patients for whom PTCA was attempted at a mean of 21.6 h. Success was achieved in seven patients, leading to a residual lesion of 29 ± 7%. In the two patients for whom PTCA was unsuccessful, total reocclusion occurred prior to the attempt despite therapy with heparin, aspirin, dipyridamole, and nifedipine. All PTCA procedures were uncomplicated. Serial two‐dimensional echocardiography at 10 days, compared to admission, demonstrated infarct zone wall motion index improvement in the patients with successful PTCA (group A, 0.83 ± 0.36 to 1.46 ± 0.49) as compared to the 13 patients without thrombolysis or successful PTCA (group B, 0.61 ± 0.26 to 0.66 ± 0.39), (P < 0.05). One patient of group A sustained a massive stroke at 2 weeks after hospital discharge. In the remaining six patients, follow‐up exercise testing and/or coronary arteriography demonstrated a negative treadmill test and/or patent infarct vessel, respectively. After successful PTCA, no patient had clinical signs of reocclusion, reinfarction, postinfarction angina, or congestive heart failure. At 9.4 ± 2 months, all six patients are asymptomatic and have returned to work. Thus, sequential PTCA after t‐PA can be performed safely and successfully in patients with MI and this approach may be associated with improved regional function and a favorable post‐MI course.
Coronary angiography and intracoronary thrombolytic therapy in the coronary care unit: An alternative approach
Authors: Gottlieb Sidney O. , Guzman Pablo A. , Brin Kenneth P. , Walford Gary D. , Brinker Jeffrey A. 
Published: March 2007

AbstractThe feasibility, safety and efficacy of performing left heart catheterization, coronary angiography, and intracoronary thrombolytic therapy in the coronary care unit setting were examined in 17 patients with acute ischemic syndromes presenting at a time when routine catheterization facilities were not available. In all cases, cardiac catheterization and coronary angiography were performed in the coronary care unit without difficulty using a portable image intensifier and a portable video recording system, and selective intracoronary streptokinase was safely administered in 13 patients with a total coronary occlusion, with successful thrombolysis in seven patients (54%). No adverse effects attributable to the performance of these procedures in the coronary care unit were observed. This approach might allow for a more prompt response and wider availability of intracoronary thrombolytic therapy for patients presenting with acute myocardial infarction.
Quantitative assessment of left ventricular function after myocardial infarction using the minnesota Q‐QS codes for resting electrocardiograms
Authors: Karnegis James N. , Matts John , Tuna Naip , Amplatz Kurt , Moore Richard B. , Buchwald Henry 
Published: March 2007

AbstractThe electrocardiogram as a quantitative predictor of left ventricular systolic function was investigated in subjects with one myocardial infarction. The first 509 consecutive subjects to enter the Program of Surgical Control of Hyperlipidemia were studied by selective left ventriculography. Electrocardiograms taken during a prior hospitalization of the subjects for acute myocardial infarction were classified according to the Minnesota Q‐QS codes. This study showed that the lower (ie, the more significant) Q‐QS codes were highly correlated with reduced left ventricular function as measured both by a lower ejection fraction and by a greater number of left ventricular segments showing abnormal systolic motion. In addition, the location of segmental wall motion abnormalities correlated with the electrocardiographic site of the Q‐QS code.
The role of intravenous streptokinase in acute arterial occlusions after cardiac catheterization
Authors: Gagnon Roger‐Marie , Goudreau Evelyne , Joyal France , Morissette Martin , Roussin André 
Published: March 2007

AbstractArterial occlusions after cardiac catheterization are usually treated surgically. We report four patients with femoral thrombosis or distal emboli that developed after cardiac catheterization. Each patient was treated successfully with intravenous streptokinase.Therapy was initiated 1–60 hr after the procedure. The duration of infusion lasted 4–42 hr (mean 27 hr). Pulses were restored 4–19 hr (mean 10 hr) after the beginning of infusion. There was no major hemorrhagic complication, even in patients with very early streptokinase infusion.Thus intravenous streptokinase may be an alternate choice to surgery for arterial occlusions after invasive procedures.
Cardiac tamponade following percutaneous transluminal coronary angioplasty: Four case reports
Authors: Goldbaum Thomas S. , Jacob Andrew S. , Smith Douglas F. , Pichard Augusto , Lindsay Joseph 
Published: March 2007

AbstractPercutaneous transluminal coronary angioplasty (PTCA) has had complications related to dilating catheters and guide wires such as coronary artery dissection, spasm, rupture, and perforation. This report describes four patients who developed cardiac tamponade following PTCA, presumably from right ventricular (RV) perforation. All four received large doses of heparin during PTCA and three received antiplatelet therapy. In three cases, cardiac tamponade occurred several hours after PTCA. All patients did well following operative intervention and no patient required repair of a cardiac perforation. We postulate that impaired hemostasis in the presence of an otherwise inconsequential RV perforation causes tamponade. Three alternatives to provide standby pacing are proposed.
Coronary artery vasospasm during treatment with intravenous nitroglycerin
Authors: Hom Gerald A. , Brent Bruce N. 
Published: March 2007

AbstractWe present a case of coronary artery vasospasm occurring during cardiac catheterization, which occurred while the patient was receiving substantial doses of intravenous nitroglycerin. Continued coronary artery vasospasm despite resolution of chest pain and response of vasospasm to intracoronary nitroglycerin are important clinical points.
Can total coronary occlusions be predicted from a previous coronary arteriogram?
Authors: Halon David A. , Sapoznikov Dan , Gotsman Mervyn S. , Lewis Basil S. 
Published: March 2007

AbstractWe studied the site, severity, and coronary angiographic morphology of coronary lesions and their ability to predict progression of coronary narrowing and obstruction of coronary arteries. Twenty‐six patients who had 94 lesions at the time of first angiography were followed for a mean of 29 ± 17 (SD) months. Progression of disease jor obstructions of vessel occurred in 11 lesions (12%): eight new total obstructions (8.5%) and three subtotal (3%). Narrowings of >75% of the luminal diameter were more likely to become totally obstructed than less severe narrowings (P = 0.01), but three total occlusions occurred at sites where mild disease had been present previously. Lesions in patients with double or triple vessel disease showed a marginally greater tendency to become totally occluded than in patients with single vessel disease (P < 0.1). We found no relationship between new total obstructions and the angiographic morphology of the lesion (smooth or irregular) nor with its length or position in the artery or the extent of atheroma in the vessel.
Aberrant main left coronary artery in a patient with unstable angina
Authors: Vega Manuel , Hamby Robert I. 
Published: March 2007

AbstractA patient with significant obstructive coronary artery disease in an anomalous left main coronary artery arising from the right coronary artery is reported. The combination of this coronary anomaly with main left atherosclerotic disease is noteworthy and presented no surgical technical problem.
Heart rate influence on the systolic gradient across the stenotic aortic valve: Theoretical evaluation and implications
Authors: Rozenman Yoseph , Gotsman Mervyn S. 
Published: March 2007

AbstractPeak systolic gradient across the aortic value, measured invasively or noninvasively is used in many laboratories for estimation of the severity of the stenosis (=actual valve area). This study shows that when cardiac output is normal the gradient across the valve is influenced by heart rate (HR) apart from valve area. A rate‐corrected peak systolic gradient (PSGc) is defined by the formula √PSGc = 0.041 √PSG HR (0.442–0.0014 HR) and its importance for clinical decision making is demonstrated. The significance of bradycardia in the pathogenesis of syncope in aortic stenosis is discussed.
The training for and practice of percutaneous transluminal coronary angioplasty: Results of two surveys
Authors: Scanlon Patrick J. 
Published: March 2007

AbstractIn order to gain understanding of how percutaneous transluminal coronary angioplasty (PTCA) is taught and practiced in the United States, two questionnaires were devised to survey all adult cardiology training programs and all adult cardiac catheterization laboratories in this country. Of the 184 programs that responded to the training questionnaire, 102 (55%) teach PTCA, usually in the form of fellowship training and especially as a specialized year, and less commonly in the form of a preceptorship. Though many programs expose trainees to an adequate number of cases as defined by the program directors, at least 37% do not. Of 388 laboratories responding to the practice questionnaire, 74% perform PTCA. The total number of PTCA's in this country seems to be doubling yearly, but many laboratories do relatively few cases per year, and 79% of physicians doing PTCA do fewer than one case per week. Average laboratory success rate for PTCA is in the range of 80–85%. Though there is now a proliferation of PTCA training programs, 93% of those practicing angioplasty are self‐ or preceptor‐trained, and have not learned the procedure as part of a fellowship.
The use of dextran‐40 during percutaneous transluminal coronary angioplasty: A report of three cases of anaphylactoid reactions—one near fatal
Authors: Brown Robert I. G. , Aldridge Harold E. , Schwartz Leonard , Henderson Mark , Brooks Esther , Coutanche Monica 
Published: March 2007

AbstractSuccessful percutaneous transluminal coronary angioplasty is achieved by fracture of the atheromatous plaque and perhaps dilatation of the arterial walls to increase the luminal diameter of the artery. Because this „controlled”︁ injury stimulates platelet adhesion on the subendothelial matrix, the use of dextran‐40 in addition to heparin has been advocated. The overall incidence of Dextran‐induced anaphylactoid reactions at our institution was 0.6% and of severe life‐threatening reactions, 0.2%. With the recent doubts cast on the efficacy of dextran‐40, the question arises regarding its routine use in PTCA.
Noninvasive determination of valve area in adults with aortic stenosis using doppler echocardiography
Authors: Holmvang Godtfred , McConville Briege , Tomlinson Charles W. 
Published: March 2007

AbstractDoppler ultrasound has been used to determine the pressure gradient P1P2 across the valve in patients with aortic stenosis (AS), but since the gradient varies over time and may be deceptively low in patients with impaired cardiac output, the key parameter to obtain is the orifice area (A)By calculating stroke volume (SV) from the modal flow velocity [vmode(t)] over the systolic ejection period (sep) or diastolic filling period (dfp(, wherever laminar flow exists in the heart across an area of known diameter D, (pulmonary artery or atrioventricular valves), and by substituting P1−P2 = 4Vmax2, (Vmax = peak velocity in the aortic jet), the Gorlin formula becomes:

where θ = flow intercept angle at D.This approach was applied in nine adult patients with AS (age 64 ± 8 yearsrpar; in whom recent catheterization data was available for comparison. Close correlation was found between the calculated areas: A(Doppler) = 0.82 A(Cath) + 0.17 (r = 0.94, p < 0.001). Two patients with Doppler gradients of <40 mmHg were shown by this Doppler method nevertheless to have severely narrowed orifice areas of < 0g.78 cm2.Although there is a tendency to overestimate slightly the valve area, Doppler ultrasound assessment using this technique adds valuable noninvasive information concerning the degree of aortic valve disease.
Portable intraaortic balloon counterpulsation: Clinical experience and guidelines for use
Authors: Gottlieb Sidney O. , Chew Paul H. , Chandra Nisha , Ouyang Pamela , Shapiro Edward P. , Bush David E. , Gottlieb Sheldon H. 
Published: March 2007

AbstractIntraaortic balloon (IAB) Counterpulsation is a proven treatment for patients with refractory ischemia or cardiogenic shock; however its use has been largely limited to tertiary centers due to the difficulties and risks encountered in transporting patients with this device in place. We report our initial experience with 11 patients who underwent IAB Counterpulsation at a community hospital utilizing a portable transport IAB system. All 11 patients had successful IAB insertion, resulting in prompt stabilization. Immediate transportation during uninterrupted IAB Counterpulsation was successfully accomplished in each case using routine ambulance vehicles, allowing for the prompt initiation of further tertiary care. The role of portable IAB Counterpulsation in the community hospital and guidelines for the implementation of this portable IAB system are outlined.
Atypical phasic coronary artery narrowing
Authors: Angelini Paolo , Leachman Robert D. , Autrey Alonzo 
Published: March 2007

AbstractFour unusual cases of phasic (occurring only in systole or only in diastole) coronary artery narrowing are reported. In two cases, diastolic compression of the left anterior descending coronary artery was due to tight pericardial adhesions in patients with aortic insufficiency; in the third case, systolic compression of two right ventricular coronary branches was associated with hypertrophic cardiomyopathy and a normotensive right ventricle; and in the fourth case, a large aneurysm of the inferior wall of the left ventricle caused systolic compression of the posterior descending coronary artery, which was epicardial. The diagnostic and pathophysiologic characteristics of each case are discussed.
Coronary artery spasm in a denervated orthotopic transplanted human heart
Authors: Goldenberg Irvin F. , Levine T. Barry 
Published: March 2007

AbstractA case of catheter‐induced spasm in a 40‐year‐old male one year after orthotopic cardiac transplantation is presented. The fact that spasm can occur in this setting of total cardiac denervation demonstrates that other factors can play an important part in modifying the status of coronary artery patency.