bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a new technique for reducing pressure pulse generation during 308‐nm excimer laser coronary angioplasty
Authors: Tcheng James E. , Wells Lisa D. , Phillips Harry R. , Deckelbaum Lawrence I. , Golobic Robert A. 
Published: March 2007

AbstractDespite expectations that excimer laser ablation would result in a low incidence of coronary dissection, studies have documented a 15–20% incidence of dissection (including a 4–6% incidence of clinically significant dissection) during excimer interventions. This investigation sought to determine if pressure pulses produced by the exposure of fluid phase media (blood and contrast) to 308‐nm excimer radiation might contribute to unto‐ward outcomes. Pressure pulses generated in these media were quantitated to be > 100 atm. In vitro ablation of porcine aorta in the presence of blood or contrast resulted in tissue dissection, while ablation in pure crystalloid did not. Next, a “flush and bathe” technique designed to replace all blood and contrast with crystalloid was applied to a pilot population of 57 consecutive patients. There were no rhythm disturbances or laserrelated clinically significant dissections in this group, and the clinical success rate was 95%. In summary, this report quantitates a potential etiology for excimer dissection and suggests that replacement of blood and contrast with crystalloid might improve procedural and clinical success rates.
Balloon dilation of critical valvar pulmonary stenosis in the first month of life
Authors: Colli Anna M. , Perry Stanton B. , Lock James E. , Keane John F. 
Published: March 2007

AbstractBetween 1985 and 1992, 36 consecutive neonates, aged 1–29 days, weight 2.4–5.0 kg, with critical valvar pulmonary stenosis underwent attempted balloon dilation (BD). At catheterization, 30 were on prostaglandin (PGE1) therapy and 20 were intubated. The valve was successfully crossed and dilated in 34/36 (94%), including three with an echocardiographic diagnosis of valvar pulmonary atresia and a right ventricle of adequate size. The valve was first dilated with a 2‐ to 5‐mm balloon and then with serially larger ones (up to 12 mm) to a final balloon/annulus value of 126%. The RV/systemic pressure value fell from 150 ± 32 to 83 ± 30%, O2 saturation rose from 91 ± 6% to 96 ± 4%, and PGE1 was discontinued at the end of the procedure. There were 11 complications (31%) including one early death from sepsis and necrotizing enterocolitis, endocarditis in another, two myocardial perforations, one femoral‐iliac vein tear, and one transient pulse loss.A repeat BD was carried out in five patients, two of whom subsequently had surgery. At follow‐up (33 ± 23 months), the 31 patients managed by BD alone were well and had echocardiographic gradients of < 30 mm Hg in 90% and pulmonary regurgitation, considered mild in most, in 52%.In neonates with critical valvar pulmonary stenosis, we believe BD mortality is less than with surgery and is the treatment of choice.
Transvenous coronary arteriography via ventricular septal defect for infants and children with tetralogy of fallot
Authors: Sakamoto Tohru , Suzuki Akio 
Published: March 2007

AbstractSelective coronary arteriography was performed by the antegrade transvenous technique in 13 cases of young children with tetralogy of Fallot utilizing two specially designed catheters. Right coronary arteriography was successfully performed in all, and left coronary arteriography was successful in the latest four cases. The importance of the catheter design is discussed based on the anatomical characteristics of the anomaly.
Systemic anaphylactoid reactions to lodinated contrast media during cardiac catheterization procedures: Guidelines for prevention, diagnosis, and treatment
Authors: Goss Jerome E. , Chambers Charles E. , Heupler, Jr Frederick A. 
Published: March 2007

AbstractThis report represents the first guidelines for prevention, diagnosis, and treatment of anaphylactoid reactions to contrast media occurring specifically during cardiac catheterization. The incidence of contrast media complications in the catheterization laboratory is 0.23% with 1 death per 55,000. Anaphylactoid reactions are nonimmune mediated, but histamine release and other mediators produce a clinical presentation indistinguishable from anaphylaxis. In patients with known previous reactions, pretreatment with steroids and diphenhydramine and the use of nonionic contrast media have significantly reduced the potential of recurrent reaction. Minor reactions such as limited urticaria may be watched for progression or treatment with diphenhydramine, whereas more serious reactions such as angioedema or laryngeal edema require airway stability and ephinephrine administration. Shock should be vigorously treated simultaneously with intravenous epinephrine and large volumes of normal saline. If the patient can be stabilized, the study should be completed as histamine, leukotrienes, and other vasoactive products should be relatively depleted.
Stenting with the half (disarticulated) palmaz‐schatz stent
Authors: Mehan Vivek K. , Kaufmann Urs , Urban Philip , Chatelain Pascal , Meier Bernhard 
Published: March 2007

AbstractA total of 110 half (disarticulated) Palmaz‐Schatz coronary stents were implanted in 102 patients. Procedural success rate was 98%. Elective stenting was performed in five patients. The others received half stents for bail‐out situations, including short dissections, relapsing stenoses, dissections not adequately covered by a full stent, ostial stenoses, and thrombus containing lesions. Seventeen patients received no anticoagulation except aspirin. Complications included one procedural death, three acute occlusions (resulting in one Q and two non‐Q wave myocardial infarctions), and one non‐Q wave infarction related to side branch closure.Stenting with the half Palmaz‐Schatz coronary stent is an effective technique. It allows stenting in situations where a full stent may not be ideally suited. Use of only half a stent reduces thrombogenicity and halves costs.
Emergency endoluminal stenting for abrupt vessel closure following coronary angioplasty: A randomized comparison of the wiktor and palmaz‐schatz stents
Authors: Goy Jean‐Jacques , Eeckhout Eric , Stauffer Jean‐Christophe , Vogt Pierre , Kappenberger Lukas 
Published: March 2007

AbstractIn order to compare the efficacy of two different stent types in case of bailout stenting, 65 patients, with abrupt or threatened vessel closure following coronary angioplasty, were randomly assigned to either Wiktor (Medtronic Inc., Minneapolis, MN, 33 patients) or Palmaz‐Schatz (Johnson & Johnson Interventional, Warren, NJ, 32 patients) stent implantation. Stenting was technically feasible in all except one patient and immediately successful in reverting ischemia and vessel closure in 60 patients (92%). At hospital discharge, complication rates were comparable: early vessel closure, 18% (Wiktor) versus 13% (Palmaz‐Schatz) (P=0.53); any clinical event (such as death, myocardial infarction, and surgical revascularization): 18% (Wiktor) versus 22% (Palmaz‐Schatz) (P=0.71). At 6 months follow‐up, these complication rates remained equal: restenosis, 38% (Wiktor) versus 27% (Palmaz‐Schatz) (P=0.42); any clinical and angiographic (vessel closure and restenosis) event: 45% (Wiktor) and 41% (Palmaz‐Schatz) (P=0.69). Baseline, direct postprocedural, and follow‐up quantitative coronary analysis data were similar, with, however, an exception for the postprocedural residual stenosis [28% (24‐32%) (Wiktor) and 21% (18‐23%) (Palmaz‐Schatz] (means and 95% confidence intervals). In conclusion, despite a discrete postprocedural angiographic benefit observed with the Palmaz‐Schatz stent, the long‐term clinical and angiographic outcome is similar in both treatment groups. The choice whether to implant a Wiktor or Palmaz‐Schatz stent may probably be left to the discretion of the operator and his experience with one particular device.
Percutaneous transradial coronary palmaz‐schatz stent implantation, guided by intravascular ultrasound
Authors: Kiemeneij Ferdinand , Laarman Gert Jan , Slagboom Ton 
Published: March 2007

AbstractIntravascular ultrasound (IVUS) allows accurate assessment of stent deployment, its use being confined to the use of 8 French (F) guiding catheters. We evaluated the feasibility of combining transradial artery Palmaz‐Schatz stent implantation through 6F guiding catheters with IVUS for assessment of stent diameter after delivery at moderate inflation pressures (10‐12 atmospheres [atm]) with compliant balloons and after high pressure dilatations with balloons of intermediate compliance. In 8 consecutive patients, 12 stents were delivered with Scimed® ExpressTM balloon catheters at 10‐12 atm followed by IVUS (EndoSonics® CathScanner; Visions® FX 3.5F 20 MHz transducer). An ultrasound study was repeated after high pressure dilatations (16‐20 atm) with Schneider® Magical SpeedyTM balloon catheters. The balloon diameters were derived from manufacturer provided specifications. In all patients the transducer could easily be advanced through the guiding catheters. Reference diameter of the stented segment was 3.7 ± 0.5 mm (2.7‐4.5) and the diameter of Scimed® ExpressTM balloons during inflation was 4.0 ± 0.3 mm (3.6‐4.7). Stent diameter was 3.0 ± 0.1 mm (2.8‐3.2) (P < 0.001 compared to the reference and the balloon diameter). The diameter of the Schneide® Magical SpeedyTM balloons at secondary dilatations with 16 ± 3 atm (14‐20) was 4.1 ± 0.4 mm (3.3‐4.5) (P = 0.50 compared to the initial balloon diameter). Final stent diameter was 3.3 ± 0.4 mm (2.9‐4.1) (P = 0.02 compared to the initial stent diameter). All stents were symmetrically deployed and well apposed. No damage to vessel or stents was detected after passage of the transducer. Thus ultrasound guided stenting via 6F guiding catheters is feasible, and high pressure dilatations with balloons of intermediate compliance results in better stent expansion than after 10‐12 atm inflations with compliant balloon catheters.
Sequential implantation of dissimilar tandem stents for long dissections complicating percutaneous transluminal coronary angioplasty
Authors: Sankardas Mullasari Ajit , Garrahy Paul John , McEniery Paul Timothy 
Published: March 2007

AbstractAcute closure remains a significant complication of percutaneous angioplasty, and coronary artery stenting serves as a useful bail‐out device. We describe two cases of sequential implantation of dissimilar tandem stents, a Gianturco—Roubin (4 × 20mm) stent and a Palmaz‐Schatz (4 × 15mm) stent, for long dissection complicating percutaneous transluminal coronary angioplasty.
Intracoronary stenting without coumadin: One month results of a French multicenter study
Authors: Morice Marie C. , Zemour Gilles , Benveniste Edgar , Biron Yves , Bourdonnec Claude , Faivre René , Fajadet Jean , Gaspard Philippe , Glatt Bernard , Joly Patrick , Labrunie Pierre , Lienhart Yves , Marco Jean , Petiteau Pierre Y. , Royer Thierry , Valeix Bernard 
Published: March 2007

AbstractIn order to simplify post‐coronary stenting treatment and to obtain a lower rate of complications, especially in bailout situations, seven French institutions treated 246 stented patients with 0.25 g/day of ticlopidine, 0.1 g/day of IV aspirin, and 2 days of heparin followed by low‐molecular‐weight heparin for 1 month. Fifty percent of patients had a planned stenting procedure, and 50% had an unplanned procedure, including 29 (11.8%) in bailout situations. Subacute occlusion occurred in three (1.2%) patients (one death, two non‐Q‐wave infarctions). During the 1 month follow‐up period, another death was reported (non‐stent‐related), two elective coronary artery bypass grafts were performed, and three additional patients presented with non‐Q‐wave myocardial infarctions. Nine (3.7%) patients had a groin complication that required blood transfusion or surgical repair. These results suggest that while waiting for the technological advancements of stents, postprocedural treatment that includes a low dosage of ticlopidine, aspirin, and low‐molecular‐weight heparin is a very effective alternative to conventional poststenting therapy. © 1995 Wiley‐Liss, Inc.
Comparison of bedside and hospital laboratory coagulation studies during and after coronary intervention
Authors: Blumenthal Roger S. , Carter Andrew J. , Resar Jon R. , Coombs Vicki , Gloth Sean T. , Dalal Jyostna , Brinker Jeffrey A. 
Published: March 2007

AbstractThe activated clotting time is routinely used to monitor anticoagulation during coronary intervention, whereas the hospital laboratory APTT guides pre‐ and postprocedure heparin therapy. An optimal coagulation test for patients undergoing percutaneous revascularization would provide a rapid and accurate assessment of anticoagulation throughout a broad range of heparin therapy. We studied the relationships of the bedside whole blood APTT, ACT, and the laboratory APTT in 166 patients undergoing coronary intervation. The whole blood APTT correlated closely with the laboratory APTT (range 18‐80 sec) (r = .75), whereas the ACT and laboratory APTT had only a fair correlation (r = .42). Also, the whole blood APTT demonstrated a strong correlation with the ACT throughout the range of heparin therapy for intervention (r = .81). The diagnostic accuracy of the whole blood APTT, based on the receiver operating characteristic curve, was significantly better than that for the ACT in determining the anticoagulation status. The whole blood APTT obtained by bedside monitoring provides a rapid and accurate assessment of anticoagulation throughout the range of heparin dosing associated with coronary intervention. In situations in which an adequate assessment of residual anticoagulation is necessary, the whole blood APTT is superior to the ACT and probably should be the method of choice. © 1995 Wiley‐Liss, Inc.
The forgotten chamber: The importance of the right ventricle
Authors: Rigolin Vera H. , Robiolio Paul A. , Wilson John S. , Harrison J. Kevin , Bashore Thomas M. 
Published: March 2007

AbstractHistorically, the right heart was viewed as less important than the left heart in the maintenance of normal overall hemodynamic performance. However, there is now considerable evidence that emphasizes the significance of intact right ventricular (RV) function. The RV's anatomy and physiology are reviewed in order to provide insight into how changes in volume can be accommodated within a low‐pressure environment and how this contributes to hemodynamic stability. The interdependent relationship between the right and left ventricles is also explored.The contribution of RV performance to overall hemodynamics is best exemplified when the RV becomes diseased. RV infarction, atrial septal defect, and cor pulmonale are used as examples to illustrate the dramatic sequelae associated with RV dysfunction, as well as to identify the RV's specific adaptive mechanisms. © 1995 Wiley‐Liss, Inc.
Controversies in balloon mitral valvuloplasty: The when (timing for intervention), what (choice of valve), and how (selection of technique)
Authors: Lau Kean‐Wah , Hung Jui‐Sung , Ding Zee‐Pin , Johan Abdullah 
Published: March 2007

AbstractDespite the established role of percutaneous balloon mitral valvuloplasty (BMV) in the treatment of mitral stenosis, major controversial issues in the realm of BMV persist. With increased operator experience, BMV has now been extended to include various controversial scenarios, such as mild mitral stenosis, adverse valve morphologies, and highrisk patients with concomitant anatomic distortions which are technically demanding. In skilled hands, however, BMV has yielded a favorable outcome in these settings. Furthermore, the debate on whether the Inoue or the double‐balloon approach is superior continues. Studies to date have shown equal efficacy of the two BMV methods in terms of valve enlargement although the Inoue approach is clearly simpler to execute and may potentially be associated with a lower risk of creating severe mitral regurgitation. Last, because of the lack of consensus on optimal balloon sizing for BMV, perhaps the best method to adopt at this stage is one that is simple and safe to apply across a broad spectrum of valve anatomy. © 1995 Wiley‐Liss, Inc.
Coronary artery fistulas in adults: Incidence, angiographic characteristics, natural history
Authors: Vavuranakis Manolis , Bush Charles A. , Boudoulas Harisios 
Published: March 2007

AbstractThe incidence, angiographic characteristics, and natural history of coronary artery fistulas in patients undergoing diagnostic cardiac catheterization have not been well defined. Of 33,600 patients who had diagnostic cardiac catheterization, 34 (0.1%) had coronary artery fistula. Nineteen fistulas originated from the right, 11 from the left anterior descending, and 4 from the circumflex coronary arteries, respectively. The mean ratio of pulmonary to systemic flow was 1.19 ± 0.33. Only one patient with coexistent atrial septal defect had a pulmonic to systemic flow ratio >1.5. Right and left heart pressures, with the exception of three patients in whom left ventricular end‐diastolic pressure was >12 mm Hg, were within normal limits. During a mean follow‐up period of 6.3 years (range 2–14 years), there were no complications related to coronary artery fistula.It was concluded that the incidence of coronary artery fistulas detected during diagnostic coronary angiography is very low. Coronary artery fistulas originate predominantly from the right coronary artery and are not associated with hemodynamic abnormalities or other congenital heart diseases. The prognosis of coronary artery fistulas in adults is good. © 1995 Wiley‐Liss, Inc.
Intracoronary ST‐T alternans during coronary balloon angioplasty
Authors: Kwan Tak , Feit Alan , Chadow Hal , Chio Francisco , Huber Michael S. , Chebaclo Mohamed , Breitbart Sheldon , Stein Richard A. 
Published: March 2007

AbstractTo evaluate the presence and clinical significance of electrical alternans during PTCA, intracoronary electrocardiography (ic‐ECG) was performed in 65 consecutive lesions. ST‐T alternans, defined as a beat‐to‐beat difference in the ST elevation ⩾1 mm, was present in five lesions (7.7%), all in the proximal left anterior descending (LAD) coronary artery. The phenomenon was seen only after 130 sec (mean 174 ± 57) of balloon inflation. Only two of the five showed ST‐T alternans simultaneously on both surface and ic‐ECG. One of five patients had premature ventricular contractions following ST‐T alternans. Three of these five lesions required a second balloon inflation with duration of ⩾ 300 sec; there was no ST‐T alternans on the second inflation in any of these lesions. We conclude: (1) the detection of ST‐T alternans during PTCA is enhanced by use of ic‐ECG, (2) electrical alternans during PTCA was seen only in proximal LAD lesions, implicating a large amount of ischemic myocardium as a requisite for the phenomenon, (3) electrical alternans is not immediate, requiring a certain duration of balloon occlusion and hence ischemia to occur, and (4) the absence of ST‐T alternans during second balloon inflations suggests ischemic preconditioning may abolish this phenomenon.
Successful intravenous streptokinase treatment of a child with Kawasaki disease complicated by acute myocardial infarction
Authors: Liang Chi‐Di , Huang Song‐Chei , Su Wen‐Jen , Chen Hui‐Yung , Lee Chiang‐Hsuan 
Published: March 2007

AbstractA 9‐year‐old boy developed ischemic cardiac symptoms 1 year after he presented with Kawasaki disease. The myocardial infarction was confirmed by the typical changes of electrocardiograms, echocardiograms, cardiac enzymes, thallium myocardial scintigrams, and angiograms. With successful intravenous streptokinase therapy, he remained well during the following 4 months. © 1995 Wiley‐Liss, Inc.
Radiation‐induced mitral and tricuspid regurgitation with severe ostial coronary artery disease: A case report with successful surgical treatment
Authors: Raviprasad G. S. , Salem Bakr I. , Gowda Siddhesh , Leidenfrost Ronald 
Published: March 2007

AbstractA 71‐year‐old woman presented with congestive heart failure due to severe mitral and tricuspid regurgitations. In addition, she had significant ostial right coronary stenosis. She received radiation therapy following left radical mastectomy for carcinoma of breast in the past. She underwent successful combined mitral valve replacement, tricuspid annuloplasty, and coronary artery bypass graft for radiation‐induced heart disease. © 1995 Wiley‐Liss, Inc.
Functional characteristics of a new coronary perfusion balloon: Comparison with the flowtrack 40 in closed chest swine
Authors: Lambert Charles R. , Bikkina Mahesh 
Published: March 2007

AbstractThis study was designed to compare a new investigational coronary perfusion balloon (Wave, Scimed Life Systems Inc.) with that of an approved, widely used, current generation device (Flowtrack 40, Advanced Cardiovascular Systems). Domestic swine were anesthetized with pentobarbital and instrumented using standard percutaneous technique. Left ventricular contractile function (dP/dt) was monitored using a micromanometer while intracoronary and surface ECGs were also recorded. Eight target vessels were studied (4 LAD and 4 Cx) in random order. The perfusion balloons were kept inflated for 10 min. Complete coronary occlusion with a standard angioplasty balloon produced marked decreases in mean aortic pressure, left ventricular developed pressure, peak + dP/dt, peak ‐dP/dt, and significant ST segment elevation in both intracoronary and surface ECG at 30 seconds. Neither the Wave or Flowtrack 40 produced any change in heart rate or mean aortic pressure. Both catheters caused a drop in left ventricular developed pressure immediately after balloon inflation. At 10 min, however, there was a small but significant decrease only with the Flowtrack 40. Similarly, peak + dP/dt was slightly depressed during Flowtrack 40 inflation at 10 min but not with the Wave catheter. Both catheters produced ST segment elevation on the surface and intracoronary electrocardiographic records. These changes were significantly greater with the Flowtrack 40 system. Thus, both the Flowtrack 40 and Wave perfusion balloons are effective in preventing ischemia during coronary occlusion in swine; however, the latter system may be more effective in this model. © 1995 Wiley‐Liss, Inc.
Angiographic diagnosis of true and false LV aneurysms after inferior wall myocardial infarction
Authors: Al‐Saadon K. , Walley V. M. , Green M. , Beanlands D. S. 
Published: March 2007

AbstractFalse aneurysms of the left ventricle are rare complications of myocardial infarction. In this unusual case, a 57‐year‐old male patient had a false aneurysm, that took origin from a true aneurysm in the inferior wall, both discovered 7 years postinfarct. The aneurysms were demonstrable by ventriculography and were resected because of ventricular tachycardia. © 1995 Wiley‐Liss, Inc.
Balloon expandable stent implantation after latrogenic arterial dissection of the left subclavian artery
Authors: Galli Mario , Goldberg Steven L. , Zerboni Santoni , Almagor Yaron 
Published: March 2007

AbstractA patient undergoing attempted angioplasty of a left internal mammary artery graft to left anterior descending coronary artery developed an iatrogenic dissection of the left subclavian artery, with symptoms of left arm claudication. A balloon expandable stent was inserted with an excellent angiopgraphic result. The patient has remained free of symtoms or signs of decreased arm flow, with a patent subclavian artery demonstrate on angiography 8 months later. The excellent early‐to‐moderate term clinical and angiographic results support the efficacy of this technical approach. © 1995 Wiley‐Liss, Inc.