bluuebunny/crossref_metadata_2025_split huggingface dataset:
Isolated unruptured sinus of Valsalva aneurysm producing right ventricular outflow obstruction
Authors: Haraphongse Mant , Na Ayudhya Rapeephon Kunjara , Jugdutt Bodh , Rossall Richard E. 
Published: March 2007

AbstractAn unusual case of right ventricular outflow obstruction and right heart failure due to an isolated unruptured congenital sinus of Valsalva aneurysm originating from the right coronary sinus in a 75‐year‐old‐man is described. The diagnosis was made by twodimensional echocardiography and cardiac catheterization. Successful surgical resection of the aneurysm resulted in dramatic symptomatic improvement.
Management of complicated coronary angioplasty by intracoronary urokinase and immediate re‐angioplasty
Authors: Verna Edoardo , Repetto Sergio , Boscarini Mauro , Onofri Marco , Qing Lu Guo , Binaghi Giovanni 
Published: March 2007

AbstractPercutaneous transluminal coronary angioplasty was complicated by acute coronary occlusion, dissection of the arterial wall, or angiographic evidence of intraluminal thrombosis in 33 high‐risk patients from 153 consecutive angioplasty procedures (21.5%). Ten patients (group I) were managed with nitroglycerin (0.2 to 0.4 mg i.c.) and repeated attempts at mechanical guide wire recanalization or dilation, but they did not receive thrombolytic therapy. In the remaining 23 patients (group II), intracoronary urokinase (100,000 to 360,000 U.I.) was administered over 15–20 min after onset of coronary occlusion or thrombosis and continued during attempts at repeated dilation of the stenosis. The incidence of sudden coronary artery occlusion was 70% in group I patients and 52% in group II. The angiographic evidence of thrombus formation was observed in a higher, but not significant, proportion of group II patients (65%) as compared with group I(30%). The incidence of intimal tearing or dissection was similar in the two groups of patients (40 vs. 34.7%). The overall final success rate of the complicated angioplasty series was 48% (6/33). However, the success rate was lower (10%) in group I than in group II patients (10 vs. 65%; P < 0.005), and the frequency of emergency coronary artery bypass grafting was lower in group II patients (13 vs. 60%; P = 0.01), suggesting that thrombolytic therapy with urokinase may be effective in the management of acute coronary occlusion and thromboembolic complications of coronary angioplasty.
Effectiveness of the Arani double‐loop guiding catheters in angioplasty of aorto‐coronary vein grafts
Authors: Arani Djavad T. , Visco John P. , Conley James G. , Bunnell Ivan L. 
Published: March 2007

AbstractDouble‐loop guiding catheters have been used for angioplasty of aorto‐coronary vein grafts (VG) or grafted arteries through the VG in 31 cases. A catheter with a 90° primary curve was usually the best choice for angioplasty of the VG to the right coronary artery (RCA). For angioplasty of the VG to the left coronary artery branches (LCA), a 90° primary curve was used when the proximal segment of the VG was oriented horizontally and a 75° (USCI, C.R. Bard, Inc., Billerica, MA) was used when the proximal segment was directed superiorly.Angioplasty of 32 lesions was attempted in 31 patients. These catheters provided good “back‐up” in angioplasty of 30 lesions (94%). The lesions were crossed with balloon catheters in 29 cases (91%). There was one acute VG occlusion requiring coronary artery bypass graft (CABG) surgery, a complication not attributed to the guiding catheter. We conclude that Arani guiding catheters provide strong back‐up, are helpful in angioplasty of the vein grafts, and could be used as the primary choice for VG angioplasties.
Swan‐Ganz catheter‐induced rupture of the pulmonary artery: Successful early management by transcatheter embolization
Authors: Jondeau Guillaume , Lacombe Pascal , Rocha Paulo , Rigaud Michel , Hardy Anne , Bourdarias Jean‐Pierre 
Published: March 2007

AbstractAn 84‐year‐old patient with severe aortic valve stenosis suffered Swan‐Ganz catheterinduced massive pulmonary hemorrhage. Immediate therapeutic embolism of the segmental artery by using a liquid, tissue‐adhesive, occlusive agent (isobutyl‐2‐cyanoacrylate) controlled bleeding.
Estimation of coronary flow reserve by intracoronary doppler flow probes and digital angiography
Authors: Graham Susan P. , Cohen Mark D. , Hodgson John McB. 
Published: March 2007

AbstractThis prospective study investigated two different methods used clinically to estimate coronary flow reserve during cardiac catheterization. First, the relationship between simultaneous digital angiography and intracoronary Doppler velocity measurements was determined in 61 patients. The correlation coefficient for 233 simultaneous pairs of papaverine‐induced flow reserve was 0.70 (Doppler = 0.41 digital + 0.93, P<0.0001). Repeated basal flow determinations showed little variability (Doppler: 2 ± 5% (mean ± 95% confidence intervals); digital: 3 ± 10%). Repeated hyperemic flow estimates by the Doppler technique were more reproducible (10 ± 2%) than those by the digital method (26 ± 6%).Second, estimates of coronary flow reserve by side‐mounted and end‐mounted Doppler catheters were compared in vitro and in patients. In vitro measurement of blood velocity was linear for both catheter designs and was highly correlated with volume flow determined by electromagnetic flow meter (r = 0.99 side‐mounted; r = 0.96 end‐mounted). In patients (n=20), average coronary flow reserve for the side‐mounted Doppler crystal was 2.64 ± 0.15 and for the end‐mounted Doppler crystal was 2.40 ± 0.14 (P0.02). When flow reserve was determined twice for each catheter, there was greater variability in repeated measurements using the side‐mounted Doppler crystal (21 ± 10%, n = 14) than using the end‐mounted Doppler crystal (12 ± 4%, n = 32). When the two catheters were placed sequentially in the same patient, measurements of flow reserve varied by 19.0 ± 5.5% (n =20). A specially constructed catheter with both side‐ and end‐mounted crystals on the same shaft was evaluated in five patients. Coronary flow reserve was similar for both crystals (side: 2.54 ± .68, end: 2.60 ± .20) but variation between crystals remained high (19.8 ± 4.4%).
Total inferior vena cava thrombosis following coronary artery bypass surgery
Authors: Rama Bhola N. , Salem Bakr I. , Haikal Maged , Mera Ronald , Ortbals David , Gowda Siddhesh 
Published: March 2007

AbstractA 44‐yr‐old male presented with abdominal and back pain following coronary bypass surgery (CABG). Total inferior vena cava (IVC) thrombosis was then documented by computed tomography as well as IVC contrast cineangiography. Furthermore, the patient developed multiple pulmonary emboli.This presentation with severe abdominal and back pain with lack of early peripheral edema without apparent hepatic or renal dysfunction and with extreme elevation of erythrocyte sedimentation rate seems rather unusual.To our knowledge, such massive IVC thrombosis has not been reported following CABG. Thrombolytic and anticoagulant therapy was utilized with good recovery.
Foreign body retrieval using a simple snare device
Authors: Bogart Douglas B. , Earnest James B. , Miller John T. 
Published: March 2007

AbstractWe report three patients who had intravascular catheter fragments removed using an easily made snare device fashioned from a 0.038 inch movable‐core J‐wire and a multipurpose catheter. The device is easily manipulated and facilitates safe removal of embolized catheters.
Retrieval of a fractured USCI probe tip from a diseased coronary artery using another fixed‐wire balloon catheter, the Cordis Orion
Authors: Feldman Robert L. , Trice William A. , Hennemann Willard W. , Furst Ariel 
Published: March 2007

AbstractWe report a novel technique for removing an intracoronay wire fragment using a fixedwire steerable angioplasty balloon catheter, the Cordis Orion.
Left ventricular pressure effects on right ventricular pressure and volume outflow
Authors: Damiano Ralph J. , Cox James L. , Lowe James E. , Santamore William P. 
Published: March 2007

AbstractMassive destruction of the right ventricular free wall has been shown to cause only mild hemodynamic alterations. Further, the derivative of right ventricular (RV) pressure (P) is broad or double peaked, with one peak occurring coincidentally with peak left ventricular (LV) dP/dt. Both observations suggest a direct LV assistance to RV function. Since the ventricles contract nearly simultaneously, the relative contribution of LV to RV pump function has been difficult to determine. This LV assistance was quantified in six canine experiments using a unique electrically isolated RV preparation. While on total cardiopulmonary bypass, the RV free wall was electrically isolated from the remainder of the heart. This preparation allowed for wide variations in the timing interval between RV and LV contractions. Double‐peaked waveforms for RVP and pulmonary flow (RVF) occurred over a wide range (0 to 300 ms) of pacing intervals between the RV and LV. One derivative peak always followed RV contraction for RVP and RVF (r = 0.971 ± .011, P 0.01: r = 0.972 ± .012, p < 0.01; respectively). The second derivative peak was unrelated to the RA‐RV pacing interval (r = 0.297 ± .191, P > 0.5 RVP; 4 = 0.237 ± .278, P > 0.5 RVF), but corresponded to the maximal LVP rise. Additionally, the magnitude of the two derivative peaks was similar when the ventricles contracted synchronously. When RV contraction preceded or followed LV contraction, the derivative peak associated with LV contraction was significantly greater (P < 0.05, range 2.1 ± 0.6 to 6.7 ± 1.6 for RVP; P ± 0.05 range 1.9 ± 0.4 to 6.7 ± 1.5 for RVF) than the derivative associated with RV contraction. These data demonstrate a normally present, large LV assistance to RV contraction and may help to explain the RV response to myocardial infarction.
Probe exchange catheter used for angioplasty of total coronary artery occlusions
Authors: Kiemeneij F. , Suwarganda J. S. M. , van der Wieken L. R. 
Published: March 2007

AbstractPercutaneous transluminal coronary angioplasty (PTCA) for total occlusions frequently fails, because the guidewire fails to pass the occlusion. With the use of the Probe exchange catheter (PEC), however, stiffness of the guidewire is increased and a higher pushability is obtained in order to manipulate the guidewire beyond the lesion. Once the guidewire has passed, the PEC is advanced and a non‐over‐the‐wire dilatation catheter can be introduced through the PEC. This paper describes the technique in a representative case. The results of this technique in 19 consecutive patients with class III‐IV/IV(NYHA) angina due to an occluded coronary artery are presented. In 16 patients the PEC reached the lesion (84%) and in all these patients the guidewire could pass the occlusion. A successful PTCA was performed in 14 patients (74%).
Detection and quantification of aortic regurgitation during aortic valvuloplasty
Authors: Lopez J. F. , Khouri M. 
Published: March 2007

AbstractThe degree of aortic regurgitation, before and after balloon aortic valvuloplasty, was assessed in 32 patients, using double indicator dilution curves: a) the forward curve was obtained by dye injection into the left ventricle and sampling in the aorta; b) the regurgitant curve was obtained by dye injection in the aorta and sampling in the left ventricle. A regurgitant index (RI) was calculated by obtaining the ratio of the areas of the triangles from regurgitant and forward curves. Eight‐five percent of the patients were 70 years or older. After valvuloplasty, aortic valve area increased from 0.5±t 0.3 cm2 to 0.7 ± 0.3 cm2 (P = 0002) while left ventricular to aortic gradient decreased from 77 ± 32 to 51 ± 24 (P=.0001). RI did not significantly change in 58% of patients, increased in 25%, and decreased in 15.2%. We conclude that in most patients undergoing aortic valvuloplasty, regurgitation does not change after the procedure. In some patients it may increase significantly, and in a few it may even decrease. Indicator dilution curves technique seems to provide a sensitive, accurate, and reproducible method to detect and quantify aortic incompetence before and after valvuloplasty.
Internal mammary angiography: A review of technical issues and newer methods
Authors: Kuntz Richard E. , Baim Donald S. 
Published: March 2007

AbstractUp to 90% of coronary bypass operations in some centers now include at least one IMA graft. In parallel with the increased use of IMA grafts, our catheterization laboratory records for 1986‐7–8 demonstrate a progressive increase in IMA angiography, both absolutely (11, 28, 48 cases/yr) and as a percent of restudy procedures performed after prior bypass (14, 25, 43%). Unfortunately, these records also show that cannulation of the right and left IMAs may involve substantial technical hurdles, resulting in a mean time of 19 ± 19 min from catheter insertion toselective IMA angiography.Based on this experience, we review a standard technique for IMA angiography using preformedcatheters, and describe alternative methods (including use of PTCA guidewires with or without super‐selective catheters, and non‐selective angiography utilizing a specially designed balloon occlusion catheter).
Aortic valve tumor: An unusual cause of coronary obstruction during cardiac catheterization
Authors: Israel Douglas H. , Sherman Warren , Sharma Samin K. , Estioko Manuel R. , Ambrose John A. 
Published: March 2007

AbstractCoronary artery obstruction during cardiac catheterization is a rare but serious complication that has been reported to occur in 0.15 to 0.5% of cases [1,2]. The most common causes of intraprocedural coronary occlusion include thromboembolism, air embolism, and coronary dissection. This report describes the angiographic findings of a patient who developed chest pain with electrocardiographic evidence of myocardial ischemia due to obstruction of the right coronary artery by an aortic valve tumor.
Hypothesis: Warfarin administered simultaneously with heparin infusion will prevent heparin‐discontinuance associated coronary Thrombosis
Authors: Craddock Lane , Miller Brian , Krumbach Barbara , Marmont Paula , Shander David 
Published: March 2007

AbstractRecent studies have evidenced an association between the time of heparin discontinuance and coronary artery reocclusion. Some investigators have concluded that inadequate heparinization was responsible, and further heparin infusion or an increase in dose would have been indicated. However, several investigators (Rao: Thrombosis Research 24:181–186, 1981; Marciniak and Gockerman: Lancet September 17:581–584, 1977; Fisken et al.: Lancet December 10: 1231, 1977; Conard et al.: Thrombosis Research 22:507–511, 1981; Kakkar et al.: Lancet January 12:103–104; Green: Lancet February 16:374,375; Harborne and Nicolaides: Thrombosis Research 43:657–662, 1986; Bonen et al.: Thrombosis Research 27:123–124, 1982; Blomback et al.: Acta Physiologica Scandinavica 58:306–318, 1963; Holm et al.: Scandinavian Journal of Haematology 35:564–569, 1985; Andersson et al.: Thrombosis Research 34:333–340,1984) have demonstrated that antithrombin III levels are reduced in patients on intravenous heparin. Both reduced antithrombin III levels and reduced rate of antithrombin inhibition of thrombin at the time of heparin discontinuance may increase the risk of coronary rethrombosis. If this theory is correct, increasing heparin infusion may exacerbate this risk. We propose an investigation that will provide evidence for or against the decreased antithrombin III theory, and in doing so, test an experimental therapy designed to prevent coronary reocclusion upon heparin discontinuance. In a randomized, placebo‐controlled double‐blinded study, we will determine whether simultaneous administration of warfarin with heparin initiation provides more time to increase antithrombin III levels and prevent coronary reocclusion upon heparin discontinuance, compared to heparin without warfarin therapy.
Retrograde coronary angioplasty of isolated arterial segments through saphenous vein bypass grafts
Authors: Kahn Joel K. , Hartzler Geoffrey O. 
Published: March 2007

AbstractProgression of native coronary artery disease proximal to the placement of saphenous vein grafts may leave arterial segments isolated by stenoses on either side. In 16 patients, we attempted coronary angioplasty in a retrograde direction through saphenous vein grafts to revascularize 17 isolated arterial segments. The retrograde dilatation was successful in 12 of 17 attempts (71%). Failure in 5 attempts was due to severe angulation between the graft insertion site and the retrograde proximal arterial limb. There were no major complications of these procedures. Symptoms and signs of myocardial ischemia were relieved following successful retrograde dilatation. Thus, retrograde dilatation through saphenous vein grafts provides another means of achieving complete revascularization using coronary angioplasty in patients with prior coronary bypass surgery.
Preliminary results utilizing a new percutaneous transluminal coronary angioplasty balloon catheter
Authors: Talley J. David , Joseph Abraham , Kupersmith Joel 
Published: March 2007

AbstractWe report our initial experience with a new percutaneous transluminal coronary angioplasty (PTCA) balloon catheter and compare it to a similar over‐the‐wire system in a retrospective, nonrandomized fashion. There was no statistical difference in pre‐PTCA angiographic indices and post‐PTCA angiographic and clinical success rates between the two groups. There was a trend toward a decrease in length of fluoroscopy (P = 08) and a significant decrease in the amount of contrast utilized (P = .007) with the new balloon catheter. Several new construction features of the new catheter account for this improvement and are discussed. The long‐term success of this balloon catheter remains to be investigated.
Successful resuscitation of a patient with critical aortic stenosis and cardiac arrest by peripheral cardiopulmonary support system
Authors: Pavlides Gregory , Cieszkowski John , Timmis Gerald C. , O'Neill William 
Published: March 2007

AbstractPatients with critical aortic stenosis have an increased risk of complications during diagnostic cardiac catheterization, and those who arrest are particularly difficult to resuscitate. Recent advances in therapeutic techniques may change this unfavorable prognosis, as it is illustrated in the presented case. A 68 year‐old women with critical aortic stenosis sustained a cardiac arrest during diagnostic cardiac catheterization. Conventional cardiopulmonary resuscitation for 45 minutes failed to restore cardiac function and rhythm, which had degenerated to ventricular fibrillation, electromechanical dissociation, and asystole. Peripheral cardiopulmonary support system restored cardiac rhythm and blood pressure, with a subsequent successful aortic valve replacement.
Circumferential rupture and entrapment of a balloon‐On‐a‐wire device during coronary angioplasty
Authors: Nukta Emad , Meier Bernhard , Urban Philip , Muller Thierry 
Published: March 2007

AbstractWhile attempting to dilate a distal lesion in a right coronary artery, using a balloonon‐a‐wire catheter, circumferential balloon rupture occurred with temporary entrapment of the balloon in the stenosis. The balloon was retrieved, and the dilatation completed, using an over‐the‐wireballoon catheter.
Accuracy of subjective and computer‐assisted assessments of angiographic left ventricular regional wall motion
Authors: Kussmaul William G. , Kleaveland J. Patrick , Zeevi Gary R. , Hirshfeld John W. 
Published: March 2007

AbstractTo evaluate the accuracy of angiographic methods for analysis of left ventricular regional wall motion, we measured the ability of a carefully performed subjective analysis (three independent observers) and that of three computer‐assisted methods (centerline, radial, and area) to detect the presence of significant coronary artery disease. Normal ranges were established in 90 studies showing normal wall motion, and accuracy was tested in a second, consecutive series of 43 ventriculograms. The results show that the subjective method best separated those regions with from those without significant coronary disease. The subjective method also demonstrated sensitivity comparable to the centerline and radial methods. Among the computer‐assisted methods, the area method was least sensitive but most specific for both anterior and inferior region coronary disease. The centerline and radial methods were highly sensitive, but less specific. When coronary disease was defined by electrocardiographic Q‐waves, the area method had superior accuracy. Further analysis showed the following: 1) For the centerline and radial methods, long‐axis reregistration of the end‐systolic frame resulted in loss of sensitivity but increased specificity for anterior wall coronary disease, and little change in analysis of the inferior wall; 2) inclusion or exclusion of the apex had little effect on predictive accuracy for anterior wall coronary disease; 3) as expected, sensitivity and specificity results of all methods were dependent on the selection of a normal range cutoff value; but when performance was optimized, the subjective and area methods had a higher overall predictive accuracy than the centerline method; 4) It is likely that all three computer‐assisted methods could be calibrated to give indications of degrees of hypokinesis, as their results correlated well with subjective observers evaluations over the entire range of scores. These results should assist in selection of the optimal method for regional wall motion analysis in clinical and research applications. As currently applied, the area method is the most specific of the computer‐assisted methods tested; the centerline and radial methods have highest sensitivity and therefore are most suited to detection of mild degrees of hypokinesis.
Anomalous origin of the posterior descending artery from the obtuse marginal
Authors: Ilia Reuben , Gilutz Harel , Gussarsky Yehoshua , Gueron Moshe 
Published: March 2007

AbstractWe describe a patient with an unusual coronary anatomic variant in which the obtuse marginal gives rise to the posterior descending artery. The angiographic features and clinical recognition of this anomaly are reviewed.
Fractured and retained guide‐wire fragment during coronary angioplasty—unforeseen late sequelae
Authors: Doorey Andrew J. , Stillabower Michael 
Published: March 2007

AbstractDuring a difficult coronary angioplasty, the tip of the guide wire became inadvertently wedged in a distal vessel, fractured, and retained in situ. Because of the otherwise successful nature of the angioplasty and the patient's great risk for cardiac surgery, it was elected to leave the wire fragment in place. Recurrence of symptoms led to recatheterization, which in addition to restenosis of the original angioplasty site showed diffuse narrowing of the arterial segment that contained the retained wire fragment. This occurred despite systemic anticoagulation with Coumadin in the interval between procedures. Thus retained guide wire fragments in patent coronaryarteries may cause arterial narrowing despite systemic anticoagulation.
Entrapment of a folded‐over introducer sheath in the lliofemoral artery: An unusual complication of PTCA guiding catheter exchange
Authors: Marsa Robert J. , Smith Douglas C. , Park Jeong S. , Jang G. David 
Published: March 2007

AbstractAn arterial introducer sheath became folded over in the iliac artery during PTCA. This probably resulted from withdrawal of a doubled over Judkins left coronary guiding catheter through the introducer sheath. Nonsurgical, atraumatic removal was accomplished after the acute bend of the introducer sheath had been withdrawn to the site of arterial entrance.
An alternative method for transcatheter retrieval of intracoronary angioplasty equipment fragments
Authors: Mintz Gary S. , Bemis Charles E. , Ali Unwala A. , Hadjimiltiades Stavros , Kimbiris Demetrios 
Published: March 2007

AbstractA case is described of retrieval of the broken wire tip of a Probe balloon catheter from the distal right coronary artery with the help of a grasping forceps type of retrieval device.