bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of respiration and vasodilation on venous volume in animals and man, as measured with an impedance catheter
Authors: Ferguson James J. , Miller Michael J. , Sahagian Peter , Aroesty Julian M. , McKay Raymond G. 
Published: March 2007

AbstractVenous return determines cardiac preload and is in turn affected by respiration and vasodilation. The purpose of the present study was to examine the dynamics of venous return and venous volume, using impedance volume measurements in the venous system. In order to develop a methodology for the assessment of venous volume and venous return in man, we first studied 17 endotracheally intubated and ventilated anesthetized closed‐chest dogs. We measured central venous and inferior vena cava (IVC) pressure (micromanometer) and volume (impedance catheter). Studies were done above and below the diaphragm with normal ventilation, with positive end‐expiratory pressure (PEEP), and with beta‐adrenergic blockade and i.v. nitroglycerin. Intrathoracic IVC volume fell and extrathoracic IVC volume rose with lung inflation, while PEEP raised extrathoracic IVC volume and lowered intrathoracic IVC volume. Nitroglycerin lowered intrathoracic IVC volume. Beta blockade did not affect IVC volume, ventilatory variation, or response to PEEP and nitroglycerin. We performed similar studies in 14 human subjects during normal quiet respiration, with measurements above and below the diaphragm, and with interventions including Valsalva maneuver and i.v. nitroglycerin. Intrathoracic IVC volume fell and extrathoracic IVC volume rose with expiration and Valsalva maneuver. Nitroglycerin again lowered intrathoracic IVC volume.We conclude that venous volume and the dynamics of venous return can be assessed in animals and man with an impedance catheter. Specifically, we show the divergent effects of respiration, ventilation, PEEP, and nitroglycerin on IVC volumes above and below the diaphragm. Beta‐adrenergic blockage does not appear to play a role in altering any of these effects. Continuous measurement of venous pressure and impedance volume may be used in the future to examine more closely venous pressure‐volume relationships.
Left heart catheterization by direct ventricular puncture: Withstanding the test of time
Authors: Morgan J. M. , Gray H. H. , Gelder C. , Miller G. A. H. 
Published: March 2007

AbstractIf retrograde arterial catheterization of the left ventricle fails because of a stenosed native or tissue valve or is contraindicated because of the presence of a mechanical aortic prosthesis, then alternative routes of access to the left ventricle are either transseptal or direct (transapical) left ventricular puncture. The transseptal approach is contraindicated in the presence of a mechanical mitral valve prosthesis. Under these circumstances we have used direct transapical left ventricular puncture in the treatment of 112 patients and have found this technique to be successful with little associated risk. A major complication occurred in 3% of the patients, but the study provided the required data in 95%, and these figures compare favorably with the reported results of transseptal catheterization.
Angina and vasospasm at rest in a patient with an anomalous left coronary system
Authors: Maddoux Gerry L. , Goss Jerome E. , Ramo Barry W. , Raff Gilbert L. , Heuser Richard R. , Shadoff Neal , Leatherman George F. , Blake Kathleen , Wilson John N. , Deane William M. , Hoyt Thomas W. , Fowler Burt N. , Gerety Richard L. , Sansonetti Diane 
Published: March 2007

AbstractAn anomalous left main coronary artery with passage between the right ventricular infundibulum and aortic root has been incriminated as the causation of sudden death in a small number of individuals, many of whom are quite young. Mechanical features such as angulation and compression are most often incriminated. A 59‐year‐old man with such a coronary anomaly who had chest pain at rest, ST segment elevation, and ventricular tachycardia, but who had no evidence of effort‐related myocardial ischemia, is reported. Improvement in the degree of coronary tone in the anomalous left main coronary with intracoronary nitroglycerin administration was demonstrated. This represents the first report of an individual with an anomalous left main coronary system with ventricular tachycardia/ventricular fibrillation and documented vasospasm in the anomalous artery.
Initial coronary occlusion improves tolerance to subsequent prolonged balloon inflations
Authors: Heibig Jacques , Bolli Roberto , Harris Scott 
Published: March 2007

AbstractAn acute coronary occlusion with severe ischemic signs during percutaneous transluminal coronary angioplasty was successfully treated with a long balloon inflation. Subsequent balloon inflations did not produce ischemic signs. Distal coronary occlusion pressure rose significantly during balloon inflations of more than 2 min. It is hypothesized that an initial ischemic occlusion may improve tolerance to prolonged coronary occlusions. The underlying mechanism may be that further coronary collateral circulation is recruited over time.
Mitral valve rupture during percutaneous dilation of aortic valve stenosis
Authors: De Ubago Jose Luis M. , De Prada Jose Antonio Vazquez , Moujir Fernando , Olalla Juan Jose , Figueroa Alvaro , Colman Thierry 
Published: March 2007

AbstractA 62‐year‐old patient underwent catheter balloon valvuloplasty for aortic valve stenosis. During the procedure, iatrogenic severe mitral regurgitation was induced, requiring emergency surgery. At operation, extensive laceration of the septal mitral leaflet was found; chordae tendinae were intact.Retrospective examination of the cineangiogram revealed the presence of balloon indentation at the chordal level during inflation, which disappeared at full inflation. Mitral valve rupture was probably related to balloon entrapment in chordae tendinae, severe chordal stretching at inflation, and subsequent valve laceration.This severe complication or aortic valvuloplasty in adults has not been reported previously and probably could be avoided by careful observation of guidewire and balloon position before inflation.
Fatal aortic rupture: An unusual complication of percutaneous balloon valvuloplasty for acquired valvular aortic stenosis
Authors: Vrolix Matty , Piessens Jan , Moerman Philip , Vanhaecke Johan , De Geest Hilaire 
Published: March 2007

AbstractA case report complicated by a perforation of the ascending aorta during percutaneous balloon valvuloplasty for acquired aortic stenosis in a bicuspid aortic valve is presented. The clinical and pathological findings are discussed. It is suggested that in patients with hard calcified valve cusps and calcifications of the aortic annulus balloon sizes exceeding the aortic diameter should be avoided.
Coronary air embolism during coronary angioplasty
Authors: Hadjimiltiades Stavros , Goldbaum Thomas S. , Mostel Ed , Mintz Gary S. , Kimbiris Demetrios 
Published: March 2007

AbstractA case is described in which the use of the Hartzler microcatheter during coronary angioplasty resulted in coronary air embolism. The recognition, prevention, and mechanism of this occurrence are discussed.
Dual connection of the left anterior descending coronary artery to the left and right coronary arteries
Authors: Bittner Vera , Nath Hrudaya P. , Cohen Mark , Soto Benigno 
Published: March 2007

AbstractOrigin of the left anterior descending coronary artery from the right coronary artery is a well‐described but rare congenital coronary anomaly. In this report, we describe two cases in which the mid left anterior descending coronary artery is connected to the right coronary artery through an intraseptal connecting vessel, while the proximal left anterior descending coronary artery originates normally from the left main coronary artery. This previously unreported pattern suggests partial persistence of the peritruncal ring, which occurs during normal embryologic development of the coronary circulation. Even though it is classically described as an epicardial structure, the vascular pattern in our cases suggests that the peritruncal ring may have an intramural segment in some individuals.
Echocardiographic findings in patients with acquired immunodeficiency syndrome (AIDS) and AIDS‐related complex (ARC)
Authors: Kinney Evlin L. , Brafman David , Wright Robert J. 
Published: March 2007

AbstractAlthough a variety of cardiac abnormalities have been described in AIDS patients, it is unclear whether these are incidental findings or they presage clinically important heart disease. Also, because AIDS‐related complex (ARC) is, in general, a milder form of AIDS, we wondered if echocardiographic abnormalities would differ in kind or in frequency, when compared with AIDS. To answer these questions, we studied the echocardiographic findings and the demographic features of 15 patients with AIDS and 24 patients with ARC. The ARC group had abnormalities in the same proportion as in our AIDS group, except for echocardiographic mitral valve prolapse. The MVP, however, did not appear to be due to intrinsic valvular disease. Rather, echocardiographic MVP was associated with low body weight (P = .02) but not with the cardiac signs or symptoms of MVP. Four AIDS patients had LV dysfunction. Of the echocardiographic variables, only a wide EPSS was significantly correlated with survival, as it is in other populations. We conclude that although echocardiographic abnormalities are common in AIDS and ARC patients, most of these abnormalities lack clinical significance.
Anomalous drainage of the inferior vena cava into a left atrial connection: A case report involving a 41‐year‐old man
Authors: Meyers David G. , Latson Larry A. , McManus Bruce M. , Fleming William H. 
Published: March 2007

AbstractA 41‐year‐old man had an anomalous inferior vena cava directly connected to the left atrium demonstrated by contrast echocardiography, magnetic resonance imaging, angiography, and at operation. The anomaly is due to developmental failure of the right sinus venosus valve, septum secundum, and dorsal portion of the atrial septum.
Myocardial infarction due to multiple coronary‐ventricular fistulas
Authors: McLellan Bruce A. , Pelikan Peter C. D. 
Published: March 2007

AbstractCoronary‐ventricular fistulas have been described in both right and left coronary arteries and have been implicated in causing cardiac symptoms and coronary ischemia. We present a case of three‐vessel coronary‐ventricular fistulas emptying into both ventricles, associated with a left‐to‐right shunt and a myocardial infarction.
Coronary bifurcation stenoses: The kissing balloon probe technique via a single guiding catheter
Authors: Myler Richard K. , McConahay David R. , Stertzer Simon H. , Johnson Warren , Cumberland David C. , Boucher Ralph A. , Hidalgo Benito 
Published: March 2007

AbstractA new technique employing two balloon probes via a single (large‐lumen) guiding catheter is described. Examples involving the left anterior descending, diagonal, left main (protected), left circumflex‐obtuse marginal, and atrioventricular branches and the right coronary artery‐posterior descending and posterolateral branches are described and illustrated.This new technology (balloon probes and large‐lumen guiding catheter) permits an effective and simplified alternative to the use of the single‐guide/two‐wire and doubleguide/two‐dilatation catheter‐wire approaches in selected cases in which significant branch vessels (vis‐a‐vis myocardial regional blood supply) are at risk.
Coronary arteriography 1984–1987: A report of the registry of the society for cardiac angiography and interventions. II. An analysis of 218 deaths related to coronary arteriography
Authors: Lozner Eugene C. , Johnson Lewis W. , Johnson Sarah , Krone Ronald , Pichard Augusto D. , Vetrovec George W. , Noto Thomas J. ,   The Registry Committee of the Society for Cardiac Angiography and Interventions
Published: March 2007

AbstractIn a 42‐month period, 218 deaths occurred in 222, 553 patients undergoing coronary arteriography (0.098%). Age > 60 years, NYHA Class IV function, presence of left main coronary disease, and ejection fraction < 30% all significantly increased the risk of the procedure. Sex and approach (brachial or femoral) used for the catheterization did not affect mortality. Since the SCAI report in 1982, the death rate has dropped significantly in high‐risk patients. Low‐risk patients (NYHA Class I or normal coronary arteries) who died generally were elderly or had associated valvular heart disease.
Early occlusion following successful coronary angioplasty: Clinical and angiographic observations
Authors: Goldbaum Thomas , Disciascio Germano , Cowley Michael J. , Vetrovec George W. 
Published: March 2007

AbstractTo assess clinical and angiographic features of early occlusion after percutaneous transluminal coronary angloplasty (PTCA), 25 successful PTCA procedures (3%) with early occlusion were analyzed from a PTCA population of 917. Twenty patients (80%) had unstable angina, while 12 (48%) had a recent (< 1 mo) myocardial infarction subtended by the PTCA vessel. All patients received a calcium blocker, aspirin, dipyridamole, and heparin prior to PTCA. In 20 of 25 patients (80%), occlusion occurred in the catheterization laboratory, while five occurred out of laboratory, three within 5 hours and 1 each within 24 and 48 hours. Angiographic features before PTCA included complex lesions (hazy, stained, or ulcerated) in 12 (48%) and intracoronary filling defects in eight patients (32%). Post‐PTCA intracoronary filling defects were present in 17 dilated stenoses (68%). Compared to a consecutive control population of 100 patients with similar demographics but without acute occlusion, the frequency of unstable angina, acute myocardial infarction, and filling defects was greater in patients with early occlusion (P < .001 for all). Intracoronary nitroglycerin was utilized in all patients with reopening in only one (4%), while bypass surgery was performed in five (20%). Intravenous streptokinase was administered to two patients with reperfusion in one. Immediate repeat PTCA was successful in 15 of 17 patients (88%).In summary, recent unstable angina, myocardial infarction, complex lesions or intracoronary filling defects before and particularly after PTCA all suggest an association of clot with early occlusion. Immediate repeat PTCA is frequently successful.
Coronary angioplasty in a patient with dextrocardia
Authors: Gaglani Rajesh , Gabos Dennis K. , Sangani Bharat H. 
Published: March 2007

AbstractThis report, concerning the procedures applied to a patient with dextrocardia, describes how such a patient was able to undergo a normal diagnostic catheterization. These data should be added to the limited data on interventional procedures in patients who have this anomaly.
Single large‐balloon percutaneous mitral valvuloplasty
Authors: Herrmann Howard C. , Kussmaul William G. , Hirshfeld John W. 
Published: March 2007

AbstractSuccessful percutaneous balloon mitral valvuloplasty was performed in six patients utilizing single large (up to 30 mm diameter) balloons. Mitral valve area increased from 1.1 ± 0.1 to 2.5 ± 0.3 cm2 (P < 0.01), and there were no complications or significant increases in mitral regurgitation. Single largeballoon mitral valvuloplasty may be as effective as the currently used double‐balloon technique and may allow the procedure to be performed more easily and quickly.
Morphology of coronary lesions in the prediction of early ptca outcome
Authors: Haft Jacob I. , Bassil Habib F. , Goldstein Jonathan E. , Haik Bruce 
Published: March 2007

AbstractThe coronary lesions in 164 patients who underwent 194 PTCA procedures were analyzed in an effort to define if there were morphological characteristics that would predict thrombotic problems following percutaneous transluminal angioplasty (PTCA). Patients with smooth and concentric or eccentric lesions rarely had difficulty at PTCA, whereas those with filling defects or with eccentric and irregular lesions frequently had postprocedure thrombi. Total occlusions were amenable to angioplasty when there was lesion staining present, but the success rate was significantly less in patients in whom there was no staining. These findings suggest that the acute outcome of PTCA can be predicted on the basis of the morphology of coronary lesions on preprocedure angiography.
Acute reocclusion during percutaneous transluminal coronary angioplasty: Immediate and long‐term outcome
Authors: Buccino Kenneth R. , Brenner Alan S. , Browne Kevin F. 
Published: March 2007

AbstractAcute total occlusion of a coronary artery during percutaneous transluminal coronary angioplasty (PTCA) has previously resulted in emergency surgical intervention (CABG). We retrospectively surveyed 211 elective procedures and 65 procedures for acute myocardial infarction (AMI). There were 42 patients (pts) [29 elective (14%) and 13 AMI (20%)] in whom total occlusion occurred after initial dilation had been achieved. In 30 of 42 pts reangioplasty successfully reperfused the vessel. Ten patients (24%) required CABG and two (5%) were treated medically for AMI. Death occurred in 2 pts due to irreversible cardiogenic shock despite successful angioplasty. After 6 months follow‐up 22 pts remained asymptomatic. It is concluded that aggressive redilation of total occlusions which develop during PTCA will frequently result in a successful angioplasty with a long‐term restenosis rate comparable to uncomplicated angioplasty.
Results of percutaneous valvuloplasty for calcific aortic stenosis with different balloon catheters
Authors: Voudris V. , Drobinski G. , L'Epine Y. , Sotirov I. , Moussallem N. , Canny M. 
Published: March 2007

AbstractPercutaneous aortic valvuloplasty is a palliative treatment for patients with calcific aortic stenosis who would be poor candidates for surgical treatment. The results and associated complications of this procedure were analysed in a series of 47 patients in which different types of dilating catheters were used. In 25 patients a single balloon (19 mm) was used (group A), in 13 patients a bifoil balloon (2 × 15mm) (group B), and in the remaining nine patients (group C) a trefoil balloon (3 × 10mm) was used. An increase in aortic valve area was achieved in all patients. The results obtained with the bifoil balloon were better than with the other types of balloon catheter, with an increase in aortic area of + 118% vs. + 74% (monofoil) and + 76% (trefoil) (P < 0.05). The tolerance of the inflation procedure was also better with this type of balloon, as it allowed for shorter inflation and deflation times. These results show that balloon aortic valvuloplasty, when indicated, is best performed with a bifoil balloon dilating catheter, and undue complications usually do not occur.
Angioplasty of unusually large coronary arteries using the hugging balloon technique via a single guiding catheter
Authors: Mayo Joseph R. , Myler Richard K. , Stertzer Simon H. , Cumberland David C. , Bashour Tali , Manubens Sergio , Hidalgo Benito 
Published: March 2007

AbstractUnusually large native coronary arteries, in particular those supplying expansive regions of myocardium, may not be adequately dilated using currently available coronary angioplasty catheters. The “hugging balloon” technique, in which two dilatation catheter balloons are simultaneously inflated side‐by‐side, has been previously described for lesions in large saphenous vein grafts using the double guiding catheter (and dual entry site) technique. With the development of large lumen guiding catheters and lower profile dilatation catheters, we report the initial use of the hugging balloon technique via a single guiding catheter in oversized native coronary arteries.
Percutaneous aspiration of a coronary thrombus
Authors: Lablanche Jean Marc , Fourrier Jean Louis , Gommeaux Antoine , Becquart Jean , Bertrand Michel E. 
Published: March 2007

AbstractRight coronary artery occlusion by a thrombus occurred during the coronary angiography performed in a patient with anterior myocardial infarction. Emergency coronary aspiration was undertaken via a 9F guiding catheter, which allowed the thrombus to be removed. The patient, who was in cardiogenic shock, immediately improved and was subsequently discharged without any complications or sequelae.
Percutaneous transluminal angioplasty in diffuse subtotally occluded vein grafts
Authors: Shimshak Thomas M. , Hartzler Geoffrey O. 
Published: March 2007

AbstractIn this brief case report, we describe the results of percutaneous transluminal angioplasty in two diffusely diseased, atretic saphenous vein grafts 18 and 72 months after surgery. At late follow‐up, both patients remain angina‐free. Although the diffuse nature of such lesions may be associated with increaced rates of restenosis, these preliminary observations support future efforts to dilate similar, chronically diseased saphenous vein grafts.
Use of pulmonary capillary wedge aspirates for the antemortem diagnosis of pulmonary microvascular tumor
Authors: Safian Robert D. , Come Steven E. , Kadin Marshall , Lorell Beverly H. 
Published: March 2007

AbstractThe diagnosis of pulmonary lymphangitic carcinoma usually requires fiberoptic bronchoscopy with transbronchial biopsy, percutaneous needle aspiration of the lung, and/or open lung biopsy. We performed right heart catheterization in three patients with adenocarcinoma, in whom the diagnosis of pulmonary lymphangitic carcinoma was made on the basis of cytologic examination of pulmonary capillary blood.
Preoperative left ventricular wall stress, ejection fraction, and aortic valve gradient as prognostic indicators in aortic valve stenosis
Authors: Smucker Mark L. , Manning Scott B. , Stuckey Thomas D. , Tyson Donald L. , Nygaard Thomas W. , Kron Irving L. 
Published: March 2007

AbstractPatients with aortic valve stenosis (AS) and left ventricular (LV) dysfunction may dramatically improve after aortic valve replacement, but operative risk is high. In an earlier study, all patients with low preoperative wall stress and low ejection fraction, or with low aortic valve gradient, died or had persistent heart failure after operation. Because wall stress is difficult to calculate, we reassessed its effect and the effect of other preoperative characteristics on outcome in 66 consecutive catheterization patients with predominant aortic stenosis referred for valve replacement. Despite ejection fraction that was inordinately low compared with afterloading wall stress in nine patients, seven patients improved with surgery. All three patients with ejection fraction < 20% improved after surgery. Two of three patients with mean aortic valve gradients of < 30 mm Hg improved. Mortality was 33% in patients with mean gradient < 30 mm Hg and 19% with mean gradient < 50 mm Hg. In the 54 patients with calculated aortic valve areas of ≤ 0.8 cm2, 1 (2%) had continuing heart failure, while 6 of 12 (50%, P < .01) patients with aortic valve areas of 0.9–1.2 cm2 had continued symptoms of or died of heart failure. Patients who died or failed to improve after operation were older (71 ± 9 years) than those who improved (65 ± 9 years, P = .02). We conclude that wall stress calculations do not predict which patients with aortic stenosis will benefit from aortic valve replacement and that poor left ventricular function and low mean aortic valve gradient do not absolutely preclude operation. On the other hand, low gradient, non‐critical valve area, and advanced age are all relative contraindications to aortic valve replacement in aortic stenosis.