bluuebunny/crossref_metadata_2025_split huggingface dataset:
Double loop guiding catheter: A primary catheter for angioplasty of the right coronary artery
Authors: Arani Djavad T. , Bunnell Ivan L. , Visco John P. , Conley James G. 
Published: March 2007

AbstractDouble loop guiding catheters have been used for percutaneous transluminal coronary angioplasty (PTCA) of the right coronary artery (RCA) in 42 consecutive cases. A catheter with a 90‐ degree primary curve was used when the proximal RCA had horizontal or inferior orientation. When the proximal segment of the RCA was oriented superiorly (shepherd's crook), the catheter with a 75‐degree primary curve was used. Catheters were fabricated with short (1.5 cm) or long (2.3 cm) (USCI, C.R. Bard, Inc., Billerica, MA) distal tips. Short‐tip catheters were satisfactory in the majority of cases. When the RCA had a complex course and more backup was necessary or when the ascending aorta was wide, long‐tip catheters were found to be the best choice.Angioplasty of 49 lesions was attempted in 42 consecutive patients. In 39 patients successful dilatation was achieved (93%). In three patients the procedure was unsuccessful. In one patient, the lesion could not be crossed with the guidewire despite an excellent backup. In another patient, two of three stenoses were dilated successfully; the distal lesion was crossed with a guidewire but could not be crossed with the balloon catheter in spite of a good backup. The lack of a satisfactory engagement and inadequate backup were responsible for the failure in only one patient. There were no complications related to these guiding catheters. We conclude that double loop guiding catheters are safe and can be the primary choice in all right coronary angioplasties. These catheters provide an excellent backup with consequent high success rate.
Angiographic demonstration of atherosclerotic stenosis, arterial spasm, and thrombus formation in an infarct‐related coronary artery
Authors: De Marchena Eduardo J. , Trohman Richard G. , Palomo Andres R. , Myerburg Robert J. , Kessler Kenneth M. 
Published: March 2007

AbstractClinical, angiographic, and pathologic data support the contention that atherosclerosis, platelet aggregation, and coronary vasomotility work in unison to cause coronary thrombosis, which in turn leads to myocardial infarction. A patient is described in whom, 2 months after an acute myocardial infarction, inducible coronary artery spasm and a nonocclusive thrombus were angiographically demonstrated at the site of a minimal atherosclerotic narrowing in the infarction‐related vessel. This report, to the best of our knowledge, is the first time that these three pathophysiologic mechanisms have been shown, in vivo, to be occurring concomitantly in an infarct‐related vessel. Documentation of the unified occurrence of these phenomena support the current concept of the pathophysiology of myocardial infarction.
Percutaneous transluminal angioplasty for shepherd's crook right coronary artery stenosis
Authors: Gossman David E. , Tuzcu E. Murat , Simpfendorfer Conrad , Beck Gerald J. 
Published: March 2007

AbstractAngiograms from 1,043 consecutive patients undergoing right coronary artery angioplasty were reviewed to determine the incidence of “shepherd's crook” origin of the right coronary artery. Primary results, complications, and technical difficulties were compared with a control group. Fifty‐one patients (4.9%) were found to have this anatomic variation. Compared with a control group, the primary success rate was lower (86% vs. 98%) and the incidence of procedural difficulties was higher (33% vs. 13%). Technical problems led to the use of more guiding catheters and more guidewires per patient than in the control group. Thus, coronary angioplasty of shepherd's crook right coronary artery imposes technical problems and is associated with less than an optimal primary success rate.
Chronic bundle branch block and use of temporary transvenous pacemakers during coronary arteriography
Authors: Gilchrist Ian C. , Md Airlie Cameron 
Published: March 2007

AbstractA retrospective analysis of 217 consecutive patients with chronic bundle branch blocks undergoing cardiac catheterization was done to evaluate the need for temporary transvenous pacing during coronary arteriography. In patients without temporary right ventricular pacemakers (n = 185), only one episode of high‐grade atrioventricular block occurred during coronary arteriography which required the urgent use of temporary pacing. All other bradyarrhythmias, including five episodes of transient asystole (greater than 3‐sec pause) and four episodes of artioventricular block (second degree or higher), were successfully managed without pacemaker utilization. Patients with prophylactic right ventricular pacemakers (n = 32) had a greater prevalence of ventricular fibrillation than those without pacing electrodes located in the right ventricle (2% vs. 9% respectively; P < 0.05). These findings suggest that routing phrophylactic pacemaker insertion during coronary arteriography in patients with chronic bundle branch block is not warranted and may place the patient at risk for developing iatrogenic ventricular arrhythmias.
Unstable angina secondary to left main coronary thrombus extending from prosthetic aortic valve
Authors: Avanindra Jain  , Mazanek Greg J. , Armitage John M. 
Published: March 2007

AbstractEmbolic complications due to prosthetic heart valves are common. The present report documents a left main coronary artery thrombus extending from a Starr Edward's aortic ball valve prothesis 22 years after its placement. It resulted in unstable angina and a small myocardial infarction. This rare complication illustrates the importance of adequate anticoagulation
Percutaneous radial artery approach for coronary angiography
Authors: Campeau Lucien 
Published: March 2007

AbstractPercutaneous entry into the distal radial artery and selective coronarography using a French 5 sheath and preshaded catheters were attempted in 100 patients with a normal Allen test. Cannulation of the radial artery was not possible in ten patients, and selective catheterization of the coronary arteries was unsuccessful in two. Manipulation of catheters presented no problem, and arterial spasm was rarely observed, only before the use of a 23‐cm‐long sheath. Only two complications without symptoms were observed: arterial dissection of the brachial artery in one patient and occlusion of the radial artery in another. With experience, this approach may become as effective and possibly safer than the transbrachial entry.
Search and retrieval of a radiolucent foreign object
Authors: McLvor Michael E. , Kaufman Stephen L. , Satre Richard , Porterfield James K. , Brinker Jeffrey A. 
Published: March 2007

AbstractSuccessful percutaneous removal of an intravascular foreign body requires precise localization of the object so that retrieval devices can be properly positioned. Here we report the successful search for and retrieval of a catheter embolus lost in the ascending aorta during PTCA whose localization was complicated because it was radiolucent.
Role of angioplasty in patients with previous coronary artery bypass surgery
Authors: Cooper Ian , Ineson Neil , Demirtas Ertan , Coltart John , Jenkins Stephea , Webb‐Peploe Michael 
Published: March 2007

AbstractFifty‐nine patients with previous coronary artery bypass surgery (CABG) underwent coronary artery or vein graft angioplasty following a recurrence of symptoms, 141 lesions were attempted in 70 procedures. The overall angiographic success rate was 77%. Some angiographic success was achieved in 83% of patients. Complications included myocardial infarction in three (4.3%), death in one (1.4%), and iliac artery thrombosis in one (1.4%). No patients were referred for urgent surgery. Twenty‐eight patients have undergone repeat coronary arteriography after 7.5 ± 2.6 months (mean ± SD), and 31% of lesions have recurred. Fifty‐eight percent of patients without recurrence at follow‐up continue to have improved symptoms. Treadmill exercise time was significantly prolonged in patients in whom all attempted lesions had been successfully dilated and in those in whom only some lesions were dilated. Our experience suggests that approximately 29% of patients with recurrence of angina following CABG may be suitable for angioplasty.
Use of the internal mammary artery guiding catheter for percutaneous transluminal coronary angioplasty of the shepherd's crook right coronary artery
Authors: Kulick Daniel L. 
Published: March 2007

AbstractPercutaneous transluminal coronary angioplasty (PTCA) of shepherd's crook right coronary arteries presents a difficult technical challenge. Presented here are two cases demonstrating the use of an internal mammary guiding catheter for PTCA of shepherd's crook right coronary arteries. The advantages of this guiding catheter, a short tip with an acute distal angle, are emphasized.
Coronary artery bypass grafts: New universal markers
Authors: Hoffman Richard B. , Po Jonathan B. 
Published: March 2007

AbstractThis report describes a new system to facilitate the identification of coronary artery bypass grafts during repeat coronary angiography. Geometric markers (square, triangle, circle, hexagon) are placed over the aortic end of the graft, with each geometric shape designating the target vessel of the graft, e.g. square, right coronary; triangle, anterior descending. This system significantly simplifies cannulation of the postoperative patient and also allows immediate recognition of specific vessels bypassed by mere perusal of the chest film.
Dissecting intramyocardial hematoma masquerading as a pseudoaneurysm of the left ventricle
Authors: Meyers David G. , Lund Gunnar B. , Moulton Anthony L. , Robinson Lary A. 
Published: March 2007

AbstractThis report presents a case of left ventricular intramyocardial dissection masquerading as a ventricular pseudoaneurysm, as documented by echocardiography, magnetic resonance imaging, and angiography with subsequent confirmation at operation.
Percutaneous balloon valvuloplasty for mitral stenosis complicated by fatal pericardial tamponade in a patient with extreme pulmonary hypertension
Authors: Berland J. , Gerber L. , Gamra H. , Boussadia H. , Cribier A. , Letac B. 
Published: March 2007

AbstractA case of left ventricular perforation by straight‐tipped balloon catheter during double‐balloon mitral valvuloplasty with fatal outcome is presented. Technical considerations to prevent this complication are discussed.
Simultaneous left ventricular and ascending aortic pressure measurements via single artery access for assessment of aortic stenosis
Authors: Nath Amar , Vetrovec George W. , Mukharji Jhulan , Cole Sharon , Lewis Stephen A. , Disciascio Germano , Cowley Michael J. 
Published: March 2007

AbstractIn order to determine the reliability of a single arterial access technique for hemodynamic assessment of aortic stenosis, data obtained from this method was compared with that from dual arterial access in 13 patients. A 59 cm long, 8 Fr. Mullins Transseptal Sheath (MTS) was placed in the ascending aorta (AA) and a 5 Fr. pigtail catheter advanced through the MTS (using a hemostatic “Y” adapter) into the left ventricle for simultaneous pressure recordings. Another 5 Fr. pigtail catheter (PTC) was advanced in the AA from the contralateral femoral artery. Peak pressures, AA pressure‐tracing characteristics, mean gradients, and the aortic valve area using tracings from the MTS and the PTC were compared. Peak pressures 120 ± 8 vs. 119 ± 8 mmHg (r = .998), “T” time .16 ± .01 vs. .15 ± .01 sec. (r = .913), “U” time .36 ± .02 vs. .36 ± .02 sec. (r = .983), mean gradients 38.4 ± 6.1 vs. 39.6 ± 6.9 mmHg (r = .990) and the AV area .78 ± .08 vs. 79 ± .08 cm2 (r = .994) were similar. Therefore, this single arterial technique provides data comparable to the traditional dual access system for hemodynamic assessment of aortic stenosis.
Precordial ST elevation with acute conus branch occlusion
Authors: Matthews Ray V. , Oesterle Stephen N. 
Published: March 2007

AbstractA 70‐year‐old man developed anterior precordial ST elevation during coronary angiography in the presence of a normal left coronary artery. Injection of a proximally totally occluded right coronary artery caused occlusion of the conus branch. The electrocardiographic findings are shown, and the pathogenesis is discussed.
Permanent cerebral blindness after cardiac catheterization
Authors: Thomas Timothy Darrell , Troost B. Todd 
Published: March 2007

AbstractCerebral blindness is usually a transient event that can complicate cardiac catheterization. The neurologic deficit clears in 1–3 days. We present a patient who developed permanent cerebral blindness after undergoing transfemoral cardiac catheterization. Bilateral hemorrhagic occipitotemporal infarcts were demonstrated on magnetic resonance imaging (MRI). The patient also demonstrated denial of blindness and had transient memory disturbances due to occipitotemporal lobe infarct. The probable source of the emboli was cardiac.
Relative efficiency and risk of endomyocardial biopsy: Comparisons in heart transplant and nontransplant patients
Authors: Anastasiou‐Nana Maria I. , O'Connell John B. , Nanas John N. , Sorensen Sherman G. , Anderson Jeffrey L. 
Published: March 2007

AbstractRight ventricular endomyocardial biopsy remains the gold standard for the diagnosis of acute rejection of the cardiac allograft. Among 704 consecutive procedures performed in 39 transplant recipients (2,842 myocardial samples), endomyocardial biopsy by either the right internal jugular (n = 661) or the femoral venous (n = 43) approach was compared with 243 consecutive procedures performed in nontransplant patients (n = 149 and n = 94, internal jugular and femoral approach, respectively). The internal jugular vein could not be located In only 0.61% (4/661) of heart transplant versus 5% (7/149) of nontransplant procedures (P < 0.001). Vascular access plus sufficient myocardial sampling was obtained in all but 0.61% (4/661) internal jugular procedures performed in heart transplant patients and in all but 7% (11/149) of those performed in nontransplant patients (P < 0.0001). (Vascular access was achieved in all femoral venous procedures performed in both transplant and nontransplant patients; sampling was successful after vascular access in all heart transplant recipients and all but two [2.1%] nontransplant procedures.) Cardiac complications occurred in nontransplant patients after one internal jugular procedure (cardiac perforation with tamponade) and after one femoral venous procedure (pericardial effusion). No cardiac complications occurred in transplant recipients, but 2 other complications were observed: One local abscess and one superior vena caval perforation with hemothorax associated with hypotension, both after an internal jugular approach. The overall efficiency (no safety problem; vascular access and adequate sample) was higher among transplant than nontransplant procedures (99% vs 93%, respectively, P < 0.0001). These observations continue to support routine application of endomyocardial biopsy for monitoring rejection in cardiac transplant patients. Safety and effectiveness of a single transvenous biopsy procedure in nontransplant patients, although still high, may not be equal to that predicted by the experience in transplant patients. These observations plus the more controversial nature of biopsy indications for nontransplant applications suggest greater caution in its use in nontransplant patients.
Effect of balloon aortic valvuloplasty on the dynamics of left ventricular ejection
Authors: Ferguson James J. , Bush Howard S. , Riuli Edward P. 
Published: March 2007

AbstractTo evaluate the effect of balloon aortic valvuloplasty on left ventricular ejection dynamics, simultaneous left ventricular and aortic pressures were obtained by use of a micromanometer catheter in nine patients before and after the procedure. Ejection times, stroke volumes (thermodilution), ejection rates, and pressure gradients were measured. For each parameter, ejection was then divided into two components: accelerative (onset systole to peak gradient) and decelerative (peak gradient to end systole).After valvuloplasty, there was (1) a decrease in overall ejection time and in mean and peak pressure gradients; (2) an increase in overall ejection rate; (3) no change in stroke volume or heart rate; (4) an increase in both accelerative and decelerative ejection rates and a decrease in the decelerative ejection time (expressed as a percentage of the R–R interval); and (5) a decrease in the time for the ejection of the final 25% of stroke volume (P < 0.01) and time occupied by the final 25% of the gradient.Immediately following balloon aortic valuloplasty, there is a decrease in ejection time and in increase in ejection rate. Balloon aortic valvuloplasty has a significant effect on the dynamics of left ventricle ejection, with changes primarily expressed in late systole. By improving the mobility of calcified leaflets, balloon aortic valvuloplasty may reduce the forces opposing forward blood movement during the decelerative phase of ejection.
Probe “balloon on a wire” ultra‐low‐profile coronary catheter: Results of ptca in 107 patients
Authors: Martinez Alejandro , Pichard Augusto , Little Thomas , Lindsay Joseph 
Published: March 2007

AbstractA new low‐profile “balloon‐on‐a‐wire” angioplasty catheter, the Probe™ (USCI), was used in 107 patients over a 4‐month period. Twenty‐nine patients had stable angina, 59 had unstable angina, and 19 had had myocardial infarction (Ml) 3 to 15 days prior to the procedure; 71 patients had single‐vessel and 36 had multi‐vessel disease. In this series, 57 lesions were defined as complex. Successful dilatation was defined as a residual stenosis of <30%.Of 132 non‐total obstructions, 127 (97%) were successfully dilated. Two distal lesions could not be reached, two lesions could not be crossed by the balloon, and a distal lesion dilatation resulted in acute closure in one case. Of 19 total obstructions, 16 (84%) were successfully dilated (mean residual stenosis 23%). The wire tip was unable to cross the lesion in the three unsuccessful procedures.Seven complications occurred in the series, all involving non‐total obstructions: closure of a distal vessel and a side branch caused no clinical symptoms or EKG changes; three local dissections were tacked back with repeat dilatation; and two longitudinal dissections caused no apparent reduction in luminal diameter.The Probe's low‐profile and exceptional trackability enabled it to cross very tight lesions with minimal trauma to the vessel wall. The high degree of conformability of the PET balloon minimizes vessel straightening or sheer forces and appears to reduce the potential for dissection. The device may therefore extend the indications and ease of PTCA while reducing complications of the procedure.
Rapid lysis of life‐threatening pulmonary thromboembolism following recent abdominal surgery using a modified systemic infusion of rt‐pa
Authors: Wysham Douglas G. , Ulstad Valerie K. 
Published: March 2007

AbstractA case of pulmonary thromboembolism in a young woman three days status post‐abdominal surgery is treated successfully with a low‐dose infusion rate of tissue plasminogen activator (10 mg/hr over 10 h). Clinical improvement is rapid and there are no bleeding complications.
Emergency cardiopulmonary bypass support in patients with cardiac arrest in the catheterization laboratory
Authors: Shawl Fayaz A. , Domanski Michael J. , Wish Marc H. , Davis Mark , Punja Sudhakar , Hernandez Tomas J. 
Published: March 2007

AbstractCardiac arrest in the catheterization laboratory is fatal if unresponsive to advanced cardiac life support (ACLS). Seven patients not responding to ACLS following cardiac arrest in the catheterization laboratory underwent percutaneously instituted cardiopulmonary bypass support. Cardiac arrest occurred following abrupt closure postcoronary angioplasty in three patients, during cardiogenic shock in three patients, and during diagnostic angiography in one patient. Cardiopulmonary bypass was instituted 10–45 min (mean, 21 min) following the onset of cardiac arrest. Flows on bypass ranged from 4.0 to 5.2 liter/min. Mean blood pressure ranged from 70 to 110 mm Hg on bypass. Six of the seven patients regained consciousness after the institution of bypass. Acid‐base balance was normalized in all patients. Coronary bypass surgery was subsequently performed in three patients and coronary angioplasty in two. Four patients survived. One patient died following coronary bypass surgery. Two patients, who were not suitable candidates for revascularization, expired. Total bypass time was 1.5–8.5 hr (mean, 2.7 hr). At a mean follow‐up of 6 months, all four survivors are alive and asymptomatic or NYHA class 1. We conclude that cardiopulmonary bypass support 1) can stabilize patients following cardiac arrest in the catheterization laboratory, 2) can facilitate emergency coronary angioplasty or transfer to the operating room for coronary bypass surgery, and (3) can improve survival in patients unresponsive to ACLS when instituted early following cardiac arrest in the catheterization laboratory.
Anomalous aortic origin of the left anterior descending coronary artery with dilated cardiomyopathy
Authors: Okura Takafumi , Sekiya Michihito , Sumimoto Takumi , Mukai Mikio , Hamada Mareomi , Hiwada Kunio 
Published: March 2007

AbstractSerious complications such as angina pectoris and myocardial infarction in patients with anomalous origin of a coronary artery have been documented. However, this anomaly with dilated cardiomyopathy is very rare. We present the first case of anomalous origin of the left anterior descending coronary artery with dilated cardiomyopathy.
Peripheral transluminal angioplasty of the subclavian and innominate arteries utilizing the brachial approach: Acute outcome and follow‐up
Authors: Dorros Gerald , Lewin Ruben F. , Jamnadas Pradip , Mathiak Lynne M. 
Published: March 2007

AbstractPercutaneous transluminal angioplasty (PTA) of the subclavian and innominate arteries was performed in 27 patients at 33 sites (30 subclavian, 3 innominate). All procedures were successful angiographically and clinically and were without complication. The ipsilateral arm was utilized in all cases. Indications for the procedure included claudication (ten patients), neurological symptoms (seven patients), to gain vascular access for other interventions (eight patients), and scheduled coronary bypass surgery with internal mammary utilization (two patients). There were 22 stenoses and 11 occlusions. Thrombi was retrogradely recovered through the arteriotomy site in three patients with vessel occlusions. No early or late episode of neurological deficit was seen. Follow‐up was obtained in 22 patients (82%) at a mean time of 28 months (range, 2–73 months). The cumulative patency rate was 95%. The three restenosed sites were treated with successful repeat PTA. Angioplasty of stenotic or occluded subclavian or innominate arteries should be the procedure of choice in symptomatic patients.
Tissue‐type plasminogen activator: Intracoronary applications
Authors: Tiefenbrunn Alan J. 
Published: March 2007

AbstractIntracoronary tissue‐type plasminogen activator (t‐PA) was employed successfully before, after, or in place of coronary artery angioplasty in four patients referred for emergency cardiac catheterization during evolving myocardial infarction. The potential roles of intracoronary thrombolysis, dose considerations for intracoronary t‐PA, factors influencing the choice of plasminogen activator, and safety issues are discussed.