bluuebunny/crossref_metadata_2025_split huggingface dataset:
A fluoroscopic method to confirm proper catheter position to measure pulmonary artery wedge pressure
Authors: Smucker Mark L. , Lipscomb Kirk 
Published: March 2007

AbstractThe proper position of a catheter to measure pulmonary wedge pressure is usually confirmed by measuring the oxygen saturation of withdrawn blood. However, this method of confirmation is tedious and frequently unsuccessful. A fluoroscopic method to confirm proper catheter position to measure wedge pressure was tested. Between 2 and 5 ml of contrast medium was injected into the artery distal to the catheter tip. Lack of movement for 15 seconds after injection indicated proper catheter position. As judged by the saturation of withdrawn blood and by comparison of wedge and left atrial or ventricular pressure, the fluoroscopic method of confirmation was correct in 71/75 attempts. Thus the flouroscopic method of confirmation of proper catheter position is simple, rapid, and reliable.
What is the appropriate “dress code” for the cardiac catheterization laboratory?
Authors: Leaman David M. , Zelis Robert F. 
Published: March 2007

AbstractIn order to determine the effect of the manner of dress by personnel and observers on cardiac catheterization‐related infections, a retrospective survey was undertaken of 107,203 catheterization procedures done during the calendar year prior to this survey. An analysis of 55,976 cutdowns and 53,578 percutaneous procedures was performed (some subjects had both procedures performed). A total of 379 infections in 109,554 entrance sites were reported for an overall incidence of infection of 0.35%. There were 33 infections at the percutaneous site (incidence = 0.06%) and 346 at the cutdown site (incidence = 0.62%). The manner of dress of personnel not involved with catheter manipulation and of the observers had no relationship to the incidence of infection when the percutaneous technique was used. When cutdowns were performed, there was a lower incidence of infection in those laboratories where all personnel and observers were required to wear a mask, cap, and gown (17,311 cutdowns, 83 infections, 0.48% infection rate) than in those laboratories where none of these was required (15,170 cutdowns, 109 infections, 0.72% infection rate) (P < 0.025). Laboratories which did 150 or less cutdowns/year had more infections than those laboratories performing more than 150/year (P < 0.0001). Our data suggest that the risk of infection from cardiac catheterization is more closely correlated with the volume of studies done in the laboratory than in the manner of dress of the laboratory personnel and visitors in the laboratory. However, the wearing of full “sanitary clothing” will help decrease the infection rate in cutdowns.
Selective coronary arteriography: A clinical comparison of two contrast agents
Authors: Shirey Earl K. , Sones F. Mason , Greenstreet Richard L. 
Published: March 2007

AbstractThe radiopacity and complications of meglumine iothalamate 52% and sodium iothalamate 26% (Vascoray®) were compared with those of meglumine diatrizoate 66% and sodium diatrizoate 10% (Renografin®‐76) in 2258 patients with and without cardiac disease. There was no difference in radiopacity and the type and incidence of adverse reactions were similar, but the frequency was significantly higher (p < 0.05) with Vascoray® in patients with constrictive pericarditis, dissecting aortic aneurysm, and primary pulmonary hypertension. The difference in the frequency of hypotension, sinus bradycardia, and transient asystole in the Renografin®‐76 and Vascoray® groups was statistically significant. Ventricular arrhythmias occurred in 6% of the patients with primary myocardial disease compared to an average of 0.7% in those without this cardiac abnormality (p < 0.01), but there was no significant difference in the frequency in the two contrast agent groups. All reactions were treated and the studies were performed without mortality. Results of this study show that iothalamate formulation with sodium to meglumine ratio of 1:2 containing 410 mEq/L of sodium (Vascoray®) is suitable and safe for clinical use for roentgenographic studies of the heart, and coronary artery circulation.
Anomalous right coronary artery arising from left mainstem
Authors: Husaini S. Nayeem , Beaver Wayne L. , Wilson Ian J. , Lach Ralph D. 
Published: March 2007

AbstractVarious coronary artery anomalies occur in both symptomatic and asymptomatic individuals. We have described a unique case of an aberrant right coronary artery arising from the left mainstem, resulting in clinical myocardial infarction in the absence of coronary atherosclerosis. Though different anomalies of the right coronary artery have been described, we feel this case is unique in that the right coronary artery arises from the left mainstem, truly forming a single coronary artery.
Usefulness of left ventricular wall thickness‐to‐diameter ratio in thallium‐201 scintigraphy
Authors: Manno Bruno , Hakki A‐Hamid , Kane Sally A. , Iskandrian Abdulmassih S. 
Published: March 2007

AbstractThe ratio of left ventricular wall thickness to the cavity dimension, as seen on thallium‐201 images, was used in this study to predict left ventricular ejection fraction and volume. We obtained rest thallium‐201 images in 50 patients with symptomatic coronary artery disease. The thickness of a normal‐appearing segment of the left ventricular wall and the transverse diameter of the cavity were measured in the left anterior oblique projection. The left ventricular ejection fraction and volume in these patients were determined by radionuclide ventriculography. There was a good correlation between thickness‐to‐diameter ratio and ejection fraction (r = 0.80) and endsystolic volume (r = −0.71). In 18 patients with a thickness‐to‐diameter ratio less than 0.70, the ejection fraction was lower than in the 16 patients with thickness‐to‐diameter ratio greater than or equal to 1.0 (22 ± 2% versus 49 ± 3%, mean ± SEM, p <0.001). Similarly, in patients with a thickness‐to‐diameter ratio less than 0.70, the end‐diastolic and end‐systolic volume were higher than in the remaining patients with higher thickness‐to‐diameter ratios (p < 0.02, p < 0.001, respectively). All 18 patients with a thickness‐to‐diameter ratio less than 0.70 had ejection fractions less than 40%; 14 of 15 patients with a thickness‐to‐diameter ratio greater than or equal to 1.0 had an ejection fraction greater than 40% (p < 0.001). The remaining 16 patients with a thickness‐to‐diameter ratio of 0.7–0.99 had intermediate ejection fractions and volumes.Our results indicate that the left ventricular wall‐thickness‐to‐diameter ratio, as measured from rest thallium‐201 images may be useful in categorizing patients as having either abnormal or normal left ventricular ejection fractions and volumes.
Use of the fluid column in a cardiac catheter for emergency pacing
Authors: Meester Geert T. , Simoons Maarten L. , Slager C. J. , Kint Peter P. , Spaa Walter , Hugenholtz Paul G. 
Published: March 2007

AbstractGiven the not infrequent need for intracardiac pacemaking during intensive cardiac care, a new type of cardiac pacemaker has been designed and tested [1]. With this pacemaker the heart can be stimulated through the fluid column of any conventional catheter, provided it is filled with a 0.9% NaCl solution. This fluid column pacemaker (FCP) is of the “constant current” type. The FCP was tested in 37 animals, in 30 patients in sinus rhythm, and also in two critical patients. In addition to the pacemaker circuit, a special connector was designed, enabling a fast, effective, and safe contact between patient and pacemaker. The FCP is considered to be ideally suited for use in emergency cardiac pacing in intensive care units and other areas where sudden bradycardias may occur and where intrathoracic catheters are inserted for a variety of reasons.
Nitroglycerin‐induced coronary vasoconstriction
Authors: Dalal J. J. , McCans J. L. , Parker J. O. 
Published: March 2007

AbstractNitroglycerin is routinely used during coronary angiography for its vasodilating effects. An unusual case is described in which nitroglycerin induced severe coronary artery spasm. Interpretation of coronary angiograms after nitroglycerin should be made with caution.
Clinical evaluation and application of cardiac laboratory high‐definition video systems
Authors: Holmes David R. , Smith Hugh C. , Gray Joel E. , Wondrow Merrill A. 
Published: March 2007

AbstractThis study evaluated a new high line rate (1,023‐line) high band‐width (10 MHz) system, compared it to our high‐definition, 525‐line video system, and compared both video systems to 35‐mm cine angiography in 117 patients undergoing clinically indicated coronary angiography. The subjective image quality of the 1,023‐line video system was not significantly better than that of the 525‐line system. High line rate, high band‐width systems may have theoretical advantages, but the increased noise level under clinical angiographic conditions reduces their diagnostic quality. Comparison between video (all modes) and cine images resulted in cine being rated as the best modality, but the differences were slight. Radiation levels required for video imaging, however, were significantly less than those required for cine recording. Current clinical and computer interactive uses of video systems in the cardiac laboratory are described. The eventual role and potential replacement of cine recording by video tape systems will depend on continued developments in video recording techniques.
Cross‐Sectional echocardiographic diagnosis of azygos continuation of the inferior vena cava
Authors: Huhta James C. , Smallhorn Jeffrey F. , Macartney Fergus J. 
Published: March 2007

AbstractAzygos continuation of the inferior vena cava has importance for both the invasive diagnosis of congenital heart disease by catheterization and for surgical treatment. Cross‐sectional echocardiography was used to examine 1,000 patients (1 day to 16 years, mean 3.3 years) who also had angiographic or surgical confirmation. Twenty‐eight patients (3%) had azygos continuation (left 13, right 14, bilateral 1) and, in 26 patients, the hepatic portion of the inferior vena cava was absent. Azygos continuation was prospectively detected in all and was directly visualized in subcostal scans as a venous structure posterior to the aorta coursing behind the heart and not entering the inferior aspect of either atrium in 26/28 (93%). Azygos connection to the ipsilateral superior vena cava or atrium was correctly predicted in all. The inferior vena cava was visualized in all patients without azygos continuation, except one neonate with omphalocele.We conclude that cross‐sectional echocardiography can accurately detect azygos continuation of the inferior vena cava and predict its side and connection.
Structural and functional abnormalities of the left ventricle after closed mitral valvotomy
Authors: Mohan Jagdish C. , Reddy K. Srinath , Mukhopadhyaya Sima , Bhatia Madan L. 
Published: March 2007

AbstractLeft ventricular apical aneurysms were observed in six of 84 (7.1%) patients consecutively catheterised after closed mitral valvotomy for relief of mitral stenosis. All these patients had angiographically normal coronary arteries. Such aneurysms represent a potential source of cardiovascular complications.
Left ventricular endomyocardial biopsy in children with the transseptal long sheath technique
Authors: Rios Billy , Nihill Michael R. , Mullins Charles E. 
Published: March 2007

AbstractLeft ventricular endomyocardial biopsies were obtained in 19 infants and children using a long sheath as an introducer after transseptal puncture of the atrial septum. From July 1982 to August 1983, 19 patients, ages 7 months to 12 years (mean = 4.6 years), underwent both right and left ventricular biopsies with only one failure. The long sheath technique allows positioning of the bioptome in different areas of the left ventricular chamber. Right ventricular biopsies were also obtained with the long sheath technique in 11 other patients.
Inotropic effects of ionic contrast media: The role of calcium binding additives
Authors: Murdock David K. , Walsh John , Euler David E. , Kozeny Greg , Scanlon Patrick J. 
Published: March 2007

AbstractRenografin‐76 (RG76) regularly depresses myocardial contractility during coronary angiography. Angiovist‐370 (AV370) is a contrast medium similar to RG76 except the calcium sequestering agents sodium citrate and EDTA in RG76 have been replaced by calcium EDTA (an additive that does not bind additional calcium). To determine if the calcium sequestering agents contribute to the mechanical depression produced by ionic contrast media, this study compared the inotropic response of RG76 to that of AV370. Additionally, saline solutions containing sodium citrate + EDTA and calcium EDTA at concentrations found in the respective contrast media were also compared. In 10 open chest dogs the percent change and duration of the inotropic response following intracoronary injections of RG76 and AV370, as well as solutions of sodium citrate + EDTA and calcium EDTA were compared using Walton‐Brodie strain gauges. Injections, 2 cc, of RG76 and AV370 produced a biphasic response characterized by an initial negative inotropic response followed by a more prolonged positive inotropic response. The magnitude (67 ± 3% vs 59 ± 2%; p < 0.001) and duration (34 ± 3 vs 24 ± 2 sec; p < 0.001) of the initial negative inotropic response was greater with RG76 than with AV370. The magnitude of the secondary positive inotropic response with RG76 was not different from that obtained with AV370 (31 ± 12% vs 28 ± 10%; p > 0.3). This positive response was not affected by b̃‐adrenergic blockage with 0.2 mg/kg of timolol. Similarly, 4 cc of sodium citrate + EDTA produced a significantly greater magnitude (56 ± 5%) and longer (42 ± 7 sec) negative inotropic response than calcium EDTA (17 ± 2% and 15 ± 3 sec) or 0.9% saline (18 ± 8% and 13 ± 2 sec; p < 0.001). The results suggest that the calcium sequestering agents sodium citrate + EDTA produce significant negative inotropic effects contributing to the mechanical depression produced by RG76. However, the calcium binding additives are not solely responsible for the depression in contractility produced by ionic contrast media. Contrast media lacking calcium binding additives may be preferable for coronary angiography.
Successful result from delayed streptokinase administration: Subtotal thrombotic occlusion in a subsequently normal coronary artery
Authors: Osborn Larry A. , Cooper M. Wayne 
Published: March 2007

AbstractThis report describes successful results from intracoronary streptokinase administered beginning 6 hr after onset of symptoms to a 32‐year‐old male with subtotal vessel occlusion by thrombus. Coronary angiography 26 days later demonstrated normal vessels. We conclude that 1) duration of symptoms beyond 3–4 hr should not preclude the use of thrombolytic therapy in evolving myocardial infarction, 2) this patient exemplifies the higher incidence of subsequently demonstrated normal coronary arteries in patients under age 35 with acute myocardial infarction; arterial spasm and platelet aggregation are the most likely causes of coronary occlusion in these patients.
Posterior descending artery origin from the left anterior descending: An unusual coronary artery variant
Authors: Clark Vivian L. , Brymer James F. , Lakier Jeffrey B. 
Published: March 2007

AbstractWe recently observed the unusual origin of the posterior descending from the left anterior descending coronary artery in three patients undergoing coronary angiography. These three cases are presented and the clinical implications of this variation are discussed.
Isolated aortic stenosis with severe pulmonary hypertension
Authors: Riegel Norman , Ambrose John A. , Mindich Bruce P. , Fuster Valentin 
Published: March 2007

AbstractSevere pulmonary hypertension is rare in patients with aortic stenosis. When present, it usually implies either associated mitral valve disease, poor left ventricular function, or pulmonary disease. In this case report, severe pulmonary hypertension was present in a patient with isolated aortic stenosis and normal left ventricular systolic function. Pulmonary hypertension was probably related to left ventricular diastolic dysfunction. Following successful aortic valve replacement, pulmonary pressures declined but symptoms of shortness of breath persisted and the patient still required daily diuretics.
A less traumatic catheter for coronary arteriography
Authors: Van Robert A. Tassel , Gobel Fredarick L. , Rydell Ba Mark A. , Vlodaver Zeev , Maccarter Dean J. 
Published: March 2007

AbstractA deformable soft‐tipped angiographic catheter has been designed and developed to reduce vascular trauma during coronary arteriography. In order to test the ability of the catheter tip to glide over vascular endothelium, the coefficient of resistance was tested using fresh human aortic tissue. The mean frictional coefficients of resistance (FRc) for the soft‐tipped catheter, as compared with two commonly used catheters (N = 10/group), were .78 ±.08 units for the soft‐tipped catheter and 1.10 ± .10 (p < .006) and .98 ± .10 (p < .034) for the conventional catheters. This demonstrates a significant 23% reduction in FRc with the soft‐tipped catheter. The ease of penetration into a wax media was also measured using the soft‐tipped catheter and compared with the same two conventional catheters. The indentation depths for the soft‐tipped catheter and the two other catheter groups (N = 7/group) were 140 ± 18 m̈m, 246 ± 15 m̈m and 318 ± 20 m̈m, respectively. This represents a 56% decrease in indentation depth with the soft‐tipped catheter.Histologic studies in canines have demonstrated considerably less endothelial damage and subsequent intimal proliferation in the aorta and coronary ostia with the soft‐tipped catheters compared with control catheters.It is concluded that a soft‐tipped angiographic catheter is less traumatic to vascular tissue and may offer a safer approach to intravascular studies.
The use of an exchange guide wire in coronary angioplasty
Authors: Dervan John P. , McKay Raymond G. , Baim Donald S. 
Published: March 2007

AbstractOf 84 consecutive patients referred for coronary angioplasty, an exchange length (260 cm) guide wire was used in 17 (20%) to allow serial passage of different sized dilatation catheters. Exchanges were performed for the following reasons: 1) inability to cross the stenotic segment with a full‐sized dilatation catheter, with exchange for a smaller catheter to permit initial dilatation followed by a second exchange to reintroduce the full‐sized balloon catheter; 2) premeditated initial use of a low‐profile balloon catheter in severe stenosis, with subsequent exchange to a full‐sized balloon catheter; 3) inability to achieve a satisfactory reduction of the transstenotic gradient or angiographic stenosis with the initial dilation catheter, requiring subsequent passage of a larger balloon catheter into the partially dilated segment. Eighteen of 19 attempted exchanges and 18 of 19 angioplasty procedures were completed successfully.The use of exchange guide wires permits multiple recrossings of a dilated segment, allows safe serial passage of different sized balloon catheters, and obviates the need for renegotiating difficult proximal coronary anatomy. The exchange guide wire techique can be applied safely and effectively to coronary angioplasty and provides an additional option in the successful completion of movable guide wire angioplasty procedures.
Injection of contrast medium within the interatrial septum: An unusual complication of right atrial angiography
Authors: Markiewicz Walter 
Published: March 2007

AbstractA 56‐year‐old male with right ventricular dysplasia underwent right atrial angiography. Though the catheter tip appeared to be in the right atrial cavity, an appreciable amount of contrast medium dissected the interatrial septum, resulting in unusual radiologic and ultrasonic patterns.
Endomyocardial biopsy: A review of the literature
Authors: Przybojewski Jerzy Z. 
Published: March 2007

AbstractA review of the literature relating to endomyocardial biopsy (EMB) is presented. This is considered important at this time since EMB is being utilized with increasing frequency, particularly for the diagnosis of myocarditis. The development of the technique is briefly outlined. Emphasis is placed on the clinical application of EMB in the various primary cardiomyopathies (dilated, hypertrophic, restrictive, and obliterative), the infiltrative secondary cardiomyopathies (amyloidosis, sarcoidosis, hemochromatosis), myocarditis, as well as such conditions as adriamycin cardiotoxicity, cardiac transplant rejection, and Kawasaki disease. More controversial application of EMB in primary mitral valve prolapse (Barlow's syndrome), idiopathic ventricular arrhythmias, and the elucidation of the enigmatic finding of angina with angiographically normal coronary arteries is detailed. Experience with immunological and biochemical investigation of biopsy material, as well as with virus isolation and drug assays in the myocardium, is alluded to. Complications encountered with this procedure are also discussed, and its future role is contemplated.
Combined medical and mechanical recanalization in acute myocardial infarction
Authors: Erbel Raimund , Pop Tiberius , Meinertz Thomas , Kasper Wolfgang , Schreiner Gerd , Henkel Bernd , Henrichs Karl Jürgen , Pfeiffer Claudia , Rupprecht Hans Jürgen , Meyer Jürgen 
Published: March 2007

AbstractA technique of combined medical and mechanical recanalization was employed in 96 patients with acute transmural myocardial infarction. The mean time between onset of symptoms and admission to hospital was 170 ± 65 min (χ ± SD). After 10 ± 16 min, 250,000 U streptokinase was administered intravenously for 20 min. Intracoronary thrombolysis was commenced within 38 ± 14 min. First coronary angiograms demonstrated reperfusion, an open vessel in 25/96 patients (26%). In 15/71 patients (21%) reperfusion occurred during thrombolysis therapy, before mechanical recanalization could be performed. Recanalization was achieved mechanically in 37/71 patients (52%) with occluded coronary vessels. In 8/71 patients (11%) mechanical recanalization failed but the vessel opened during thrombolysis. In 12/96 patients (12%), the coronary vessel remained occluded. Thus, reperfusion could be achieved in 88% of the patients. Reperfusion rate was 76% in the first 38 patients and 95% subsequently. After reperfusion, coronary thrombi were found in 25/96 patients (26%) but dissolved during thrombolysis in 16/25 patients (64%). Peripheral coronary embolism was observed in 3/25 patients (12%). For the whole group, reocclusion occurred in 8/84 patients (10%).By combined medical and mechanical recanalization, the recanalization rate could be increased with low reocclusion rate. Trends showed an improvement in regional and global left ventricular function in patients with anterior myocardial infarction.
Ventricularization of right atrial wave form in amyloid restrictive cardiomyopathy
Authors: Gowda Siddhesh , Salem Bakr I. , Haikal Majed 
Published: March 2007

AbstractTwo patients with biopsy‐proven amyloid restrictive cardiomyopathy were presented. Both cases showed ventricularization of an elevated right atrial pressure wave form in absence of tricuspid regurgitation. Possible explanations for this finding as well as its clinical implications are discussed.This observation indicates that ventricularization of right atrial pressure wave form could be a useful hemodynamic sign in amyloid restrictive cardiomyopathy in absence of tricuspid regurgitation. Furthermore, such a finding does not seem to be specific for tricuspid regurgitation.