bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of outpatient cardiac catheterization
Authors: Mahrer Peter R. , Young Charlie , Magnusson Peter T. 
Published: March 2007

AbstractOutpatient cardiac catheterization has become the standard in our laboratory. The only exclusion for outpatient study is current hospitalization for cardiac symptoms. Thus, any patient well enough to be at home is studied on an outpatient basis. We reviewed our experience on 4,094 diagnostic studies of which 3,537 (86%) were done on a same‐day basis. The complication rates were generally lower than in published series with a mortality of 0.05%. There were no admissions for late bleeding. Ninety‐seven percent of the procedures were done by the percutaneous technique utilizing 7‐French catheters. Patients were heparinized, and protamine was not used. The low complication rate is to a large extent due to meticulous postoperative care by critical care nurses in an outpatient observation unit contiguous to the laboratory. Outpatient cardiac catheterization is a safe, cost‐saving approach applicable to a large majority of cardiac patients.
Coronary collateral blood flow in a patient with angiographically normal coronary arteries
Authors: Celano Charles , Peters Robert W. , Fisher Michael L. 
Published: March 2007

AbstractA 36‐year‐old man underwent coronary anteriography for evaluation of chest pain. His coronary arteries were smooth and free of obstructive disease. Selective right coronary injection revealed a large collateral vessel that opacified distal and proximal portions of the left circumflex coronary artery. Our case supports the view that coronary collateral vessels may occur in the absence of obstructive lesions.
Multiple coronary thromboses in previously normal coronary arteries treated with streptokinase
Authors: Renlund Dale G. , Chandra Nisha Chibber , Gottlieb Sidney O. 
Published: March 2007

AbstractA patient is presented with normal coronary arteries in whom total occlusions in three branches of two epicardial coronary arteries developed in association with chest pain and electrocardiographic evidence of transmural ischemia. A combination treatment strategy addressing both coronary vasoconstriction and thrombosis is illustrated.
Reporting, filing, and retrieval of coronary angiographic findings: A new personal computer‐based system
Authors: Bozzi G. , Casolo F. , Ferrante M. , Presti F. Lo , Terranova P. 
Published: March 2007

AbstractA software system for semiautomatic reporting and automatic filing of coronary angiographies has been developed and is suitable for an IBM Personal Computer (PC) with graphic tablet and printer. Coronary angiographic findings referring to the native anatomy, pathology, and post‐surgical status can be easily recorded. The data is automatically coded and filed according to category of information. This system can analyze previously filed data and perform searches under one or more angiographic findings. This allows for a comparison of different series of patients.
Comparative safety and efficacy of percutaneous transluminal coronary angioplasty in men and in women
Authors: McEniery Paul T. , Hollman Jay , Knezinek Valerie , Dorosti Khosrow , Franco Irving , Simpfendorfer Conrad , Whitlow Patrick 
Published: March 2007

AbstractIn early reports of percutaneous transluminal coronary angioplasty (PTCA) in women, the complication rate was higher and the success rate lower than in men. From December, 1980, to December, 1986, 969 women aged 61 (32––84) years and 2,727 men aged 57 (27––84) years underwent PTCA, at our institution. At the time of PTCA 26% of the women had functional class IV angina pectoris compared to 16% of the men (P<0.005). Women more often had hypertension (56% vs 39%), left ventricular hypertrophy, diabetes mellitus (19% vs 11%; P<0.0005), and family history of coronary artery disease than men. Significantly more of the men (74%) smoked than did the women (53%). The success rate in women was 93% as compared to an angiographic success rate in 2,727 men of 93.5% (ns). The rate of emergency bypass surgery in women was 3.8% as compared to 3.2% in men (ns). The death rate was 0.3% in women as compared to 0.09% in men. Women underwent more PTCA of the left anterior descending coronary artery (52% vs 48% of lesions in men; P<0.05) and right coronary artery (32% vs 27% in men; P<0.0005). Fewer of the women (9%) had had previous bypass surgery than had the men (15% P<0.0005). Procedural details, including balloon diameter, vessel diameter, lesion response pressure, inflation number, and maximum inflation pressures used at PTCA, were not different between men and women. Women had significantly more ST segment shift of 1 mm of more at the time of balloon inflation than men (P<0.0005). Thirty‐five percent of women demonstrated intimal tear at the site of PTCA as compared to 30% of men (P<0.0005). Men and women demonstrated similar angiographic change following successful PTCA, with reduction of stenosis from 79% ± 13% and reduction in gradient from 52 ± 19 mmHg to 11 ± mmHg. Women demonstrated more guiding catheter problems with PTCA (14% vs 11% in men; P<0.05) and more damping of the pressure with the guiding catheter (6% vs 3% in men; P<0.0005). One percent of women had a problem with vascular access compared to 0.3% of men (P<0.05). Of the first 300 women undergoing PTCA at our institution, 94% underwent single‐vessel PTCA, whereas 86% of the last 300 women underwent single‐vessel PTCA. The emergency bypass surgery rate declined from 5.7% to 3.7%. At follow‐up of 20 ± 12 (1––69) months, chest discomfort was improved in 90% of women and in 89% of men; 2.9% of women had suffered a myocardial infarction as compared to 2% of men; 4.9% of women had undergone repeat PTCA as compared to 5.3% of men; and 7% of women underwent open heart surgery late after PTCA as compared to 6.8% of men. In summary, PTCA in women did not carry an increased rate of emergency bypass surgery or death as compared with that in men. The long‐term efficacy is similar to that seen in men.
Nitroglycerin‐induced coronary vasodilatory responses in patients during isometric handgrip exercise
Authors: Kern Morton J. , Henry Rodney L. , Miller John T. 
Published: March 2007

AbstractIntracoronary nitroglycerin is frequently administered during invasive procedures such as coronary angioplasty or thrombolysis which may be associated with pain and sympathetic neural stimulation. Whether sympathetic‐mediated reflex vasoconstriction interferes with nitroglycerin‐induced augmentation of coronary blood flow is unknown. Therefore, coronary and systemic hemodynamics were measured in 19 patients during isometric handgrip exercise (3 min × 25% maximal effort), during intracoronary nitroglycerin, and during handgrip plus intracoronary nitroglycerin. Nine patients had no significant left anterior descending coronary artery stenosis (group 1) and ten patients had > 70% left anterior descending coronary artery stenosis (group 2). Handgrip exercise increased heart rate, mean arterial pressure, and coronary sinus and great vein flow 15% while increasing coronary resistance 10%. Intracoronary nitroglycerin (200 μg) reduced mean arterial pressure ‐ 4 ± 6% and increased great cardiac vein flow 35–72%. Anterior left ventricular regional coronary flow responses to intracoronary nitroglycerin were unaffected by sympathetic stimulation for group 1. Group 2 had a greater increase in great vein flow with intracoronary nitroglycerin plus handgrip compared to nitroglycerin alone due to increased mean arterial pressure with no change in the great vein resistance. These data indicate that sympathetic stimulation does not alter the nitroglycerin‐induced augmentation of coronary sinus and great vein blood flow in patients with and without significant left anterior descending coronary artery stenosis. In patients undergoing invasive interventions who may have increased circulating catecholamines, mild sympathetic (isometric) stimulation does not appear to interfere with the coronary vasodilatory responses to intracoronary nitroglycerin.
Percutaneous transluminal coronary angioplasty in patients with unstable angina pectoris refractory to medical therapy: Long‐term clinical and angiographic results
Authors: Thijs Plokker H. W. , Ernst Sjef M. P. G. , Bal Egbert T. , Van Den Berg Eduard C. J. M. , Mast Gijs E. G. , Van Feltz Taco A. Der , Ascoop Carl A. P. L. 
Published: March 2007

AbstractThe purpose of this study was to assess the results of percutaneous transluminal coronary angioplasty (PTCA) in 469 consecutive patients with unstable angina pectoris refractory to medical therapy. The primary success rate was 88%, but, since the introduction of the steerable wire system, the success rate has increased to 90%. Mortality was 1%. There were no statistically significant differences in success rates per vessel. Actuarial total 5 year survival was 94%. After 5 years, actuarially, 79% of the patients were free of events (recurrence of angina, residual myocardial infarction, re‐PTCA, coronary artery bypass surgery or death). Aortocoronary bypass surgery was performed in 9% of the 469 patients. The angiographic recurrence rate was 28%, but, of the patients who were symptom‐free and who had a follow‐up angiogram, only 3% had an angiographic recurrence, whereas 98% of the patients who did not have a repeat angiogram were symptom‐free. It is concluded that, in a selected group of patients with the clinical syndrome of unstable angina pectoris refractory to medical therapy, the long‐term clinical results are good and survival is excellent.
The safety of protamine sulfate in diabetics undergoing cardiac catheterization
Authors: Reed David C. , Gascho Joseph A. 
Published: March 2007

AbstractThe frequency of anaphylactoid reactions to protamine sulfate was examined by reviewing the records of diabetic patients undergoing cardiac catheterization over a 5‐year period, and by prospectively monitoring diabetic patients receiving NPH insulin during the infusion of protamine sulfate.No anaphylactoid reactions were noted after protamine administration (48 ± 5 mg) in the retrospective study in either patients with prior exposure to protamine (74 catheterizations) or in diabetics with no exposure to protamine (132 catheterizations). In the prospective study, no anaphylactoid reactions were seen in the 24 NPH insulin‐dependent diabetics during the infusion of protamine sulfate (45 ± 5 mg). Five of the 42 patients (12%) from the retrospective study who underwent vascular surgery developed severe reactions to much larger doses of protamine (380 ± 118 mg).Diabetics with prior exposure to protamine sulfate do not appear to be at increased risk of anaphylactoid reaction after the administration of protamine sulfate in the dose range of < 50 mg at the time of cardiac catheterization.
Pulsus alternans induced by inferior vena caval occlusion in man
Authors: Bashore Thomas M. , Walker Stephen , Van Fossen Douglas , Shaffer Philip B. , Fontana Mary E. , Unverferth Donald V. 
Published: March 2007

AbstractTo assess the effect of rapid preload reduction on left ventricular performance in nonischemic cardiomyopathy, 11 patients were studied during inferior vena caval (IVC) balloon occlusion. Five developed sustained pulsus alternans.During pulsus alternans, the strong beats demonstrated systolic performance characteristics similar to baseline values, despite a drop in both left ventricular (LV) enddiastolic diameter (66 ± 13 to 61 ± 13 mm; p < 0.05) and LV end‐diastolic pressure (21 ± 8 to 9 ± 6 mmHg; p < 0.05). In contrast, the weak beats demonstrated a reduction in peak systolic pressure (130 ± 36 to 109 ± 33 mmHg; p < 0.02), fractional shortening (20% ± 4% to 17% ± 9%; p < 0.05) and peak positive dP/dt (1,006 ± 224 to 921 ± 287 mmHg; p < 0.05).Measures of diastolic performance (peak negative dP/dt, the time constant of LV relaxation, the length of diastasis, and LV end‐diastolic stress) were not different between baseline beats and the strong beats; and only LV end‐diastolic stress differed when baseline beats were compared to the weak beats.When the strong beats were compared to the weak beats during induced pulsus alternans, significant differences were observed in peak systolic pressure, peak positive dP/dt, and fractional shortening, but no differences in any measured diastolic parameter was observed. A slight difference was noted in the left ventricular end‐diastolic diameters, with the weak beat consistently beginning at a slightly smaller diameter (61 ± 13 mm vs 59 ± 13; p < 0.05).In summary, these data are consistent with an augmentation and deletion of intrinsic contractile forces in association with an alternation in preload on a beat‐to‐beat basis as best describing left ventricular performance during pulsus alternans.
Clinical trial of the disposable transducer catheter
Authors: Cha Se Do , Roman Cecelia F. , Maranhao Vladir 
Published: March 2007

AbstractWe compared the intracardiac and intravascular pressures obtained by a conventional strain gauge transducer (CT) with a recently developed disposable high‐fidelity transducer catheter (DT) during cardiac catheterization. CT was positioned at the patient's midchest level.The pressure measurements obtained by DT compared favorably with those of CT. Femoral arterial pressures by the two methods showed no statistical difference. Right heart pressures were similar using both transducers. However, right ventricular pressures by DT in five of eight patients were lower than that from CT. Higher pulmonary arterial pressures were noted in two of seven patients and higher pulmonary capillary wedge pressures were seen in four patients using DT compared to CT. None of these differences were of statistical significance.These pressure differences may be due to transducer position. Because the midchest position of CT does not precisely define the anatomic location of the cardiac chamber being studied, pressure measurements can be overestimated or underestimated. DT eliminates this problem, as well as overshooting and concern with air bubbles in the catheter system commonly associated with CT.Therefore DT may provide accurate hemodynamic measurements. It would appear to be useful regardless of patient position and may be useful in ambulatory hemodynamic determinations.
Balloon valvuloplasty for pulmonic valve stenosis—two‐year follow‐up: Hemodynamic and doppler evaluation
Authors: Mullins Charles E. , Ludomirsky Achi , O'Laughlin Martin P. , Vick G. Wesley , Murphy Daniel J. , Huhta James C. , Nihill Michael R. 
Published: March 2007

AbstractThe purpose of this investigation was to evaluate the efficacy, technique, and follow‐up results of balloon dilation angioplasty for valvular pulmonary stenosis. Percutaneous dilation was performed on 63 patients with pulmonary stenosis (ages 3 months to 76 years, mean = 4.3 years). In 43 patients, a single balloon was used; in 20 patients two balloons were used simultaneously.The pressure gradient across the pulmonary valve was determined with right ventricular and main pulmonary artery catheters. Pressure gradients simultaneously were estimated by continuous wave Doppler (CWD) during catheterization. The peak systolic ejection gradient was obtained by both techniques both pre‐ and postangioplasty. There was excellent linear correlation between the simultaneous catheter pressure gradient and the pressure gradient estimated by Doppler (r = 0.99). Follow‐up pressure gradient estimations by Doppler echocardiogram were obtained in 30 patients between 6 months and 30 months postcatheterization (mean = 13 months).The mean preangioplasty gradient of 64 mm Hg (range 30–160 mm Hg) was reduced to 22 mm Hg (range 2–31 mm Hg). A significant reduction of transvalvular gradient (52–95%, mean 68%) occurred in each patient. A linear correlation was found between the predilation gradient and the pressure gradient drop (r = 0.92). Mean follow‐up gradient by Doppler was 20 mm Hg (range 0–31 mm Hg), and there was no significant difference between these gradients and the postdilation gradient. No important complications were noted. These data confirm that balloon dilation angioplasty for valvular pulmonary stenosis is safe and effective, and suggest that stenosis does not recur.
Anomalous origin of the circumflex coronary artery in association with the right superior septal artery
Authors: Callaham Peter , Shandling Adrian , Lang William , Feld Gregory K. 
Published: March 2007

AbstractThe presence of anomalous coronary arteries is observed infrequently during routine coronary angiography. However, their identification is crucial to the management of the patient with associated coronary artery disease. A case is described in which concomitant anomalous origin of the circumflex coronary artery from the right coronary artery, and a right superior septal coronary artery with a separate ostium occurred in association with severe three‐vessel coronary artery disease requiring bypass graft surgery. Clues to the presence of the anomalous vessels were (1) their visualization during left ventriculography and (2) their presence or absence during injection of the normally originating vessels. This particular association of anomalous vessels was previously unreported.
Vasospastic coronary occlusion associated with a myocardial bridge
Authors: Ciampricotti R. , El Gamal M. 
Published: March 2007

AbstractA 53‐year‐old woman was admitted with unstable angina. Acute coronary angiography showed myocardial bridging and total occlusion of the left anterior descending artery in the middle one‐third of its course. The occlusion was completely relieved by intracoronary administration of nitroglycerin. The occurrence of coronary spasm may explain angina and myocardial infarction in symptomatic patients with myocardial bridges.
The balloon on a wire device: A new ultra‐low‐profile coronary angioplasty system/concept
Authors: Myler Richard K. , Mooney Michael R. , Stertzer Simon H. , Clark David A. , Hidalgo Benito O. , Fishman Jodi 
Published: March 2007

AbstractA new ultra‐low‐profile coronary angioplasty device, a “balloon probe,” is presented. This device consists of a balloon on a coronary guidewire and is the lowest profile dilatation system presently available. The balloon material is polyethylene terephthalate, a new polymer with high inflation pressure limits and very low compliance. This report discusses this device and its usage in coronary artery disease.
Use of a balloon‐tipped catheter to guide placement of the bioptome sheath in right ventricular percutaneous endomyocardial biopsy
Authors: Johnson Dennis E. , Vacek James L. , Dunn Marvin 
Published: March 2007

AbstractA common problem during biopsy of the right ventricular septum using the flexible King's bioptome is the difficulty of accurately directing the tip of the long biopsy sheath against the septal surface. This can be important in that inadvertent biopsy of the more delicate ventricular free wall may lead to perforation and pericardial tamponade. An alternate method of sheath placement is presented. This involves the use of a No. 5 or 6 French balloon‐tipped catheter within the long bioptome sheath in order to facilitate sheath passage and positioning. Catheter positioning is readily accomplished when documented by bioplane fluoroscopy, with alternate or additional two‐dimensional echocardiographic position check as desired. Balloon‐guided positioning for right ventricular septal biopsy appears to be a simple and safe technique that may be especially useful for relatively inexperienced operators and for patients with abnormal cardiac anatomy for whom endomyocardial biopsy (EMB) might normally be technically difficult.
Coronary reperfusion with a new catheter in six patients with acute occlusion after angioplasty
Authors: Werter C. , El Gamal M. , Bonnier H. , Michels R. , van Gelder L. , Krieken A. V. D. 
Published: March 2007

AbstractA new catheter was used in an attempt to re‐establish coronary flow in six patients with acute occlusion after angioplasty and prior to emergency coronary artery bypass surgery. All patients suffered from severe chest pain, and the electrocardiogram showed signs of acute transmural ischemia. A reperfusion catheter manufactured by Advanced Cardiovascular Systems (ACS) has 36 side holes spirally arranged along the distal 10 cm. It is introduced over an exchange wire. After the catheter was positioned across the occlusion, five patients had complete relief of chest pain, and another patient had partial relief. The electrocardiogram normalized in all six patients (in one only initially). Two patients developed a limited myocardial infarction, but four did not. The time between introduction of the reperfusion catheter and aorta cross clamping varied between 1.5 and 6.5 hours, and there were no complications related to its use. We conclude that the ACS reperfusion catheter is useful in re‐establishing coronary blood flow after failed angioplasty and prior to emergency coronary artery bypass surgery.
Assessment of global and regional left ventricular function in ischemic heart disease using ultrafast computed tomography
Authors: Macmillan Robert M. , Rees Michael R. , Weiner Ronald , Maranhao Vladir 
Published: March 2007

AbstractContrast‐enhanced ultrafast computed tomography (CT) of the left ventricle was done in the long axis and short axis within one day of cardiac catheterization in 14 males with ischemic heart disease and a mean age of 58 years. Imaging was R wave‐triggered at 58‐msec intervals (13/level). Left ventriculography was performed in 30° right anterior oblique (RAO) and 60° left anterior oblique (LAO) caudal 12°. CT left ventricular ejection fraction was measured using a modified Simpson's reconstruction of end‐systolic and end‐diastolic slices. Catheterization left ventricular ejection fraction was measured by area‐length method. Six left ventricular segments (septal, apex, anterior, lateral, inferior, and posterior) were scored by different paired observers as follows: dyskinesis (−1), akinesis (0), moderate‐severe hypokinesis (1), mild hypokinesis (2), and normal (3). Correlations of left ventricular ejection fraction for catheterization vs. long‐axis CT and short‐axis CT were r =.83 and r =.86, respectively. Seven of eight patients with transmural myocardial infarction were identified on CT by akinetic/dyskinetic segments. Eighty‐four segments were scored. There was agreement (normal vs. abnormal) in 76 (90%). CT detected 47 normal segments vs. 51 by catheterization (92%), 11 akinetic/dyskinetic segments (92%), and 14 hypokinetic segments vs. 21 (67%). Wall motion scores between CT and catheterization differed by > 1 in 6 of 84 segments (7%). Therefore, ultrafast CT can accurately assess global and regional left ventricular function.