bluuebunny/crossref_metadata_2025_split huggingface dataset:
Heterotopic heart transplantation: catheterization, endomyocardial biopsy, and coronary angiography of the donor heart
Authors: Lowry Richard W. , Bitar Jamil N. , Carter Grinstead W. , Young James B. , Noon George P. , Vardan Sandeep , Cocanougher Beth , Kleiman Neal S. 
Published: March 2007

AbstractFollow‐up after heart transplantation presently requires invasive techniques to assess graft viability and function. As the heterotopic transplant technique assumes a more important therapeutic role for patients not eligible for an orthotopic allograft, an understanding of the inherent challenges associated with management of these patients is mandatory to optimize patient care. Heterotopic transplant technique was used in 19 of 135 (14%) consecutive heart transplant procedures over a 41 month period. Invasive diagnostic procedures performed in follow‐up revealed (1) adequate tissue for histologic evaluation in 140/158 (89%) biopsy procedures, (2) successful pulmonary wedge pressure measurements in 142/158 (90%) right heart catheterizations, and (3) successful coronary arteriography in 18 patients undergoing angiography (both vessels in 12 and one vessel in six patients). Thus, biopsy and surveillance procedures are feasible and productive in patients who have undergone heterotopic heart transplantation.Background: Although heterotopic heart transplantation has become an increasingly utilized therapy for some patients with heart failure, there are no guidelines for routine biopsy and angiographic techniques in these patients. The objective of this study was to determine the feasibility of angiographic and endomyocardial biopsy procedures in heterotopic heart transplant recipients.Methods: The complete experience with heterotopic heart transplant recipients at Baylor College of Medicine and The Methodist Hospital over a 41 month period including endomyocardial biopsy, right heart catheterization, and selective coronary arteriography results were analyzed.Results: Eighteen patients underwent 310 procedures without significant complications. Of 158 biopsy procedures, 140 (89%) yielded tissue adequate for histologic evaluation. Right heart pressures were obtained in almost all patients undergoing right heart catheterization. Pulmonary wedge pressures were obtained in 137 (90%). A rapid decrease in right heart pressures was noted following transplant; however, a gradual but significant rise in mean arterial pressure occurred. Eighteen selective coronary arteriogram procedures were performed; 12 (66%) resulted in successful cannulation of both coronary arteries. Of 12 patients followed for at least 1 year, five (40%) have developed evidence of allograft arteriopathy. The 1 and 2 year survival rates were 67% and 53%, respectively.Conclusions: Invasive diagnostic techniques can be performed safely and reliably and should not preclude the use of heterotopic heart transplantation in selected patients who are otherwise unsuitable for orthotopic transplantation. © 1994 Wiley‐Liss,Inc..
Bedside monitoring of heparin therapy: comparison of activated clotting time to activated partial thromboplastin time
Authors: Reiner Jonathan S. , Coyne Karin S. , Lundergan Conor F. , Ross Allan M. 
Published: March 2007

AbstractHeparin anticoagulation is utilized during and after interventional cardiac catheterization procedures to reduce the risk of acute thrombotic coronary artery occlusion. The short half‐life of heparin, the importance of maintaining therapeutic anticoagulation, and the time delay inherent in the processing and retrieval of the activated partial thromboplastin time (aPTT) by the hospital laboratory has generated interest in point‐of‐care heparin monitoring. The activated clotting time (ACT), the aPTT as assessed by both a new portable device, as well as the hospital laboratory, and heparin levels (H) were obtained from the same sample of blood in 100 patients receiving intravenous heparin. There was an excellent correlation between the aPTT determined at the bedside and by the hospital laboratory (r = .89). The ACT did not correlate well with either the laboratory or bedside aPTT (r = .63, .68 respectively). In the sub‐therapeutic and therapeutic range, there was essentially no correlation between ACT and H. Only ACT values > 225 sec were predictive of therapeutic or supra‐therapeutic aPTTs. ACT values < 225 sec, however, were not useful in predicting degree of anticoagulation. In situations in which the maintenance of therapeutic anticoagulation is critical as well as those in which the determination of lack of anticoagulation is required, the bedside determination of aPTT appears to be a useful tool © 1994 Wiley‐Liss,Inc...
Endoluminal stenting of narrowed saphenous vein grafts: long‐term clinical and angiographic follow‐up
Authors: Eeckhout Eric , Goy Jean‐Jacques , Stauffer Jean‐Christophe , Vogt Pierre , Kappenberger Lukas 
Published: March 2007

AbstractFrom April 1986 through April 1993, 58 intracoronary stents (41 Wall and 17 Wiktor stents) were implanted for the treatment of saphenous vein graft stenosis in 40 symptomatic patients. The indication was a primary stenosis in 44 and restenosis in 14 procedures. In‐hospital complications were subacute stent thrombosis (2%), myocardial infarction (2%), and emergency coronary artery bypass grafting (CABG) (2%). Complications during a mean follow‐up period of 42±27 months were restenosis (35% by patient, 33% by lesion), myocardial infarction (12%), late bypass grafting (12%), and death (7%). On quantitative coronary angiographic analysis, the mean minimal luminal diameter (and its confidence interval) increased from 1.3 mm (1.1–1.5 mm, preprocedure) to 2.9 mm (2.7–3.1 mm, postprocedure) and 2.2 mm (2.0–2.5 mm, 6 months follow‐up, 95% angiographic follow‐up). Progression of the underlying coronary artery disease and restenosis were the main reasons for a continual decline of the proportion without cardiac event on a Kaplan‐Meier estimate. Restenosis occurred in one‐third of cases beyond the first 6 months of follow‐up. A relative risk ratio analysis for restenosis, performed on 14 variables, disclosed an increased risk for the following variables: (1) stenting of the proximal, distal or anastomosis part of the vein graft (relative risk 2.41, confidence interval: 1.28–3.59), (2) the implantation of stents <4.5 mm (2.59, 1.18–4.00), and (3) stenting of a redo–CABG vein graft (2.37, 1.17–3.58). Saphenous vein graft stenting seems to be characterized by excellent immediate clinical and angiographic results; in particular, stent thrombosis is rare. In this study, it appears that restenosis rates are lower than after conventional balloon angioplasty, but several procedural factors are related to an increased restenosis risk. Despite a lasting success in the majority of stented lesions, the estimated proportion without cardiac event is low at 5 years follow‐up. Progression of the underlying coronary artery disease, a non‐procedure‐related event, constitutes the major limitation of saphenous vein graft stenting. © 1994 Wiley‐Liss,Inc..
Coronary flow velocity during coronary angioplasty in regions of myocardial infarction
Authors: Moore Joseph A. , Kern Morton J. 
Published: March 2007

AbstractIn patients undergoing angioplasty for angina after myocardial infarction, patterns of post‐stenotic coronary blood flow velocity depend not only on satisfactory dilation of the flow‐limiting lesion, but also on the vasoregulatory capacity of infarcted myocardium. The case examples demonstrate both normal and persistently abnormal flow velocity patterns following successful coronary angioplasty for post‐infarction ischemia. Recognition of collateral flow patterns, easily available using the Doppler angioplasty guidewire, may provide valuable information predicting the viability of post‐infarcted myocardium and the resolution of abnormal distal coronary flow patterns. © 1994 Wiley‐Liss,Inc..
Transcatheter treatment of angina after coronary surgery due to concomitant internal mammary steal and right coronary artery stenosis: a need for staging
Authors: Missault Luc , Taeymans Yves , Caes Frank , Nooten Guido Van , Belleghem Yves Van , Clement Denis 
Published: March 2007

AbstractUnligated side branches of the internal mammary artery used as a conduit in bypass surgery can be responsible for a flow steal phenomenon, causing recurrent angina. In this report we describe such a case, which was treated with a transcatheter embolization technique using coils as an alternative to surgery. However, heparin administration for simultaneous balloon dilatation of another lesion delayed successful embolization. Whenever balloon dilatation and embolization have to be performed on the same patient, both procedures should be staged to avoid heparin administration during and after the embolization procedure. © 1994 Wiley‐Liss,Inc..
Efficacy and safety of using perfusion dilatation catheter as initial balloon in coronary angioplasty
Authors: Waksman Ron , Ghazzal Ziyad M. B. , Scott Neal A. , Douglas John S. , King Spencer B. 
Published: March 2007

AbstractThe efficacy and safety in using a new low‐profile perfusion balloon catheter (PBC) as the initial balloon in percutaneous coronary angioplasty (PTCA) was assessed retrospectively in 61 patients: 43 males, mean age 62 ± 12 years. Thirty‐three patients (54%) had unstable angina. PTCA was performed using an improved PBC in the following vessels: LAD 40%; CX 21%; RCA 24%. Lesion morphology was: Type A 21%; Type B1 18%; Type B2 40%; Type C 21%. Mean artery size was 3.01 ± 0.53 mm. Mean PBC size was 3.14 ± 0.45 mm. The mean number of inflations used was 2.85 ± 2.0. The mean longest inflation was 415 ± 213 sec and the total inflation time was 663 ± 342 sec to a mean maximum pressure atmosphere of 7.85 ± 2.0 bars. The number of balloons used per procedure was 1.2 ± 0.44. In 50 patients (82%) only one balloon was used during the PTCA. PTCA was successful (<50% diameter stenosis without major complications) in 60 patients (98.4%). Mean diameter stenosis at baseline was 82 ± 9.5% and post‐angioplasty 13 ± 10.6%. A mild intimal tear occurred in 6 patients (9.8%). A stent was implanted in 3 patients (4.9%) due to severe dissection. In hospital reocclusion occurred in one patient (1.6%). There were no deaths or emergency bypass surgery. A low profile PBC is safe and effective as an initial balloon in PTCA. It may reduce the number of balloons used and inflations per procedure. © 1994 Wiley‐Liss,Inc
Circumferential balloon rupture and catheter fracture due to entrapment in a calcified coronary stenosis
Authors: Carell Edgar S. , Schroth George , Ali Abdul 
Published: March 2007

AbstractWe report a case of coronary angioplasty balloon rupture and catheter fracture within a calcified lesion, requiring emergency coronary bypass surgery. The entrapped catheter could not be removed at surgery. This case re‐emphasizes the hazards associated with angioplasty of calcified lesions. © 1994 Wiley‐Liss,Inc..
Diffuse spasm of a free gastroepiploic artery graft during percutaneous balloon angioplasty
Authors: Hara Kazuhiro , Kashida Mitsuo , Tamura Tsutomu , Saeki Fumihiko , Ikari Yuji , Suma Hisayoshi 
Published: March 2007

AbstractPercutaneous transluminal balloon dilation of an 8‐month‐old free graft of the gastroepiploic artery was followed by diffuse and profound graft spasm. Because free arterial grafts are more prone to spasm, suitable precautions, such as administration of calcium channel antagonists, should be taken before attempting any interventions on these vessels. © Wiley‐Liss, Inc.
Extension of a spontaneous coronary artery dissection due to thrombolytic therapy
Authors: Buys Eugene M. , Suttorp Maarten J. , Morshuis Wim J. , Plokker H. W. Thijs 
Published: March 2007

AbstractWe describe a case of spontaneous coronary artery dissection in a 38‐year‐old woman presenting with anterior myocardial infarction who was initially treated with thrombolysis. During the administration of thrombolytics the clinical symptoms and the electrocardiogram (ECG) deteriorated. Coronary angiography revealed a major dissection in the proximal left descending coronary artery. A spontaneous dissection was hypothesized to have extended by thrombolytic‐induced bleeding into the dissected vessel wall. Therefore, we advocate that, especially in young female patients presenting with an acute myocardial infarction and without cardiac risk factors, direct coronary angiography be considered, rather than thrombolytic therapy, in order to decide for the optimal therapeutic strategy. © Wiley‐Liss, Inc.
In vitro study of a radiofrequency guidewire aimed at recanalization of totally occluded peripheral arteries
Authors: Melnik Ivan , Dupouy Patrick , Kvasnicka Jan , Bhatia Anil , Geschwind Herbert J. 
Published: March 2007

AbstractA novel radiofrequency ablative system (40 msec‐train pulses with twenty 200 msecpulses at the carrier frequency of 750 KHz and 1 Hz repetition rate) aimed at recanalizing totally occluded peripheral arteries was investigated by means of in vitro tissue ablation from human postmorten arterial wall samples. The samples were submitted to irradiation with a guidewire 150 cm long, maximum diameter of ceramic tip 0.033 inch positioned perpendicular to the tissue surface in saline, contrast medium or blood using varying generator power. Ablation efficacy was determined as the depth of vaporization per pulse delivered. Electrical current for the train duration was measured as voltage at the 1 ohm‐resistor. In saline, the ablation efficacy increased from 8 to 65 μm/pulse with generator power increasing from 11 W to 27.5 W. There was no significant difference in the ablation efficacy between saline and blood. In contrast medium, the ablation efficacy was significantly lower. For the same generator power, the electrical current varied during the ablation procedure from 1.3 ± 0.2 A at the beginning of the procedure to 1.1 ± 0.2 A after the first pulses and to 2.0 A before artery wall perforation occurred. Neither tissue ablation nor current variations were observed when radiofrequency energy was emitted on calcified tissue. The diameter of craters was 0.89 ± 0.1 mm (range: 0.85–0.96 mm). No major thermal injury such as carbonization or charring was observed. Thus. (1) radiofrequency energy emitted through a guidewire is reliable and effective for the ablation of arterial tissue; (2) the depth of penetration is related to the generator power; (3) the ablation efficacy is greater in saline and blood than in contrast medium; (4) the system is not effective in highly calcified tissue; and (5) the procedure may be monitored by electrical current measurements. © Wiley‐Liss, Inc.
Mechanical coronary artery shortening with vessel wall deformity during directional coronary atherectomy: First reported case involving the left anterior descending artery
Authors: Shea Patrick J. 
Published: March 2007

AbstractCoronary spasm, dissection, thrombosis, and mechanical coronary artery obstruction due to vessel shortening and deformity resulting from kinking, invagination, or collapse in an accordion‐like fashion are recognized sources of iatrogenic obstruction during PTCA. Rapid recognition is required to initiate appropriate therapy. Described is the first reported case of mechanical obstruction involving the left anterior descending artery. © Wiley‐Liss, Inc.
Initial clinical application of a novel coronary angioplasty guide catheter exchange device
Authors: Teirstein Paul S. 
Published: March 2007

AbstractThe initial clinical experience with a novel device designed to facilitate guide catheter exchange during coronary angioplasty while maintaining a secure guidewire position (Marathon Relay, Baxter Interventional Cardiology, Irvine, CA) is described. Over a 7‐month period, 23 guide catheter exchanges were attempted during 20 procedures. The angioplasty procedure involved the use of newer devices in 65% of attempts with coronary stent deployment in 50% of attempts. In the majority (57%) of cases, exchanges were performed to allow improved guide catheter support. The exchange procedure was successful in 91% of attempts. Ultimate procedural success was achieved in 95% of patients with no complications. In this early experience, this device was found to be safe and effectively facilitated guide catheter exchange. © Wiley‐Liss, Inc.
Volumetric intracoronary ultrasound: Methods and validation
Authors: Dhawale Paritosh J. , Wilson David L. , Hodgson John McB. 
Published: March 2007

AbstractIntracoronary ultrasound (ICUS) not only allows visualization of the vessel lumen, it gives a unique view of the transmural components of the artery wall. Analysis of lumen and plaque volume is necessary for studying atherosclerotic disease progression or regression and the mechanisms of therapeutic coronary interventions. A real‐time, ICUS pullback data acquisition scheme was developed to acquire calibrated, cardiac‐gated volumetric image data sets. A semiautomated border detection scheme was implemented using dynamic programming. In phantoms, estimated area profiles were very reproducible as measured by the root‐mean‐square from the mean (3.8‐5.9%). In phantom volume estimates, improved reproducibility (standard deviation = 1.2‐3.6%) was obtained as positive and negative errors in area profiles were averaged out. Phantom volumes were also accurate when compared to true water displacement volume. The mean error ranged from −2.59 to −8.94%. When compared to quantitative single and biplane angiographic analysis, ICUS volumetric estimates tended to be superior to single plane analysis (error −5.06 ± 2.48% vs −9.96 ± 8.01%), but similar to optimal biplane analysis (error −5.06 ± 2.48% vs −6.34 ± 3.08%). In vivo reproducibility was assessed by performing multiple cardiac‐gated pull‐backs through experimentally induced stenosis. Over the length of the stenosis, excellent reproducibility of area profiles (± 5.9%) and volumes (± 1.9%) was obtained for cardiac‐gated acquisitions. We conclude that volumetric ICUS provides accurate and reproducible estimates of lumen volume. Thus this technique may be of use in clinical trials where changes lumen volumes and vessel area profiles are of interest. © Wiley‐Liss, Inc.
Development of left atrial thrombus following attempted percutaneous mitral valvuloplasty
Authors: Lee Kamthorn S. , Tuzcu E. Murat , Elliott John M. , Griffin Brian P. 
Published: March 2007

AbstractIn this report, we describe two cases of attempted mitral valvuloplasty using an Inoue balloon in which left atrial thrombus was not present before transseptal puncture but developed within minutes of the puncture in one, and within 1 mo in the other, despite systemic anticoagulation. © Wiley‐Liss, Inc.
Right‐to‐left shunt following repair of partial anomalous pulmonary venous connection: A novel use of the Rashkind double‐umbrella occlusion device
Authors: Harrison D. A. , Benson L. N. , Cusimano R. J. , McLaughlin P. R. 
Published: March 2007

AbstractA patient with partial anomalous pulmonary venous connection complicated by postoperative occlusion of the distal superior vena cava and a baffle leak causing right‐to‐left shunt is described. Surgery was avoided by balloon dilation and stenting of the superior vena cava. The baffle leak was closed with a Rashkind double‐umbrella device. © Wiley‐Liss, Inc.
Cardiac angiosarcoma arising in a coronary artery: Angiographic and pathologic findings
Authors: Rudoff John , Slavin Richard E. 
Published: March 2007

AbstractWe discuss a unique case of an angiosarcoma which arose in an atherosclerotic coronary artery. It was widely metastatic. We describe the angiographic findings and their differential diagnosis, and briefly discuss this relatively common cardiac malignancy.
Primary stent deployment in occlusive subclavian artery disease
Authors: Kumar Krishna , Dorros Gerald , Bates Mark C. , Palmer Leslie , Mathiak Lynne , Dufek Christine 
Published: March 2007

AbstractPrimary (without antecedent balloon dilation) Palmaz™ stent implantation was successfully performed in 27 consecutive patients entering with 31 obstructed subclavian arteries. Stents (n = 50) were successfully deployed, using the brachial (n = 7), femoral (n = 16), or combined (n=8) approach, to revascularize 31 subclavian vessels [8 occluded (26%); 23 stenotic (74%)], using a 6 or 7.5 French delivery system. The indications for intervention were arm claudication in 8 patients (30%), subclavian steal syndrome in 11 patients (41%), angina pectoris secondary to impaired blood flow to the left internal mammary artery coronary bypass in 6 patients (22%), and recanalization of a left subclavian occlusion to permit central arterial access and performance of a second interventional procedure 2 patients (7%). The percent diameter stenosis improved from 85 f 12% to 6 f 7% (P<0.001); and, the peak and mean translesion gradients decreased, respectively, from 56 f 35 mm Hg to 3 f 4 mm Hg (P<0.01), and 29 f 18 mm Hg to 2 k 2 mm Hg (P<0.01). Procedural complications encountered were one stent dislodgement with migration into and uneventful deployment within the right external iliac artery, and two brachial artery repairs. No acute vessel closures, deaths, myocardial infarctions, cerebrovascular accidents, transient ischemic attacks, or need for transfusions occurred. Therefore, primary subclavian artery stent deployment can be performed using low‐profile sheath systems with excellent success (100%), resulting in immediate restoration of pulsatile flow, and few complications. The incidence of lesion recurrence remains for follow‐up studies.
Catheter‐induced “accordion effect” in tortuous right external iliac artery during peripheral angiography
Authors: Joseph Davees , Idris Mohammed 
Published: March 2007

AbstractMechanical distortion of tortuous coronary arteries mimicking spasm or dissection during percutaneous transluminal coronary angioplasty due to balloon guidewire systems has previously been reported. This case reports a similar phenomenon in the peripheral vascular system induced by a diagnostic catheter. Recognition of this pseudo lesion may help to avoid complications and unnecessary intervention.
Usefulness of interlocking detachable coil for embolization of the major aorto‐pulmonary collateral artery: A case report
Authors: Kawata Tetsuji , Hasegawa Junichi , Yoshida Yoshitsugu , Kawachi Kanji , Kitamura Soichiro 
Published: March 2007

AbstractA 5‐yr‐old male had undergone a right‐modified Blalock‐Taussig shunt operation at the age of 1 mo for stenotic patent ductus arteriosus and pulmonary atresia with ventricular septal defect. Before a corrective operation, the angiogram revealed one large major aorto‐pulmonary collateral artery from the descending aorta to the right upper lung. Embolization of the major aortopulmonary collateral artery was successfully performed using interlocking detachable coils. This is the first reported case of embolization of the major aorto‐pulmonary collateral artery using this device.