bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anomalous origin of the left anterior descending coronary artery from the pulmonary artery: Surgical correction in an adult
Authors: Singh Ram N. , Taylor Paul C. 
Published: March 2007

AbstractA 45‐year‐old female with severe anginal symptoms was found to have anomalous origin of the anterior descending branch of the left coronary artery (LCA) from the pulmonary artery. Proximal ligation and anastomosis with aortocoronary saphenous vein graft (SVG) were performed. There was complete relief of symptoms. Two‐year postoperative angiography revealed a patent SVG with excellent flow, normalization of the caliber of the right and left circumflex coronary arteries with complete regression of collaterals, and improved left ventricular function.
Aortic catheterisation via percutaneous left ventricular puncture
Authors: Wong Philip H. C. , Chow Joseph S. F. , Chen Walter W. C. , Miller Graham A. H. 
Published: March 2007

AbstractWhen retrograde catheterisation and angiography of the ascending aorta from the brachial or femoral approach is not possible, this can be accomplished by direct percutaneous left ventricular puncture. The haemodynamic and angiographic information obtained was essential to surgical correction of aortic arch anomalies as illustrated in two patients.
Progression of coronary disease in candidates for transluminal coronary angioplasty
Authors: Morton B. C. , Higginson L. A. J. , Chambers R. J. , Beanlands D. S. 
Published: March 2007

AbstractFive of our first 20 candidates for PTCA had unanticipated occlusion of the relevant coronary artery between the time of coronary angiography and PTCA. None had a change in symptoms or ECG to suggest coronary occlusion. We currently schedule PTCA within a month to help avoid this occurrence.
A case of normal coronary infarction after intracoronary thrombolysis with urokinase
Authors: Watabe Shinji , Uwatoko Masashi , Tsunekawa Atsushi , Izumi Shiro , Osugi Junichi , Takatsu Fumimaro , Ishikawa Hiroyasu , Nagaya Teruo 
Published: March 2007

AbstractWe report the case of a 50‐year‐old male who had classical ECG signs of inferior wall myocardial infarction. Intracoronary thrombolysis resulted in fragmentation of a thrombus in the lumen of the right coronary artery. Angiography 1 month later showed no abnormalities at the site of previous thrombus. Ergonovine stress did not produce spasm. We conclude that (1) a mild cardial infarction can occur with an occlusive thrombus arising in angiographically normal coronary arteries; (2) transient change in minimal atheromata or spasm may induce such thrombi; and (3) thrombolytic therapy may be able to expedite recanalization of the occluded artery and salvage the myocardium.
Transluminal coronary angioplasty: Comparison of brachial and femoral artery methods
Authors: Dorros Gerald , Stertzer Fsca Simon H. , Myler Fsca Richard K. , Kaltenbach Martin , Spring Fsca Donald A. 
Published: March 2007

AbstractThe brachial and femoral artery methods for (percutaneous) transluminal coronary angioplasty are compared. We attempted 901 angioplasties with 539 (59.8%) via the brachial and 362 (40.2%) via the femoral artery. The stenosis was crossed in 670 attempts (74%); in 410 (76%) via the brachial, and in 260 (72%) via the femoral artery. Successful angioplasty was achieved in 607 attempts (67%): in 370 (69%) via the brachial, and in 237 (65%) via the femoral artery. There was no difference between the techniques in crossing the stenosis or achieving a primary success. The left anterior descending artery stenosis was statistically more likely to be crossed than a stenosis in the right (p < 0.001), circumflex (p < 0.05), left main coronary artery (p < 0.05), or saphenous vein graft (p < 0.05); the left anterior descending artery stenosis was more likely (p < 0.05) to be successfully dilated if the lesion were crossed (410 of 445 cases, 92%) than a right coronary stenosis (117 of 136 cases, 80%). The brachial and femoral artery methods are comparable techniques. Interventional angiographers performing coronary angioplasty should utilize the angiographic approach with which they are most familiar.
Laminar flow due to venous valves masquerading as vein graft spasm
Authors: Singh Ram N. , Salvoza Manuel I. 
Published: March 2007

AbstractTwo cases of laminar flow at the venous valves were found to produce a tapered appearance of the vein grafts, similar to spasm, during angiography. This possibility should be kept in mind when considering the diagnosis of spasm in a vein graft during postoperative angiographic studies. In addition, the follow‐up of these cases suggests that valves may predispose to later stenosis or occlusion of the vein grafts.
Recent experience with transeptal catheterization
Authors: Lew Allan S. , Harper Richard W. , Federman Jacob , Anderson Stanley T. , Pitt Aubrey 
Published: March 2007

AbstractWe report our recent experience of 207 consecutive transeptal catheterizations performed in the following groups of patients: aortic valve disease in 152, mitral valve disease in 20, combined aortic and mitral valve disease in 11, hypertrophic obstructive cardiomyopathy in 11, assessment of prosthetic cardiac valves in nine, and four miscellaneous.Transeptal catheterization failed in 20 patients. There was no attempt to advance the transeptal catheter from the left atrium into the left ventricle in 18 patients, and failure to advance the transeptal catheter from the left atrium into the left ventricle occurred in 13 patients. Transeptal catheterization was achieved in a mean time of 9.7 ± 4.6 SD min.There were no deaths, two major and four minor complications. We conclude that transeptal catheterization remains a useful technique that in experienced hands is both rapid and safe.
A method for inserting two catheters, pulmonary arterial and temporary pacing, through a single puncture into a subclavian vein
Authors: Jacob Andrew S. , Schweiger Marc J. 
Published: March 2007

AbstractA method for inserting two catheters into a subclavian vein, using a single puncture, is described. Ten patients are reported in whom pulmonary arterial and temporary pacing catheters were inserted by this method. Similar techniques are discussed.
Brachial artery catheterization employing a side arm sheath
Authors: Folland Edward D. , Kemper Andrew , Bloomfield Peter , Parisi Alfred F. 
Published: March 2007

AbstractA major complication of left heart catheterization via the brachial artery is occlusion at the cutdown site. This is particularly a problem when patients with severe atherosclerosis are catheterized in laboratories where the brachial approach is not routinely used. A method of brachial artery catheterization is described which employs a continuously flushed side arm sheath in order to minimize local trauma to the artery from catheter exchange and manipulation. In 15 consecutive atherosclerotic patients catheterized by this method there were no complications, and all arteriotomies were closed easily with immediate restoration of a good radial pulse. This contrasts with the preceding 33 consecutive brachial catherizations employing standard technique in similar patients in whom four patients required surgical repair, and an additional six patients required more than one closure attempt and/or catheter thrombectomy to restore a good pulse. In our laboratory the brachial sheath technique has facilitated arterial repair and reduced local complications.
Incidence of new focal pulmonary emboli after routine cardiac catheterization comparing the brachial to the femoral approach
Authors: Gowda Siddhesh , Bollis A. M. , Haikal M. , Salem B. I. 
Published: March 2007

AbstractThe incidence of pulmonary perfusion defects after routine cardiac catheterization was assessed in 56 patients by comparing ventilation–perfusion (V/Q) lung scans obtained before and 1 day after catheterization. Patients were prospectively randomized in two groups, one in which the brachial approach was performed using an antecubital cutdown procedure, and one in which the percutaneous femoral approach was used. None of the patients with the brachial approach had any ventilation–perfusion mismatch on the V/Q scan; however, three patients (8.3%) with the femoral approach did. These two groups did not differ significantly in clinical characteristics, duration of catheterization, and hemodynamic variables. The data suggest that pulmonary emboli postcardiac catheterization is more frequent in the femoral than the brachial approach. Furthermore, since those pulmonary emboli are mostly asymptomatic, their clinical recognition would be underestimated.
Left main coronary artery stenosis: A possible complication of transluminal coronary angioplasty
Authors: Graf Ray H. , Verani Mario S. 
Published: March 2007

AbstractCoronary transluminal angioplasty is a new alternative modality for the treatment of specific lesions of coronary artery disease. Although numerous complications have been recognized, this represents the first report of development of a severe left main coronary artery stenosis following left anterior descending artery angioplasty.
Sotalol‐induced torsade de pointes
Authors: Rakovec Peter , Cercek Bojan , Rode Primoz , Brucan Andrej , Horvat Matija 
Published: March 2007

AbstractA case of sotalol‐induced polymorphous ventricular tachycardia (torsade de pointes) is presented. The patient had moderately prolonged Q‐T interval before medication with sotalol with further prolongation after application of this drug. Electrophysiological study during rechallenge with sotalol demonstrated a uniform ventricular tachycardia with a somewhat polymorphous onset; whether or not this tachycardia represented replication of the patient's spontaneous arrhythmia is questionable. Without antiarrhythmic drugs and during medication with pindolol ventricular tachycardia was not inducible.
Distal coronary artery injury following successful percutaneous transluminal coronary angioplasty
Authors: Schweiger Marc J. , Meeran M. K. , Gianelly Ralph E. 
Published: March 2007

AbstractA 65‐year‐old woman underwent successful percutaneous transluminal coronary angioplasty of a right coronary artery stenosis. Shortly thereafter, she developed chest discomfort and repeat angiography demonstrated a new area of stenosis distal to the area of original angioplasty. An attempt at a second angioplasty resulted in vessel occlusion with subsequent successful bypass surgery. The etiology of the new distal lesion is discussed.
Balloon inflation caused by contrast injection through the guiding catheter: An unusual observation during coronary angioplasty
Authors: Van Gelder L. M. , Van Der Krieken A. M. , El Gamal M. I. H. , Bonnier J. J. R. M. , Michels H. R. 
Published: March 2007

AbstractBalloon inflation caused by contrast injection through the guiding catheter has been observed during several angioplasty procedures. The phenomenon is observed when employing an 8F USCI guiding catheter in combination with an ACS dilatation catheter. Two cases demonstrating the phenomenon are described in detail, together with an in vitro experiment that illustrates and quantifies the mechanism.
Intravenous versus intracoronary streptokinase for acute transmural myocardial infarction
Authors: Blunda Michael , Meister Steven G. , Shechter Jay A. , Pickering Nancy J. , Wolf Nelson M. 
Published: March 2007

AbstractIn order to compare the thrombolytic efficacy of selective versus systemic administration of streptokinase, we gave this drug by either the intracoronary or intravenous routes to 25 patients during the first 6 hours of acute myocardial infarction. All patients had total occlusion of the infarct‐related vessel, unresponsive to intracoronary nitroglycerin. Twelve patients received intravenous streptokinase and 13 received intracoronary administration of the drug. Angiograms were taken prior to and during streptokinase administration. Reopening was achieved in 11 of 13 intracoronary patients and 8 of 12 intravenous patients (P = Ns). Time to reopening was longer (54 minutes) in the intravenous patients than in the intracoronary patients (26 minutes) (P < 0.05). In this study, intravenous streptokinase reopened infarct‐related vessels nearly as often as intracoronary streptokinase, but it took longer. Given the limited access and time to prepare for intracoronary infusion and the ease of intravenous administration, further study of intravenous streptokinase is justified.
Clinical and angiographic findings in a patient with vasospasm in an anomalous coronary artery
Authors: Schulman Peter , Ferree Joel W. , Del Mastro Patrick R. 
Published: March 2007

AbstractWe report the case of a 58‐year‐old man with coronary vasospasm that occurred within an anomalous coronary artery. The rapidly progressive clinical course and the dramatic treadmill test result preceeded the diagnostic cardiac catheterization. Combination therapy with isosorbide, beta blocker, and nifedipine resulted in complete resolution of symptoms.
Aberrant origin of the right ventricular coronary artery: A report of two cases
Authors: Vacek James L. , Stock Peter D. , Davis William Ross 
Published: March 2007

AbstractAberrant origin of coronary arteries is a not uncommon entity found on cardiac catheterization, at the time of surgery, and on post mortem examination. We present two cases of origin of a right ventricular (or atypical large conus) branch of the right coronary artery originating from a separate ostium in the right coronary cusp, which to our knowledge has been only rarely previously described. We feel that this may be a relatively frequent coronary varient that has important implications regarding patient assessment and care.
Reproducibility and accuracy of left ventricular ejection fraction and wall motion determinations using gold‐195m: A new ultrashort‐lived radionuclide for cardiac studies
Authors: Narahara Kenneth A. , Mena Ismael , Maublant Jean C. , Brizendine Marianne , Thompson Craig J. , Criley J. Michael 
Published: March 2007

AbstractGold‐195m has a halflife of 30.5 sec. Its ultrashort halflife and low radiation exposure (240 mrads to the kidney from a 20‐mCi injection) make it an ideal agent for sequential first‐transit studies of cardiac function. The reproducibility of ejection fraction and wall motion determinations were assessed from two gold‐195m first‐pass angiograms performed 3 min apart in 38 subjects. The accuracy of these evaluations was assessed by performing another first‐transit study using technetium‐99m.The correlation of the ejection fraction between the two gold‐195m angiograms was 0.95 (standard error of the estimate (SEE) = 0.049) over an ejection fraction range of 20–78. The correlation of the ejection fraction using technetium‐99m versus gold‐195m was 0.95; SEE = 0.050. Only six minor discrepancies were noted when wall motion was evaluated in the gold‐195m angiograms and compared with the technetium‐99m study.We conclude that gold‐195m can provide repeated, accurate, and reproducible ejection fraction and wall motion determinations with conventional imaging equipment at a substantially lower radiation exposure than with technetium‐99m.
Selective coronary arteriography by percutaneous transaxillary approach
Authors: Valeix B. , Labrunie P. , Jahjah F. , Collet F. , Monassier J. P. , Guarino L. , Puel J. , Roux J. J. , Heibig J. , Levy S. , Gerard R. 
Published: March 2007

AbstractCoronary angiography by the percutaneous femoral approach is widely used. This technique is potentially dangerous or impossible in patients with advanced arterial disease of the lower limbs, whether or not surgically treated. In these cases, percutaneous left or right axillary approach is an alternative to brachial approach.In this article, we report our multicenter experience involving 120 patients. The left axillary artery was used in 94 cases (78%) and the right in 26 cases (22%). We used preformed coronary catheters usually associated with the femoral approach. The left axillary artery was used preferentially since this avoids catheterization of the innominated trunk and allows easier catheterization of the coronary ostia and aortic ends of aorto‐coronary bypass grafts. The routine use of a sheath (arterial introducer) avoided arterial compression during catheterization, prevented hemorrhagic suffusion when the catheters were exchanged, and reduced the risk of thrombosis or laceration of the axillary artery. There were no failures in the catheterization of the axillary artery and no complication was observed during or after the procedure.Axillary percutaneous technique appears to have the following advantages over the brachial arteriotomy: (1) Investigation time is equivalent to the time needed for the femoral percutaneous approach. (2) There is the possibility of lateral and simultaneous bi‐plane angiograms. (3) Arterial puncture is preferable to arteriotomy.The axillary approach could also be used for percutaneous transluminal coronary angioplasty.
Experience with a technique for coronary angioplasty of bifurcational lesions
Authors: Zack Paul M. , Ischinger Thomas 
Published: March 2007

AbstractTo decrease the risk of iatrogenic side branch occlusion during coronary angioplasty of bifurcational lesions, we evaluated a technique in which two over‐the‐wire dilatation systems are positioned within the stenosed coronary artery and the side branch in jeopardy. The technique was used in eight patients undergoing angioplasty for a lesion in the left anterior descending or circumflex artery located near a large side branch. Successful dilatation of the major vessel lesion was achieved in all eight patients, and dilatation within the side branch was successful in all three patients whose lesion involved the side branch ostium. In one patient, dilatation within the major vessel led to partial closure of the side branch and the prepositioned guide wire facilitated prompt dilatation of the iatrogenic closure. There were no complications associated with use of the additional dilatation system. The technique appears to provide an efficacious method to perform safe coronary angioplasty in selected patients with bifurcational lesions.
Unusual nodular pulmonary lesions associated with thrombolytic therapy
Authors: Carmody Thomas James , Wergowske Gilbert L. , Joffe C. David 
Published: March 2007

AbstractThe occurrence of solitary nodular pulmonary lesions associated with thrombolytic therapy is reported in two patients. Resolution was spontaneous in each patient. Multiple thin needle aspiration biopsies in one case revealed only red blood cells. This unusual entity should be included as one of the potential complications associated with the use of thrombolytic agents.
Thresholds for transesophageal atrial pacing
Authors: Dick MacDonald , Campbell Robert M. , Jenkins Janice M. 
Published: March 2007

AbstractTo determine the thresholds for transesophageal atrial capture, as well as factors that may influence the thresholds, we measured the minimal current and pulse width required to pace the atria through transesophageal bipolar lead systems in 12 patients, ranging in age from 1 day to 19 years, during 19 episodes of reentrant supraventricular tachycardia. Depending on the patients' age and size several electrode catheters were used. The protocol called for 1‐msec step‐wise increments in pulse width. At each pulse width the current was increased by 1 mamp until capture was achieved. The mean minimal pulse width and mean minimal current required for capture were 5.8 msec and 13.6 mamp, respectively. Atrial capture was achieved in 75% of attempts at a pulse width and current equal to or less than 6.5 msec and 17.5 mamp, respectively. No correlation between current and pulse width on the one hand and age, height, weight, or body surface area on the other was detected. Likewise neither electrode type nor existence of structural heart disease influenced the threshold required for capture. We conclude that atrial capture can be readily achieved through transesophageal electrodes and is not influenced by the subject's age or size.
Determinants of outcome following left ventricular aneurysmectomy
Authors: Nestico Pasquale F. , Hakki A‐Hamid , Iskandrian Abdulmassih S. , Hakki A‐Hadi , Kay Harold , Mundth Eldred D. 
Published: March 2007

AbstractThe determinants of outcome after left ventricular aneurysmectomy are not well understood. We analyzed preoperative follow‐up information on 38 patients who had undergone left ventricular aneurysmectomy. At a mean follow‐up of 39 months (range 6 to 68), 25 patients (66%) improved by at least one functional class (New York Heart Association) (Group I), and 13 patients (Group II) either died (n: 8) or had persistent congestive heart failure (n: 5). Patients in Group I had significantly higher left ventricular ejection fraction before surgery than patients in Group II (38 ± 12% vs. 29 ± 14% P < 0.04). The volume of the aneurysm at end‐diastole was smaller among patients in Group I than Group II (42 ± 32 ml vs. 73 ± 47 ml, P < 0.04).The contractile indices of the nonaneurysm segment, contractile segment ejection fraction, basilar half ejection fraction, and basilar fractional area shortening were not significantly different between the two groups. There was no difference between the two groups in the preoperative left ventricular end‐diastolic pressure, cardiac index, pulmonary artery wedge pressure, pulmonary artery pressure, extent of coronary artery disease, number of bypass grafts inserted, or aortic cross‐clamp times.Conclusion: (1) The ejection fraction and volume of the aneurysm are more important predictors of outcome after left ventricular aneurysmectomy than the contractile indices of the nonaneurysmal left ventricle and (2) symptomatic improvement occurs in 66% of patients after left ventricular aneurysmectomy.
Regulation of cardiac output during upright exercise in patients with aortic regurgitation
Authors: Iskandrian Abdulmassih S. , Hakki A‐Hamid , Amenta Angelo , Mandler Jeffrey , Kane Sally 
Published: March 2007

AbstractThe change in cardiac output during upright exercise in patients with aortic regurgitation (AR) is not well known. We measured left ventricular (LV) ejection fraction (EF) and volume, regurgitant fraction (RF), total cardiac output and forward cardiac output at rest, and peak upright exercise by means of radionuclide angiography in ten normal subjects and 15 patients with AR.In the normal subjects, there was no significant change in the end‐diastolic volume but there was a significant decrease in the end‐systolic volume (p = 0.0001) and a significant increase in EF (p = 0.0001). The increase in cardiac output during exercise was due to increases in both stroke volume and heart rate.In patients with AR, there was a significant decrease during exercise in RF (53 ± 15% at rest, and 45 ± 15% during exercise; p = 0.03), and in end‐diastolic and endsystolic volume (p = 0.02, and p = 0.003, respectively). The EF increased during exercise (p = 0.003). The total stroke volume did not change (68 ± 19 ml/m2 at rest, and 67 ± 14 ml/m2 during exercise; p, NS).Thus, in patients with AR, individual changes in EF, RF, and volume are quite variable, but as a group a decrease in RF and an increase in heart rate contribute to the increase in forward flow. The total stroke volume may not increase during exercise, despite an increase in EF and a decrease in end‐systolic volume because of a concomitant decrease in end‐diastolic volume.