bluuebunny/crossref_metadata_2025_split huggingface dataset:
Excimer laser ablation before autoperfusion balloon inflation: A novel therapeutic approach to high grade stenoses in vessels supplying substantial myocardium at risk
Authors: Krause Philip B. , Schaer Gary L. , Parrillo Joseph E. , Klein Lloyd W. 
Published: March 2007

AbstractThe utility of a novel approach employing excimer laser ablation to form a channel for subsequent autoperfusion balloon angioplasty is presented. Two important advantages of this strategy are highlighted: (1) applicability to severe stenoses in vessels supplying substantial myocardium at risk and (2) ability to allow prolonged inflation time to minimize procedure related ischemia and optimize revascularization of the heart. We prospectively selected and studied five patients and performed excimer laser coronary angioplasty using either a 1.3 mm or 1.6 mm laser catheter followed by autoperfusion balloon dilatation. Procedural success was documented by a significant reduction in mean percent diameter stenosis from 89 ± 4% (S.D.) to 53 ± 4% after laser angioplasty (p<0.0001) and subsequently to 20 ± 4% after autoperfusion balloon angioplasty (p<0.0001). Clinical success was attained and characterized by resolution of anginal symptoms for at least 4 weeks after hospital discharge. There were no major acute complications encountered; however, restenosis has occurred in 2 out of 5 patients. We therefore recommend this novel pre‐dilation strategy with excimer laser followed by autoperfusion balloon angioplasty in selected patients with an extensive amount of myocardium at risk.
Ventricular standstill complicating left heart catheterization in the presence of uncomplicated right bundle branch block
Authors: Gaglani Rajesh D. , Turk Ashfaq A. , Mehra Mandeep R. , Lach Ralph D. 
Published: March 2007

AbstractWe report the unusual occurrence of complete heart block during attempted right coronary artery cannulation in a patient with pre‐existing uncomplicated right bundle branch block (RBBB). This complication occurred due to accidental impingement of the Judkin's right coronary catheter on the left bundle when it transiently slipped across the aortic valve. The block resolved without any complication.
Anomalous origin of the left coronary artery from the pulmonary artery: Direct assessment of anomalous and collateral coronary flow by pulsed doppler echocardiography
Authors: Takeshita Satoshi , Yamaguchi Tetsu , Kuwako Kenji , Isshiki Takaaki 
Published: March 2007

AbstractWe directly assessed the anomalous and collateral coronary flow profiles of a 58 year‐old‐man with Bland‐White‐Garland syndrome using pulsed Doppler echocardiography. Doppler recordings in this patient document the utility of pulsed Doppler echocardiography in the assessment of a cardiac shunt associated with a congenital coronary anomaly in an adult.
Endomyocardial biopsy: Advantages of adding a posterior bend to the bioptome
Authors: Hauptman Paul J. , Gass Alan , Cohen Marc , Goldman Martin E. , Israel Douglas , Ambrose John A. 
Published: March 2007

AbstractA modification of the distal end of a flexible bioptome used for endomyocardial biopsy is described which facilitates the approach to the interventricular septum. Contact with the right ventricular free wall is avoided.
Cardiac catheterization laboratory survey: 1990 Society for cardiac angiography and interventions laboratory performance standards committee
Authors: Cameron Airlie , Sheldon William C. , Balter Stephen 
Published: March 2007

AbstractA survey of 117 member cardiac catheterization laboratories was undertaken by the Society for Cardiac Angiography and interventions. The survey included numbers and types of procedures, both diagnostic and interventional, in adult as well as pediatric age groups. Radiation safety, various laboratory policies, frequency of short stay, and outpatient procedures were tabulated. Report generation, training programs, administrative organization, and laboratory equipment were all included. The results were compared with a 1978 survey. Areas of concern in terms of safety of the patient and possible underutilization of laboratories were identified.
PTCA with side‐by‐side balloon using fixed guide wire systems: A potential alternative autoperfusion device‐an in vitro study
Authors: Colle Jean‐Pierre , Delarche Nicolas 
Published: March 2007

AbstractThe use of “hugging balloons” for the implementation of a coronary angioplasty is a well‐known and much‐written‐about technique. It has not, on the other hand, ever been stressed that two inflated hugging balloons are not totally obstructive, leaving enough space, between the balloons and the arterial wall, for perfusion. The cross section of this free area can be as much as 12% of the total arterial cross section, when the side‐by‐side balloons are of a relatively similar size.Calculations show that similar total conduit cross sections are achieved when inflating either a 3.0 balloon or two 2.0 side‐by‐side balloons.An in vitro experiment compares how systems using 2.0 double balloons and a 3.0 autoperfusion balloon affect the distal flow of a 3 mm internal diameter conduit. A semirigid silastic tubing is perfused with a 5% glucose isotonic solution at various predetermined proximal pressure levels. Distal pressures and flows are measured at different stages: with no balloon, with deflated balloons, and with inflated balloons.Comparison shows that (1) the double balloon system offers little resistance to flow compared to the autoperfusion balloon; (2) this system's rate of perfusion run‐off is hardly affected and is constantly better than with the autoperfusion balloon; (3) this difference is all the more marked, the lower the proximal perfusion.These results suggest that the use of a double balloon could, in some cases, provide an alternative solution to autoperfusion equipment. Further clinical studies are needed to test this hypothesis.
Mitral balloon valvuloplasty with transesophageal echocardiography without using fluoroscopy
Authors: Kültürsay Hakan , Türkoǵlu Cüneyt , Akin Mustafa , Payzin Serdar , Soydas Cahide , Akilli Azem 
Published: March 2007

AbstractBalloon mitral valvuloplasty with Inoue technique was performed in two group of patients. In group I (n = 40) valvuloplasty was performed under fluoroscopy without using echocardiography, whereas in group II (n = 13) valvuloplasty was performed under the guidance of transesophageal echocardiography alone, without using fluoroscopy. Patients in two groups were comparable with regard to clinical variables and hemodynamic parameters. Two female patients in group II were pregnant.Transmitral pressure gradient decrease did not differ significantly between two groups (pressure gradient: 17 ± 5 to 4 ± 1 in group I and 15 ± 4 to 3 ± 1 mm Hg in group II). Mitral valvular area increase was also not different in two groups (1.09 ± 0.2 cm2 to 2.3 ± 0.5 cm2 in group I and 0.9 ± 0.2 to 2 ± 0.3 cm2 in group II). In 14 cases from group I and 2 cases from group II mitral regurgitation increased after valvuloplasty (p < .05). Left atrial perforation occurred in one patient from group I and 2 patients from group II.In conclusion, mitral balloon valvuloplasty under transesophageal echocardiographic guidance alone is a safe and effective procedure in the treatment of mitral stenosis.
Early ambulation following diagnostic 7‐french cardiac catheterization: A prospective randomized trial
Authors: Lau Kean Wah , Tan Arthur , Koh Tian Hai , Koo Chee Choong , Quek Susan , Ng Amy , Johan Abdullah 
Published: March 2007

AbstractThere is a paucity of randomized studies concerning transfemoral cardiac catheterization and its complications, in particular that of 7F catheterization. Accordingly, we conducted a prospective, randomized trial comparing early ambulation (group A) 6 hr after diagnostic 7F cardiac catheterization versus late ambulation (group B) the following morning. A total of 273 patients were randomized in the study; 142 in group A and 131 in group B (NS). Except for a difference in the indications for catheterization, the baseline and procedure‐related parameters were similar between the 2 groups. Early hematoma (formed within 6 hr) developed in 6 (4%) and 7 (5%) patients in groups A and B, respectively (NS). Similarly, there was no difference in the incidence of late hematoma formation (2% in each group). All hematomas detected were small and required no surgical intervention or extension of hospital stay. Our data showed that early ambulation following 7F left heart catheterization is feasible and safe. The access site complication rate is acceptably low and minor in nature.
Coronary artery rupture and pseudoaneurysm formation resulting from percutaneous coronary angioscopy
Authors: Wolff Matthew R. , Resar Jon R. , Stuart R. Scott , Brinker Jeffrey A. 
Published: March 2007

AbstractWe describe a case in which coronary angioscopy was complicated by inability to deflate the device's occlusion balloon. Rapid over‐inflation to rupture the balloon resulted in massive dissection of the artery, pseudoaneurysm formation, and ultimately coronary bypass. While the cause of failure of balloon deflation remains obscure, deliberate over‐inflation to cause rupture may be hazardous. © 1993 Wiley‐Liss, Inc.
Limitations of the zero crossing detector in the analysis of intracoronary doppler: A comparison with fast fourier transform analysis of basal, hyperemic, and transstenotic blood flow velocity measurements in patients with coronary artery disease
Authors: Di Mario Carlo , Roelandt Jos R. T. C. , De Jaegere Peter , Linker David T. , Oomen Jan , Serruys Patrick W. 
Published: March 2007

AbstractThe current clinical standard for the analysis of intracoronary Doppler signals is the application of a zero‐crossing (ZC) detector. However, the accuracy of the method is questionable, especially in areas of disturbed flow, as confirmed by in vitro studies, animal experiments, and intraoperative observations. The aim of this study is the comparison of a conventional ZC detector and a custom‐designed spectral analyzer (fast Fourier transform, FFT) in the analysis of intracoronary Doppler signals obtained in 19 patients undergoing coronary angioplasty.A 3F catheter with an end‐mounted Doppler ceramic crystal was placed over an 0.014″ guidewire in a normal or near‐normal segment proximal to the lesion to be dilated. The Doppler signal was recorded before and after intracoronary infusion of 12.5 mg of papaverine. In 9 patients high flow velocities could be recorded when the catheter was advanced across the stenosis.The blood flow velocity measurements obtained with ZC were significantly lower than the maximal FFT flow velocity measurements (16±12 cm/s vs. 29±18 cm/s, p < .001). In all the conditions of Doppler signal acquisition (baseline, hyperemia, stenosis) a large scattering of the signed differences between corresponding measurements was observed. The standard deviation of the difference ZC‐FFT was ±11 cm/s and ±5 cm/s for the maximal and mean FFT flow velocity, corresponding in both cases to ±37% of the mean of the ZC and FFT measurements. Large differences were also observed in the values of coronary flow reserve (CFR) calculated as the ratio between ZC and FFT flow velocity measurements 30 s after papaverine intracoronary and at baseline. The standard deviation of the difference ZC‐FFT based CFR was ±1.3 and ±1.2 for the values derived from the maximal and mean FFT flow velocities (percent difference ±32% and ±37%, respectively).In conclusion, the measurements obtained from the same intracoronary Doppler signal analyzed with a ZC detector and an FFT technique showed large differences in various conditions of flow and also in the assessment of relative flow velocity derived indices such as CFR. Spectral analysis should replace the current use of a ZC detector for the evaluation of coronary Doppler signals, even for the assessment of relative flow velocity changes. © 1993 Wiley‐Liss, Inc.
Comparison of shortening with timing of wall motion in detecting regional abnormalities of the left ventricle in coronary disease
Authors: Natarajan A. , Bove A. A. 
Published: March 2007

AbstractClinical observations suggest that ischemic myocardium may demonstrate delayed wall motion while absolute shortening remains normal. Wall motion timing and percent shortening were examined in 25 patients (7 normal, 18 coronary disease) with 35 mm biplane left ventriculograms and coronary arteriography. Mean age was 63 ± 2.4 years. Of 17 males and 8 females, 13 had 3 vessel, 4 had 2 vessel, and 1 had 1 vessel disease. Left ventricular regions were analyzed using the Coronary Artery Surgery Study nomenclature and quantitative computer‐based analysis as well as visual based qualitative analysis. Regional percent shortening and ejection fraction were calculated from end systolic and end diastolic frames. Regional shortening times were related to global ejection time from 30 frame/sec, frame by frame analysis. Feeder arteries were stenosed (>70%) in 135 of 225 left ventricular regions analyzed. Computer detection (shortening and timing) identified 97/225 as abnormal (P < 0.01 vs. feeder artery stenosis) while physicians identified 79/225 as abnormal (p < 0.01 vs. feeder artery stenosis). Of the 97 computer detected abnormal regions, shortening alone detected 47, timing alone detected 39, and 11 showed both abnormalities. Timing analysis increased detection of wall motion abnormalities from 58/225 (26%) to 97/225 (43%) (p < 0.001). Timing abnormalities were noted more (92%) in basal segments, while shortening abnormalities dominated (88%) in apical segments (p < 0.001). Use of temporal measurements in wall motion analysis significantly increases the likelihood of detecting abnormal left ventricular regional wall motion when compared to shortening measurements alone. © 1993 Wiley‐Liss, Inc.
Balloon mitral valvotomy by using the twin‐at catheter: Immediate results and complications in 110 patients
Authors: Berland J. , Rocha P. , Choussat A. , Lefebvre T. , Fernandez F. , Rath P. 
Published: March 2007

AbstractBalloon mitral valvotomy, using a new Twin AT catheter (two balloons attached side by side over one shaft), was performed in 110 consecutive cases. The age of the patients ranged from 19–78 yr (mean 46 ± 15). From a total of 94 females and 16 males, 23 of the patients (22%) had mitral valve calcification, 47 patients (46%) had atrial fibrillation, and 39 patients (37%) had mitral regurgitation (< +2). Twenty patients (18%) presented with restenosis following surgical commissurotomy. Total catheterization time was 101 ± 26 min and the duration of the valvotomy procedure was 37 ± 21 min in these cases. For the entire population, there was a significant reduction in mitral valve gradient (15 2 6 to 4.8 ± 2.6 mmHg, p < .001), an increase in mitral valve area (MVA) (1.1 ± 0.3 to 2.35 ± 0.7 cm2 ,p < .001), and a decrease in mean pulmonary arterial pressure (31 ± 12 to 26 ± 11, p <.002) after the balloon mitral valvotomy. Sixteen patients (1 4%) developed significant left to right shunt, and in 22 patients (20%) mitral regurgitation increased moderately but without resulting in emergency valve replacement. There was one incidence of embolic episode and one pericardial tamponade. Adequate hemodynamic results (MVA > 1.5 cm2 and % increase in MVA ≥ 50%) without major complications were obtained in 99 cases. In 9 patients with severely diseased valve (2 previous commissurotomy, one restenosis after balloon valvotomy), or small left ventricular cavity, insufficient results were obtained by the Twin‐AT catheter. The Twin‐AT balloon catheter was exchanged for larger 2 balloons combinations in 5 patients and lnoue catheter in 4, and significant improvement in MVA was obtained in 5 cases. Thus, BMV can be safely and effectively performed in most cases with this new Twin‐AT catheter, thereby saving time and cost. © 1993 Wiley‐Liss, Inc.
Cortical blindness after cardiac catheterization: Effect of rechallenge with dye
Authors: Rama Bhola Nath , Pagano Tom Victor , DelCore Michael , Knobel Kevin Robert , Lee Jonathan 
Published: March 2007

AbstractTransient cortical blindness (CB) is a rare complication of dye usage during cardiac catheterization, percutaneous transluminal coronary angioplasty (PTCA) or directed coronary atherectomy (DCA), and is limited to few case reports. In this paper, we are describing three such cases of CB who, upon reexposure to dye during subsequent cardiac catheterization, did not develop CB. To our knowledge, the consequences of reexposure of these patients to dye has not been described in literature. © 1993 Wiley‐Liss, Inc.
Coronary neovascularity: A possible sign of new and growing mural thrombus
Authors: Nakamura Tai , Yamanaka Osamu , Fujiwara Yasumasa , Honda Morihiro , Kanoh Tatsuji , Yamaguchi Hiroshi 
Published: March 2007

AbstractThis is a case report of a coronary artery fistula through a mural thrombus on a left ventricular aneurysm into the left ventricle. Serial coronary arteriography disclosed a vessel exhibiting a “smokelike” appearance originating at the anterior descending artery. This abnormal finding faded away over a period of 10 years with a decrease in size of the mural thrombus. This finding strongly suggests that the abnormal vessel represents an acquired neovascularity related to a newly developed thrombus. © 1993 Wiley‐Liss, Inc.
Successful excimer laser angioplasty following unsuccessful primary balloon angioplasty
Authors: Wolfe Christopher L. , Landin Ronald J. , Linnemeier Thomas J. , Klette Melissa , Hodes Zachary I. , Ball Michael W. , Rothbaum Donald A. 
Published: March 2007

AbstractWe report five patients where excimer laser coronary angioplasty facilitated successful balloon dilatation of heavily calcified lesions that could not be dilated by conventional angioplasty techniques alone. In each case, the lesion was crossed successfully with a guide wire. Conventional angioplasty failed because of inability to cross the lesion with a balloon (four lesions) or inability to dilate the lesion with balloon inflation (two lesions). These cases illustrate an indication for excimer laser coronary angioplasty as an adjunctive procedure in heavily calcified coronary stenoses. © 1993 Wiley‐Liss, Inc.
Is aggressive heparinization necessary for elective ptca?
Authors: Frierson John H. , Dimas Alexios P. , Simpfendorfer Conrad C. , Pearce Gregory , Miller Mike , Franco Irving 
Published: March 2007

AbstractThe optimal level of heparin anticoagulation for elective PTCA is unknown. To determine if PTCA complications are related to the level of anticoagulation, serial ACT values were prospectively measured in 189 patients undergoing 201 elective PTCA procedures. The mean heparin dose before balloon inflation (pre‐inflation) was 10,100 units, and the mean dose per procedure was 13,200 units. The mean pre‐inflation ACT was 295 sec, but was <300 sec in more than 50% of patients. Acute complications were not related to any ACT parameter and the development of new intracoronary thrombus was not observed. In elective PTCA procedures, the routine monitoring of ACT values is unnecessary when standard heparin doses are used. © 1993 Wiley‐Liss, Inc.
Intracoronary blood flow velocity and transstenotic pressure gradient using sensor‐tip pressure and doppler guidewires: A new technology for the assessment of stenosis severity in the catheterization laboratory
Authors: Mario Carlo Di , De Feyter Pim J. , Slager Cornelis J. , De Jaegere Peter , Roelandt Jos R. T. C. , Serruys Patrick W. 
Published: March 2007

AbstractIn a patient undergoing percutaneous balloon angioplasty of a stenotic proximal right coronary artery the transstenotic pressure gradient was measured using a “0.018” guidewire with a distal optical microsensor. Blood flow velocity was measured proximal to the stenosis using a “0.018” Doppler guidewire. Transstenotic pressure gradient and blood flow velocity were measured in baseline conditions and after intracoronary injection of 12.5 mg of papaverine. Coronary blood flow was calculated from the measured blood flow velocity and the corresponding cross‐sectional area. The measured pressure gradients were compared with the values derived from the stenosis geometry assessed with quantitative coronary angiography (automated edge detection measurements in two orthogonal views, assuming an elliptical cross‐sectional area).The measured transstenotic pressure gradient was 15 mm Hg in baseline conditions and 42 mm Hg at the peak effect of the papaverine injection. A 50% flow velocity increase was observed at peak hyperemia (time‐averaged maximal flow velocity = 30 cm/s before and 45 cm/s after papaverine). The transstenotic pressure gradient calculated from the measured stenosis geometry was 20 mm Hg and 42 mm Hg in baseline and hyperemic conditions, respectively.The combined use of a pressure and a Doppler guidewire provides a complete assessment of the transstenotic pressure/coronary flow velocity relation at rest and after pharmacologically induced hyperemia and allows the characterization of stenosis hemodynamics and functional severity. © 1993 Wiley‐Liss, Inc.
Epicardial and subselective transcoronary chemical ablation of incessant ventricular tachycardia
Authors: Gursoy Sinan , Nellens Paul , Guiraudon Gerard , Brugada Josep , Brugada Pedro 
Published: March 2007

AbstractIncessant ventricular tachycardia in patients with severely depressed ventricular function remains a major therapeutic challenge. Although alcohol ablation via the tachycardia related vessel has been shown to be an effective alternative, it might not be applicable in some cases due to anatomic limitations. In three patients with ischemic cardiomyopathy and incessant ventricular tachycardia no effective antiarrhythmic therapy could be found. Alcohol ablation was then attempted but the tachycardia related vessel could not be intubated. A subselective injection of alcohol into a more proximal segment of the coronary artery was then performed in two cases. In one patient as subselective injection was also not possible, the injection was performed epicardially after thoracotomy. Ablation was successful in all cases. In very selected cases of incessant ventricular tachycardia that have failed all other therapeutic interventions, alcohol ablation of the tachycardia can be performed using an epicardial or subselective transcoronary injection of alcohol. © 1993 Wiley‐Liss, Inc.
Percutaneous retrieval of a deformed guidewire by a modified snaring technique
Authors: Roy Sumit , Phadke R. V. , Kumar Sunil , Rastogi Harsh , Baijal S. S. 
Published: March 2007

AbstractAn attempt to percutaneously remove a guidewire from the inferior vena cava was hampered by kinks developing in the wire during snaring. A modified technique was adopted that permitted its retrieval, obviating the need for a formal venotomy. © 1993 Wiley‐Liss, Inc.
Percutaneous balloon angioplasty for early postoperative modified blalock‐taussig shunt failure
Authors: Ormiston John A. , Neutze John M. , Calder A. Louise , Hak Nien‐Shen Chan Wah 
Published: March 2007

AbstractPercutaneous balloon angioplasty was successful initial treatment for 2 infants who, early after operation, developed obstruction at the proximal anastomotic site of a modified Blalock‐Taussig shunt. Two years later the first child had not required reoperation and the dilatation site was patent angiographically. The other baby progressed well after angioplasty but because of surgical concern about the long‐term success of angioplasty, shunt surgery was repeated, the baby dying after reoperation.Angioplasty of proximal obstruction in these shunts is feasible and satisfactory longterm palliation can be achieved avoiding repeat shunt surgery before the more definitive Fontan‐type procedure. © 1993 Wiley‐Liss, Inc.