摘要:

The occurrence of retrograde blood flow in the ipsilateral vertebral artery of patients with proximal occlusion of the subclavian or innominate artery has been amply demonstrated by selective angiography. However, since flow artifacts may be induced by the physical or chemical effects of injections of contrast media, it was thought desirable to employ a different method for physiologic demonstration of the reversed flow.In the first case, cardio-green dye was injected into the innominate artery and a dilution curve was recorded from the left brachial artery. The early appearance of the dye (6 seconds) proved that a short circuit existed between the arterial injection and sampling sites, and confirmed the authenticity of the reversed vertebral flow shown in previous angiograms.In the second patient, who had symptoms of cerebral ischemia during exercise of the left (affected) arm, dye injected into the left carotid artery did not appear early in the brachial artery of the resting left arm. When it was injected during a period of intense hyperemia of the left arm, a fraction of the dye did appear early. This confirmed that, when the demand of the arm increased, blood was shunted to it not only from the vertebral-basilar system but also from the carotid system.The importance of anatomic factors was evident in another case in which absence of the anticipated retrograde flow was explained by the fact that the vertebral artery arose directly rectly from the aorta and did not communicate with the affected subclavian artery.These observations illustrate how radiographic and hemodynamic technics may usefully be combined to assess the effects of acquired diseases of the major blood vessels.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

摘要:

Three adults with osteogenesis imperfecta and associated cardiovascular lesions are reported. Two presented with aortic insufficiency due to dilatation of the aortic root for which none of the usual causes is apparent. The third patient was found to have lesions involving pulmonary, aortic, and mitral valves in addition to microscopic changes in the pulmonary artery and aorta. It is suggested that in osteogenesis imperfecta, as in other heritable disorders of connective tissue, cardiovascular defects may become apparent after the passage of time and play a dominant role in the natural history of the disease process.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

摘要:

The occurrence of severe pulmonary venous obstruction due to the congenital anomaly known as cor triatriatum in a 19-year-old furniture mover is described. Relentless and massive hemoptysis led to pulmonary edema, and an attempt at surgical correction under unfavorable conditions was not successful.Seven other cases of cor triatriatum in adults are reviewed. The hemodynamic abnormalities closely resemble mitral stenosis, except that pressures in the true left atrium were normal in the presence of elevated pulmonary capillary pressures. The availability of flow across the obstructing membrane during systole as well as diastole is probably the major element in the surprisingly good tolerance of severe degrees of anatomic obstruction for long periods of time. Slow increase in the degree of obstruction could also be a factor.The clinical picture in these patients very closely resembles mitral stenosis. Hemoptysis appeared to be more frequent in cor triatriatum. Features suggestive of the correct diagnosis would include the absence of an opening snap, the absence of a typical murmur of mitral stenosis, regular rhythm, and lesser evidence of left atrial enlargement in the presence of obvious pulmonary hypertension. Five of these patients have undergone successful correction of their disease by operation.Representative films from the first knownangiograms in this condition in an adult are reproduced and discussed.

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID

ISSN:0009-7322    

出版商:OVID    

年代:1965

数据来源: OVID