摘要:

AbstractAn 81‐year‐old man with severe calcific aortic stenosis and coronary artery disease who refused surgical therapy was treated with sequential percutaneous balloon aortic valvuloplasty (PBAV) and percutaneous transluminal angioplasty. Before percutaneous balloon valvuloplasty, the mean aortic gradient was 76 mmHg, and the aortic valve area was. 45 cm2. The aortic valve was dilated using 15‐mm and 18‐mm balloons. The mean gradient decreased to 40 mmHG, and the aortic valve area increased to.62 cm2. Percutaneous transluminal coronary angioplasty (PTCA) was performed 2 weeks later, and an 85% proximal left circumflex stenosis was successfully dilated to 20%. No complications were noted during either procedure. At 6‐month follow‐up, the patient had returned to normal activities and was asymptomatic. Thus, combined therapy with PBAV and PTCA is technically feasible in selected elderly patients with calcific aortic stenosis and anatomically suitable coronary artery disease. This nonsurgical therapeutic approach may be useful in the treatment of selected patients who refuse or who are deferred from card

ISSN:0098-6569    

DOI:10.1002/ccd.1810140112

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractCoronary angiography with standard ionic contrast media is associated with marked alterations in cardiac hemodynamics because of the depressant effects of the contrast media on cardiac contractility. Nonionic contrast media have been reported to produce less hemodynamic alteration than standard ionic contrast media. However, there is no information on how one nonionic media compares to another. Thus we compared the hemodynamic effects of three nonionic contrast media, lopamidol (IOP), lohexol (IOH), and loversol (IOV) to each other as well as to the standard ionic contrast media Hypaque‐76 (H76). In 20 closed‐chest anesthetized dogs, we recorded the maximal change in left ventricular systolic pressure (LVSP), mean aortic pressure, left ventricular diastolic pressure (LVDP), and left ventricular dp/dt during 10‐cc left main coronary artery injections of H76, IOP, IOH, and IOV. The mean aortic pressure and LVSP decreased 36 ± 17 mm Hg and 46 ± 21 mm Hg with H76 but only 5 ± 5 mm Hg and 6 ± 5 mm Hg with IOP, 5 ± 4 mm Hg and 6 ± 6 mm Hg with IOH, and 5 ± 4 mm Hg and 7 ± 6 mm Hg with IOV (P<0.001). The LVDP increased 6 ± 5.0 mm Hg with H76 out only 0.2 ± 0.5 mm Hg with IOP, 0.2 ± 0.3 mm Hg with IOH, and 0.5 ± 1.0 mm Hg with IOV (P<0.001). The LV dp/dt decreased 545 ± 261 mm Hg/sec with H76 but increased 886 ± 477 mm Hg/sec with IOP, 910 ± 96 mm Hg/sec with IOH, and 473 ± 335 mm Hg/sec with IOV (P<0.001). Whereas each nonionic agent produced significantly less hemodynamic abnormalities than H76, there was no significant difference between any of the nonionic agents on any hemodynamic parameter. Thus, as compared to H76, these nonionic contrast media produced only trivial alterations in hemodynamics and LV dp/dt. These agents may be preferable in patient

ISSN:0098-6569    

DOI:10.1002/ccd.1810140113

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractWe report on four patients in whom we observed inflation of the balloon following injection cf contrast material into the distal lumen during percutaneous transluminal coronary angioplasty. This is a rare technical problem. However, inadvertent balloon inflation may cause transient occlusion of the proximal coronary artery and in one case was associated with acute occlusion of a vessel that had been dilated. Management involves prompt deflation of the balloon.

ISSN:0098-6569    

DOI:10.1002/ccd.1810140114

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

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 determination

ISSN:0098-6569    

DOI:10.1002/ccd.1810140115

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

ISSN:0098-6569    

DOI:10.1002/ccd.1810140116

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

ISSN:0098-6569    

DOI:10.1002/ccd.1810140118

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

ISSN:0098-6569    

DOI:10.1002/ccd.1810140119

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

ISSN:0098-6569    

DOI:10.1002/ccd.1810140101

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY