摘要:

AbstractIn order to simplify post‐coronary stenting treatment and to obtain a lower rate of complications, especially in bailout situations, seven French institutions treated 246 stented patients with 0.25 g/day of ticlopidine, 0.1 g/day of IV aspirin, and 2 days of heparin followed by low‐molecular‐weight heparin for 1 month. Fifty percent of patients had a planned stenting procedure, and 50% had an unplanned procedure, including 29 (11.8%) in bailout situations. Subacute occlusion occurred in three (1.2%) patients (one death, two non‐Q‐wave infarctions). During the 1 month follow‐up period, another death was reported (non‐stent‐related), two elective coronary artery bypass grafts were performed, and three additional patients presented with non‐Q‐wave myocardial infarctions. Nine (3.7%) patients had a groin complication that required blood transfusion or surgical repair. These results suggest that while waiting for the technological advancements of stents, postprocedural treatment that includes a low dosage of ticlopidine, aspirin, and low‐molecular‐weight heparin is a very effective alternative to conventional poststenting therapy.

ISSN:0098-6569    

DOI:10.1002/ccd.1810350102

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

年代:1995

数据来源: WILEY

ISSN:0098-6569    

DOI:10.1002/ccd.1810350103

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

年代:1995

数据来源: WILEY

摘要:

AbstractThe activated clotting time is routinely used to monitor anticoagulation during coronary intervention, whereas the hospital laboratory APTT guides pre‐ and postprocedure heparin therapy. An optimal coagulation test for patients undergoing percutaneous revascularization would provide a rapid and accurate assessment of anticoagulation throughout a broad range of heparin therapy. We studied the relationships of the bedside whole blood APTT, ACT, and the laboratory APTT in 166 patients undergoing coronary intervation. The whole blood APTT correlated closely with the laboratory APTT (range 18‐80 sec) (r = .75), whereas the ACT and laboratory APTT had only a fair correlation (r = .42). Also, the whole blood APTT demonstrated a strong correlation with the ACT throughout the range of heparin therapy for intervention (r = .81). The diagnostic accuracy of the whole blood APTT, based on the receiver operating characteristic curve, was significantly better than that for the ACT in determining the anticoagulation status. The whole blood APTT obtained by bedside monitoring provides a rapid and accurate assessment of anticoagulation throughout the range of heparin dosing associated with coronary intervention. In situations in which an adequate assessment of residual anticoagulation is necessary, the whole blood APTT is superior to the ACT and probably should be the method of choice. © 1995 Wiley‐Lis

ISSN:0098-6569    

DOI:10.1002/ccd.1810350104

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

年代:1995

数据来源: WILEY

摘要:

AbstractHistorically, the right heart was viewed as less important than the left heart in the maintenance of normal overall hemodynamic performance. However, there is now considerable evidence that emphasizes the significance of intact right ventricular (RV) function. The RV's anatomy and physiology are reviewed in order to provide insight into how changes in volume can be accommodated within a low‐pressure environment and how this contributes to hemodynamic stability. The interdependent relationship between the right and left ventricles is also explored.The contribution of RV performance to overall hemodynamics is best exemplified when the RV becomes diseased. RV infarction, atrial septal defect, and cor pulmonale are used as examples to illustrate the dramatic sequelae associated with RV dysfunction, as well as to identify the RV's specific adaptive mechanisms. © 1995 Wiley‐Liss,

ISSN:0098-6569    

DOI:10.1002/ccd.1810350105

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

年代:1995

数据来源: WILEY

摘要:

AbstractThe coronary angiographic features of four new cases of congenital coronary arteriovenous fistulas (CAVFs) are described, and the angiograms of 15 reported cases are reviewed. The morphologic appearance of CAVFs varied from a small discrete single channel to a highly complex plexiform network with a maze of fine vessels. The majority of CAVFs in our series were composed of a single channel. Aneurysmal formation was present in 26% (6/23). Aneurysmal formation involved only the pathway and/or the termination, but never originated from the beginning of the CAVFs. © 1995 Wiley‐Liss, I

ISSN:0098-6569    

DOI:10.1002/ccd.1810350106

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

年代:1995

数据来源: WILEY

ISSN:0098-6569    

DOI:10.1002/ccd.1810350107

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

年代:1995

数据来源: WILEY

摘要:

AbstractHeparin‐induced thrombocytopenia is a well‐recognized complication after cardiac or vascular surgery, but it has not been previously reported during percutaneous coronary interventions. This case study describes a patient who developed an acute myocardial infarction during coronary angioplasty in association with the abrupt onset of heparininduced thrombocytopenia. Since balloon angioplasty achieved a satisfactory angiographic result with a widely patent epicardial vessel, it is postulated that acute myocardial infarction in this patient may have been caused by platelet aggregation and activation resulting in distal small vessel thrombosis and spasm. © 1995 Wiley‐Lis

ISSN:0098-6569    

DOI:10.1002/ccd.1810350108

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

年代:1995

数据来源: WILEY

ISSN:0098-6569    

DOI:10.1002/ccd.1810350109

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

年代:1995

数据来源: WILEY

摘要:

AbstractIn order to evaluate 6 French (6F) Voda‐type guiding catheters for left coronary artery balloon angioplasty, we randomized the choice of the guiding catheter in 100 consecutive patients between a Voda (group 1, n = 50) and a Judkins or Amplatz curve (group 2) guiding catheter. Angioplasty success rate (98% for both), need for guiding catheter crossover exchange (2 in group 1 vs. 1 in group 2), fluoroscopy time, and volume of injected contrast were similar in both groups, but the operator's appreciation of good back‐up support was better with the Voda‐type guiding catheter (90% vs. 74%,P<0.05). No complications attributed to the guiding catheter were noted in either group. Efficiency of the Voda‐type guiding catheter appeared similar for both left anterior descending (n = 35, success rate 100%) and circumflex (n = 18, success rate 94%) coronary artery angioplasty.Voda‐type guiding catheters are an efficient and safe approach to routine left coronary angioplasty. They appear to be as effective as a choice bewtween a Judkins or an Amplatz configuration and could be of particular use when a double angioplasty of the left anterior descending and circumflex arteries is attempted during the same procedure. © 1995 Wiley

ISSN:0098-6569    

DOI:10.1002/ccd.1810350110

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

年代:1995

数据来源: WILEY

ISSN:0098-6569    

DOI:10.1002/ccd.1810350111

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

年代:1995

数据来源: WILEY