ISSN:0098-6569    

DOI:10.1002/ccd.1810070402

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

年代:1981

数据来源: WILEY

ISSN:0098-6569    

DOI:10.1002/ccd.1810070403

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

年代:1981

数据来源: WILEY

ISSN:0098-6569    

DOI:10.1002/ccd.1810070404

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

年代:1981

数据来源: WILEY

ISSN:0098-6569    

DOI:10.1002/ccd.1810070406

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

年代:1981

数据来源: WILEY

摘要:

AbstractThe cost of and hospitalization required for cardiac catheterization led us to evaluate this procedure in 308 adult outpatients. Patients were scheduled on the basis of stability of symptoms. Two hundred eighty‐eight underwent left heart catheterizations and coronary arteriography. Ninety‐five percent of the procedures were performed by the percutaneous technique. Fifty patients had normal studies and 30 patients had congenital or valvular disease. Two hundred twenty‐eight patients had significant coronary artery disease, 85 patients had triple vessel disease, and 45 patients had left main coronary artery disease. There were six significant complications: one death; two myocardial infarctions; one air embolism, and two patients with hematomas. Three of the complications were in patients with left main disease. Only two of the complications can be ascribed to the outpatient nature of the procedure. The complication rate is comparable to that reported in the literature. Fifteen hundred subsequent cases were studied as outpatients, with a very low mortality and morbidity. It is concluded that cardiac catheterization can be performed on an outpatient basis with safety comparable to inpatient studies, and at a great economic sa

ISSN:0098-6569    

DOI:10.1002/ccd.1810070407

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

年代:1981

数据来源: WILEY

摘要:

AbstractPercutaneous transluminal coronary angioplasty (PTCA) was performed in 40 patients (34 male, 6 female; 51.0 ± 8.5 years) with the typical clinical picture of unstable angina. All had a short history of pain (2.9 ± 2.0 months), angina at rest, transient ST and/or T wave changes during this period, and little or no enzyme elevations. The patients had a total of 41 stenoses (39 single, one double; one main‐stem, 26 left anterior descending, 14 right coronary artery). The degree of the stenoses was 95.5 ± 4.9% (area method) and 81.8 ± 10.7% (diameter method). PTCA was successfully performed in 26 cases (63%), reducing the stenoses to 61.5 ± 12.4% (area method) and 39.1 ± 10.0% (diameter method). One patient (2.5%) received an immediate bypass operation because of an acute vessel occlusion. Eleven of the 14 not successfully treated patients received an aortocoronary bypass within the next three to 35 days. All still had symptoms of unstable angina. Three patients refused operation. Their treatment consisted of nitroglycerin, beta‐blockers and nifedipin.Seventeen of the 26 successfully treated patients were restudied after 4.9 ± 1.7 months. The degree of stenosis had risen to 69.2 ± 17.4% (area method). While the stenoses in 12 patients were equal or less than before PTCA, stenosis recurred in five cases. Two patients were successfully retreated.PTCA can be performed with a good early success rate and a low complication rate in patients with unstable angina. Relief of pain and improvement of blood supply to the jeopardized myocardium can be provided immediately and with a limited amount of expense. The method can therefore be regarded as appropriate first‐stage treatment in

ISSN:0098-6569    

DOI:10.1002/ccd.1810070408

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

年代:1981

数据来源: WILEY

摘要:

AbstractThe radiographic anatomy of the IMAs is described based on bilateral selective arteriography in 100 patients with coronary artery disease. The right and left IMAs were identical in caliber in their mid portions in 94% of cases. Fifteen percent of the IMAs measured less than 2 mm in luminal diameter at the level of the fourth costal cartilage. The side branches showed a great deal of variability and asymmetry in their origin and distribution. The understanding of the radiographic anatomy of the IMA and its branches is helpful in preoperative appraisal and is crucial for postoperative evaluation of the IMA grafts.

ISSN:0098-6569    

DOI:10.1002/ccd.1810070409

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

年代:1981

数据来源: WILEY

摘要:

AbstractPrevious studies have suggested an unexpectedly low incidence of atrial fibrillation in patients with congestive cardiomyopathy. To further investigate the incidence of chronic atrial fibrillation in these patients and its relationship to left atrial dimension and pressure, we retrospectively examined M‐mode echocardiographic and cardiac catheterization data from 54 patients with idiopathic (n = 29) and ischemic (n = 25) congestive cardiomyopathy. The incidence of atrial fibrillation (17%) was surprisingly low given the degree of left atrial enlargement (51 ± 5 mm; mean ± SD) and left atrial hypertension (19 ± 8 mm Hg). In addition, there were no significant differences in left atrial pressure or left atrial dimension between those congestive cardiomyopathy patients in sinus rhythm and those in atrial fibrillation, nor was there a higher incidence of secondary mitral regurgitation in patients in atrial fibrillation.Comparisons were also made between congestive cardiomyopathy patients and 21 patients with primary mitral valve disease and atrial fibrillation. Left atrial pressure was not significantly different between these groups. However, the mean left atrial dimension of the patients with mitral valve disease (56 ± 8 mm) was greater (P60 mm) is rarely associated with ischemic or idiopathic congestive car‐diomyopathy and suggests underlying primary mitral v

ISSN:0098-6569    

DOI:10.1002/ccd.1810070410

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

年代:1981

数据来源: WILEY

摘要:

AbstractSeventy‐five patients with ≥70% stenosis of the left main coronary artery (LMCA) were treated surgically between January 1974 and February 1980. The group consisted of 57 men and 18 women with a mean age of 62.8 years. All patients were symptomatic with angina pectoris, and 64 (85%) had unstable angina. Twenty‐nine patients (38.6%) had electrocardiographic evidence (ECG) of old myocardial infarction (MI) and only six (8%) had a normal resting ECG. Preoperative exercise testing was done in 22 of the 75 patients. The stress test was positive in all patients, 17 (77%) of whom had>2 mm ST depression; 90.6% (68/75) had significant right coronary artery disease. The intra‐aortic balloon pump (IABP) was inserted preoperatively in only four patients (5%) and was required in two additional patients postoperatively. The IABP was inserted preoperatively in four patients because of medically refractory angina and not on the basis of coronary anatomy alone. An average of three grafts per patient were inserted. There were three (4%) postoperative myocardial infarctions and two (2.6%) deaths. During the follow‐up period, which comprised 105 patient‐years, there was one myocardial infarction and one death. These data indicate that successful surgical treatment of left main coronary artery disease can be achieved with low mortality and that routine preoperative insertion of IABP is

ISSN:0098-6569    

DOI:10.1002/ccd.1810070411

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

年代:1981

数据来源: WILEY

摘要:

AbstractDirect demonstration of the orifice of a prosthetic mitral valve was obtained using an en face projection of the mitral valve during left ventriculography. With a dimensional reference and planimetry, the mitral valve area was directly measured. The value for the mitral valve area derived from en face demonstration of the mitral valve during left ventriculography agreed well with valve area estimates obtained by the Gorlin and Gorlin formula and by direct examination of the surgical specimen.

ISSN:0098-6569    

DOI:10.1002/ccd.1810070412

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

年代:1981

数据来源: WILEY