摘要:

AbstractForty‐seven patients (0.08%) from a total of 5,730 consecutive patients undergoing treadmill stress tests developed one or more episodes of ventricular tachycardia. Forty patients had heart disease, coronary artery disease being the leading cause. Rest ECG was normal in 12 patients and showed long QT (>440 msec) in 16 patients. Ventricular tachycardia was brief and self‐terminating, requiring D/C cardloverston In only one patient. “Exertional hypotension” preceded ventricular tachycardia In 16 of 34 patients. There was poor correlation (r=0.16) between the rate of ventricular tachycardia (VT) and the underlying heart rate. Only four episodes of VT were Initiated by R on T premature ventricular beats.In summary, exercise‐Induced ventricular tachycardia 1) Is a rare complication of treadmill stress test and occurs In patients with heart disease; 2) is frequently preceded by “exertional hypotension;” and 3) Is not related to the R on T phenomenon. The high incidence of prolonged QT may indicate a role for the autonomic nervous system in its

ISSN:0098-6569    

DOI:10.1002/ccd.1810070302

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

年代:1981

数据来源: WILEY

摘要:

AbstractThrombotto complications of percutaneous arterial Catheterization still remain a significant and serious problem in infants and children. Systemic heparlnlzation has been recommended for prevention of these complications. The purpose of this study was to evaluate the effect of Intraarterial injection of heparin In reducing thrombotic complications following percutaneous femoral artery Catheterization. One hundred sixteen consecutive patients (ages four months to 20 years) studied by the Desllets‐Hoffman modification of Seldlnger's technique of femoral artery Catheterization were randomly allocated to the control or heparin groups using a double‐blind technique. At the completion of the Catheterization, 0.1 ml/kg of placebo or heparin (1,000 units/ml) was injected into the common iliac artery prior to removal of the catheter and sheath. Segmental plethysmography was performed in both lower extremities prior to and after the Catheterization, and a plethysmography index (PI) was calculated.The age and sex distribution, diagnoses, number, type, and site of previous Catheterization, hemoglobin, platelet count, the amount of flush solution and the heparin contained therein, size of the catheter and sheath used, number of arterial punctures, and the length of the time in the artery were similar In the two groups (P>0.1). Thrombln time and activated partial thromboplastin time were measured prior to the use of flush solution and prior to angtography, and these remained essentially unchanged In the two groups. The PI in the control group (97.5 ± 32) was not significantly different (P>0.1) from that of the heparin group (97.7 ± 32). Similarly, the six to 24 month postcatheterlzatlon plethysmography data show no differences (P>0.1). The number of patients with reduced Ipsilateral posterior tlbial and dorsalls pedls pulses was also similar (P>0.1). None of the patients in either group required thrombectomy. The low incidence of arterial complications in our patients when compared with other studies may be related in part to use of a sheath, which is not called for in original Seldinger technique. The data suggest that full‐dose heparin administration does not significantly alter arterial complications following percutaneous femoral artery catheterization, especially in childern over five years

ISSN:0098-6569    

DOI:10.1002/ccd.1810070303

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

年代:1981

数据来源: WILEY

摘要:

AbstractLeft ventricular stroke volumes derived by two‐dimensional echocardfography (20 echo) were compared with thermodilution and Cineangiography measurements in closed‐chest dogs before and one hour after proximal LAD occlusion. Stroke volume was calculated from end‐dlastolic and end‐systolic volumes reconstructed by two models: (1) Simpson's rule employing left ventricular length and five short‐axis cross‐sectional areas; (2) a simplified volume formula (V = 5/6 area · length), utilizing a single short‐axis area at either the mitral valve or midpapillary muscle level. The comprehensive Simpson reconstruction yielded a good correlation of 2D echo stroke volume against thermodilution (r = 0.89) over a range of normal (N = 14) and ischemic (N = 8) states. The simplified formula provided a satisfactory correlation (r = .90, N = 22) when using the midpapillary cross‐section, which encompassed the Induced ischemic dys‐synergy. In contrast, when using the mitral valve level cross‐section above the site of ventricular asymmetry, there was no significant statistical correlation. Comparison of Cineangiography with 2D echo volume reconstruction based on the simplified formula with the midpapillary muscle level section yielded good correlations for stroke volume (r = 0.87) and ejection fraction (r = 0.97). Intraobserver and interobserver variability of duplicate echo stroke volume measurements was 8% and 10%, respectively. We conclude that 2D echocardlography In dogs permits quantitatlon of left ventricular stroke volume in normal

ISSN:0098-6569    

DOI:10.1002/ccd.1810070304

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

年代:1981

数据来源: WILEY

摘要:

AbstractPressure in the right ventricle (RV) as well as the right atrium (RA) and pulmonary artery (PA) were measured in 80 patients with catheter‐tip mlcromanometere and evaluated to determine If the pressures are compatible with the concept of RV diastollc suction. In 40 patients with normal PA pressure, minimal RV diastollc pressure that occurred during early filling, was negative (−2 ± 0.3 mm Hg) (mean ± SEM). In 29 patients with PA hypertension, minimal RV dlastolic pressure during expiration also was negative (−2 ± 0.7 mm Hg). In 11 patients with right ventricular failure, however, minimal RV diastolic pressure was positive (9 ± 2 mm Hg). These results indicate that the human right ventricle, in the absence of failure, has a negative early diastollc pressure, which may reflect RV diastoll

ISSN:0098-6569    

DOI:10.1002/ccd.1810070305

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

年代:1981

数据来源: WILEY

摘要:

AbstractA patient who developed a subvalvular left ventricular paeudoaneurysm following mitral valve replacement is presented, the fourth such case in the literature. The etiology of this uncommon complication is felt to be caused by excessive surgical resection of the diseased nitral valve, which may weaken or cause rupture of the heart at the mitral annulus. The diagnosis can only be made by left ventriculography. Surgical treatment is indicated, because rupture of the pseudoaneurysm can occur.

ISSN:0098-6569    

DOI:10.1002/ccd.1810070306

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

年代:1981

数据来源: WILEY

摘要:

AbstractA patient with dyspnea and lethargy 19 days after aortic valve replacement was admitted to the hospital with physical signs suggesting cardiac tamponade. Initial echocardiogram was unhelpful, but Swan‐Ganz catheterizatlon showed a gradient in diastole between the right atrium and ventricle. Anglography and repeat echocardlography then showed a mass compressing the right atrium, which was confirmed at surger

ISSN:0098-6569    

DOI:10.1002/ccd.1810070307

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

年代:1981

数据来源: WILEY

摘要:

AbstractThree cases of coronary artery dissection secondary to coronary arteriography are presented. Two of these include autopsy material demonstrating medial degeneration in the coronary arteries, which may have predisposed these arteries to dissect The literature on catheter‐induced coronary artery dissection is reviewed and an analysis is presente

ISSN:0098-6569    

DOI:10.1002/ccd.1810070308

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

年代:1981

数据来源: WILEY

摘要:

AbstractA multiple‐coiled, flow‐directed balloon‐tipped catheter was successfully untangled by hooking it with a tip‐deflector guidewlre. This nonsurgical technique was an effective means of untangling the catheter when previously reported techniques were not f

ISSN:0098-6569    

DOI:10.1002/ccd.1810070309

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

年代:1981

数据来源: WILEY

摘要:

AbstractWe have used the sidewinder catheter for selective cattwterization and anglography of aortocoronary bypass grafts and have been Impressed by the usefulness of this catheter. Selective anglography of vein grafts can be done easily and quickly wtth this catheter, with a very high success rate.

ISSN:0098-6569    

DOI:10.1002/ccd.1810070310

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

年代:1981

数据来源: WILEY

摘要:

AbstractThis paper describes the assessment of a method for measuring the oxygen consumption of infants and young children that is suitable for use in the cardiac Catheterization laboratory. It is based upon the open‐circuit technique and permits the continuous display of the oxygen consumption during the investigative procedures. The accuracy of the apparatus was assessed over the range 40‐200 ml/min, both in vitro and in vivo. It was found that the apparatus was free from systematic error and that it had a random error of approximately 2% of the measured va

ISSN:0098-6569    

DOI:10.1002/ccd.1810070311

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

年代:1981

数据来源: WILEY