摘要:

AbstractWe studied the course of coronary stenosis in the first 62 patients (45 men and 17 women) referred for coronary angioplasty in the interval between the diagnostic arteriogram and the preangioplasty coronary arteriogram. In 42 patients, the stenosis was in the left anterior descending artery, in 17 patients in the right coronary artery, in one patient in the left circumflex, and in two patients in the vein graft. Twenty‐six patients had stable angina pectoris, 34 patients had unstable angina, and two patients had no angina. The coronary stenosis did not change significantly in any patient with stable angina. Conversely, the stenosis progressed in nine of the 34 patients with unstable angina (26.5%). In five of the nine patients with progression, total occlusion ensued. In four of the five patients total occlusion occurred within the 45‐day interval between the diagnostic and the preangioplasty coronary arteriogram. New or increased preexisting collaterals to the occluded vessel developed in all five patients with total occlusion. None of these patients had clinical or electrocardiographic evidence of myocardial infarction or significant changes in ventricular function. Angiographic evidence of thrombi was seen in ten of 34 patients with unstable angina (29%). We concluded that coronary artery stenosis in patients with unstable angina pectoris is progressive in a significant number after a short time. The cause of progression of coronary stenosis in patients with unstable angina is unknown. Since in a significant number of patients with unstable angina coronary thrombus was suggested by angiography, coronary thrombosis superimposed on coronary atherosclerosis may play a significant role in this syndrome. Further prospective studies are needed, including repeat coronary arteriograms to evaluate the cause of unstable angina, define the role of coronary thrombosis, and evaluate the efficacy of more aggressive treatment adding the use of prolong heparin and antiplatelet agents prior to coronary angiopla

ISSN:0098-6569    

DOI:10.1002/ccd.1810100202

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

年代:1984

数据来源: WILEY

摘要:

AbstractThe brachial artery method to peripheral (percutaneous) transluminal angioplasty is described. A total of 232 angioplasties were attempted using the brachial and femoral artery techniques with a success achieved in 204 cases (88%): in 167 of 176 (95%) stenoses, and in 37 of 56 (66%) occlusions. 114 attempts were made via the brachial artery method with a success achieved in 109 (96%): in 98 of 102 (96%) stenoses, and in 11 of 12 (92%) occlusions. 68% of the attempts were made in the ileofemoral system with a success achieved in 73 cases (94%): in 66 of 70 (94%) stenoses, and 7 of 8 occlusions. All of the attempted renal, subclavian, and superficial femoral artery stenoses were sucessfully dilated. One local brachial artery complication was encountered. The brachial artery method to peripheral transluminal angioplasty is an acceptable and complementary alternative to the transfemoral technique.

ISSN:0098-6569    

DOI:10.1002/ccd.1810100203

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

年代:1984

数据来源: WILEY

摘要:

AbstractThe purpose of this study was to evaluate the effect of angiographic contrast medium on left ventricular (LV) function in 26 patients undergoing diagnostic cardiac catheterization. Beat‐by‐beat analysis during contrast ventriculography showed that the ejection fraction (EF) was lower in the last beats than in the first beats (P<.02). Radionuclide angiograms were obtained the day before, as well as 15 to 65 minutes after catheterization, which included contrast ventriculography and coronary anteriography. The EF by radionuclide angiography was lower after catheterization than before (43 ± 14% vs 47 ± 17%, P<.01). The EF decreased by ≥ 5% in 11 of the 26 patients (42%) after catheterization. The decrease in EF in some patients was observed up to 65 minutes after catheterization and was not associated with symptoms or ST‐T changes. The EF decreased in only one of nine patients who received nitroglycerin during catheterization, whereas it decreased in 10 of 17 patients who did not receive nitroglycerin (P<.05). The EF decreased in 9 of 14 patients (64%) who had normal resting LV function, whereas it decreased in only 2 of 12 patients (17%) who had abnormal resting function (P<.05). Thus, contrast material may depress LV function up to 1 hr and is more frequent in patients with normal resting EF. The use of nitroglycerin during catheterization may mask th

ISSN:0098-6569    

DOI:10.1002/ccd.1810100204

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

年代:1984

数据来源: WILEY

摘要:

AbstractTrue volume (y) and measured volume (x) determined from 23 right and 22 left normal human casts in four biplane angiographic positions and in their eight single‐plane components were used to find the correction factor (b) by regression through the origin (y = bx). The correction factors were applied to human studies to assess the validity of the various biplane and single‐plane modalities in vivo. The casts studies yield excellent correlations in both right and leftbiplanemethods (right volumetry: 0.555 ≤ b ≤ 0.708, 0.917 ≤ r ≤ 0.954, 4.10 ≤ SEE ≤ 6.01 left volumetry: 0.748 ≤ b ≤ 0.825, 0.974 ≤ r ≤ 0.982, 4.81 ≤ SEE 5.79). Good results were obtained withsingle‐planevolumetries as well (right volumetry: 0.316 ≤ b ≤ 0.887, 0.750 ≤ r ≤ 0.917, 10.75 ≤ SEE ≤ 18.96; left volumetry: 0.728 ≤ b ≤ 0.881, 0.897 ≤ r ≤ 0.976, 5.73 ≤ SEE ≤ 11.97). The correction factors for the single‐plane studies depend much more strongly on the spatial position relative to the radiographic system, particularly in the case of the right ventricular volumes. Thus, the application of the appropriate correction factors is mandatory. Thehumanstudies (141 left and 60 right volumetric studies in various single‐plane and biplane projections) showed a larger scatter of single‐plane values, more pronounced for the right ventricle. In certain disease conditions, single plane volumetric studies using cast‐derived correction factors cannot be used to obtain meaningful results.Correction factors for the following single or biplane mode volumetry are presented for the first time: biplane hepatoclavicular view (right and left ventricle), biplane long axial oblique view (right ventricle), and their single‐plane components; lateral and 60° Left Anterior Oblique (LAO) single plane for the left‐sided measurements, Postero‐Anterior (PA),

ISSN:0098-6569    

DOI:10.1002/ccd.1810100205

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

年代:1984

数据来源: WILEY

摘要:

AbstractThe incidence of pulmonary perfusion defects after routine cardiac catheterization was assessed in 56 patients by comparing ventilation–perfusion (V/Q) lung scans obtained before and 1 day after catheterization. Patients were prospectively randomized in two groups, one in which the brachial approach was performed using an antecubital cutdown procedure, and one in which the percutaneous femoral approach was used. None of the patients with the brachial approach had any ventilation–perfusion mismatch on the V/Q scan; however, three patients (8.3%) with the femoral approach did. These two groups did not differ significantly in clinical characteristics, duration of catheterization, and hemodynamic variables. The data suggest that pulmonary emboli postcardiac catheterization is more frequent in the femoral than the brachial approach. Furthermore, since those pulmonary emboli are mostly asymptomatic, their clinical recognition would be underestima

ISSN:0098-6569    

DOI:10.1002/ccd.1810100206

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

年代:1984

数据来源: WILEY

摘要:

AbstractCoronary transluminal angioplasty is a new alternative modality for the treatment of specific lesions of coronary artery disease. Although numerous complications have been recognized, this represents the first report of development of a severe left main coronary artery stenosis following left anterior descending artery angioplasty.

ISSN:0098-6569    

DOI:10.1002/ccd.1810100207

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

年代:1984

数据来源: WILEY

摘要:

AbstractA case of sotalol‐induced polymorphous ventricular tachycardia (torsade de pointes) is presented. The patient had moderately prolonged Q‐T interval before medication with sotalol with further prolongation after application of this drug. Electrophysiological study during rechallenge with sotalol demonstrated a uniform ventricular tachycardia with a somewhat polymorphous onset; whether or not this tachycardia represented replication of the patient's spontaneous arrhythmia is questionable. Without antiarrhythmic drugs and during medication with pindolol ventricular tachycardia was not induci

ISSN:0098-6569    

DOI:10.1002/ccd.1810100208

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

年代:1984

数据来源: WILEY

摘要:

AbstractAnomalous origin of the left circumflex coronary artery is the most common congenital coronary artery anomaly. Myocardial infarction has been seen in the distribution of this anomalous vessel. This has been noted most typically when the vessel is atherosclerotic. Sudden death and myocardial infarction, however, also have been seen in a case without atherosclerotic involvement.This is a case report of a 45‐year‐old man who suffered a myocardial infarction after strenuous and sustained physical effort and who was found to have nonatherosclerotic coronary arteries with an anomalous left circumflex coronary artery arising from the right sinus of Valsa

ISSN:0098-6569    

DOI:10.1002/ccd.1810100209

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

年代:1984

数据来源: WILEY

摘要:

AbstractA case of catheter‐induced proximal dissection of an angiographically normal left coronary artery is reported. Dissection was not associated with pressure damping and myocardial ischemia was delayed until 1 hour after dissection occurred. Prompt recognition of this entity is essential as emergency revascularization is the treatment of choice when significant amounts of myocardium are threatene

ISSN:0098-6569    

DOI:10.1002/ccd.1810100210

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

年代:1984

数据来源: WILEY

摘要:

AbstractA 65‐year‐old woman underwent successful percutaneous transluminal coronary angioplasty of a right coronary artery stenosis. Shortly thereafter, she developed chest discomfort and repeat angiography demonstrated a new area of stenosis distal to the area of original angioplasty. An attempt at a second angioplasty resulted in vessel occlusion with subsequent successful bypass surgery. The etiology of the new distal lesion is discus

ISSN:0098-6569    

DOI:10.1002/ccd.1810100211

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

年代:1984

数据来源: WILEY