摘要:

AbstractThis report presents the first year's experience of a totally computerized cardiac catheterization laboratory reporting system, including the results and complications of invasive and interventional procedures. Sixty‐three laboratories reported a total of 71,916 patients studied between January 1 through December 31,1990. Two previous registry reports have been published. Compared with data acquired by previous methods, in spite of an older and sicker population, the mortality for diagnostic procedures has remained remarkably constant (0.11%). The computerized format facilitates data collection and analysis, helps resolve new issues as they arise and serves as a method of monitoring quality of laboratories and Individual

ISSN:0098-6569    

DOI:10.1002/ccd.1810240202

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

年代:1991

数据来源: WILEY

摘要:

AbstractTo determine predictors of early death after coronary angiography In patients with significant left main coronary artery disease (≥ 60% diameter narrowing, LMCAD), we reviewed the clinical records of patients with LMCAD who died after angiography. Of 1,288 patients with LMCAD studied between January 1978 and October 1989, 21 died within 2 days after angiography (group 1). As a control group, 85 patients were randomly sampled from 1,196 patients who survived at least 30 days after angiography (group 2). The predictors of early death after angiography in patients with LMCAD were older age (P<0.05), New York Heart Association Class III or IV (P<0.005), shorter duration of unstable angina (P<0.005), higher left ventricular end‐diastolic pressure (P<0.006), lower ejection fraction (P<0.005), and significant left circumflex artery disease (P<0.006). The use of heparin infusion after angiography did not appear to be a significant factor. It is suggested that earlier operation or more aggressive management be undertaken in patients who, at cardiac catheterization, have significant LMCAD associated with the above‐listed vari

ISSN:0098-6569    

DOI:10.1002/ccd.1810240203

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

年代:1991

数据来源: WILEY

摘要:

AbstractThe safety and efficacy of percutaneous transluminal coronary angioplasty (PTCA) for stenoses involving ulcerative lesions were retrospectively studied. Seventy‐seven patients (62 men and 15 women, mean age 62 ± 10 years) representing 3.4% of 2,250 patients treated with PTCA during the period January 1, 1988 and June 30, 1990, had pre‐PTCA stenoses defined as ulcerated. Twenty‐eight (36%) of the stenoses were localized in the left anterior descending coronary artery, 9 (12%) in the left circumflex and 40 (52%) in the right coronary artery. During angioplasty, percent diameter stenosis was reduced from 73 ± 14% to 22 ± 13% and transstenotic gradient decreased from 48 ± 18 to 12 ± 6 mm Hg. Clinical success (freedom from angina at discharge without coronary bypass surgery, infarction or death) was achieved in 70 patients (90.9%). There were seven unsuccessful cases: three underwent elective coronary bypass surgery, one was managed medically, and three developed a major flow interrupting dissection during the procedure requiring emergency coronary bypass surgery. There were no deaths. At mean follow‐up of 7.6 months, 45 of 61 patients (73.7%) remained asymptomatic. One patient needed an elective coronary bypass surgery and five patients had a successful repeat PTCA. In conclusion, PTCA for an ulcerated stenosis can be performed safely with a high primary success rate and a favorable early cli

ISSN:0098-6569    

DOI:10.1002/ccd.1810240204

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

年代:1991

数据来源: WILEY

摘要:

AbstractTen healthy (aged 28 to 39) and ten heart failure NYHA II (aged 19 to 49) male subjects were prospectlvely studied under no drugs, under furosemide (40 mg/day), under captopril (150 mg/day) and under their association. Arterial compliance (ml/mmHg) was measured in all subjects at rest and supine. Heart failure etiology was dilated cardiomyopathy or ischemic heart disease without significant regurgitation. Arterial compliance was significantly higher In healthy than in heart failure patients in all studied conditions (p<0.001) (healthy = 2.2 + 0.29 vs. heart failure = 0.79 + 0.14). Neither single drug nor their association induced any change in healthy subjects. Arterial compliance progressively increased in heart failure with furosemide, captopril, and their association (no drug = 0.79 + 0.14; furosemide = 0.87 + 0.15; captopril = 0.94 + 0.15 and furosemide + captopril = 0.99 + 0.14). Captopril induced a higher increment than furosemide (p<0.001) and their association even a higher increment (p<0.001) than any single drug.Thus captopril and/or furosemide increased arterial compliance in heart failure but not in healthy subjects, possibly through changes in arterial wall edema and smooth muscle contraction.

ISSN:0098-6569    

DOI:10.1002/ccd.1810240205

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

年代:1991

数据来源: WILEY

ISSN:0098-6569    

DOI:10.1002/ccd.1810240206

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

年代:1991

数据来源: WILEY

摘要:

AbstractThis case report presents an example of the use of the double wire technique for additional guiding catheter bracing support in percutaneous transluminal coronary angioplasty (PTCA) of a stenosis in an anomalous circumflex (CX) artery arising within the ostium of the right coronary artery (RCA). It illustrates the ease of this technique in comparison to conventional guiding catheter cannulation, which may be more difficult and yield poor backup support in this unusual anatomic situation.

ISSN:0098-6569    

DOI:10.1002/ccd.1810240207

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

年代:1991

数据来源: WILEY

摘要:

AbstractA small portion of lesions are refractory to coronary angioplasty even when very high pressures are used. This leads to a failed angioplasty and emergent bypass surgery. We successfully attempted the technique of hugging balloons or two polyethelene terephthalate (PET) balloons inflated simultaneously side by side which successfully dilated a lesion which would not dilate using standard techniques. This technique successfully dilated the lesion as the geometry of two balloons inflated side by side is different from one balloon. Two balloons inflated side by side consists of two outer semi‐circles and a central trapezoidal square area. This altered geometric configuration may be important in successfully dilating a lesion refractory to standard dilating techniques. Higher pressures can be attained with smaller balloons as the burst pressure is higher in smaller balloons compared to larger balloon

ISSN:0098-6569    

DOI:10.1002/ccd.1810240208

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

年代:1991

数据来源: WILEY

摘要:

AbstractCoronary artery fistulas draining directly into the right ventricle have been recognised as a complication of transvenous endomyocardial biopsy procedures performed in heart transplant recipients. We report a case where a fistula drained into the middle cardiac vein and outline the possible mechanism of occurrence and its prevention. The diagnostic and therapeutic aspects of these “acquired” fistulas are revie

ISSN:0098-6569    

DOI:10.1002/ccd.1810240209

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

年代:1991

数据来源: WILEY

ISSN:0098-6569    

DOI:10.1002/ccd.1810240210

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

年代:1991

数据来源: WILEY

摘要:

AbstractA computerized system designed to optimize the quantitation of coronary vessels on 35 mm cineangiograms is described and validated. Because the system has two cine film digitizers, it processes paired coronary arteriograms for the evaluation of serial changes in coronary arteries. A database system was specifically designed for the storage of coronary artery quantitation data which resides on a file server in a local area network and may be accessed by multiple workstations. In radiographic phantom studies of nine contrast‐filled lucite cylinders of known size, the overall accuracy and precision for the measured diameters were 0.069 mm and 0.066 mm respectively. Measurements of minimum diameter and percent diameter stenosis of 21 coronary lesions selected from 17 routine cineangiograms showed high degree of intraobserver and interobserver reproduclbllit

ISSN:0098-6569    

DOI:10.1002/ccd.1810240211

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

年代:1991

数据来源: WILEY