ISSN:0098-6569    

DOI:10.1002/ccd.1810040402

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

年代:1978

数据来源: WILEY

摘要:

AbstractThe outlet chamber of the human heart can show considerable variations in its morphology and topography (relationship to main ventricular chamber), and such variations in anatomy and spacial relationship may be predictive of the associated intracardiac anatomy. Although there is considerable debate about whether the position of the outlet chamber is indicative of the type of bulboventricular loop (whether D‐ or L‐), a right‐sided and anterior outlet chamber has different implications than a left‐sided, superior, and more posterior positioned one. The inflows into the outlet chamber can vary anatomically, and progressive changes in the calibers of these communications can adversely alter the natural history. One or both of the greak vessels, or neither, or a persistent truncus arteriosus can originate from the outlet chamber, and any significant morphological change in the outlet chamber may or may not adversely affect either the pulmonary or systemic blood supply, or both. Finally, any consideration of the outlet chamber raises important conceptual difference in terminologies. At present, there is not unanimity as to what constitutes either an outlet chamber (as compared to a “small right ventricle” in tricuspid atresia) or a single (primitive) ventricle. Any discussion of the morphological and topographical variations of the outlet chamber must be viewed with respect to the terminolo

ISSN:0098-6569    

DOI:10.1002/ccd.1810040403

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

年代:1978

数据来源: WILEY

摘要:

AbstractAlthough glutaraldehyde‐preserved porcine aortic Hancock heterografts have lower thromboembolism incidence than mechanical aortic valves, Hancock xenografts provide less functional aortic outflow orifices and thereby greater transvalvular gradients than mechanical prostheses. The newly developed aortic Carpentier‐Edwards porcine heterografts comprise a thin‐walled Elgiloy flexible metal stent covered with Teflon which provides somewhat wider internal orifices than aortic Hancock valves of the same external annulus diameter. Since aortic Carpentier‐Edwards xenografts have not been clincially evaluated previously, the present study assessed cardiac function and heterograft performance (1.7 months postoperation) and clinical status (4.2 months postoperation) of 19 patients with severe aortic stenosis and/or regurgitation prior to surgery. Left ventricular end‐diastolic pressures decreased (17 to 9 mm Hg), cardiac index remained normal, and clincial symptomatology diminished markedly. Mean peak transxenograft systolic pressure was only 16 mm Hg (valve area 1.73 cm2), without meaningful regurgitation. Thus aortic Carpentier‐Edwards bioprostheses provide generally excellent heterograft function which appears more favorable than previous reports of Hancock

ISSN:0098-6569    

DOI:10.1002/ccd.1810040404

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

年代:1978

数据来源: WILEY

摘要:

AbstractThe purpose of this investigation was to quantitate the changes in left ventricular volume and end‐diastolic pressure that occur with rapid infusion of 500 ml of low molecular weight dextran, and thus to study left ventricular pressure‐volume relationships. Left ventricular pressure and echocardiographic dimensions were recorded before, during, and following dextran infusion in eight patients with normal left ventricular function. With the infusion of dextran, left ventricular end‐diastolic pressure rose progressively from 10 ± 3 mmHg (mean ± SD) to 24 ± 5 mmHg, whereas end‐diastolic volume increased from 95 ± 23 ml to 118 ± 26 ml (24%). These results serve to emphasize the steepness of the left ventricular pressure‐volume relationship at end‐diastole in subjects with normal ventricular function when in the

ISSN:0098-6569    

DOI:10.1002/ccd.1810040405

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

年代:1978

数据来源: WILEY

摘要:

AbstractA study of single‐plane right anterior oblique left ventricular angiography was undertaken to determine the importance of obtaining correct positioning of a magnification grid and to develop a simple but accurate technique to minimize magnification errors. Theoretical and experimental volume determinations demonstrated 3% to 28% volume errors for grid placement errors ranging from 1 centimeter to 5 centimeters. An experiment was designed whereby cross table lateral radiographs of the chest were taken during contrast injections of the left ventricle. The relative position of the left ventricular center was found at a point 66% of the distance from the anterior to the posterior margin of the heart. Finding this point on noncontrast lateral films of the chest for positioning of a square centimeter grid should yield a more accurate determination of the magnification factor than other current emperic method

ISSN:0098-6569    

DOI:10.1002/ccd.1810040406

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

年代:1978

数据来源: WILEY

摘要:

AbstractIn order to evaluate the cardiac sympathetic nerve tone in cardiomyopathies, plasma norepinephrine concentration in the coronary sinus (NECS) and artery (NEA) was measured by THI method in five patients with the hypertrophic type (HCM) and in seven with the congestive type (CCM); six patients with functional murmur served as controls. NECSwas 182 ± 39 ng/liter (SEM) in HCM, 288 ± 47 in CCM, and 306 ± 65 in controls. The NECS– NEAdifference (Δ) was 9 ± 22 ng/liter in HCM, −57 ± 34 in CCM, and 81 ± 29 in controls. Norepinephrine overflow into the coronary sinus, which was calculated by multiplying coronary sinus plasma flow by Δ, was 0.54 ± 0.86 ng/min/100gm, −2.81 ± 1.47, and 3.73 ± 1.77, respectively. Norepinephrine overflow and Δ were significantly lower in CCM than in controls. The results suggest that an excessive sympathetic discharge does not exist in HCM and that cardiac sympathetic activity

ISSN:0098-6569    

DOI:10.1002/ccd.1810040407

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

年代:1978

数据来源: WILEY

摘要:

AbstractVarious anomalies of coronary arterial origin have been described. These anatomical variations are discovered either by coronary angiography or at autopsy. We are reporting a case of anomalous origin of the right coronary artery above the left sinus of Valsalva. To our knowledge, this anomaly has not been described before. A technique for selectively catheterizing such an aberrant coronary artery is described.

ISSN:0098-6569    

DOI:10.1002/ccd.1810040408

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

年代:1978

数据来源: WILEY

摘要:

AbstractWe present the clinical, angiographic and surgical findings in a 63‐year‐old man with anomalous origin of the left main coronary artery from the right sinus of valsalva. The course of the left main artery was abnormal in that it passed between the aorta and the pulmonary artery; in addition, there was obstructive disease involving the left main coronary artery. The association of these two entities in this age group is unus

ISSN:0098-6569    

DOI:10.1002/ccd.1810040409

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

年代:1978

数据来源: WILEY

摘要:

AbstractFive patients with critical aortic stenosis (aortic valve area 0.6 cm2or less) died 2 days to 21 days following cardiac catheterization performed in anticipation of cardiac surgery. A sixth patient was successfully resuscitated for spontaneous ventricular fibrillation, and successful aortic valve replacement was accomplished. Two patients had prior history of syncope; one patient, of ventricular tachycardia; three patients, of pulmonary edema; and three patients, of crescendo angina. One patient had severe hypotension during maintenance hemodialysis for chronic renal failure. The mode of death was sudden but not witnessed in two patients. The terminal cardiac rhythms were slow junctional in one patient, idioventricular in one, ventricular tachycardia in one, and ventricular fibrillation in the fourth patient. We conclude that symptomatic patients with critical aortic stenosis should be monitored after cardiac catheterization, and surgery should be performed as soon as possible since sudden death is not unusual.

ISSN:0098-6569    

DOI:10.1002/ccd.1810040410

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

年代:1978

数据来源: WILEY

摘要:

AbstractCatheter passage into the left atrium from the right atrium greatly facilitates invasive cardiovascular evaluation and reduces the risks attendant on cardiac catheterization studies. We reviewed 371 consecutive cardiac catheterizations to establish the presence of natural interatrial communications. Catheter course, pressure equalization, and left‐to‐right atrial shunt on recirculation angiography were considered to determine intact interatrial septum (IIS), patent foramen ovale (PFO) or atrial septal defect (ASD).During the first year of life, 88% of infants had PFO or ASD; in 12%, the interatrial septum was intact. In children 1–10 years old, 49% had IIS, 27% had PFO, and 24% had ASD. In children 10–21 years old, 24% had PFO, or ASD. Though there seems to be a greater likelihood of ISS in those with left heart obstruction, hemodynamic factors did not completely explain the timing of closure of the foramen ovale.Presence of an interatrial communication allows catheter entrance into all left heart structures including the aorta; therefore, in patients with PFO or ASD, retrograde arterial procedure or transseptal puncture technique can be avoided when performing left heart catheterization. This appears possible in 88% of those under 1 year of age, in 51% of those 1–10 years old, and in 24% of children 10–2

ISSN:0098-6569    

DOI:10.1002/ccd.1810040411

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

年代:1978

数据来源: WILEY