ISSN:0098-6569    

DOI:10.1002/ccd.1810200102

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

年代:1990

数据来源: WILEY

摘要:

AbstractThe degree of aortic regurgitation, before and after balloon aortic valvuloplasty, was assessed in 32 patients, using double indicator dilution curves: a) the forward curve was obtained by dye injection into the left ventricle and sampling in the aorta; b) the regurgitant curve was obtained by dye injection in the aorta and sampling in the left ventricle. A regurgitant index (RI) was calculated by obtaining the ratio of the areas of the triangles from regurgitant and forward curves. Eight‐five percent of the patients were 70 years or older. After valvuloplasty, aortic valve area increased from 0.5±t 0.3 cm2to 0.7 ± 0.3 cm2(P= 0002) while left ventricular to aortic gradient decreased from 77 ± 32 to 51 ± 24 (P=.0001). RI did not significantly change in 58% of patients, increased in 25%, and decreased in 15.2%. We conclude that in most patients undergoing aortic valvuloplasty, regurgitation does not change after the procedure. In some patients it may increase significantly, and in a few it may even decrease. Indicator dilution curves technique seems to provide a sensitive, accurate, and reproducible method to detect and quantify aortic incompetence before and after valvulop

ISSN:0098-6569    

DOI:10.1002/ccd.1810200103

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

年代:1990

数据来源: WILEY

摘要:

AbstractUp to 90% of coronary bypass operations in some centers now include at least one IMA graft. In parallel with the increased use of IMA grafts, our catheterization laboratory records for 1986‐7–8 demonstrate a progressive increase in IMAangiography, both absolutely (11, 28, 48 cases/yr) and as a percent of restudy procedures performed after prior bypass (14, 25, 43%). Unfortunately, these records also show that cannulation of the right and left IMAs may involve substantial technical hurdles, resulting in a mean time of 19 ± 19 min from catheter insertion toselective IMA angiography.Based on this experience, we review a standard technique for IMA angiography using preformedcatheters, and describe alternative methods (including use of PTCA guidewires with or without super‐selective catheters, and non‐selective angiography utilizing a specially designed balloon occlusion c

ISSN:0098-6569    

DOI:10.1002/ccd.1810200104

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

年代:1990

数据来源: WILEY

摘要:

AbstractLeft ventriculography (LVG) was performed to assess severity of mitral regurgitation (MR) on a scale of 0–4 + in 157 patients before and immediately after percutaneous mitral balloon valvotomy (PMV). There were 129 women and 28 men aged 51 ± 1 (range 13–87) yr. With PMV, mitral valve area increased from 0.9 ± 0.1 cm2to 2.0 ± 0.1 cm2(P<.0001). Increase in mitral regurgitation (MR) occurred in 69 patients (44%). Patients were divided into two groups based on increase in MR after PMV. Group A (n = 136) had 0–1 + increase in MR. Group B (n = 20) had ± 2 + increase in MR after PMV. The only predictor of increase in MR≥2+ was the ratio of effective balloon dilating area to body surface area (EBDA/BSA). EBDA/BSA was 4.0 ± 0.1 cm2/m2in Group A vs. 4.37± 0.2 cm2/m2in Group B (P=.02).Follow‐up of patients in Group B showed: Four patients remained NYHA Class III and required mitral valve replacement 4.3 ± 1.1 (range 5–21) mo after PMV. One patient who had undergone combined aortic and mitral valvotomy died in the hospital of worsening heart failure. One patient died 1 mo later of sepsis related to a dental abscess. Follow‐up of the remaining 14 patients at 9.5 ± 1.1 (range 2–7) mo showed 10 in NYHA Class I and four in NYHA Class II. Eight of 15 patients (53%) who had repeat left ventriculogram at 9.0 ± 0.8 mo after PMV had a decrease in MR of one grade when compared to L

ISSN:0098-6569    

DOI:10.1002/ccd.1810200105

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

年代:1990

数据来源: WILEY

摘要:

AbstractA National Registry of 14 centers performing elective supported angioplasty was formed to collate the initial experience with high‐risk patients. Suggested indications were ejection fraction less than 25% and/or target vessels supplying greater than half of the viable myocardium. The data from 105 patients were entered into the Registry during 1988. This group included 30 patients who had dilation of their only patent coronary vessel and 20 patients whose disease was deemed too severe to undergo bypass surgery. Chest pain and ECG changes were uncommonly experienced during balloon inflation. The group experienced a high angioplasty success rate (95%) with an average of 1.7 dilatations per patient. Morbidity was frequently experienced, the majority of which was associated with cannula (18–20F) placement and/or removal. The overall hospital mortality was 7.6%, although half of the deaths occurred in patients who were both over 75 years of age and had left main coronary artery stenosis. Patients under the age of 75 years without left main coronary artery stenosis experienced a hospital mortality rate of 2.6%. Symptomatic improvement occurred in 91% of the patients surviving hospitalization. During the followup period of 1–12 months, three patients died of cardiac complications. This multicenter experience suggests that supported angioplasty can be performed safely in high‐risk patients in several high‐risk subgroups with the expectation of good symptomatic improvement and short‐te

ISSN:0098-6569    

DOI:10.1002/ccd.1810200106

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

年代:1990

数据来源: WILEY

ISSN:0098-6569    

DOI:10.1002/ccd.1810200107

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

年代:1990

数据来源: WILEY

摘要:

AbstractA cardiopulmonary bypass system that can be percutaneously inserted is available. In addition to its use in stabilization of severely hemodynamically compromised patients, it has many uses in cardiology including use as an adjunct to high‐risk interventional procedures. The purpose of this report is to communicate our experience with cardiopulmonary bypass in the Catheterization Laboratory and discuss technique, indications, and potential complication

ISSN:0098-6569    

DOI:10.1002/ccd.1810200108

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

年代:1990

数据来源: WILEY

摘要:

AbstractDuring angioplasty of the left coronary artery, an acute thrombotic occlusion of the right coronary artery occurred at the site of a borderline stenosis. The source of the unexplained chest pain at the end of the procedure was identified but the next day when inferior Q‐waves appeared. It was documented by repeat angiography. The coronary angiogram of the right coronary artery preceding the angioplasty of the left coronary artery is likely to have triggered the occlusion. Chest pain during or after angioplasty without apparent cause in the dilated artery must prompt a contrast medium injection into the nonattempted artery, paricularly if the latter had undergone a diagnostic sutdy at the beginning of the procedur

ISSN:0098-6569    

DOI:10.1002/ccd.1810200109

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

年代:1990

数据来源: WILEY

摘要:

AbstractAngioplasty of a stenosis at the origin of a diagonal branch was initially unsuccessful because of the straight course of the anterior descending artery and a sharp bend at the diagonal branch. Therefore, in a second attempt, the anterior descending artery was blocked by inflating a balloon distal to the diagonal branch, thereby facilitating the passage of guidewire and ballooninto the diagonal branch.

ISSN:0098-6569    

DOI:10.1002/ccd.1810200110

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

年代:1990

数据来源: WILEY

摘要:

AbstractAngioplasty of large saphenous vein grafts may present problems because of unavailability of adequately sized balloon dilatation catheters. We report a case of successful PTCA of a left anterior descending graft by using a 5 mm balloon and a standard 8F guiding catheter.

ISSN:0098-6569    

DOI:10.1002/ccd.1810200111

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

年代:1990

数据来源: WILEY