ISSN:0098-6569    

DOI:10.1002/ccd.1810210202

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

年代:1990

数据来源: WILEY

摘要:

AbstractWe report on the complication rates in 660 consecutive coronary angioplasties (725 lesions) performed using four procedures that differed with respect to catheter technology and adjuvant medication. After the PTCA regimen in our laboratory had beem changed from conventional steerable systems to the monorail technique, we observed a significant increase in the incidence of transient vessel occlusions from 2.6% to 7.7%, of permanent occlusions from 3.6% to 8.8%, and of intracoronary thrombus‐formation from 2.6% to 5.5%. This was associated with the frequent observation of thrombotic material on the partially Tefloncoated guidewires. Coronary perfusion with urokinase (1,670‐ 6,670 U/min) lead to a further increase in the complication rates (10.4%/10.3%/6.5%). Our present percutaneous transluminal coronary angioplasty (PTCA)‐regimen (monorail technique with P.E.T. balloons, fully silicon‐coated guidewires, no urokinase) shows an incidence of 3.8% for intermittent and recurrent coronary occlusions and 1.9% for permanent occlusions.Urokinase did not prevent intracoronary thrombus formation with the monorail technique. Furthermore, we suspect that in the case of PTCA‐induced regional lntimal dissection, fibrinolysis can prevent reestablishment of intima adherence to the vessel wall. Because five procedural deaths were observed in the 212 patients treated with i.c. urokinase as opposed to three deaths in the 448 procedures without urokinase, we feel that i.c. urokinase in PTCA is a potentially harmful regimen. We suggest that the monorail technique should be performed with fully silicon‐coated guidewires and withou

ISSN:0098-6569    

DOI:10.1002/ccd.1810210203

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

年代:1990

数据来源: WILEY

摘要:

AbstractBetween July 1985 and March 1988,22 adult patients with congenital pulmonary stenosis underwent balloon pulmonary valvuioplasty. There were 10 males and 12 females aged 16‐45 (average 25 ± 9.9) years. All patients had additional mild to severe infundibular stenosis; 16 were restudied 6‐36 (mean 12.6) months later by repeat Catheterization. Student'st‐test was used for comparison of data.Right ventricular (RV) systolic pressure before dilatation was 84–196 (mean 129 ± 32.3) mm Hg, and the peak pulmonary gradient (PPG) was 60–176 (mean 111 ± 33.2) mm Hg immediately after dilatation. The RV systolic pressure dropped to 32–140 (mean 59.2 ± 27) (P<0.001); and PPG dropped to 10–113 (mean 37.8 ± 26.4) (P<0.001), and the infundibular gradient ranged from 8 to 113 (mean 35.1 ± 25.8) mm Hg. The infundibular diameter, before dilatation, ranged from 2 to 15 (mean 9.5 ± 4) mm Hg. At repeat catheterization, the RV systolic pressure dropped further to 33–66 (mean 42.8 ± 9.7) mm Hg and the PPG was reduced to 0–48 (mean 18.4 ± 10.9) mm Hg (P<0.001). The infundibular gradient regressed to 0–34 (mean 15 ± 8.8) mm Hg (P<0.001). The infundibular diameter Increased to 8–25 (mean 15.8 rt 5.4) (P<0.001). It is concluded that moderate to severe lnfundibular stenosis, in adults, can regress after suc

ISSN:0098-6569    

DOI:10.1002/ccd.1810210204

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

年代:1990

数据来源: WILEY

摘要:

AbstractArteriographic findings of neovascularity and fistula formation between coronary arteries and left atrium have occasionally been described in association with left atrial thrombosis in patients with mitrai valve disease. The validity of these coronary arteriographic findings in diagnosis of atrial thrombi has been evaluated in 112 patients with mitral valve disease. Comparison was made with surgery. The study furnished these diagnostic values: sensitivity 70%, specificity 85%, positive predictive value 72%. Even if this angiographic finding is complementary in diagnosis of atrial thrombosis, its identification during coronary arteriography in patients with mitral valve disease is useful. Its detection could improve diagnostic prediction of thrombosis, especially in patients without previous emboiic events or where echocardiography failed to reveal thrombi.

ISSN:0098-6569    

DOI:10.1002/ccd.1810210205

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

年代:1990

数据来源: WILEY

摘要:

AbstractThe authors describe the use of a table for rapid measurement of the cardlo‐thoracic ratio on a standard PA chest film. The method is free of calculation

ISSN:0098-6569    

DOI:10.1002/ccd.1810210206

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

年代:1990

数据来源: WILEY

摘要:

AbstractWe report a case of coronary angioplasty of a left anterior descending artery lesion that was complicated by the rupture of three successive balloon catheters. Each rupture occurred as a pinhole jet of contrast into a diagonal side branch, causing subintlmal staining. This case demonstrates that balloon rupture may result from lesion morphology.

ISSN:0098-6569    

DOI:10.1002/ccd.1810210207

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

年代:1990

数据来源: WILEY

摘要:

AbstractThe case described is a death due to emboliration of calcium debris from a bioprosthesis, dislodged at cardiac catheterization. As more bioprosthetic valves are implanted, and more of them fail long‐term with calcification, such complications of the lnvasive study of these valves may be expecte

ISSN:0098-6569    

DOI:10.1002/ccd.1810210208

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

年代:1990

数据来源: WILEY

摘要:

AbstractPulmonary artery migration of pacemaker lead is rare and may result in pulmonary emboli originating from the thrombus around the infected catheter and causing multiple pulmonary infarcts. We report an unusual case of pacemaker lead migration to the right pulmonary artery with septic pulmonary embolism. While being treated with intravenous Cefuroxamine, the patient had spontaneous migration of the lead to the left pulmonary artery with subsequent left pulmonary embolism.

ISSN:0098-6569    

DOI:10.1002/ccd.1810210209

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

年代:1990

数据来源: WILEY

摘要:

AbstractBypass graft occlusion by a thrombus 30 min before elective coronary angiography was treated by percutaneous thrombus aspiration, followed by an angioplasty with a good follow‐up resul

ISSN:0098-6569    

DOI:10.1002/ccd.1810210210

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

年代:1990

数据来源: WILEY

摘要:

AbstractThe case of a 45‐yr‐old woman who had balloon valvuloplasty for rheumatic mltral stenosis is presented. An anterior mitral leaflet tear occurred as a complication of the procedure. Both partlal healing of the anterior mitral leaflet and gradual dilatation of the left atrium occurred which allowed the damaged valve to remain in situ for several months. Some of the late changes which occur after such a complicated valvuloplasty are illustrated here, as this patient eventually required surgery and valve excision for deflnitive rep

ISSN:0098-6569    

DOI:10.1002/ccd.1810210211

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

年代:1990

数据来源: WILEY