ISSN:0098-6569    

DOI:10.1002/ccd.1810100502

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

年代:1984

数据来源: WILEY

ISSN:0098-6569    

DOI:10.1002/ccd.1810100503

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

年代:1984

数据来源: WILEY

摘要:

AbstractTo decrease the risk of iatrogenic side branch occlusion during coronary angioplasty of bifurcational lesions, we evaluated a technique in which two over‐the‐wire dilatation systems are positioned within the stenosed coronary artery and the side branch in jeopardy. The technique was used in eight patients undergoing angioplasty for a lesion in the left anterior descending or circumflex artery located near a large side branch. Successful dilatation of the major vessel lesion was achieved in all eight patients, and dilatation within the side branch was successful in all three patients whose lesion involved the side branch ostium. In one patient, dilatation within the major vessel led to partial closure of the side branch and the prepositioned guide wire facilitated prompt dilatation of the iatrogenic closure. There were no complications associated with use of the additional dilatation system. The technique appears to provide an efficacious method to perform safe coronary angioplasty in selected patients with bifurcational lesi

ISSN:0098-6569    

DOI:10.1002/ccd.1810100504

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

年代:1984

数据来源: WILEY

摘要:

AbstractIn recent years, some concepts regarding the etiology and hemodynamics present in the syndrome of mitral regurgitation have changed. Coronary artery disease and mitral valve prolapse have replaced rheumatic heart disease as the most frequent cause of mitral regurgitation. Hemodynamic studies have shown that tall V waves in the pulmonary capillary wedge tracings are neither specific nor sensitive in detecting the presence of mitral regurgitation.In this study, we evaluated the role of various clinical, echocardiographic, and hemodynamic findings with regard to left atrial (LA) size, pressure, and V wave height. We found that the mean pulmonary capillary wedge pressure (PCW) and V wave height for the subset of patients with acute mitral regurgitation (PCW = 24.1 ± 10.9; V = 41.2 ± 20.7 mm Hg) was similar to the subset with chronic mitral regurgitation (PCW = 17.9 ± 7.5; V = 32.0 ± 18.2 mm Hg). In addition, we found that there was a significant logarithmic relationship between the LA size and the duration of the mitral regurgitation (y = 1.404 [log X] + 3.948; R = 0.678; p<0.0005). Lastly, we found that LA size, compliance, regurgitant volume, and regurgitant valve orifice area all increase with t

ISSN:0098-6569    

DOI:10.1002/ccd.1810100505

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

年代:1984

数据来源: WILEY

摘要:

AbstractRenografin‐76 (RG76) regularly depresses myocardial contractility during coronary angiography. Angiovist‐370 (AV370) is a contrast medium similar to RG76 except the calcium sequestering agents sodium citrate and EDTA in RG76 have been replaced by calcium EDTA (an additive that does not bind additional calcium). To determine if the calcium sequestering agents contribute to the mechanical depression produced by ionic contrast media, this study compared the inotropic response of RG76 to that of AV370. Additionally, saline solutions containing sodium citrate + EDTA and calcium EDTA at concentrations found in the respective contrast media were also compared. In 10 open chest dogs the percent change and duration of the inotropic response following intracoronary injections of RG76 and AV370, as well as solutions of sodium citrate + EDTA and calcium EDTA were compared using Walton‐Brodie strain gauges. Injections, 2 cc, of RG76 and AV370 produced a biphasic response characterized by an initial negative inotropic response followed by a more prolonged positive inotropic response. The magnitude (67 ± 3% vs 59 ± 2%; p<0.001) and duration (34 ± 3 vs 24 ± 2 sec; p0.3). This positive response was not affected by b̃‐adrenergic blockage with 0.2 mg/kg of timolol. Similarly, 4 cc of sodium citrate + EDTA produced a significantly greater magnitude (56 ± 5%) and longer (42 ± 7 sec) negative inotropic response than calcium EDTA (17 ± 2% and 15 ± 3 sec) or 0.9% saline (18 ± 8% and 13 ± 2 sec; p<0.001). The results suggest that the calcium sequestering agents sodium citrate + EDTA produce significant negative inotropic effects contributing to the mechanical depression produced by RG76. However, the calcium binding additives are not solely responsible for the depression in contractility produced by ionic contrast media. Contrast media lacking calcium binding additives may be preferable for

ISSN:0098-6569    

DOI:10.1002/ccd.1810100506

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

年代:1984

数据来源: WILEY

摘要:

AbstractA case who developed severe and potentially fatal reaction to an angiographic contrast medium despite adequate pretreatment with steroids for 2 weeks is reported. This is the second such case reported in the English literature.

ISSN:0098-6569    

DOI:10.1002/ccd.1810100507

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

年代:1984

数据来源: WILEY

ISSN:0098-6569    

DOI:10.1002/ccd.1810100508

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

年代:1984

数据来源: WILEY

摘要:

AbstractWe report a 29‐year‐old female who presented with thyrotoxicosis and a massive right pleural effusion. Cardiac catheterization in the presence of the effusion revealed equalization of abnormally elevated right and left heart filling pressures. Repeat study after thoracentesis demonstrated normal intracardiac pressures, which were unchanged by volume loading with normal saline. This case report suggests that both extrinsic cardiac chamber compression produced by the large unilateral effusion and ventricular interdependence altered diastolic function of the right and left ventricle in a manner resembling constrictive pericarditis or restrictive cardiomyopa

ISSN:0098-6569    

DOI:10.1002/ccd.1810100509

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

年代:1984

数据来源: WILEY

摘要:

AbstractA 50‐year‐old woman with chest pain and an exercise thallium‐201 scintigram positive for focal ischemia was found on coronary arteriography to have a heretofore unreported variant of single left coronary artery with the right coronary artery originating as a branch from the first septal perforator. Proximally, the aberrent vessel coursed through the ventricular septum at the level of the right ventricular outflow tract. A conus artery was absent and this is a possible basis for the focal basal ventricular ischemia and the patient's sym

ISSN:0098-6569    

DOI:10.1002/ccd.1810100510

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

年代:1984

数据来源: WILEY

摘要:

AbstractThe occurrence of solitary nodular pulmonary lesions associated with thrombolytic therapy is reported in two patients. Resolution was spontaneous in each patient. Multiple thin needle aspiration biopsies in one case revealed only red blood cells. This unusual entity should be included as one of the potential complications associated with the use of thrombolytic agents.

ISSN:0098-6569    

DOI:10.1002/ccd.1810100511

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

年代:1984

数据来源: WILEY