ISSN:0098-6569    

DOI:10.1002/ccd.1810090102

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

年代:1983

数据来源: WILEY

摘要:

AbstractAn Intracoronary Infusion of streptokinase is often administered in patients with acute myocardial infarction. To address the question of how long intracoronary streptokinase should be infused, we studied 13 patients with symptoms and electrocardiographic findings suggesting an evolving myocardial infarction. We used subselective catheterization techniques and made quantitative angiographic measurements of the percentage of reduction of coronary artery (CA) diameter before intracoronary streptokinase therapy, immediately after reperfusion was established, and at the completion of streptokinase infusion. Before intracoronary streptokinase and after intracoronary nitroglycerin, nine patients had 100% obstruction of the CA in the “infarct‐related vessel.” In seven patients reperfusion was established (25 ± 21 min, mean ± SD) at which time CA diameter was reduced by 77 ± 22%. The streptokinase infusion was then continued until repeated films (every 10 to 15 min) suggested no further change at the site of CA obstruction (93 ± 68 min). The percentage of CA diameter reduction when streptokinase infusion was discontinued was 55 ± 32%; this value was less (P<0.05) than that observed early after reperfusion. These data show that after initial reperfusion was achieved by the use of intracoronary streptokinase, additional streptokinase lessened the reduction of CA diameter. Residual thrombus may be present at the narrowed CA site early after reperfusion, and further “cleanup” can be achieved by prolonging streptok

ISSN:0098-6569    

DOI:10.1002/ccd.1810090103

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

年代:1983

数据来源: WILEY

摘要:

AbstractAn hydraulic orifice formula offering the possibility of quantifying cardiac output in conditions of mitral stenosis is tested using potentially noninvasive portions of catheterization data from patients evaluated for obstructive mitral valve disease. The equation studied is V = (1/21) R A T2, where V is the cardiac output (mi/min), R is the heart frequency, A is the mitral valve area (cm2), and T is the diastolic filling interval (sec/min). The mitral valve area was determined by the Gorlin formula, and R and T were measured from the pressure tracings recorded at cardiac catheterization. The degree of correspondence between the equation tested and the measured cardiac output as determined by the Fick principle technique is characterized by r = 0.87, SE = 450 mi/min, N = 10. The results suggest that the new formulation may offer a noninvasive method for estimating the cardiac output status of patients with mitral valve disease once mitral valve area is measured either at catheterization or by two‐dimensional echocardiograph

ISSN:0098-6569    

DOI:10.1002/ccd.1810090104

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

年代:1983

数据来源: WILEY

摘要:

AbstractPulmonary artery oxygen saturation (PA) was measured directly and estimated from venal cavae samples in 175 adults without intracardiac shunts to ascertain which of four formulas (MV1, MV2, MV3, or MV4) best estimated mixed venous oxygen saturation. Because the formula MV1, which favored IVC samples, most closely approximated pulmonary artery saturation, we recommend its use to estimate systemic flow in patients with left‐to‐right shunts. In addition, a difference between directly measured PA and calculated MV1 of 6% or greater indicates the presence of a left‐to‐right shunt in 97% o

ISSN:0098-6569    

DOI:10.1002/ccd.1810090105

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

年代:1983

数据来源: WILEY

摘要:

AbstractIn order to determine the effect of the manner of dress by personnel and observers on cardiac catheterization‐related infections, a retrospective survey was undertaken of 107,203 catheterization procedures done during the calendar year prior to this survey. An analysis of 55,976 cutdowns and 53,578 percutaneous procedures was performed (some subjects had both procedures performed). A total of 379 infections in 109,554 entrance sites were reported for an overall incidence of infection of 0.35%. There were 33 infections at the percutaneous site (incidence = 0.06%) and 346 at the cutdown site (incidence = 0.62%). The manner of dress of personnel not involved with catheter manipulation and of the observers had no relationship to the incidence of infection when the percutaneous technique was used. When cutdowns were performed, there was a lower incidence of infection in those laboratories where all personnel and observers were required to wear a mask, cap, and gown (17,311 cutdowns, 83 infections, 0.48% infection rate) than in those laboratories where none of these was required (15,170 cutdowns, 109 infections, 0.72% infection rate) (P<0.025). Laboratories which did 150 or less cutdowns/year had more infections than those laboratories performing more than 150/year (P<0.0001). Our data suggest that the risk of infection from cardiac catheterization is more closely correlated with the volume of studies done in the laboratory than in the manner of dress of the laboratory personnel and visitors in the laboratory. However, the wearing of full “sanitary clothing” will help decrease the infection rate in cut

ISSN:0098-6569    

DOI:10.1002/ccd.1810090106

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

年代:1983

数据来源: WILEY

摘要:

AbstractRecognition of pyrogen reactions in patients studied with multiple‐use cardiac catheters led to recommendations regarding their cleaning and ultimately to the expensive practice of discarding catheters after a single use. Primarily because of cost considerations, our laboratory continued to clean and reuse catheters through 1981. This afforded an opportunity to assess the endemic rate of adverse reactions associated with this practice. We prospectively evaluated 341 patients who were studied with single‐use or multiple‐use catheters. The overall incidence of adverse reactions was: hypotension 27%, fever 3%, chills 3%, and all three 0.6%. There were no statistically significant increases in these reactions associated with the reuse of catheters. Bacterial infection did not appear responsible for these reactions, and it is possible that they were due to angiographic dye. We conclude that careful cleaning and reuse of catheters does not create an obvious increase in the risk of infection, and it appears to play a minor role, if any, in the development of other adverse reac

ISSN:0098-6569    

DOI:10.1002/ccd.1810090107

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

年代:1983

数据来源: WILEY

摘要:

AbstractA two‐year‐old child with massive cardiomegaly was proved to have restrictive cardiomyopathy. A literature search has shown only two other cases of this in young children. All three have had massive biatrial dilatation with nearly normal ventricular function. This case is the first with clearly defined echocardiography and complicating diagnostic features associated with persistence of a left superior vena c

ISSN:0098-6569    

DOI:10.1002/ccd.1810090108

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

年代:1983

数据来源: WILEY

摘要:

AbstractThis 45‐year‐old white male was evaluated for congestive heart failure initially ascribed to a rapidly progressive cardiomyopathy. Both radionuclide ventriculography and echocardiography correctly identified a left ventricular pseudoaneurysm as the cause for heart failure. Thallium‐201 scintigraphy, by demonstrating a large perfusion defect, suggested a large ostium of the pseudoaneurysm. Following resection of the false aneurysm, a Dacron prosthesis was required to close a large posterior wall defect. We conclude that both radionuclide ventriculography and echocardiography can independently demonstrate a left ventricular pseudoaneurysm. The combined noninvasive approach is able to delineate various anatomical aspects of the pseudoaneurysm and help in planning adequate surgical interve

ISSN:0098-6569    

DOI:10.1002/ccd.1810090109

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

年代:1983

数据来源: WILEY

摘要:

AbstractA case of transient complete heart block and lateral wall myocardial infarction secondary to nonpenetrating chest trauma is presented. Lack of any associated cardiac lesions is an interesting feature of this case report. Proposed criteria for heart block secondary to trauma and difficulty in making the diagnosis of myocardial infarction secondary to trauma due to lack of appropriate “gold standard” are discus

ISSN:0098-6569    

DOI:10.1002/ccd.1810090110

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

年代:1983

数据来源: WILEY

摘要:

AbstractAn unusual case of consumptive coagulopathy due to hematoma formation, which occurred as a local complication of percutaneous transfemoral coronary arteriography, is reported. To our knowledge, this entity has not been reported in previous series. Prompt recognition of the syndrome through appropriate laboratory tests and early surgical intervention is indicated.

ISSN:0098-6569    

DOI:10.1002/ccd.1810090111

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

年代:1983

数据来源: WILEY