摘要:

AbstractAn international survey of nonsurgical retrieval of intracardiac foreign bodies provided data on 180 published and unpublished cases.The data was analyzed to evaluate the respective merits and drawbacks of the 3 basic retrieval techniques, the snare, the wire basket, and the endoscopy forceps, the routes and methods of insertion, the success rate, and the complications. Eighty percent of foreign bodies were polyethylene central venous pressure catheters, cut in two by the needle introducer. The site of lodgement of these fragments was predictable and determined by the site of entry and length of the fragment. The basic retrieval instruments and their modifications are described. Operating instructions are detailed together with adjunct methods of repositioning fragments for easier retrieval. Factors associated with the small percentage of unsuccessful retrieval attempts include fragments totally in the distal pulmonary artery, extravascular lodging sites, chronically‐implanted fragments, and pacemaker‐catheter fragments.For the vast majority of cases, however, these simple and uncomplicated techniques have been highly successful and widely utilized in the nonsurgical retrieval of intracardiac foreign bod

ISSN:0098-6569    

DOI:10.1002/ccd.1810040102

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

年代:1978

数据来源: WILEY

摘要:

AbstractThe electrocardiograms (ECG) of 64 subjects who exhibited an echocardiographically demonstrable increase in thickness of the interventricular septum and left ventricular posterior wall (Group 1,22 patients), isolated left ventricular internal dimension (Group 2, 26 patients), combined wall thickness and chamber diameter (Group 3, 2 patients), and septal thickness, (Group 4, asymmetric septal hypertrophy, 14 patients) were reviewed in order to determine sensitivity of ECG criteria for the diagnosis of left ventricular hypertrophy (LVH) proposed in 1949 by Sokolow and Lyon (13), in 1968 by Romhilt and Estes (14), and in 1973 the New York Heart Association (15). Relative sensitivity of the three methods was as follows: Total group, NYHA (77%)>Sokolow and Lyon (67%)>Romhilt and Estes (58%); Group 1, NYHA (91%)>Sokolow and Lyon (73%)>Romhilt and Estes (54%); Group 2, NYHA and Sokolow and Lyon (65%)>Romhilt and Estes (61%); Group 4, NYHA (79%)>Sokolow and Lyon (64%)>Romhilt and Estes (57%). We conclude that (1) ECG criteria of the NYHA for the diagnosis of LVH correlate best with an increase of ultrasonically determined septal, left ventricular posterior wall or left ventricular internal dimensions when compared with voltage criteria of Sokolow and Lyon and the point score system of Romhilt and Estes; and (2) isolated increase of left ventricular internal dimension, in the absence of thickened septum or posterior left ventricular wall, frequently results in ECG criteria compatible with the diagnosis of LVH.

ISSN:0098-6569    

DOI:10.1002/ccd.1810040103

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

年代:1978

数据来源: WILEY

摘要:

AbstractThe purpose of this study was to determine if aortic root systolic anteroposterior excursion measured ultrasonically is related to cardiac performance. Aortic motion was 9 ± 1.5 mm (mean ± SD) in 30 normal subjects (range 7–12 mm). Ten patients with coronary artery disease and congestive failure and 10 with congestive cardiomyopathy had significantly smaller values of 4 ± 1.2 and 5 ± 1.7 mm, respectively (P<0.001). In 28 subjects undergoing cardiac catheterization, aortic root motion correlated positively with stroke volume (r = 0.59), but did not correlate significantly with ejection fraction. By increasing heart rate in 14 subjects from 75 to 174 beats/min with atrial pacing, stroke volume decreased from 81 ± 22 to 34 ± 14 ml/beat and aortic excursion from 10 ± 1.6 to 5 ± 1.5 mm (P<0.001). This study has shown: (1) Aortic root motion less than or equal to 6 mm indicates left ventricular dysfunction; (2) stroke volume correlates positively with, but cannot be accurately predicted from, ro

ISSN:0098-6569    

DOI:10.1002/ccd.1810040104

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

年代:1978

数据来源: WILEY

ISSN:0098-6569    

DOI:10.1002/ccd.1810040105

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

年代:1978

数据来源: WILEY

ISSN:0098-6569    

DOI:10.1002/ccd.1810040106

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

年代:1978

数据来源: WILEY

摘要:

AbstractA patient with a loud intermittent midsystolic click presented a problem in differential diagnosis between mitral valve prolapse (intracardiac origin of the click) and left pneumothorax (extracardiac origin). External phonocardiography performed at the time of cardiac catheterization revealed that this loud midsystolic click disappeared whenever a catheter was positioned across the mitral valve. It reappeared whenever the catheter was removed from the transmitral position. Selective left ventriculography confirmed the diagnosis of mitral valve prolapse.

ISSN:0098-6569    

DOI:10.1002/ccd.1810040107

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

年代:1978

数据来源: WILEY

摘要:

AbstractSudden momentary fluctuations of left ventricular, aortic, right ventricular, and pulmonary arterial pressure were noted during isovolumic relaxation of the respective ventricles. The presence of such transients raised questions related to their meaning and significance. The purpose of this report is to emphasize the nonartifactual nature of these pressure transients and to describe their origin and significance in the cardiac cycle. Pressure transients were observed in 31 of 32 patients with normal aortic valves, and in 17 patients with normal pulmonary valves in whom right‐sided measurements were made. Such transients, however, were absent on the left ventricular and aortic pressure recordings of three patients with calcific aortic stenosis. These sudden changes in pressure are indicative of momentary compressions and rarefactions of the blood that occur within the ventricles and their respective arterial chambers. Whenever present, pressure transients were noted to occur coincident with the major aortic or pulmonary components of the second sound. Since intraarterial sound pressure is derived from the pressure signal by filtering the low frequencies and amplifying the high frequencies, one can deduce that intraarterial sound pressure is in fact a representation of these pressure changes. The recognition of these pressure transients on an otherwise smooth ventricular, aortic, or pulmonary arterial pressure places in proper perspective their role in the production of the second heart soun

ISSN:0098-6569    

DOI:10.1002/ccd.1810040108

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

年代:1978

数据来源: WILEY

摘要:

AbstractElectrical alternans concomitant with pericardial effusion has been considered a pathognomonic sign suggestive of a large effusion with cardiac tamponade, particularly if there is P wave alternans as well as QRS alternans. However, the mechanism of this phenomenon remains controversial. A patient with pericardial effusion secondary to adenocarcinoma of the lung with metastases, pericardial effusion, electrical alternans, and cardiac tamponade was studied by echocardiography, right and left heart catheterization, and pericardiocentesis. Hemodynamic data were consistent with cardiac tamponade. The echocardiogram demonstrated a large anterior and posterior pericardial effusion. Noncongruous motion of the septum and posterior wall was recorded at a rate equal to the heart rate. In addition, congruous motion of the septum and posterior wall was recorded at a rate that was half the heart rate and corresponded to the electrical alternans. The congruous movement disappeared after pericardiocentesis, as did the electrical alternans. The electrical alternans is synchronous with and due to the pendulous movement of the heart within the pericardial sac, as demonstrated by echocardiogram and cineangiograms.

ISSN:0098-6569    

DOI:10.1002/ccd.1810040109

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

年代:1978

数据来源: WILEY

摘要:

AbstractCongenital tricuspid insufficiency is a rare disease secondary to malformations of the tricuspid valve and of their chordae tendinae. Diagnosis is difficult but worthwhile, since surgery can be performed. We report one case repaired by surgery.

ISSN:0098-6569    

DOI:10.1002/ccd.1810040110

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

年代:1978

数据来源: WILEY

摘要:

AbstractA patient with known intrathoracic tumor presented with findings suggestive of cardiac tamponade. At cardiac catheterization, the entire heart was displaced superiorly and anteriorly by the tumor mass, and this accounted for the observed cardiac hemodynamics, in the absence of discernible pericardial effusion.

ISSN:0098-6569    

DOI:10.1002/ccd.1810040111

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

年代:1978

数据来源: WILEY