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Biomedical subjects

A Nigri

Publications and source records attributed to A Nigri.

71 records · Page 4Linked to original sources

Coronary air embolism complicating accessory pathway catheter ablation: detection by echocardiography.

Percutaneous radiofrequency catheter ablation has been recently introduced for treatment of Wolff-Parkinson-White syndrome. Access to left free-wall atrioventricular accessory pathways can be obtained either via retrograde cardiac catheterization or via the transseptal procedure, which allows ablation of the accessory pathway at its ventricular or atrial insertion, respectively. We describe a patient with Wolff-Parkinson-White syndrome in whom coronary air embolism occurred as a complication of transseptal percutaneous radiofrequency catheter ablation. The diagnosis was made by two-dimensional echocardiography showing a marked echocontrast effect in the posterior wall and in the posterior half of the interventricular septum. A grossly evident breakage of the rubber seal of the vascular sheath was supposed to be the cause of air insinuation. This report suggests that the transseptal approach should be used with caution in performing percutaneous radiofrequency catheter ablation to avoid the risk of air embolization. Two-dimensional echocardiography is an ideal tool to detect this complication.

Adult↗

Correlation between angiographic success and functional improvement assessed by exercise test following percutaneous transluminal coronary angioplasty.

Sixty-one consecutive patients with stable effort angina and single vessel disease underwent successful (reduction of coronary stenoses by greater than or equal to 20%) percutaneous transluminal coronary angioplasty (PTCA). Anatomical results were analysed on the basis of functional evaluation obtained by exercise test (ET) 1 week before (pre-PTCA) and within 1 month after (post-PTCA) PTCA. Total exercise duration and maximal double product significantly increased after PTCA (4.5 +/- 1 min vs 6.9 +/- 1.5 min, p less than 0.001 and 14.1 +/- 3.6 x 1000 mmHg x bpm vs 18 +/- 4.2 x 1000 mmHg x bpm, p less than 0.001). Pre-PTCA ET was positive in 43 patients (70%) and post-PTCA ET in 15 (24%). In patients with post-PTCA positive ET, mean stenosis diameter reduction was significantly lower than that obtained in patients with negative post-PTCA ET (29.6 +/- 8.9% vs 61.1 +/- 18.8%, p less than 0.001). In conclusion, PTCA improved exercise tolerance in the majority of patients with myocardial ischemia, however the definition of anatomical success used in this study appears to be poorly correlated with functional improvement as assessed by ET.

Angioplasty, Balloon, Coronary↗