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D Bialostozky

Publications and source records attributed to D Bialostozky.

45 records · Page 3Linked to original sources
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[Ligation of the inferior vena cava and the Mobin-Uddin filter in the treatment of recurrent pulmonary embolism. Comparative study].

Twenty six cases of inferior vena cava interruption for the treatment of recurrent pulmonary embolism are reviewed. Ten patients were treated with inferior vena cava ligation while in the other 16 a Mobin-Uddin umbrella was placed. The recent and late complications of both groups were analyzed. The most common complication of the inferior vena cava ligation was edema of the lower extremities in 40% of the patients. In the Mobin-Uddin group, the most frequent complication was the recurrence of thrombophlebitis in lower limbs, that appeared in 50% of the cases studied. We conclude that inferior vena cava ligation may be more beneficial to these patients because the long term complications are fewer in number and severity.

Edema↗
PubMedDate not supplied

[Right ventricular function in chronic obstructive pneumopathy with pulmonary cardiopathy. A study at the altitude of Mexico City (2240 meters)].

Hemodynamic studies at rest, at exercise and during oxygen breathing (FiO2 99.6%) were carried out in 12 patients with severe chronic obstructive lung disease and cor pulmonale without congestion (NOCA). All lived in Mexico city (2,240 meters). Our data confirm the concept of a spectrum of ventricular behaviour, from normal to the one when right ventricular pressure abnormalities exist and blood flow is restricted. The right ventricular stroke work index was considerably higher due mainly to the increase in pressure work. Grossly right ventricular performance at altitude is not different from the described at sea level. When stroke index (SI) is related to the right ventricular end diastolic pressure (RVEDP), patients with NOC at sea level show depressed right ventricular function. This relation was different for NOC-A and it could be related indirectly to higher altitude. On the basis of the relation found for SI-RVEDP at our altitude we could not conclude that NOC-A show depressed right ventricular function.

Aged↗
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[Myocardial viability].

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Angioplasty, Balloon↗
PubMedDate not supplied

[Simultaneous assessment of perfusion and myocardial viability with 2 isotope studies (thallium at rest and sestamibi in exercise). Initial experience in Mexico and Latin America].

UNLABELLED: Rest-stress sestamibi single photon emission computed tomography (SPECT) has sensitivity and specificity similar to those of thallium 201 SPECT for detection of coronary artery disease. However, sestamibi is not ideal agent to study myocardial viability. There is not published experience in Latin American using dual isotope SPECT protocol to evaluate myocardial perfusion and viability. We studied 44 consecutive patients with coronary artery disease, 37 of them with previous myocardial infarction. Coronary angiography was performed in all patients. We used a 3 mCi rest T 201 SPECT followed by stress and 25 mCi sestamibi injection. Sestamibi SPECT was performed 30 minutes after exercise or 1 hour after pharmacologic stress with dipyridamole. To validate perfusion findings patients returning next day for rest sestamibi injection and SPECT. Scintigraphic data were read by two blinded expert using 20 SPECT segment analysis and each segment was scored using 5 points scoring system (0 = normal, 4 = absent uptake). The segmental score agreement between rest thallium 201 and rest sestamibi and the comparison of defect reversibility percentage and non reversibility between both protocols was 90.7%. CONCLUSION: Separate acquisition dual isotope myocardial perfusion SPECT is accurate for coronary artery disease evaluation. It showed a good agreement with rest-stress sestamibi SPECT for assessment of rest perfusion defects and reversibility and it was a better method to evaluate myocardial viability.

Exercise Test↗
PubMedDate not supplied

[Usefulness of SPECT (single-photon emission-computed tomography) in the detection of coronary disease].

OBJECTIVE: To evaluate the clinical usefulness of cardiac SPECT in the detection of coronary artery disease, and the relation with the site, number and severity of the angiographic lesions. METHOD: We studied 216 patients; with myocardial perfusion imaging with SPECT (T1-201 and/or Tc-99 Sestamibi) and coronary angiogram. We defined the localization of myocardial perfusion defects (anterior, inferior, septal, lateral or apex), and their correlation with coronary angiogram, based on the location, number and severity of coronary angiographic lesions. We considered significative coronary stenosis obstructions of 60% or more. RESULTS: Of the 216 patients studied, 181 (83.8%) were male and 35 (16.2%) female. Age ranged between 30 and 82 years; 143 males and 23 females had a previous myocardial infarction. The SPECT sensitivity for diagnosing ischemia of one, two and three vessel disease was 94%, 96% and 100%. The sensitivity for diagnosing disease in specific vascular territories was 91.6% for LAD 100% for RCA, 92.8% for CX and 100% for left main. CONCLUSIONS: Myocardial perfusion imaging with SPECT has high sensitivity for diagnosing coronary artery disease. The sensitivity and specificity were more accurate in proximal anterior descending artery disease, left main and three-vessel coronary artery disease. We found correlation in the site, number and severity of the angiographic lesions and in myocardial perfusion defects.

Adult↗