Biomedical subjects

D Clitsakis

Publications and source records attributed to D Clitsakis.

3 recordsLinked to original sources

PubMed1985

Endocardectomy for the surgical treatment of endocardial fibrosis of the left ventricle.

Two patients with endomyocardial fibrosis of the left ventricle were treated by endocardectomy plus mitral valve replacement. In both cases the results of surgery were satisfactory. No consequences related to eosinophilia, which was present before operation in one of them, were noted. The poor prognosis of this progressive disease and the inefficiency of medical treatment compared with the good surgical results already reported from various centres encourage early operation for all patients with endomyocardial fibrosis who have symptoms. Because of the pathophysiology of the disease, endocardectomy should be attempted in all cases and anti-coagulant treatment continued for life.

Adult↗

PubMed1982

Normal coronary arteriogram. An avoidable test?

Between 10 and 20% of coronary arteriograms in patients with chest pain show normal vessels, often in association with a history of "atypical" angina. Conventional non-invasive tests are inaccurate in this group of patients compared with those with classical angina. This study prospectively evaluates combined 12 lead exercise electrocardiography and thallium-201 scintigraphy as a screening test in patients with atypical angina in order to determine whether normal arteriograms are avoidable in this important subgroup of patients presenting with chest pain. Sixty seven consecutive patients with atypical angina underwent both maximal exercise testing and thallium scintigraphy before coronary arteriography. Chest pain during exercise was a poor predictor of coronary disease in this group. Eleven (16%) had abnormal arteriography, with the sensitivity of exercise and thallium tests being 45% and 73%, respectively. When both tests were applied the predictive accuracy for normal coronary arteries was 96% (54/56) and that for the presence of coronary disease was 82% (9/11). If coronary arteriography was withheld in patients in whom both the exercise test and thallium scintigraphy were negative, the number of normal coronary arteriograms could be reduced with only a very small risk of failing to detect individuals with coronary disease.

Adult↗

PubMed1981

Effect of stenosed and occluded coronary arteries on immediate and late myocardial uptake of thallium-201.

Exercise and redistribution myocardial scintigraphy using thallium-201 was compared with the left ventricular angiogram and with the presence of stenosis or occlusion of coronary arteries on angiography. Irreversible scintigraphic defects representing areas of myocardial infarction were found in all patients with occlusion of the left anterior descending artery but nearly one-third of patients with stenosis of that artery also showed evidence of infarction. For the right coronary or circumflex arteries the incidence of infarction was 82% with vessel occlusion and 57% with vessel stenosis. Of abnormally contracting segments on the left ventricular angiogram, 95% showed irreversible scintigraphic defects but 33% of normally contracting segments supplied by a diseased artery also showed this. Myocardial infarction is not uncommon in patients with angina even in the absence of coronary occlusion. The incidence is underestimated by the left ventricular angiogram. These findings are of importance in the assessment of patients with coronary disease and their evaluation before coronary artery surgery.

Angiocardiography↗