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J D Slack

Publications and source records attributed to J D Slack.

At least 19 recordsLinked to original sources
PubMed1992

Morphologic aspects of pericardial heart disease: Part I.

Pericardial heart disease is a common entity at necropsy. Frequently, focal areas of fibrin deposits or parietal-visceral pericardial adhesion are observed at necropsy without previous clinical evidence of pericardial dysfunction. Some of these instances are related to clinically silent acute or healed myocardial infarction, but the vast majority of cases are incidental (idiopathic) findings. The purpose of this review is to summarize various morphologic responses of the pericardium and to provide an etiologic framework for these responses. Part I will review general morphologic responses of pericardial layers.

Heart Diseases↗
PubMed1992

Morphologic aspects of pericardial heart disease: Part II.

Pericardial heart disease is a common entity at necropsy. Frequently, focal areas of fibrin deposits or parietal-visceral pericardial adhesion are observed at necropsy without previous clinical evidence of pericardial dysfunction. Some of these instances are related to clinically silent acute or healed myocardial infarction but the vast majority of cases are incidental (idiopathic) findings. The purpose of this review is to summarize various morphologic responses of the pericardium and to provide an etiologic framework for these responses. Part II will review specific morphologic responses of pericardial layers to selected diseases.

Cardiac Surgical Procedures↗
PubMed1992

Anatomy, histology, and pathology of coronary arteries: a review relevant to new interventional and imaging techniques--Part I.

In the last 15 years, intense interest has focused on various interventional pharmacologic and mechanical forms of therapy for the treatment of atherosclerosis coronary artery disease. Many techniques and devices (dilating balloons, perfusion catheters, thermal probes and balloons, lasers, atherectomy devices, stents, intravascular ultrasound) have been used or are under study for future use. Many of these techniques and devices require an understanding of histologic and pathologic features of the coronary arteries and diseases which affect them. This article reviews selective areas of anatomy, histology, and pathology relevant to the use of various new interventional techniques. Part I of this review will focus on anatomic aspects of the epicardial coronary artery system, coronary arterial distribution, myocardial supply, and histologic features of the normal coronary artery.

Angioplasty, Balloon, Coronary↗
PubMed1992

Anatomy, histology, and pathology of coronary arteries: a review relevant to new interventional and imaging techniques--Part II.

In the last 15 years, intense interest has focused on various interventional, pharmacologic, and mechanical forms of therapy for the treatment of atherosclerotic coronary artery disease. Many techniques and devices (dilating balloons, perfusion catheters, thermal probes and balloons, lasers, atherectomy devices, stents, intravascular ultrasound) have been used or are under study for future use. Many of these techniques and devices require an understanding of histologic and pathologic features of the coronary arteries and diseases which affect them. This article reviews selective areas of anatomy, histology, and pathology relevant to the use of various new interventional techniques. Part II of this four-part review will focus on aging changes seen in the epicardial coronary arteries and will review selected features of atherosclerotic plaque, including fissure and topography.

Angioplasty, Balloon, Coronary↗
PubMed1992

Anatomy, histology, and pathology of coronary arteries: a review relevant to new interventional and imaging techniques--Part III.

In the last 15 years, intense interest has focused on various interventional, pharmacologic, and mechanical forms of therapy for the treatment of atherosclerotic coronary artery disease. Many techniques and devices (dilating balloons, perfusion catheters, thermal probes and balloons, lasers, atherectomy devices, stents, intravascular ultrasound) have been used or are under study for future use. Many of these techniques and devices require an understanding of histologic and pathologic features of the coronary arteries and diseases which affect them. This article reviews selective areas of anatomy, histology, and pathology relevant to the use of various new interventional techniques. Part III of this four-part review focuses on eccentric and concentric plaques, formation of coronary thrombus, and status of the "infarct artery" after mechanical and pharmacologic forms of acute reperfusion therapy.

Angioplasty, Balloon, Coronary↗
PubMed1992

Anatomy, histology, and pathology of coronary arteries: a review relevant to new interventional and imaging techniques--Part IV.

In the last 15 years, intense interest has focused on various interventional pharmacologic and mechanical forms of therapy for the treatment of atherosclerosis coronary artery disease. Many techniques and devices (dilating balloons, perfusion catheters, thermal probes and balloons, lasers, atherectomy devices, stents, intravascular ultrasound) have been used or are under study for future use. Many of these techniques and devices require an understanding of histologic and pathologic features of the coronary arteries and diseases which affect them. This article reviews selective areas of anatomy, histology, and pathology relevant to the use of various new interventional techniques. Part IV of this review will focus on congenital coronary artery anomalies, myocardial bridges, coronary aneurysm, emboli, and dissection and clinical implications regarding echocardiographic imaging techniques.

Coronary Aneurysm↗
PubMed1992

Embolus in transit.

Since the advent of echocardiography, embolus in transit, historically found during surgical exploration or on postmortem examination, has been found with increasing frequency on antemortem examination. There is an inherent high mortality rate with this condition and awareness of the association between deep venous thrombosis and embolus in transit is paramount. On echocardiography the embolus is typically seen as a pleomorphic mass moving in a tumbling fashion. The most frequent symptoms are dyspnea and near syncopal episodes. The most common signs are diastolic "tumor plop" and a systolic ejection murmur heard on auscultation. Despite the success of some medical interventions, surgery should be strongly considered in patients with embolus in transit.

Aged↗
PubMed1991

Restenosis 1 to 24 months after clinically successful coronary balloon angioplasty: a necropsy study of 20 patients.

This report describes clinical, morphologic and histologic findings at necropsy late (range 1.6 to 24.1 months [average 8.2 months]) after clinically successful coronary balloon angioplasty in 20 patients with coronary angioplasty restenosis. Clinical evidence of restenosis occurred in 14 patients (70%), including 6 patients with sudden coronary death. Of the 20 patients, 14 (70%) had a cardiac cause of death and 6 (30%) had a noncardiac cause of death. Two major subgroups of histologic findings were observed: 1) intimal proliferation (60%), and 2) atherosclerotic plaque only (40%). Of the eight sites with atherosclerotic plaque only, six were eccentric lesions and two were concentric lesions. No morphologic evidence of previous angioplasty injury (cracks, breaks, tears) was observed in the eight patients with atherosclerotic plaque only. Proposed mechanisms for the development of intimal proliferation involve the reaction of smooth muscle cells and platelets, whereas elastic recoil of overstretched eccentric or concentric atherosclerotic lesions represents the most likely explanation for the findings in the latter subgroup. On the basis of these morphologic findings at angioplasty restenosis sites, specific treatment strategies for restenosis after coronary artery balloon angioplasty are proposed.

Angioplasty, Balloon, Coronary↗
PubMed1991

Morphological observations late (greater than 30 days) after clinically successful coronary balloon angioplasty.

This report describes clinical, morphological, and histological findings late (1.6-24.1 months [average, 8.2 months]) after clinically successful coronary balloon angioplasty in 20 necropsied patients with coronary angioplasty restenosis. Clinical evidence of restenosis occurred in 14 (70%) of patients, including six patients with sudden coronary death. Of the 20 patients, 14 (70%) had cardiac causes of death and six (30%) had noncardiac causes of death. Two major subgroups of histological findings were observed: 1) intimal proliferation (60%) and 2) atherosclerotic plaques only. Of the eight sites with atherosclerotic plaques only, six were eccentric lesions and two were concentric lesions. No morphological evidence of previous angioplasty injury (cracks, breaks, or tears) was observed in the eight patients with atherosclerotic plaques only. Proposed mechanisms for the development of intimal proliferation involve the reaction of smooth muscle cells and platelets, whereas elastic recoil of overstretched eccentric or concentric atherosclerotic lesions represents the most likely explanation for the findings in the latter subgroup. On the basis of these morphological findings at angioplasty restenosis sites, specific treatment strategies for coronary artery balloon angioplasty restenosis are proposed.

Angioplasty, Balloon, Coronary↗
PubMed1990

Tomographic views of normal and abnormal hearts: the anatomic basis for various cardiac imaging techniques. Part I.

Recent developments have taken place in the diagnosis of cardiovascular disorders in the area of cardiac imaging techniques. From a previous era of imaging by silhouettes (chest roentgenography, fluoroscopy, angiocardiography), we have emerged into an era of imaging by tomographic scanning (echocardiography, radionuclide tomography, computed tomography, magnetic resonance). A basic understanding of tomographic cardiac anatomy is the foundation for proper use and interpretation of these new imaging modalities. The present report provides a description of the techniques of tomographic cutting of necropsy cardiac specimens and illustrates some of the pathologic cardiac abnormalities cut in these tomographic planes. Part I of this report describes position of the heart and tomographic axis planes, preparation of the heart and methods of cutting at necropsy, and the short-axis, two-chamber, and four-chamber views of the heart.

Heart↗
PubMed1990

Tomographic views of normal and abnormal hearts: the anatomic basis for various cardiac imaging techniques. Part II.

Recent developments have enhanced the diagnosis of cardiovascular disorders in the area of cardiac imaging techniques. From an era of imaging by silhouettes (chest roentgenography, fluoroscopy, angiocardiography), we have emerged into an era of imaging by tomographic scanning (echocardiography, radionuclide tomography, computed tomography, magnetic resonance). A basic understanding of tomographic cardiac anatomy is the foundation for proper use and interpretation of these new imaging modalities. The present report provides a description of the techniques of tomographic cutting of necropsy cardiac specimens and illustrates some of the pathologic cardiac abnormalities cut in these tomographic planes. Part II of this report describes the long-axis method, methods using the body rather than the heart as the reference axis, and includes transverse, frontal, and parasagittal methods of imaging the heart.

Autopsy↗
PubMed1990

Cardiac myxoma: the Indiana Heart Institute experience.

Surgical resection of a cardiac myxoma was performed in 14 patients at the Indiana Heart Institute at St. Vincent Hospital and Health Care Center in Indianapolis from 1974 to 1989. Thirteen were located in the left atrium and one in the right atrium. The 10 women and four men ranged in ages from 28 to 75 years. Surgical complications included one perioperative death, one late death and one late recurrence requiring reoperation. Physicians must be highly suspicious to correctly diagnose this unusual but surgically correctable entity. Two-dimensional echocardiography is the diagnostic technique of choice for both early diagnosis of a cardiac myxoma and late follow-up after resection.

Adult↗
PubMed1990

Cardiac rupture following acute myocardial infarction: a case with successful surgical treatment.

This report involves a patient who sustained an acute lateral wall myocardial infarction complicated by cardiogenic shock. Cardiac catheterization revealed diastolic equilibration of all intracardiac pressures. Cardiac angiography revealed only acute occlusion of a small branch of the left circumflex coronary artery with good left ventricular systolic function. Since these findings could not explain the degree of cardiogenic shock, an immediate echocardiogram revealed a moderate pericardial effusion with an echo-dense mass suggestive of subacute cardiac rupture. Emergency cardiac surgery confirmed the diagnosis and successful surgical correction resulted in survival of the patient.

Cardiac Catheterization↗
PubMed1990

The signal averaged electrocardiogram: a practical primer.

Sudden cardiac death unfortunately continues to be a relatively common clinical problem despite recent advances in anti-arrhythmic medications, cardiac surgery and angioplasty. A non-invasive screening test capable of identifying specific patients at high risk for sudden cardiac death is needed. A technique using sophisticated electronic signal filtration and computerized signal enhancement permits analysis of the electrocardiogram for evidence of ventricular conduction delay, which may serve as a matrix for sustained ventricular tachycardia. This procedure, termed the signal averaged electrocardiogram, is reviewed. Its use in context with the left ventricular ejection fraction, Holter monitoring and exercise testing also is examined.

Arrhythmias, Cardiac↗
PubMed1989

Percutaneous transluminal coronary angioplasty: update 1988.

This report updates the current indications, techniques and investigational devices used in a busy interventional cardiology practice. Specific attention is devoted toward the problem areas of thrombolytic treatment of acute myocardial infarction, restenosis after angioplasty and the use of angioplasty in the treatment of multivessel coronary artery disease.

Angioplasty, Balloon, Coronary↗