Search PubMed⌕ Search

Biomedical subjects

L Wexler

Publications and source records attributed to L Wexler.

125 records · Page 7Linked to original sources
PubMedDate not supplied

Thromboembolic complications of percutaneous transluminal coronary angioplasty for myocardial infarction.

To determine the incidence of thromboembolic complications of percutaneous transluminal coronary angioplasty (PTCA) in the setting of recent and acute myocardial infarction, the clinical sequelae and coronary angiographic findings were examined in a series of 13 patients who underwent PTCA either as acute intervention during the infarction or as treatment for recurrent myocardial ischemia that occurred soon after the initial completed infarction. In all cases, the angiographic appearance in the infarct-related artery was that of thrombus in the setting of total or subtotal occlusion. Balloon dilatation without antecedent thrombolytic therapy, was performed in 14 arteries and was successful in establishing reperfusion with reduction of the degree of intraluminal narrowing to less than 50% in all cases. Residual thrombus at the site of inflation was noted in two cases (15%), and embolization was noted in four cases (29%), for an incidence of complication of 44%. In five of six instances in which either residual thrombus or embolization were noted, the initial infarction had occurred greater than 24 h before. In only one of seven cases in which PTCA was used as acute intervention during infarction of less than 4 h duration was the presence of residual thrombus noted after PTCA. Therefore, these findings suggest that thromboembolic complications after PTCA in the setting of recent or acute myocardial infarction are uncommon when the syndrome is less than 4 h duration; however, complications are relatively frequent when infarction has occurred greater than 24 h before. PTCA as a primary intervention in this latter setting should be approached cautiously.

Adult↗
PubMedDate not supplied

Revascularization of tracheal anastomosis following heart-lung transplantation.

The mechanism by which tracheobronchial arterial supply is reconstituted following heart-lung transplantation was investigated in seven monkeys (3 allografts, 2 autografts, and 2 nontransplanted control monkeys) and three patients. Descending tracheal branches of the thyrocervical arteries provided the major tracheal vascular supply. A collateral branch arising from atrial branches of the left coronary artery supplied tracheobronchial branches in the region of the carina in one allograft. In the three patients studied to date by coronary arteriography, a similar collateral supply to the region of the carina and proximal bronchi was demonstrated from atrial branches of both the left and right coronary circulation.

Adult↗
PubMedDate not supplied

Echocardiographic-like angled views of the heart by MR imaging.

Cardiac magnetic resonance (MR) imaging has developed rapidly to rival echocardiography as a noninvasive imaging modality. Anatomic detail may exceed that currently available using echocardiography techniques, and the ability to image moving protons may compete with Doppler color flow mapping in detecting valvular diseases and shunts. Because of the considerable clinical experience with echocardiography, as angled MR imaging planes become available as standard software packages, it may be useful for MR cardiac imaging to use standard, accepted echocardiographic nomenclature and imaging planes. This article describes the principles used to obtain long and short axis MR images that are comparable with echocardiographic imaging planes. Diagrams and illustrations are provided to orient the viewer using nomenclature common to echocardiography. These views may eventually be useful for functional analysis of the left ventricle and for detection and evaluation of valvular heart disease and intracardiac shunts.

Echocardiography↗
PubMedDate not supplied

Ambulatory post-operative care of patients following coronary artery bypass and valve replacement surgery: discussion and algorithms.

Patients who are seen for medical follow-up after coronary artery bypass graft (CABG) or valve replacement (VR) surgery often present with a complex array of complaints and can be difficult to assess. We provide a summary of the components of the surgical procedure, the associated post-operative problems and potential significant complications. In addition, as an aid to simplify and direct outpatient post-operative care, we present an algorithm which addresses the expected clinical features of post-operative patients, recommended routine follow-up diagnostic tests, signs, symptoms and appropriate screening procedures for significant post-operative complications and recommendations for rehabilitation and risk factor management. This approach is designed to enable the practitioner to address these complex patients with confidence and to assist them with positive lifestyle adaptations and risk factor reduction and to predict and prevent significant post-operative complications.

Ambulatory Care↗