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Biomedical subjects

M B Weiss

Publications and source records attributed to M B Weiss.

72 records · Page 4Linked to original sources
PubMed1975

Studies of regional myocardial perfusion in patients with coronary atherosclerosis, using xenon-133 and a multiple crystal scintillation camera.

Regional myocardial perfusion was measured in 164 patients at coronary arteriography. Washout of xenon-133 from multiple areas of the heart was monitored with a multiple crystal scintoooillation camera after tracer injection int the left or right coronary artery. Rate constants of radioisotope clearance were computed by monoexponential analysis of the initial portion of each washout curve. Regional myocardial blood flow rates in ml/100 g.min were calculated by the Kety formula. The pattern of local myocardial perfusion rates was compared to the coronary arteriogram obtained during the same study. In patients with normal coronary arteriograms, the average mean myocardial perfusion rate in the left ventricle (LV) significantly exceeded that of the right ventricle and the right atrial area. Mild heterogeneity of local myocardial flow rates in the LV was observed. In patients with essential hypertension, aortic stenosis, and aortic insufficiency, the average LV perfusion rates were similar to those of subjects with normal coronary arteriograms, pressures, and ventriculograms. The mean LV perfusion rates were significantly reduced in patients without coronary disease who had cardiomyopathy and cardiac failure.

Collateral Circulation↗
PubMedDate not supplied

Long-term clinical outcome of rescue balloon angioplasty compared with rescue stenting after failed thrombolysis.

Failed thrombolysis following acute myocardial infarction is associated with a poor prognosis. Balloon angioplasty with or without stenting is an established procedure in acute myocardial infarction and for failed thrombolysis (rescue percutaneous transluminal coronary angioplasty [PTCA]). Intracoronary stenting improves initial success rates, decreases incidence of abrupt closure, and reduces the rate of restenosis after angioplasty. The purpose of this study was to compare the effect of rescue PTCA with rescue stenting in the treatment of acute myocardial infarction after failed thrombolysis. Clinical data are from a retrospective review of 102 patients requiring rescue balloon angioplasty or stenting after failed thrombolysis for acute myocardial infarction. There was a greater incidence of recurrent angina in 11 patients (22%) in the rescue PTCA group versus 2 patients (4%) in the rescue stenting group. The in-hospital recurrent myocardial infarction rate was 14% in the rescue PTCA group versus 2% in the stented group. In the rescue PTCA cohort, 11 patients (22%) required in-hospital repeat revascularization versus 2 patients in the stented group. The in-hospital mortality rate was higher in the PTCA group (10%) versus that in the stent group (2%). There was no significant difference in the incidence of postdischarge deaths. Rescue stenting is superior to rescue angioplasty. The procedure is associated with lower in-hospital angina and recurrent myocardial infarction, and the need for fewer repeat revascularizations. Long-term patients treated with stents required fewer revascularization procedures. Overall, rescue stenting was associated with a significantly lower mortality.

Angioplasty, Balloon, Coronary↗
PubMedDate not supplied

Long-term clinical outcome of stenting in primary and rescue angioplasty in acute myocardial infarction.

Long-term clinical outcome after use of stents in primary and rescue coronary angioplasty for treatment of acute myocardial infarction has not been described in detail. This study was conducted to evaluate long-term (more than one year) outcome in patients treated for acute myocardial infarction with stents. Between January 1, 1997 and September 1997, 101 consecutive patients had coronary artery stents implanted either for primary treatment of myocardial infarction or after failed thrombolytic therapy. Medical records of these patients were reviewed and telephone follow-up was performed using a standard questionnaire. Mean duration of follow-up was 17.8 +/- 1.7 months. During initial hospitalization only one patient had emergent percutaneous transluminal coronary angioplasty due to stent thrombosis (1%); two patients underwent emergent coronary artery bypass surgery (2%) and two patients died (2%). During the follow-up period, ten patients (10%) had recurrent angina, eight patients were treated medically (8%), two required repeat angioplasty (2%), two patients died (2%), and three patients (3%) were lost to follow-up. Stenting of the culprit vessel during acute myocardial infarction appears to be a safe and effective treatment associated with favorable in-hospital and long-term outcomes.

Angioplasty, Balloon, Coronary↗
PubMedDate not supplied

Percutaneous transluminal coronary angioplasty (PTCA) combined with stenting improves clinical outcomes compared with PTCA alone in acute myocardial infarction.

Balloon angioplasty in acute myocardial infarction is an established procedure. The procedure is limited by the potential for early abrupt reocclusion (18-20%) and other complications. Coronary stenting improves the initial success rate, decreases the incidence of abrupt closure, and is associated with a reduced rate of restenosis. For these reasons, coronary stenting is increasingly utilized to treat acute myocardial infarction. The purpose of this study was to compare the effect of coronary stenting with percutaneous transluminal coronary angioplasty (PTCA) in the management of acute myocardial infarction. Clinical data from a retrospective review of 228 consecutive patients admitted with acute myocardial infarction who underwent primary or rescue coronary intervention were used. There was a significantly greater incidence of in-hospital recurrent myocardial infarction in the PTCA group (10%) versus the stented group (1%). In the PTCA cohort, 10 patients required in-hospital repeat revascularization by PTCA compared with one patient in the stented group. The in-hospital death rate was significantly higher in the PTCA group (8%) compared with the stented group (1%). There was no significant difference in the incidence of postdischarge death or repeated revascularization. The results suggest that patients who undergo PTCA with stent deployment have fewer episodes of in-hospital recurrent angina, myocardial infarctions, repeat angioplasties, and fewer in-hospital deaths. PTCA with stenting was associated with a low in-hospital mortality (1%). For patients who had PTCA alone and survived to be discharged, there was no significant difference in overall mortality or the need for revascularization over the 2-year follow-up period.

Angioplasty, Balloon, Coronary↗
PubMedDate not supplied

A case of a large coronary artery fistula in an elderly patient surgically corrected 12 years after initial diagnosis.

This case report discusses the natural history of a large coronary artery fistula in an elderly patient treated conservatively for 12 years. There has been no previous report of long term follow-up in a patient with a large coronary artery fistula with symptoms of congestive heart failure. The surgical management and clinical response to surgical correction will be discussed, and an extensive review of the literature will be performed.

Aged↗