The risk of cardioembolic events and the role of anti-coagulation therapy in the management of patients with lone atrial flutter is not well defined in the medical literature. We report the case of an otherwise healthy 42-year-old man with chronic established atrial flutter, unassociated with any other heart disease or systemic illness, with transesophageal echocardiographic findings of a mobile left atrial appendage thrombus. The literature to date, potential mechanisms, and recommendations are discussed. The role of transesophageal electrocardiography and anticoagulation in atrial flutter may need to be considered more seriously, especially if atrial flutter has been present for a prolonged period of time.

Adult↗

PubMedDate not supplied

Serial prognostic capabilities of electrocardiographic indices of infarcted and hibernating myocardium in predicting short- and long-term outcome following coronary artery bypass surgery.

The present study was performed to test the hypothesis that patients with a large amount of ischemic (hibernating) myocardium are most likely to develop a perioperative myocardial infarction undergoing coronary artery bypass grafting (CABG). Furthermore, we evaluated the Selvester QRS scoring system as a postoperative prognostic tool. A relationship between a high amount of hibernating myocardium determined by ventriculographic and electrocardiographic investigations and an increased risk of perioperative myocardial infarction was found. The Selvester QRS scoring system used in diagnosing and prognosing after acute myocardial infarction was proven valid in predicting prognosis after CABG as well.

Adult↗

PubMedDate not supplied

Development and long-term fate of a cellular lining in fibrous polyurethane vascular prostheses implanted in the dog carotid and femoral artery. A scanning and light microscopical study up to 53 months after implantation.

The development and long-term fate of the inner cellular lining in 72 small caliber (3 mm inner diameter) fibrous polyurethane vascular prostheses explanted from dog carotid and/or femoral arteries at times ranging from 1.5 weeks up to 53 months after implantation were studied by scanning electron and light microscopy. A continuous cellular ingrowth from the vascular stumps into the 3 cm long prostheses was observed, which eventually resulted in a complete cellular lining 6 months after implantation. No other ways of endothelialization were noted. In fully endothelialized prostheses, the cellular ingrowth extended approximately 8 mm into the prostheses and consisted of several layers of fibroblasts and smooth muscle cells, covered by a very thin endothelioid cell layer. The newly developed lining was firmly anchored onto the inner prosthetic surface by means of cellular protrusions extended into the fibrous texture of the prosthetic wall. It was concluded that under experimental conditions in the dog complete endothelialization can be obtained in fibrous polyurethane vascular prostheses and that the lining remained thin and stable throughout the observation period of 53 months after implantation.

Anastomosis, Surgical↗

PubMedDate not supplied

Relation of serum lipoproteins and lipids to the ABO blood groups in patients with intermittent claudication.

UNLABELLED: In the present study we investigated the serum lipoprotein and lipid levels in patients with intermittent claudication (n = 66), divided according to their blood groups in the ABO system (bloodtype A, n = 40 and bloodtype "non-A", n = 26). We again found the expected predominance of blood type A (61%). However, we found no significant differences in any of the biochemical variables between patients belonging to blood group A and "non-A". Fifty-seven of the patients had arteriographies done and the arteriograms were evaluated blindly by a radiologist according to occlusive and stenotic atherosclerotic lesions. However, as previously suggested by other investigators, we were not able to demonstrate any significant differences between the number of occlusions and stenotic lesions when dividing the patients into blood group A and "non-A". The biochemical differences between patients with either occlusive or stenotic atherosclerotic lesions were also tested and found without any significance. IN CONCLUSION: the serum lipoprotein and lipid levels in the present study do not give an obvious explanation, why patients with blood group A seem more liable to develop atherosclerosis than those with blood group "non-A".

ABO Blood-Group System↗

PubMedDate not supplied

Endothelialization of polyurethane vascular prostheses implanted in the dog carotid and femoral artery.

A new type of vascular prosthesis made of polyurethane with a fibrous structure of the wall was implanted in the carotid and/or femoral artery of dogs. The healing process and neo-intima formation after implantation of this type of prosthesis was followed with light- and scanning electron microscopy. A total of 18 prostheses, which had been implanted for 1, 3, 6, 9 or 20 weeks were studied. Endothelial like cells invaded the prosthesis over the anastomoses, starting the first week after implantation. The growth zones advanced steadily, and prostheses measuring 3 cm in length were completely endothelialized by 20 weeks after implantation, a mean growth rate of the endothelial like cells of 0.09 mm/day. Subsequently, fibroblasts and smooth muscle cells grew between the neoendothelial layer and the prosthetic inner surface, forming a new multi-layered neo-intima. Cellular elements of the neo-intima were firmly anchored onto the inner wall of the prosthesis by cells with extending cytoplasmic protrusions between the fibers of the prosthetic wall. Since in this type of fibrous polyurethane prosthesis, endothelial like cells continually grew until a new lining was formed, apparently facilitated by the fibrous structure of the wall, further investigations are indicated for progression toward clinical implantation of this type of prosthesis.

Animals↗