We report on 11 patients with "very proximal" lesions out of a total of 300 consecutive patients who underwent percutaneous transluminal coronary angioplasty (PTCA). Eight patients had native left anterior descending (LAD) lesions and three had LAD saphenous vein grafts lesions. Lesions were considered to be "very proximal" when one half or more of the balloon was inflated in the left main coronary artery for the native LAD lesions or the aorta for the LAD coronary artery saphenous vein bypass graft (CABG) lesions. There was a mean reduction in stenosis from 88.3% (range 75-99) to 13.8% (range 0-60) and a mean reduction in transtenotic gradient from 47.2 mmHg (range 20-80) to 8.3 mmHg (range 0-20). The initial success rate was 90.9% (10 out of 11 patients) with a partial success in the other patient. No complications occurred in any of the patients. Two patients had restenosis (18.2%) at 3 months and 6 months, respectively, post-PTCA. It is concluded that "very proximal" lesions can be successfully dilated with a high initial success rate and low complication rate. Nevertheless, these lesions may present problems with guiding catheter stability and, because of the potential risk of circumflex (CX) occlusion, this vessel may have to be protected with a second guidewire.

Aged↗

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A modified hand injector for percutaneous transluminal coronary angioplasty.

This paper introduces a modified hand injector for percutaneous transluminal coronary angioplasty (PTCA). The new hand injector allows powerful injections to be performed through No. 8 or 9 French guiding catheters with little strain on the operator's hands. This device may reduce the time and cost of the procedure and would be useful in laboratories performing a high volume of PTCAs.

Angiography↗

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Analysis of the position of the left ventricular apex and base during systole.

The relative positions of the left ventricular apex and base in end-diastole (ED) and end-systole (ES) were determined in a group of normal individuals using cross-sectional echocardiography (group A) and in a group of patients with normal hemodynamics and angiographic parameters using cine-computed tomography (group B). In both groups no change was detected in the position of the epicardial aspect of the apex from ED to ES. The base moved in direction of the apex by 10.2% +/- 1.9% (mean +/- standard deviation) of the longitudinal dimension of the chamber in group A and by 12.9% +/- 5.1% in group B. In both groups the apical cavity was obliterated by the peri-apical walls. Apical obliteration is responsible for the apparent movement of the apical segment seen in cineventriculography.

Adult↗

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Cine-computed tomography of cor triatriatum.

A case of cor triatriatum in a 51-year-old man was demonstrated by rapid acquisition cine-CT (CCT). The CCT findings are compared with cardiac catheterization and two-dimensional echocardiography.

Cineradiography↗

PubMedDate not supplied

Resection of regrowth of a left atrial myxoma complicated by complete heart block three years following its primary resection.

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Blood Pressure↗

PubMedDate not supplied

Hemodynamic findings after mitral valve replacement with the Pyrolite Beall prosthesis.

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Adult↗