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Biomedical subjects

W V Vieweg

Publications and source records attributed to W V Vieweg.

At least 127 records · Page 7Linked to original sources
PubMed1978

False aneurysms of the left ventricle. Identification of distinctive clinical, radiographic, and angiographic features.

False aneurysms of the left ventricle were observed in 14 patients. They were caused by obstructive coronary arterial disease with resultant myocardial infarction in 11, bacterial endocarditis in 1, a knife wound in 1, and disruption of a ventriculotomy in 1. Most of them extended posteriorly on the lateral radiograph, as opposed to the usual anterior position of true aneurysms. Enlargement was frequently observed on sequential studies. Angiography usually demonstrated involvement of the diaphragmatic or posterolateral segment due to occlusion of the right coronary artery; in contrast, true aneurysms are apical or anterolateral and are due to occlusion of the left anterior descending artery. The frequency of rupture of false aneurysms points up the importance of dinstinguishing them from true aneurysms.

Aged↗
PubMed1978

Evaluation of the in vivo function of the Hancock porcine xenograft in the aortic position.

We evaluated the vivo hemodynamic function of the stent-mounted glutaraldehyde-fixed porcine xenograft in 23 patients who had undergone aortic valve replacement from 2 days to 24 months prior to the study. Functional aortic valve orifice areas for the porcine xenograft ranged from 0.58 to 3.0 sq. cm., the average area being 1.36 sq. cm. Six patients had calculated prosthetic valve orifice areas less than 1.0 sq. cm. Valve orifice area did not correlate significantly with valve size or the time interval from surgery to postoperative study. Left ventricular stroke volume showed a significant, positive correlation with calculated xenograft orifice area. Systemic thromboembolism was not encountered. One patient required reoperation for xenograft stenosis caused by dense fibrin deposition on the aortic leaflets. We conclude that use of the stent-mounted glutaraldehyde-fixed porcine xenograft can be associated with significant functional stenosis which may be related to annulus size or inertial properties of the valve. These factors should be taken into consideration when considering use of the stent-mounted glutaraldehyde-fixed porcine xenograft in individual patients.

Adult↗
PubMed1977

Incidence and age distribution of patients with myocardial infarction and normal coronary arteriograms.

Over a 41 month period selective coronary arteriography was performed on all patients age 35 and under seen at our hospital with a documented myocardial infarction. In these 25 patients, 4 (16%) demonstrated no arteriographic evidence of coronary artery disease. One-hundred and fifty-two patients over age 35 with a documented myocardial infarction underwent selective coronary arteriography during the same period. In each of the 15 2 cases, obstructive coronary artery disease was demonstrated. The generally favorable prognosis of patients with myocardial infarction and normal coronary arteriograms has been previously documented. On the basis of our experience and a review of the literature, it is recommended that all patients age 35 and under sustaining a myocardial infarction should undergo selective coronary arteriography, in order to establish prognosis.

Adult↗
PubMed1977

Single left pulmonary vein with normal pulmonary venous drainage: association with partial anomalous pulmonary venous return.

An unusual case of a single left pulmonary vein draining the left lung and joining the left atrium without venous obstruction is reported. This anomaly occurred in association with partial anomalous pulmonary venous return from the upper lobe of the right lung to the superior vena cava. A similar case has been previously reported from our laboratory. The diagnosis of a single left pulmonary vein can be made by routine chest roentgenography because of the characteristic radiologic appearance of this anomaly. It is important to distinguish this benign entity from more ominous pulmonary radiodensities.

Adult↗
PubMed1977

Mediastinal teratoma masquerading as idiopathic enlargement of the right atrium.

A chest roentgenogram of an asymptomatic 22-year-old man revealed prominence of the right heart border characteristic of idiopathic dilatation of the right atrium. On further evaluation, a malignant teratoma was found. The importance of including teratoma and idiopathic enlargement of the right atrium in the differential diagnosis of abnormalities of the right heart border is discussed.

Adult↗
PubMed1977

Anomalous pulmonary venous return with intact atrial septum: diagnosis and pathophysiology.

Twenty-one patients with partial anomalous pulmonary venous drainage with intact atrial septum have been studied. These include 13 patients not previously reported from our laboratories and eight patients with complete hemodynamics reported by others. Methods for identification of this abnormality and for identification of an intact atrial septum are described, including differential indicator dilution curves, catheter probing of the atrial septum and pulmonary angiography. Blood flow through anomalously draining lobes of the lung is usually higher than through normally drainage lobes attributable to the higher pressure differences across the anomalous lung, right atrial pressure being uniformly lower than left atrial pressure. The pulmonary vascular resistance when "standardized" to the flow of blood normally present in different portions of the lung indicated that no significant differences existed between normally and anomalously draining lobes. Six patients had coexisting rheumatic mitral stenosis and one had congenital mitral stenosis. Its influence on the hemodynamic changes produced by PAPVD is discussed.

Adolescent↗
PubMed1977

Left ventricular function in massive pulmonary embolism.

Serial echocardiographic and angiographic measurements of left ventricular function were obtained in a patient with massive pulmonary embolism before and after pulmonary embolectomy. These data suggest that left ventricular dysfunction secondary to right ventricular failure is the results of markedly decreased left ventricular filling in this settings.

Echocardiography↗
PubMed1977

Safety of hot and cold liquids in patients with acute myocardial infarction.

Patients with acute myocardial infarction are frequently not fed hot and cold liquids because of possible deleterious effects on heart rate, blood pressure, and cardiac rhythm. In an attempt to identify and quantify such changes, hot liquid with a temperature in excess of 70 degrees C and cold liquid at an average temperature of 7 degree C were ingested by 20 patients within 36 hours of documented myocardial infarction and by 11 control patients with severe anginal episodes or chest wall syndromes. Heart rate and rhythm were continuously monitored during ingestion of the hot and cold liquids, and blood pressure was recorded intermittently. No patient in either group had a change in cardiac rhythm or an increase in ectopy during ingestion of the hot and cold liquids. Changes in blood pressure and heart rate were also not significant during liquid ingestion by patients with infarction and control patients. The practice of avoiding ingestion of hot and cold liquids by patients with acute myocardial infarction is not supported by these observations.

Arrhythmias, Cardiac↗
PubMed1977

Normal single coronary artery and myocardial infarction.

A single left coronary artery was found in an asymptomatic 21-year-old man who initially had electrocardiographic and vectorcardiographic evidence of anterolateral myocardial infarction. The single left coronary artery, which supplied the distribution of both the left and right coronary arteries, was free of disease at catheterization. There has been no previous association of a normal single left coronary artery and anterior myocardial infarction. Patients with the finding of a single coronary artery should be watched closely, as this may represent a potentially fatal condition.

Adult↗
PubMed1977

Electrographic exercise stress testing and coronary arteriography. Correlation among 114 men with chest pain.

The electrocardiographic response to exercise stress testing (EST) was compared with coronary arteriographic findings in 114 men referred for evaluation of chest pain. The men were divided into two groups: group A (69 men) in whom the coronary arteriograms showed at least one major vessel with greater than 70 percent reduction in cross sectional area, and group B (45 men) in whom there was no evidence of coronary arterial narrowing. In both groups A and B the description of chest pain was judged to be at least consistent with the diagnosis of angina pectoris if not always representing classical angina pectoris. Only men with a positive finding to EST and those with a negative EST response after achieving at least 90 percent of predicted maximum heart rate were included in the calculations. Our results were strikingly similar to those obtained from an extensive review of the literature and showed the following: sensitivity, 80.4 percent; specificity, 88.6 percent; predictive value of a positive test result, 91.1 percent; predictive value of a negative test result, 75.6 percent, and efficiency of the test 83.7 percent. The maximal EST is a useful predictor of coronary artery disease when a male population is evaluated for chest pain. When a population is selected on some basis other than chest pain (such as elevated lipids or age), EST is a much less useful predictor of coronary artery disease.

Angina Pectoris↗
PubMed1976

Caliber and distribution of normal coronary arterial anatomy.

Selective coronary arteriograms of 125 patients with normal coronary arteries were reviewed to establish the caliber and distribution of normal coronary arterial anatomy. Measurements established the following normal values for coronary arterial caliber in right (R), (M), and left (L) inferior emphasis systems expressed in mm (+/-SEM): (See article). Significant differences in the caliber of right coronary arterial systems and left circumflex coronary arterial systems validate the separation of coronary arterial anatomy into right, mixed, and left inferior emphasis systems, depending upon the blood supply to the inferior wall of the left ventricle. Classification of the anatomical pattern into right, mixed, and left inferior emphasis systems is useful in the cardiac catheterization laboratory at the time of selective coronary arteriography. If the expected distribution of the coronary vessels is not found, then missing vessels must be sought out. A knowledge of the range of normal size for the coronary arterial tree should be of value in defining the severity of coronary arterial narrowing.

Arteries↗
PubMed1976

Anomalous origin of the right coronary artery from the left sinus of Valsalva with associated chest pain: report of two cases.

Ectopic origin of the right coronary artery from the left sinus of Valsalva is an infrequent coronary anomaly. The right coronary artery then passes between the aorta and pulmonary artery. We report two such cases with chest pain suggestive of angina pectoris in the absence of atherosclerosis, as demonstrated by selective coronary arteriography. A technique for selectively catheterizing the ectopic right coronary artery is described.

Coronary Vessel Anomalies↗