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[The immediate and long-term prognosis following unprotected left main coronary artery stenting in Chinese--Chinese Registry of Unprotected Left Main Coronary Artery Stenting (CHANCE Study)].

OBJECTIVE: To evaluate the immediate and long-term outcomes of unprotected left main coronary artery (LMCA) stenting in Chinese patients and to approach the factors affecting the outcomes. METHODS: This was a multicenter retrospective registry study. From May 1997 to March 2003 all patients in 23 hospitals undergone elective unprotected LMCA stenting with bare metal stents were enrolled into the registry. All patients enrolled were filled in a Case Report Form. RESULTS: 224 patients were enrolled into the registry, including 166 male (74.1%) and 58 female (25.9%), with mean age of 60.1 +/- 12.0 (22 - 88) years. There were 53 cases (23.7%) with prior myocardial infarction (MI) and 45 cases (20.1%) with diabetes mellitus. Isolated LMCA stenosis was in 126 cases (56.2%) and combined with multivessel disease in 98 cases (43.8%). Mean left ventricular EF was 63.9% +/- 12.3%. Stents were successfully implanted into LMCA in 223 cases (99.6%) and into non-LMCA in 91 cases (92.9%). In-hospital death developed in 1 case (0.45%), now-Q wave MI in 1 case (0.45%). The patients were followed up to 15.6 +/- 12.3 months. Death developed in 12 cases (5.4%), including cardiac death in 10 cases (4.5%) and non-cardiac death in 2 cases (0.9%), MI in 4 cases (1.8%), TLR of LMCA in 26 cases (11.7%) and accumulated MACE in 36 cases (16.1%). LVEF < 40%, female and LMCA combined with multivessel disease increased mortality, combined multivessel diseases with incomplete revascularization increased MACE. Logistic regression analysis revealed that LVEF < 40% and female were independent predictors of cardiac death and MACE. Follow-up angiography was performed in 102 cases (45.7%). The binary restenosis rate was 31.4% (in 32 cases). CONCLUSION: Stenting for selected patients with unprotected LMCA stenosis is feasible and safe. Currently, unprotected LMCA stenting should be performed in patients with LVEF >or= 40% and isolated LMCA disease or LMCA combined with multivessel diseases in whom complete revascularization could be obtained or inoperable patients.

Adult↗

[Main features of helminth parasitism in cattle in Ituri (Haut-Zaire). III. Geographic distribution and prevalence of the main helminths].

A necropsic survey, carried out in eleven slaughterhouses in Ituri (Haut-Zaïre), has permitted to define the geographic distribution and prevalences of the main cattle helminths. Trematodes, except the paramphistomes, had a very heterogeneous distribution. Prevalence of Fasciola gigantica ranged from 9 to 72% according to the sites, but these variations were not linked to topographic or climatologic parameters. The infection with Schistosoma bovis was much variable as well (12.5 to 72%) and seemed absent from the central high altitude area. The occurrence of Dicrocoelium hospes was restricted to the northern part of Ituri with a moderate prevalence of about 35%. By contrast, nematodes had a fairly homogeneous distribution in Ituri. Prevalences were high for gastro-intestinal strongyles of the following genera, Haemonchus, Cooperia and Oesophagostomum (over 60%). Cysticercosis (Cysticercus bovis) occurred in 10 to 14% of cattle in the middle and south areas of Ituri whereas the north areas were nearly free.

Animals↗

[The diameter of main pancreatic duct on endoscopic retrograde pancreatography and the appearance of main pancreatic duct on computed tomography: a comparative study].

We have carried out a comparative study of the diameter of main pancreatic duct (MPD) on endoscopic retrograde pancreatography (ERP) with the frequency of detection of MPD by computed tomography (CT) in order to clarify the importance of MPD appearance on CT in the pancreatic and biliary diseases. The normal MPD on ERP was demonstrated by CT in a low frequency. MPD was most frequently observed in the pancreatic body on CT. The dilatation of MPD on ERP was found in both moderate and advanced pancreatitis group. However, the significant demonstration of MPD by CT was found in advanced group alone. We observed that CT finding of dilated duct correlated with that on ERP in advanced group alone.

Cholangiopancreatography, Endoscopic Retrograde↗

Angioplasty of the left main coronary artery for isolated left main coronary artery disease.

Operative technique and results of angioplasty of the left main coronary artery (LMCA) for isolated LMCA disease are reported. Nine consecutive patients, six men and three women, were operated upon. Their ages varied from 46 to 69 years, mean 51 years. All had 50% to 90% stenosis of the LMCA and Class III angina. Cardiopulmonary bypass and a cold cardioplegic solution were used for all operations. There were no operative deaths or infarctions. Follow-up ranged from 0.5 to 4 years, mean 1.9 years. Except for the first patient, who has new stenosis of the proximal anterior descending artery, all patients are free of angina. Repeat angiography in five patients showed a widely patent LMCA with excellent runoff. Our preliminary results suggest that angioplasty of the LMCA can be carried out with low operative risks. The technique appears to be a promising alternative to coronary artery bypass grafting in isolated LMCA disease.

Aged↗