Search Results
Results 501 - 550 of 1077
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Izutani Hironori - - 2004
BACKGROUND: The surgical approach to transmyocardial laser revascularization (TMR) via thoracotomy has been approved for the treatment of angina in inoperable patients, but it has had limited use as a stand-alone procedure. OBJECTIVES: To assess the feasibility and efficacy of robotically assisted endoscopic TMR using the Zeus robotic surgical system ...
Penny W F - - 2004
Anginal symptoms due to myocardial ischemia continue to affect millions of patients despite ongoing improvements in the diagnosis and treatment of coronary artery disease. Revascularization therapy with percutaneous coronary interventions and coronary artery bypass graft surgery can be highly effective in eligible subjects, but many patients are suboptimal candidates due ...
Han Hai-Chao - - 2004
An important goal of cardiac revascularization is to improve the left ventricular ejection fraction, which is an important clinical determinant of the long-term outcome for patients with coronary artery disease. Regional myocardium function improvement may be expected from revascularization when viable myocardium is detected using non-invasive cardiac imaging. However, the ...
Yüceyar Lale - - 2004
PURPOSE: To determine the effect of epidural anesthesia (EP) on oxygenation of the chronically ischemic limb in patients undergoing aorto-femoral bypass grafting and to assess whether it produces an alteration of lipid peroxidation and antioxidant status following revascularization. METHODS: In this prospective, randomized, single-blinded study 40 ASA II or III ...
Seidel Judy E - - 2004
BACKGROUND: The centralization of health care services has numerous potential benefits but April compromise access for individuals living in remote areas. OBJECTIVES: To examine the association between a patient's place of residence and the likelihood of undergoing a coronary revascularization procedure within one year after cardiac catheterization. METHODS: All Alberta ...
Ebersole Douglas - - 2004
Patients who develop acute myocardial infarction due to occlusion in a saphenous vein graft (SVG) constitute a revascularization challenge. Excimer laser angioplasty may have a potential advantage in the treatment of SVGs, since its 308 nanometer wavelength is avidly absorbed by both atherosclerotic plaque and thrombus. The data presented herein ...
Coutu Marianne - - 2004
Since surgical correction of congenital heart diseases began in the early 1950s, a growing number of patients are reaching older age and becoming a risk for developing coronary artery disease. This study presents the clinical experience of myocardial revascularization in 4 symptomatic coronary artery disease patients with unrepaired or corrected ...
McConnell Patrick I - - 2004
Historically, few patients with ischemic congestive heart failure (CHF) have been considered for cardiac surgical intervention unless there was an obvious need for coronary revascularization or valve repair. New surgical procedures and non-mechanical assist devices are being used and tested in patients with end-stage CHF. We report on The Ohio ...
Svorkdal Nelson - - 2004
Intractable angina from refractory coronary disease is a severe form of myocardial ischemia for which revascularization provides no prognostic benefit. Inoperable coronary disease is also accompanied by a "vicious cycle" of myocardial dystrophy from a chronic alteration of the cardiac sympathetic tone and sensitization of damaged cardiac tissues. Several adjunctive ...
Nikolsky Eugenia - - 2004
The long-term prognosis of diabetic patients with multivessel coronary artery disease (CAD) treated by surgical or percutaneous coronary revascularization is significantly worse as compared to non-diabetics. Lower rates of complete revascularization may be one factor that influences the poor long-term outcome in the diabetic population. Our study assessed the impact ...
Beek Johan F - - 2004
OBJECTIVES: This study was designed to investigate whether transmyocardial laser revascularization induces myocardial denervation and to correlate this with myocardial perfusion and clinical status. METHODS: Transmyocardial laser revascularization was performed with a Holmium:YAG (n = 3) or xenon chloride excimer laser (n = 5). Preoperative and postoperative iodine 123-labeled meta-iodobenzylguanide ...
Kozàkovà Michaela - - 2004
BACKGROUND: The recovery of left ventricular function (LVF) after revascularization takes time. alpha-Adrenergic blockade acutely improves coronary blood flow and LVF, whereas the effects of more prolonged alpha-adrenergic blockade on LVF recovery after stenting are unknown. METHODS: In 32 patients (age 58 +/- 12 y) with an 82% +/- 6% ...
Eckart Robert E - - 2004
BACKGROUND: Extracellular matrix remodeling is a component of coronary artery disease (CAD). Matrix metalloproteinases (MMPs) are enzymes involved in extracellular matrix degradation. The extrapolation of the role MMPs play in the clinical setting of acute coronary syndromes has not yet been defined. METHODS: Samples from 100 subjects undergoing cardiac catheterization ...
Westaby Stephen - - 2004
This article first discusses coronary artery disease, including left-ventricular dysfunction, hibernating myocardium, the relationship between stunning, hibernation, and heart failure, and molecular mechanisms underlying myocardial hibernation. Left ventricular function and the prognosis and pathophysiology of left-ventricular dysfunction are then examined. Selection of patients for revascularization is discussed, to include which ...
Bonanomi G - - 2004
Dextrocardia is a rare condition not spared by coronary artery disease. We report the case of a 72-year-old patient with dextrocardia associated with situs inversus totalis who presented to our Institution with acute myocardial infarction complicated by congestive heart failure. Due to the severe general conditions of the patient, an ...
Fukuda Shota - - 2004
BACKGROUND: Quantitative intravenous myocardial contrast echocardiography (MCE) has been shown to measure regional myocardial blood flow velocity noninvasively. PURPOSE: To determine whether quantitative intravenous MCE could be used clinically to predict functional recovery after revascularization in patients with chronic coronary artery disease. METHODS: Twenty-eight patients with chronic stable coronary artery ...
Erdil Nevzat - - 2004
We report the case of a 51-year-old man who underwent arterial myocardial revascularization with the use of bilateral radial arteries, 17 years after undergoing a right pneumonectomy. We used a fast-track anesthesia protocol for the procedure. There was no perioperative complication, and postoperative recovery was uneventful. The patient was discharged ...
Horvath Keith A - - 2004
Transmyocardial laser revascularization (TMR) is a technique that has been performed on over 10,000 patients around the world. Most of the patients were not suffering from heart failure. TMR is principally used for the treatment of angina, but in patients with significant reversible ischemia that is not amenable to conventional ...
Pittarello D - - 2004
BACKGROUND: Optimum transfer of energy from the left ventricle to the arterial circulation requires appropriate matching of these mechanical systems. Left ventricular-arterial coupling describes this relationship between the ventricular elastance (Ees) and arterial elastance (Ea). The ratio of these elastances defines the efficiency of myocardium and provides in our study ...
Syed Imran S - - 2004
The use of angiogenic factors to effect therapeutic angiogenesis may be an attractive treatment modality for a substantial number of patients who have diffuse coronary artery disease and who are not candidates for traditional revascularization procedures. Delivery of angiogenic factors as a protein or gene encoding for the respective protein ...
Schinkel Arend F L - - 2004
Contractile function in patients with ischemic left ventricular (LV) dysfunction may improve after myocardial revascularization. Currently, the incidence of contractile function recovery after revascularization in these patients is unclear. The aim of this study was to assess the incidence of function improvement after myocardial revascularization in patients with ischemic LV ...
Samuels Louis - - 2004
Coronary artery bypass and percutaneous intervention have become the established methods of coronary revascularization in treating angina pectoris. Subsets of angina patients, however, are not amenable to either of these procedures. Transmyocardial laser revascularization (TMR) has been developed as a potential treatment to address such patients, and clinical research to ...
Quigley Robert L RL Division of Cardiothoracic Surgery, Albert Einstein Medical Center, Jefferson Health System, Philadelphia, Pennsylvania 19141, USA. - - 2004
Diffuse and distal left anterior descending (LAD) coronary disease that is refractory to conventional surgical and/or percutaneous revascularization represents a clinical and economic dilemma. Transmyocardial laser revascularization (TMLR) has improved angina without clear measurable improvement of myocardial perfusion. This study was undertaken to determine if combining a Vineberg implant with ...
Ouriel Kenneth - - 2003
Acute peripheral arterial occlusion is associated with great risk to the patient's limb and life. Failure to restore adequate arterial flow in a timely fashion can result in the development of irreversible tissue infarction and the opportunity for limb salvage is lost. On the other hand, patients with acute limb ...
Washington Donna L - - 2003
BACKGROUND: Clinical practice guidelines quickly become outdated. One reason they might not be updated as often as needed is the expense of collecting expert judgment regarding the evidence. The RAND-UCLA Appropriateness Method is one commonly used method for collecting expert opinion. We tested whether a less expensive, mail-only process could ...
Beanlands Rob - - 2003
Patients with severe ventricular dysfunction and coronary disease have high morbidity and mortality. They may benefit from revascularization but have significant perioperative morbidity and mortality. Positron emission tomography (PET) imaging with F-18-fluorodeoxyglucose (FDG) can detect viable myocardium that may recover from revascularization in such patients. It is unclear whether use ...
Jones J W - - 2003
AIM: The therapeutic mechanism of transmyocardial revascularization (TMR) is not yet fully understood, and continues to be a subject of controversy and active research. Immediate direct laser channel flow, gradual angiogenesis, denervation, and perioperative infarction of the ischemic area have been all discussed, without clear evidence indicating superiority of individual ...
Rathore Saif S SS Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, - - 2003
To determine if there are sex differences in the use of coronary revascularization in elderly patients after acute myocardial infarction (AMI), and if sex differences vary by type of revascularization therapy. Retrospective analysis of medical record data. US acute-care nongovernment hospitals. A total of 66,830 Medicare patients > or =65 ...
Brophy James M - - 2003
In clinical trials, cholesterol-lowering medications have been proven to decrease mortality and morbidity and are strongly recommended as secondary prevention for patients with established coronary artery disease. Whether physicians and patients follow this recommendation is unknown. Our objective was to determine the rate at which patients fill at least one ...
Kleiman Neal S - - 2003
Stable angina pectoris secondary to ischemic heart disease is a common and disabling condition. Medical therapy aims to relieve symptoms, improve exercise capacity, and decrease cardiac events by reducing myocardial oxygen demand or improving coronary blood supply to the ischemic myocardium. If medical treatment is inadequate, invasive revascularization procedures to ...
Coleman Kenneth A - - 2003
BACKGROUND: Patients considered for electrophysiologic study (EPS) are often first referred for stress myocardial perfusion scintigraphy (MPS) to assess for inducible ischemia before testing. The purpose of this investigation was to determine the utility of this approach by examining the relationship between MPS and any interim cardiac catheterization and revascularization, ...
Shah Pallav J - - 2003
OBJECTIVE: The aim was to prospectively analyze all-cause mortality, predictors of survival, and late functional results after myocardial revascularization for ischemic cardiomyopathy over a 10-year follow-up. METHODS: We prospectively studied 57 patients with stable coronary artery disease and poor left ventricular ejection function (<35%), enrolled between 1989 and 1994. Stress ...
Eckart Robert E - - 2003
Clinical trials have found increased morbidity in elderly persons presenting for percutaneous coronary intervention for chronic stable angina. Long-term follow-up is limited for the elderly following percutaneous coronary intervention. The authors reviewed all coronary interventions performed from January 1998 to August 2001. One year following the procedure, subjects were screened ...
Fang Jing - - 2003
PURPOSE: The use of coronary revascularization among patients with myocardial infarction varies by race/ethnicity and socioeconomic status. The objective of this study was to determine whether local availability of facilities might influence apparent racial disparities in revascularization and health outcomes. METHODS: Using Statewide Planning and Research Cooperative System data (1988-1999) ...
Hachamovitch Rory - - 2003
OBJECTIVES: The objective of this work was to define the relationship between left ventricular perfusion/ function measures and referral rates to catheterization and revascularization early after stress gated myocardial perfusion single-photon emission computed tomography (MPS). BACKGROUND: Although revascularization yields the greatest survival benefit in patients with low ejection fraction (EF) ...
Guzzetti Stefano - - 2003
BACKGROUND: Percutaneous myocardial revascularization with laser (PMR) is a catheter-based technique that has generated much interest in the treatment of patients with severe coronary artery disease. Several mechanisms have been proposed to explain the reported clinical benefits of this technique. Cardiac autonomic denervation is among these. METHODS: We studied 32 ...
Gupta Milan - - 2003
BACKGROUND: Revascularization rates vary substantially between countries in patients with acute ST-elevation myocardial infarction (STEMI). The impact of early revascularization on clinical outcomes in such patients remains uncertain. The ASSENT-2 fibrinolytic trial provides the opportunity to compare revascularization rates following STEMI in patients across 29 countries, and to explore the ...
Garza Juan J - - 2003
Coronary artery revascularization by either percutaneous coronary intervention or coronary artery bypass graft surgery in patients >/=80 years of age can be accomplished with acceptable in-hospital and 2-year clinical outcomes. However, up to 20% of patients have a prolonged recovery and are unable to immediately return home. It is important ...
Marelli Daniel - - 2003
OBJECTIVE: Cardiac allografts with coronary artery disease may permit a selective expansion of the donor pool. Twenty-two recipients who received donor hearts with mild to moderate coronary artery disease on angiography were reviewed. All donor organs had preserved left ventricle function on echocardiogram. METHODS: The procedure was explained to the ...
Keeley Ellen C - - 2003
Ischemic heart disease is the most common cause of death in patients with chronic kidney disease (CKD). Patients with CKD who develop an acute coronary syndrome (ACS) have a poor prognosis, with >70% mortality at 2 years. Despite this heavy burden of disease, the optimal management of ACS in this ...
Almeda Francis Q - - 2003
Although there have been remarkable advances in medical therapy, percutaneous coronary interventions, and coronary artery bypass graft surgery, complete revascularization remains a challenge given the more complex coronary artery disease prevalent in contemporary practice. The lack of donors for cardiac transplantation will fuel the search for effective alternative strategies for ...
Dabal Robert J - - 2003
BACKGROUND: The purpose of this study was to determine whether use of the left internal mammary artery (LIMA) during coronary revascularization influences short-term morbidity in all patients undergoing revascularization, as well as in patients over the age of 75 years, female patients, and patients with diabetes. The study also explored ...
Luft Harold S - - 2003
To assess revascularization and mortality after acute myocardial infarction (AMI) for all Medicare patients in fee-for-service (FFS) and health maintenance organization (HMO) settings in California. Hospital discharge abstract and death certificate data linked with Medicare enrollment files for patients aged 65 and over with Medicare coverage (69,040) discharged from a ...
Bhatt Deepak L - - 2003
Inflammation is increasingly recognized as having an important role in patients with acute coronary syndromes. We sought to determine whether an elevated white blood cell (WBC) count would predict subsequent mortality and whether revascularization would have a protective effect. We analyzed data from 10,480 patients with acute coronary syndromes enrolled ...
Ruel Marc - - 2003
Therapeutic angiogenesis, in the form of growth factor protein administration or gene therapy, has emerged as a new method of treatment for patients with severe, inoperable coronary artery disease. Improved myocardial perfusion and function after the administration of angiogenic growth factors has been demonstrated in animal models of chronic myocardial ...
Meluzín Jaroslav - - 2003
The aim of this study was to assess the prognostic value of the amount of dysfunctional but viable myocardium in revascularized patients with coronary artery disease and left ventricular dysfunction. To quantify the amount of dysfunctional but viable myocardium, low-dose dobutamine echocardiography was performed. The wall motion was scored using ...
Guleserian Kristine J - - 2003
BACKGROUND: The purpose of this investigation was to assess postoperative survival and quality of life with transmyocardial laser revascularization (TMR) in high-risk patients. METHODS: During a 24-month period, 81 consecutive patients underwent either sole therapy TMR (n = 34) or TMR with coronary artery bypass grafting (n = 47) using ...
Ricotta J J - - 2003
In this article we will review some of the issues surrounding the prevention of neurological and cardiac morbidity in patients with combined coronary and carotid disease and discuss the role of various algorithms of care. Advances in medical care have resulted in a significant prolongation of life. Since atherosclerosis is ...
Muxí Africa - - 2003
OBJECTIVE: Transmyocardial laser revascularization is a new technique that improves symptoms in patients with refractory angina not amenable to conventional revascularization. The aim of this study was to assess whether transmyocardial laser revascularization produces changes in innervation, perfusion scintigraphy, or both that could explain the benefit to patients. METHODS: Sixteen ...
Sadeghi H Mehrdad - - 2003
Successful percutaneous intervention of unprotected left main coronary artery (LMCA) in lieu of surgical revascularization represents the next wave of challenges that the field of interventional cardiology will try to overcome. Significant LMCA stenosis, commonly secondary to atherosclerosis, is seen in about 4-10% of cases presenting to the cardiac catheterization ...
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