Search Results
Results 401 - 450 of 1077
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Di Giammarco Gabriele - - 2006
BACKGROUND: The aim of this retrospective study was to evaluate the safety and efficacy of left anterior small thoracotomy for treatment of isolated chronic total occlusion of the left anterior descending artery. METHODS: From November 21, 1994, to December 31, 2002, 143 patients with isolated left anterior descending artery chronic ...
Shaw Leslee J - - 2006
BACKGROUND: Stress gated myocardial perfusion single photon emission computed tomography (gSPECT) is increasingly used before and after intercurrent therapeutic intervention and is the basis for ongoing evaluation in the Department of Veterans Affairs clinical outcomes utilizing revascularization and aggressive drug evaluation (COURAGE) trial. METHODS AND RESULTS: The COURAGE trial is ...
James Stefan K - - 2006
OBJECTIVES: This study was designed to evaluate biomarkers for selection of patients with non-ST-segment elevation acute coronary syndromes (ACS) that derive mortality benefit from revascularization. BACKGROUND: Biomarkers are essential for identification of patients at increased risk, which may be reduced by revascularization. METHODS: During the initial 30 days, 2,340 patients ...
Lanzer P - - 2006
AIMS: The aim of this study was to document the early outcome of coronary-like revascularization for atherosclerotic renal artery stenosis (ARAS). METHODS AND RESULTS: A total of 181 consecutive patient, 102 men, mean age 66.1 (+/- 9.2) years and 79 females, mean age 68.4 (+/- 9.2) years and 198 lesions ...
Tsuyuki Ross T - - 2006
Although practice guidelines recommend coronary revascularization for patients with heart failure, the evidence to support this recommendation is weak. The objective of our study was to determine the association of coronary revascularization with survival in patients who have had heart failure. Data were obtained from the Alberta Provincial Project for ...
Kertai M D - - 2006
Cardiac complications are the leading cause of peri-operative morbidity and mortality of patients undergoing vascular surgery. This high incidence of cardiac complications is related to the presence of underlying coronary artery disease. The optimal treatment strategy for these high-risk patients, including the use of pre-operative coronary revascularization for the purpose ...
Yang Felix - - 2006
INTRODUCTION: Female gender has been associated with worse clinical outcomes following coronary revascularization. Whether a gender-specific difference in vessel size is contributing to this finding remains controversial. We sought to better define the relationship between gender and coronary artery size. METHODS: Baseline characteristics were obtained and quantitative coronary angiography was ...
Barnhart Janice M - - 2006
Racial/ethnic and sex disparities in coronary heart disease treatment exist. We previously reported that physicians perceive non-clinical variables, such as a patient's desire for a second opinion, as affecting revascularization decisions. The results of that study are further examined here, using factor analysis to identify significant interrelationships among the non-clinical ...
Brunsting Louis A LA - - 2006
We describe the first use of totally endoscopic, off-pump, robot-assisted transmyocardial laser revascularization in a 58-year-old man with refractory rest angina who had undergone two prior coronary bypass operations. Preoperative testing revealed reversible ischemia of the left ventricular apex with diffuse coronary atherosclerotic disease not suitable for further treatment by ...
Danchin Nicolas - - 2006
As patients with coronary artery disease live longer and more often reach the stage where further myocardial revascularization procedures can no longer be performed, efficacious and well-tolerated antianginal medications are needed. Metabolic agents offer the advantage of controlling symptoms without untoward hemodynamic effects. This article reviews the epidemiology of stable ...
Levitsky Sidney - - 2006
BACKGROUND: Using the ischemic myocardial cell as a paradigm, competitive coronary revascularization technologies will be analyzed for their potential in causing additional myocardial cell damage during the course of therapeutic procedures. METHODS AND RESULTS: Percutaneous coronary intervention (PCI) using balloon and/or stent (bare metal or coated) approaches may be associated ...
Lindstaedt Michael - - 2006
BACKGROUND: Correct assessment of the significance of left main stem lesions is of pivotal importance to the patient with coronary artery disease. On the basis of clinical and angiographic information alone, this evaluation often cannot be done reliably. Limited data suggest that coronary pressure-derived fractional flow reserve (FFR) supports decision ...
Guida Máximo C - - 2006
BACKGROUND: Off-pump coronary artery bypass is commonly performed through a full median sternotomy; however, the tendency to reduce surgical trauma has stimulated cardiac surgeons to use less invasive techniques for single-vessel disease. The use of thoracotomy for reoperative and valvular surgery has also been reported, but its application in primary ...
Raghunathan Amritha - - 2006
To determine the perioperative mortality, myocardial infarction rate, and long-term survival of patients with critical limb ischemia (CLI) compared with those with intermittent claudication (IC) within a cohort selected for significant coronary artery disease, a secondary analysis was conducted of a prospective, randomized, multicenter trial of Coronary Artery Revascularization Prophylaxis ...
Tabata Mimiko - - 2006
OBJECTIVES: Recently off-pump coronary artery bypass grafting (CABG) is being widely used for coronary revascularization. However, there is some evidence that off-pump surgery increases the risk of recurrent angina and the need for reintervention, suggesting poor graft quality or incomplete revascularization. We describe our experience to demonstrate the feasibility of ...
Popescu Ioana - - 2006
CONTEXT: Certificate of need regulations were enacted to control health care costs by limiting unnecessary expansion of services. While many states have repealed certificate of need regulations in recent years, few analyses have examined relationships between certificate of need regulations and outcomes of care. OBJECTIVE: To compare rates of coronary ...
Cigarroa Joaquin E - - 2006
An ever-growing number of patients are being referred for coronary revascularization in an attempt to reduce morbidity or to reduce mortality. Multiple randomized trials comparing percutaneous and surgical coronary revascularization have been performed. The decision to proceed with percutaneous or surgical revascularization should be based ona thorough understanding of the ...
Hau William K - - 2006
The pressure-derived fractional flow reserve (FFR) is a valuable and well validated index for assessing the ischemic significance of coronary lesions. The 0.75 cutoff value of FFR discriminates between lesions with and without ischemic potential, helps decision making as to whether to revascularize a coronary stenosis and assists in evaluating ...
Baciewicz Frank A - - 2006
We present a female Jehovah's Witness patient with concomitant severe left main and left anterior descending coronary artery disease and pheochromocytoma who underwent successful off-pump myocardial revascularization. Perioperative management of this patient included alpha-blockade with Doxazosin followed by beta-blockade with Metoprolol. A short-acting Phentolamine was used for alpha-blockade before surgery. ...
Kaul Padma - - 2006
AIMS: To examine the relationship between revascularization within 7 days and 1-year mortality among ST-elevation myocardial infarction patients enrolled in GUSTO-V trial (n=13 451). To examine the relative contribution of system and patient level factors to the variation in international revascularization rates, and their impact on mortality outcomes. METHODS AND ...
Allen Keith B - - 2006
Transmyocardial revascularization, using the US FDA-approved holmium: yttrium-aluminum-garnet (Ho:YAG) laser system, is a surgical option for patients with debilitating angina caused by diffuse coronary artery disease in areas of the heart not amenable to complete revascularization using conventional treatments. Increased utilization of this therapy is warranted, in parallel with continuing ...
Kim Harry K W - - 2006
Recent studies show that bisphosphonates can decrease the development of femoral head deformity following ischemic osteonecrosis by inhibiting osteoclast-mediated bone resorption. Given the potential new indication, improved understanding of pharmacokinetics of bisphosphonates as it applies to the infarcted head would be beneficial. The purpose of this study was to investigate ...
Engbers Hannelie M - - 2006
Coronary artery disease is one of the most important causes of death in Western society. Attempts to revascularize the coronary artery by myocardial retroperfusion, direct revascularization from the left ventricle, and bypass surgery have finally led to percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG) as standard ...
Tarakji Khaldoun G - - 2006
BACKGROUND: The clinical value of revascularization and other procedures in patients with severe systolic heart failure is unclear. It has been suggested that assessing ischemia and viability by positron emission tomography (PET) with fluorodeoxyglucose (FDG) imaging may identify patients for whom revascularization may lead to improved survival. We performed a ...
Lilly R Eric - - 2006
Off-pump beating heart coronary revascularization is a valuable surgical technique for high-risk patients, particularly those with severe atherosclerotic changes of the aorta, COPD, recent stroke, or for those in whom blood administration is contraindicated. Advances in clampless surgical techniques should further the benefit of OPCAB versus conventional CABG mostly in ...
Buffolo Enio - - 2006
BACKGROUND: Surgical myocardial revascularization without cardiopulmonary bypass (CPB) is not new, with the first consecutive series of patients appearing in the early eighties. There has been increased interest in this alternative approach, especially in patients with comorbidities. There is controversy regarding advantages, risks, and usefulness of this method of myocardial ...
March Robert J - - 2006
Advanced revascularization strategies continue to uncover a growing number of patients with symptomatic diffuse coronary artery disease. Transmyocardial laser revascularization (TMR) provides significant benefit in terms of improved quality of life and more complete revascularization for these difficult to treat patients when TMR is used as sole therapy or in ...
Bridges Charles R - - 2006
Patients with chronic, severe angina refractory to medical therapy who cannot be completely revascularized with either percutaneous catheter intervention or coronary artery bypass graft surgery (CABG) are clinically challenging. Transmyocardial laser revascularization (TMR), as sole therapy or as an adjunct to CABG, may be appropriate therapy for these patients. The ...
Cardarelli Marcelo - - 2006
Laser transmyocardial revascularization, a procedure originally intended to simulate the perfusion mechanism of the reptilian heart, has evolved into an effective but poorly understood treatment for angina when traditional revascularization is not an option. Herein, we review the explanations that have been proposed over the years and suggest a new ...
Cooper George N GN - - 2006
Large numbers of people have anterior myocardial infarctions, many in mid-life, with progressive left ventricular dilatation and heart failure with diminished life expectancy. Myocardial revascularization alone helps ischemia, but does little in cases of large ventricular volume, which is the major determinant of post infarction mortality. Ventricular restoration results in ...
Allen Keith B - - 2006
Many patients with angina related to coronary artery disease respond to medical management or can be completely revascularized using available percutaneous coronary interventions or coronary artery bypass grafting (CABG). There is evidence, however, to indicate that up to 25% of patients are incompletely revascularized following CABG and that incomplete revascularization ...
Hannan Edward L - - 2006
A few studies have investigated differences in elective procedure rates across small and medium sized referral regions. The purposes of this study are to investigate differences in revascularizations across 11 entire states and to investigate differences in choice of revascularization procedure (percutaneous coronary intervention (PCI) vs. coronary artery bypass graft ...
Vanasse Alain - - 2006
Randomized clinical trials showed the benefit of pharmacological and revascularization treatments in secondary prevention of myocardial infarction (MI), in selected population with highly controlled interventions. The objective of this study is to measure these treatments' impact on the cardiovascular (CV) mortality rate among patients receiving usual care in the province ...
Bauer Axel - - 2006
AIMS: To assess the association of prolonged QRS duration and late mortality in unselected post-infarction patients of the revascularization era. METHODS AND RESULTS: A total of 1455 survivors of acute myocardial infarction (MI) in sinus rhythm and under 76 years of age were enrolled. Ninety eight percent of the patients ...
Van Belle Eric - - 2005
Data on the nature of coronary artery disease in patients with insulin resistance and its treatment have been obtained mostly in the diabetic population. The 'quantitative' and 'qualitative' changes in the course of coronary artery disease and the relationship with the increased rate of cardiac events in this population will ...
Kiaii Bob - - 2005
Hybrid myocardial revascularization combines coronary surgery with percutaneous intervention as an alternative therapy for ischemic heart disease. The order and sequence of the hybrid approach is not yet clearly defined. We report on the benefits of an enhanced surgical suite equipped with a carbon fiber operating table and digital C-arm ...
Bernhardt Peter - - 2006
BACKGROUND: Assessing myocardial first-pass wash-in during pharmacological induced stress allows detection of perfusion deficits and indicates stenotic coronary arteries (CA). The aim of our study was to demonstrate clinical relevance of contrast-enhanced stress magnetic resonance imaging (CMR) by predicting necessity of CA intervention. METHODS: 738 patients with scheduled coronary angiography ...
Levine Glenn N - - 2005
The degree to which catheterization and revascularization procedures are utilized in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS) during hospitalization has broad implications with respect to initial pharmacotherapeutic decisions (upfront therapies), treatment and hospital transfer protocols, guideline recommendations, and allocation of training, material, and financial resources. Analysis of ...
Alvarez Julian - - 2005
PURPOSE OF REVIEW: Even though high thoracic epidural anesthesia has been shown to be highly efficacious in the control of symptoms in refractory angina, its general use is still restricted. In patients who undergo coronary revascularization, however, the technique is becoming more and more popular. The present review outlines the ...
Leos Cara L - - 2005
Glucose-insulin-potassium (GIK) utilization in the treatment of acute myocardial infarction (AMI) has been studied since the early 1960s with varying results. It is well established that ischemic myocardial cells convert from aerobic metabolism of glucose to toxic anaerobic free fatty acid (FFA) metabolism for the production of energy. It has ...
Baran I - - 2005
This study assessed the amount and prognostic value of myocardial viability in patients with non-Q-wave myocardial infarction (NQMI) and Q-wave myocardial infarction (QMI). A total of 175 patients with MI and an ejection fraction < or = 45% underwent dobutamine stress echocardiography. On the basis of clinical criteria and myocardial ...
Kindo Michel - - 2005
Chronic mesenteric ischemia is a rare disorder that is frequently associated with coronary artery disease. Myocardial ischemia is a leading cause of morbidity and mortality after revascularization of the splanchnic arteries. The optimal treatment of concomitant chronic mesenteric ischemia and myocardial ischemia is unknown. We report a case of this ...
Rizzello Vittoria - - 2005
In the present study, the relation between improvement in the left ventricular ejection fraction (LVEF) and heart failure symptoms was evaluated in 100 patients with ischemic cardiomyopathy undergoing coronary revascularization. In patients with viable myocardium, the improvement in the LVEF after revascularization was accompanied by improvement in heart failure symptoms ...
Allen Gary S - - 2005
BACKGROUND: Transmyocardial revascularization is a surgical therapy for the relief of severe angina in patients who are not suitable candidates for coronary artery bypass graft surgery or percutaneous coronary interventions. Historically, surgical techniques employed a left thoracotomy with or without thoracoscopic assist for visualization. This study evaluated the feasibility and ...
Brophy James M - - 2005
BACKGROUND: In clinical trials, cholesterol-lowering medications have been proven to decrease mortality and morbidity and are strongly recommended as secondary prevention in patients with established coronary artery disease. In routine practice, the translation of these benefits to elderly patients with recent coronary revascularization is less well known. METHODS: Using the ...
Kelly Russell F - - 2005
Rates of cardiologists' recommendations for revascularization and rates of performance of these procedures were compared in 1,961 black and white patients who underwent cardiac catheterization at a larger inner-city public hospital. After adjustment for clinical and angiographic characteristics, recommendations to undergo revascularization were similar in blacks and whites who had ...
Bolad Islam - - 2005
Primary prevention trials of implantable cardioverter defibrillator (ICD) therapy have generally excluded patients early after revascularization. Clinicians are commonly faced with patients who have ventricular dysfunction and nonsustained ventricular tachyarrhythmia developing shortly after revascularization. Since there are no evidence-based guidelines, management is currently at the discretion of the treating clinician. ...
Scheidt Stephen - - 2005
Currently available therapies for chronic stable angina are reviewed. Revascularization, i.e., coronary artery bypass surgery and percutaneous transluminal coronary angioplasty, is summarized briefly, with short- and long-term results summarized from several large registries and review articles. Advancing age is a risk factor for both coronary artery bypass surgery and percutaneous ...
Grandmougin Daniel - - 2005
Coronary surgery with diabetes and severe hemophilia B is a challenging situation requiring specific and adequate therapeutic considerations. We herein report the case of a 52-year-old diabetic patient with severe factor IX deficiency and impaired ventricular function, who was scheduled for myocardial revascularization because of exertional angina and recurrent myocardial ...
Kozower Benjamin D - - 2005
BACKGROUND: Complete revascularization is important in young patients undergoing coronary artery bypass grafting, but this principle remains less absolute in elderly patients. The purpose of this study was to determine how complete revascularization influenced long-term survival after coronary artery bypass grafting in octogenarians. METHODS: From 1986 to 2003, 500 consecutive ...
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