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4801. Angiotensinergic versus nonangiotensinergic hemodynamic effects of converting enzyme inhibition in patients with chronic heart failure. Assessment by acute renin and converting enzyme inhibition.
作者: W Kiowski.;J Beermann.;P Rickenbacher.;R Haemmerli.;M Thomas.;F Burkart.;T Meinertz.
来源: Circulation. 1994年90卷6期2748-56页
The contribution of nonangiotensinergic effects of converting enzyme inhibitors to their hemodynamic effects in patients with chronic heart failure is not clear. A comparison of the effects of renin and converting enzyme inhibition should help to clarify this issue.
4802. Trapidil (triazolopyrimidine), a platelet-derived growth factor antagonist, reduces restenosis after percutaneous transluminal coronary angioplasty. Results of the randomized, double-blind STARC study. Studio Trapidil versus Aspirin nella Restenosi Coronarica.
作者: A Maresta.;M Balducelli.;L Cantini.;A Casari.;R Chioin.;M Fabbri.;A Fontanelli.;P A Monici Preti.;S Repetto.;S De Servi.
来源: Circulation. 1994年90卷6期2710-5页
Trapidil is an antiplatelet drug with specific platelet-derived growth factor antagonism and antiproliferative effects in the rat and rabbit models after balloon angioplasty.
4803. Mortality within 24 hours of thrombolysis for myocardial infarction. The importance of early reperfusion. The GUSTO Investigators, Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries.
作者: N S Kleiman.;H D White.;E M Ohman.;A M Ross.;L H Woodlief.;R M Califf.;D R Holmes.;E Bates.;M Pfisterer.;A Vahanian.
来源: Circulation. 1994年90卷6期2658-65页
A paradoxical increased risk of death has been reported during the first 24 hours after thrombolysis for myocardial infarction. The mechanism of this phenomenon is not known, nor is its relation to the success or failure of reperfusion. The present study was a prospectively designed analysis of deaths occurring within the first 24 hours in the GUSTO trial.
4804. Artificial circulatory support with textured interior surfaces. A counterintuitive approach to minimizing thromboembolism.
作者: E A Rose.;H R Levin.;M C Oz.;O H Frazier.;Q Macmanus.;N A Burton.;E A Lefrak.
来源: Circulation. 1994年90卷5 Pt 2期II87-91页
Although numerous left ventricular assist devices (LVADs) have been used clinically, frequent thromboembolic complications have been reported despite the smooth interior LVAD surfaces and systemic anticoagulant medication. In contrast, the Thermo Cardiosystems HeartMate 1000 IP LVAD has textured interior surfaces that are promptly covered by a densely adherent neointima. We hypothesize that elimination of a direct interface between prosthetic material and blood elements reduces the risk of peripheral embolization and minimizes the necessity for systemic anticoagulant medication. This report defines the thromboembolic risk of this type of LVAD and characterizes the nature and effectiveness of the various anticoagulation regimens that were tested during the initial clinical trial with this device.
4805. Implantable left ventricular assist device. Approaching an alternative for end-stage heart failure. Implantable LVAD Study Group.
作者: P M McCarthy.;K B James.;R M Savage.;R Vargo.;K Kendall.;H Harasaki.;R E Hobbs.;F J Pashkow.
来源: Circulation. 1994年90卷5 Pt 2期II83-6页
The implantable left ventricular assist device (LVAD) was designed to provide circulatory support as an alternative to heart transplantation or to continued medical therapy of end-stage heart failure. Initial experience with the implantable LVAD used as a bridge to heart transplantation provides a clinical opportunity to study the function of the device and adaptation by the patient.
4806. Adult orthotopic heart transplantation using undersized pediatric donor hearts. Technique and postoperative management.
作者: V Jeevanandam.;P Mather.;S Furukawa.;B Todd.;T Regillo.;A A Bove.;J McClurken.;V P Addonizio.
来源: Circulation. 1994年90卷5 Pt 2期II74-7页
Because of the critical shortage of adult donor hearts, many recipients die awaiting transplantation of an organ of appropriate size. Undersized hearts (donor/recipient weight ratio < 0.7) have been used for heterotopic heart transplantation. We report on 6 moribund adult heart transplant candidates who were rescued with orthotopic heart transplantation of undersized pediatric hearts.
4807. Life-threatening arrhythmias and RV dysfunction after surgical repair of tetralogy of Fallot. Comparison between transventricular and transatrial approaches.
作者: C A Dietl.;M E Cazzaniga.;S J Dubner.;N A Pérez-Baliño.;A R Torres.;R G Favaloro.
来源: Circulation. 1994年90卷5 Pt 2期II7-12页
Late postoperative arrhythmias and right ventricular dysfunction may occur after classic repair of tetralogy of Fallot.
4808. Examination of the early 'learning curve' for transcatheter closure of patent ductus arteriosus using the Rashkind occluder. PDA Closure Comparative Study Group.
Results of transcatheter implantation of the Rashkind double umbrella occluder for treatment of patent ductus arteriosus (PDA) have improved over time. We evaluated factors associated with changes in outcomes seen in the early clinical experience with this device.
4809. Metabolic and functional evidence that retrograde warm blood cardioplegia does not injure the right ventricle in human beings.
作者: P Menasché.;J P Fleury.;L Droc.;A N'Guyen.;J Larivière.;B Faris.;F Caffarelli.;A Piwnica.;G Bloch.
来源: Circulation. 1994年90卷5 Pt 2期II310-5页
Retrograde warm blood cardioplegia is now recognized as an effective method of myocardial protection, but concerns persist about its ability to adequately preserve the right ventricle.
4810. Restoration of atrial function after the maze procedure for patients with atrial fibrillation. Assessment by Doppler echocardiography.
作者: M S Feinberg.;A D Waggoner.;K M Kater.;J L Cox.;B D Lindsay.;J E Pérez.
来源: Circulation. 1994年90卷5 Pt 2期II285-92页
The purpose of the present study was to evaluate the effects of the maze procedure on atrial function in patients operated on for atrial fibrillation. The maze procedure is a new surgical intervention that is designed to restore sinus rhythm and active mechanical atrial contraction as a definitive treatment for patients with atrial fibrillation.
4811. Does normothermia during cardiopulmonary bypass increase neutrophil-endothelium interactions?
作者: P Menasché.;J Peynet.;J Larivière.;F Tronc.;A Piwnica.;G Bloch.;A Tedgui.
来源: Circulation. 1994年90卷5 Pt 2期II275-9页
The use of warm blood cardioplegia is usually associated with that of warm cardiopulmonary bypass (CPB). Little is known, however, about the effect of temperature during bypass on neutrophil-endothelium interactions, which are currently considered a key component of the inflammatory response to CPB.
4812. Treatment of postoperative hypertension after coronary artery bypass surgery. Double-blind comparison of intravenous isradipine and sodium nitroprusside.
作者: J Leslie.;N Brister.;J H Levy.;J P Yared.;A Marty.;H Martin.;R Hines.;J Savino.;M Cohen.
来源: Circulation. 1994年90卷5 Pt 2期II256-61页
Hypertension commonly occurs after cardiac surgery and requires therapy to prevent the potentially deleterious effects.
4813. Cardiopulmonary bypass, temperature, and central nervous system dysfunction.
作者: R F McLean.;B I Wong.;C D Naylor.;W G Snow.;E M Harrington.;M Gawel.;S E Fremes.
来源: Circulation. 1994年90卷5 Pt 2期II250-5页
Neurological injury is an important cause of morbidity and mortality after cardiac surgery. With the advent of warm heart surgery, the neuroprotective role of hypothermic cardiopulmonary bypass (CPB) has come under increasing scrutiny. Preliminary work by us in the area found no increased risk of neurological morbidity with normothermic CPB in a small group of patients and suggested a possible benefit. The purpose of the present study is to compare the incidence of neurological and neuropsychological dysfunction in a larger number of patients randomized to warm or cold aortocoronary bypass surgery.
4814. Effect of aging on cerebral autoregulation during cardiopulmonary bypass. Association with postoperative cognitive dysfunction.
作者: M F Newman.;N D Croughwell.;J A Blumenthal.;W D White.;J B Lewis.;L R Smith.;P Frasco.;E A Towner.;R M Schell.;B J Hurwitz.
来源: Circulation. 1994年90卷5 Pt 2期II243-9页
Age is a predictor of cognitive dysfunction after cardiac surgery, but the mechanism is unknown. The purpose of our study was to determine whether age-related decrements in cognition are associated with cerebral blood flow (CBF) autoregulation during cardiopulmonary bypass (CPB).
4815. Comparison of anticoagulation regimens after Carpentier-Edwards aortic or mitral valve replacement.
作者: K L Blair.;A C Hatton.;W D White.;L R Smith.;J E Lowe.;W G Wolfe.;W G Young.;H N Oldham.;J M Douglas.;D D Glower.
来源: Circulation. 1994年90卷5 Pt 2期II214-9页
To identify the optimal use of anticoagulants after Carpentier-Edwards valve replacement, a retrospective study of all patients undergoing Carpentier-Edwards aortic (N = 378) or mitral (N = 370) valve replacement was done.
4816. Right ventricular volume overload results in depression of left ventricular ejection fraction. Implications for the surgical management of tricuspid valve disease.
Right ventricular volume overload (RVVO) occurring in conditions such as Ebstein's anomaly may result in depression of left ventricular ejection fraction (LVEF). This study tests this hypothesis by measuring LVEF in 10 patients with RVVO due to tricuspid valve resection for isolated tricuspid valve endocarditis and in 10 age-matched healthy persons.
4817. Decreasing incidence of systolic anterior motion after mitral valve reconstruction.
作者: E A Grossi.;B M Steinberg.;M LeBoutillier.;G Ribacove.;F C Spencer.;A C Galloway.;S B Colvin.
来源: Circulation. 1994年90卷5 Pt 2期II195-7页
With the widespread application of mitral valve reconstructive techniques, systolic anterior motion (SAM) of the anterior mitral leaflet causing left ventricular outflow tract obstruction has been recognized by several groups. SAM occurred in 9.1% of the first 441 patients operated on for mitral valve reconstruction at our institution. Fortunately, SAM subsided with medical therapy within 1 year for a majority of patients as reported in May 1993. Some surgeons, however, have considered abandoning repair for prosthetic replacement after SAM was detected on intraoperative echocardiogram.
4818. Late hemodynamic effects of the preserved papillary muscles during mitral valve replacement.
作者: M Komeda.;T E David.;V Rao.;Z Sun.;R D Weisel.;R J Burns.
来源: Circulation. 1994年90卷5 Pt 2期II190-4页
The late hemodynamic effects of preserving the papillary muscles during mitral valve replacement have not been evaluated.
4819. Differences in vasoreactivity between gastroepiploic artery grafts late after bypass surgery and grafted coronary arteries.
The gastroepiploic artery is increasingly used as an alternative arterial coronary bypass conduit. In vitro studies have reported differences in vasoreactivity among various types of coronary graft conduits, susceptible to influencing the adaptation of myocardial blood flow and long-term patency rate.
4820. Quantitative angiographic follow-up study of the free inferior epigastric coronary bypass graft.
作者: O Gurné.;M Buche.;P Chenu.;J L Paquay.;J P Pelgrim.;Y Louagie.;B Marchandise.;E Schroeder.
来源: Circulation. 1994年90卷5 Pt 2期II148-54页
Attempts to improve late results of bypass coronary surgery have focused on the use of arterial conduits because of the high attrition rate of venous grafts.
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