Efficacy and safety of contrast injection beyond total occlusions in acute cardiac patients: a method to confirm balloon position within coronary lumen.

Objectives: To evaluate the sensitivity and safety of contrast injection beyond total occlusions in acute cardiac patients in order to ensure balloon position within the coronary lumen and occasionally to enable the estimate of occlusion length.

Background: Percutaneous therapy of total coronary occlusions is generally more challenging than the treatment of stenotic lesions. It more frequently entails the risk of irreversibly disrupting a protruding plaque, of advancing the wire through a false route, or rarely, of causing coronary perforation.

Relation of left atrial size to function as determined by transesophageal echocardiography.

One hundred thirty-nine patients who underwent transesophageal echocardiographic studies were grouped by their maximal left atrial (LA) volumes, and their stroke volumes, emptying fractions, and fractional shortening were calculated. In large atria, an inverse relation was found between further increases in LA volume and LA function, determined by emptying fractions and fractional shortening.

Utilization of low-profile intra-aortic balloon catheters inserted by the sheathless technique in acute cardiac patients: clinical efficacy with a very low complication rate.

Unlabelled: Initial intra-aortic balloon pump (IABP) catheters were of large caliber and their utilization resulted in a high incidence of complications, including limb ischemia, bleeding and thrombosis, peripheral neurologic sequelae, and infection. Despite eventual decrease in the size of IABP catheters, the complication rate has remained high.

Hypothesis: The study was undertaken to determine whether use of recently available low-profile IABP catheters would result in a lower incidence of vascular and bleeding complications.