Protection against ischemia during prolonged balloon inflation by distal coronary perfusion with use of an autoperfusion catheter or Fluosol.

Objectives: The purpose of this report was to study the protective effects of passive and active distal coronary perfusion during prolonged balloon inflation.

Background: Prolonged balloon inflation has been proposed to improve immediate and long-term results of percutaneous transluminal coronary angioplasty, but it requires protection against myocardial ischemia.

Methods: A 30-min balloon occlusion of the left anterior descending artery was performed in three groups of closed chest anesthetized dogs: 1) control (no distal coronary perfusion, n = 13), 2) passive distal coronary perfusion (autoperfusion catheter, n = 10), and 3) active distal coronary perfusion (infusion of the perfluorochemical Fluosol at 30 ml/min, n = 11).

Primary pulmonary hypertension, then and now: 28 years of experience.

To determine whether a better understanding of primary pulmonary hypertension has affected its clinical presentation, natural history, and prognosis, we retrospectively compared patients with primary pulmonary hypertension presenting to our institution during two different periods: 1962 to 1978 (group 1, n = 38) and 1979 to 1989 (group 2, n = 33). Demographic characteristics were similar in both groups. Dyspnea on exertion was the most frequent presenting symptom in both groups.

Atrial natriuretic factor and catecholamine levels during exercise in patients with and without coronary artery disease.

To investigate the effects of exercise-induced ischemia on the release of atrial natriuretic factor (ANF), we measured peripheral plasma ANF, epinephrine and norepinephrine in 18 male patients with and without coronary artery disease. The patients underwent tomographic thallium treadmill stress tests. After exercise, patients with coronary artery disease showed higher increments of plasma ANF than patients without coronary disease, but the increase of ANF was not related to exercise-induced ischemia, nor to changes in catecholamines, heart rate, or blood pressure.

Percutaneous balloon valvotomy for the treatment of isolated tricuspid stenosis.

A 46-year-old woman with isolated tricuspid stenosis complained of increasing fatigue and dyspnea on exertion. Exercise Doppler echocardiography reproduced her symptoms and revealed a marked increase in trans-tricuspid gradient. Successful percutaneous balloon tricuspid valvotomy was performed, with resolution of her symptoms.

Association between primary pulmonary hypertension and portal hypertension: analysis of its pathophysiology and clinical, laboratory and hemodynamic manifestations.

To determine the clinical, laboratory and hemodynamic profile in patients with primary pulmonary hypertension and associated portal hypertension, 7 new cases and 71 previously reported cases were analyzed. There was no gender predilection and the average age at diagnosis was 41 years. Liver cirrhosis was the most frequent cause of hypertension (82%) and a surgical portosystemic shunt was present in 29%.