Revascularization procedures in patients with transplant coronary artery disease.

Objective: To assess the efficacy of revascularization in cardiac transplant patients who developed de novo coronary artery disease.

Methods: Eighteen patients underwent one or more of four methods of revascularization: percutaneous transluminal coronary angioplasty (PTCA), percutaneous transluminal coronary rotational atherectomy (PTCRA), coronary artery bypass grafting (CABG), and transmyocardial laser revacularization (TMLR). Eleven PTCA procedures were performed in 10 patients 55.

High-risk coronary angioplasty assisted by active hemoperfusion. A feasibility study.

We assessed the effectiveness of distal hemoperfusion support during gradual, prolonged balloon inflation during percutaneous transluminal coronary angioplasty in high-risk patients. The patients were identified as having a poor left ventricular ejection fraction ( < 35%), > 50% of viable myocardium at risk percutaneous coronary balloon angioplasty, or both. A total of 64 procedures were performed in 61 patients.

Coronary angioplasty of anomalous left anterior descending artery with the left coronary artery originating from the right coronary sinus of Valsalva.

Percutaneous transluminal coronary angioplasty of anomalous coronary arteries presents several technical challenges to interventional cardiologists. Choosing the best guiding catheter and other equipment is crucial to the technical success of the procedure. We performed successful coronary angioplasty of an anomalous left anterior descending artery lesion in a 51-year-old man who had a left coronary artery originating from the right coronary sinus.

High-dose thrombolytic therapy and angioplasty for thrombosis in a subacute femoropopliteal bypass graft.

The rate of success in reoperation for thrombosed infrainguinal grafts is unimpressive, particularly in patients with disease of distal vessels. In certain cases, combining high-dose urokinase and angioplasty appears to offer a safe and effective alternative. We describe the successful use of this combined treatment in a patient with a recently occluded femoropopliteal bypass graft.

Indications and choices in pacemaker therapy.

During their 33-year history of clinical use, cardiac pacemakers have evolved from devices primarily intended to save lives into complex systems designed to improve the cardiac patient's overall quality of life. To help physicians cope with this rapidly changing field, this review outlines current indications for pacemaker therapy and examines the wide range of options available. After describing the standard nomenclature for identifying the various systems, the author discusses pacemaker selection on the basis of cardiac rhythm alone, as well as rate-modulated therapy.