Percutaneous pulmonary valvuloplasty in an octogenarian with calcific pulmonary stenosis.

We describe a patient in whom calcific pulmonary vascular stenosis was diagnosed at the age of 84 years. Valve stenosis was relieved by percutaneous transluminal pulmonary valvuloplasty. To our knowledge, PTPV performed at this age has not been previously reported.

Distensibility of the ascending aorta: comparison of invasive and non-invasive techniques in healthy men and in men with coronary artery disease.

Distensibility of the ascending aorta, measured non-invasively, was compared with values obtained by invasive techniques in 46 males (30 patients with coronary artery disease and 16 age-matched normal subjects). Aortic diameters were measured at a level 3 cm above the aortic valve using both echocardiographic and angiographic techniques. Aortic distensibility was calculated from the aortic diameters and aortic pressure or brachial artery pressure using the formula: 2 x (change in aortic diameter)/(diastolic aortic diameter) x (change in aortic pressure).

Antianginal drugs and relationship between epicardial ST segment depression and moderate regional myocardial blood flow reduction in experimental partial coronary artery occlusion.

Study Objective: The aim of the study was to determine whether moderate reduction in regional myocardial blood flow is related to epicardial ST segment depression and to the changes in grade and extent induced in this variable by antianginal drugs.

Design: Blood flow through the anterior descending coronary artery was reduced to 25-30% of control in open chest dogs, using a cuff flow meter as a monitor, and glyceryl trinitrate, propranolol and nifedipine were infused 60 min later. Regional left ventricular blood flow was measured with 15 mu radioactive microspheres and electrocardiograms were recorded from the epicardial surface of the anterior left ventricular wall before and after administration of the drugs.

Percutaneous balloon mitral valvuloplasty by retrograde left atrial catheterization.

A new technique was developed for percutaneous mitral valve balloon valvuloplasty, using a retrograde approach to the left atrium via the left ventricle. A newly designed externally steerable guiding catheter is used for the introduction of 1 or 2 guidewires to the left atrium and the balloon catheters are advanced along these guidewires into the mitral orifice. The technique was used successfully in 10 adult patients with rheumatic mitral stenosis.

Single coronary artery associated with annuloaortic ectasia and ventricular septal defect.

A 60-year-old man with a single left coronary artery associated with an annuloaortic ectasia and a ventricular septal defect is described. He presented with severe heart failure and underwent open-heart surgery during which all these entities were confirmed.

Percutaneous transluminal coronary angioplasty using a steerable guiding catheter: a new technique.

A new type of steerable guiding catheter is described for use in percutaneous transluminal coronary angioplasty (PTCA). It is simple to use and externally steerable. The catheter incorporates a steering system by means of which the catheter tip can be made to assume the form of either a right or left Judkins catheter or to be fixed in any intermediate configuration, entirely through external manipulation.

Determination of left ventricular residual function by analysis of post-extrasystolic beat in mitral stenosis.

Residual function of the left ventricle was assessed in 25 patients with mitral stenosis and a normal left ventriculogram. The post-extrasystolic beat (R2) in sinus rhythm (nine patients) and the first beat after an early beat (R2) in atrial fibrillation (16 patients) were analysed angiocardiographically. Five subjects with a normal heart (controls) were also studied.

Sinus node coronary arteries studied with angiography.

Coronary angiograms of 309 consecutive patients undergoing coronary angiography were reviewed to investigate the blood supply to the sinus node area. Blood was supplied from the right coronary artery in 59% of cases, from the left coronary artery in 38%, and from both coronary arteries in 3%. The posterior sinus node artery was demonstrated in 32 patients (27% of the 119 patients with the sinus node artery originating from the left circumflex and 10.

Bumetanide in congestive heart failure.

Bumetanide, a new diuretic exerting its major effect on the ascending limb of the loop of Henle, was evaluated in 20 patients with congestive heart failure. Dosage ranged from 1 mg to 3 mg daily depending on the patient's condition. The results after 3 and 8 days' treatment showed that bumetanide caused a significant diuresis, an increased excretion of sodium, potassium and chloride, and a comparable fall in the serum levels of these electrolytes.