Percutaneous iliac artery stent: angiographic long-term follow-up.

The authors conducted a prospective study of 49 consecutive patients with 53 lesions in 52 iliac arteries. All were treated between October 1987 and April 1990 with percutaneous transluminal angioplasty (PTA) and insertion of either a self-expandable or balloon-expandable stent. Lesions included total occlusion (28%), dissection (42%), post-PTA restenosis (21%), and unsatisfactory PTA (9%).

Body surface isopotential mapping of the entire QRST complex in the Wolff-Parkinson-White syndrome. Correlation with the location of the accessory pathway.

Body surface potential maps were recorded during sinus rhythm and during atrial pacing at the time of electrophysiologic studies in 42 patients with Wolff-Parkinson-White syndrome. The locations of the accessory pathways were determined by epicardial mapping during surgery in 34 patients and by multicatheter endocavitary electrophysiologic studies in eight additional patients. During delta wave inscription, the shape and extension of areas of the negative and positive potentials on the thorax correlated better with the preexcitation site (69% of patients) than with the localization of the minimum potential alone (45.

Atrial activation sequence during atrial flutter in the canine pericarditis model and its effects on the polarity of the flutter wave in the electrocardiogram.

Stable atrial flutter induced in both conscious and open chest states was studied in 30 mongrel dogs after production of sterile pericarditis. During the conscious state studies, induced atrial flutter (mean cycle length 128 +/- 15 ms) was always sustained greater than 15 min and was stable. Three types of flutter wave polarity were noted in electrocardiogram (ECG) lead II: positive in 16 dogs, negative in 3 and flat or slightly positive in 11.

Transitions among atrial fibrillation, atrial flutter, and sinus rhythm during procainamide infusion and vagal stimulation in dogs with sterile pericarditis.

The mechanism of atrial flutter and fibrillation induced by rapid pacing in 22 dogs with 3-day-old sterile pericarditis was investigated by computerized epicardial mapping of atrial activation before and after administration of agents known to modify atrial electrophysiologic properties: procainamide, isoproterenol, and electrical stimulation of the vagosympathetic trunks. Before the administration of any of these agents, a total of 30 episodes of sustained atrial flutter (greater than 1 min duration, monomorphic; regular cycle length, 127 +/- 12 ms, mean +/- SD) was induced in 15 out of 22 dogs and 9 episodes of unstable atrial flutter (duration, less than 1 min; cycle length, 129 +/- 34 ms; monomorphic, alternating with fibrillation) were induced in the remaining 7 preparations. In the latter, administration of procainamide transformed unstable atrial flutter and atrial fibrillation to sustained atrial flutter (cycle length, 142 +/- 33 ms; n = 9 episodes).

Perioperative autotransfusion and its correlation to hemostasis and coagulopathies.

The use of autologous blood techniques affords the reduction or elimination of homologous blood transfusions for most patients. In addition, for certain religious faiths such as Jehovah's Witnesses or those patients with rare blood types, intraoperative salvage and return of the patient's own blood is the only source of available blood. Autologous blood salvage in the perioperative period includes: hemodilution; intraoperative salvage of lost blood; postoperative collection of shed blood.

Prevention of peritoneal adhesions in rats with trimetazidine.

The effect of trimetazidine (an antianginal drug that acts as a scavenger of oxygen radicals) in the prevention of peritoneal adhesions induced by complete vascular obstruction of an ileal segment for 30 minutes followed by reperfusion was investigated in rats. Group A (n = 20) acted as controls. Group B (n = 20) received trimetazidine intravenously in a dose of 2.

Surgical treatment of the Wolff-Parkinson-White syndrome. Endocardial versus epicardial approach.

From 1983 to 1988, 51 patients with the Wolff-Parkinson-White syndrome underwent surgical ablation of an accessory conduction pathway, 25 by the classic endocardial approach and 26 by the epicardial technique supplemented by cryosurgery. In the endocardial and epicardial groups, the accessory pathway was in the left free wall in 22 and 18 patients, respectively, posterior septal in two and seven, and in the right free wall in one patient in each group. There was no early or late death in the endocardial group, and postoperative complications developed in five patients (20%).

[The origin of late potentials in patients with ventricular tachycardia after myocardial infarction].

In order to study the origin of late potentials, their distribution was analyzed in 16 patients who had undergone surgery for arrhythmia due to ventricular tachycardia following myocardial infarction. The potentials were measured in sinus rhythm using 63 unipolar leads placed on the chest before the operation, then on the epicardium and endocardium during the operation. Epicardial and/or endocardial activity extending beyond the QRS complex measured from unfiltered chest signals and characterized by slowed propagation at the edge or inside of necrotic regions, stable from one beat to the next, and showing simple (39 per cent), double (34 per cent) or fragmented (27 per cent) deflections on the electrocardiograms were observed in 5/6 patients without bundle-branch block and in 5/10 patients with block.

[Percutaneous angioscopy in the diagnosis of arteriopathies of the lower limbs].

Because of the poor specificity of the arteriography, the authors have performed a percutaneous angioscopy before every angioplasty of the arteries of lower limbs for nearly 3 years. They define the angioscopy and describe materials and technique. The percutaneous route without surgery and without anesthesia underlines the originality of the technique.

Comparative accuracy of the vectorcardiogram and electrocardiogram in the localization of the accessory pathway in patients with Wolff-Parkinson-White syndrome: validation of a new vectorcardiographic algorithm by intraoperative epicardial mapping and electrophysiologic studies.

The scalar electrocardiograms (ECGs) and vectorcardiograms (VCGs) of 41 patients with Wolff-Parkinson-White (WPW) syndrome were used to compare the accuracy of these techniques in the identification of the site of preexcitation. The location of the accessory pathway (AP) was determined by endocavitary electrophysiologic studies in all patients and the location was confirmed during intraoperative epicardial mapping in 28 of them. The ECGs were classified according to Gallagher's criteria and with Milstein's algorithm, whereas the VCGs were classified according to a new two-step algorithm.

The metabolism of 2,4-dibromo-17 alpha-ethynyl[6,7-3H]oestradiol in the rat.

1. The metabolism of 2,4-dibromoethynyloestradiol (2,4-DBEE2) in the rat was studied in order to determine the influence of ring-A substituents on the phase I biotransformations of oestrogens. 2.

Spatial domain analysis of late ventricular potentials. Intraoperative and thoracic correlations.

For investigation of late potentials seen on the signal-averaged electrocardiogram, intracardiac and thoracic distributions of terminal activity were analyzed in 16 patients undergoing cryosurgery for ventricular tachycardia after remote myocardial infarction. The body surface potentials measured with 63 time-averaged unipolar leads were compared with epicardial and endocardial potential maps in six patients without and 10 patients with bundle-branch block. Intracardiac post-QRS activity, defined as extending beyond the thoracic QRS offset, was found in five of six patients without bundle-branch block (83%) and in five of 10 patients with bundle-branch block (50%), corresponding to 4 +/- 5% of the total number of electrograms in each patient.

[Atypical cylindroma of the ethmoid].

The authors relate an ethmoidal cylindroma, whose extension includes the orbital apex, without any ocular symptomatology. They wonder about the possibility of an early diagnosis of such tumors.

Surgical treatment of ventricular tachycardia. Regional cryoablation guided by computerized epicardial and endocardial mapping.

Extended cryoablation as a single method of myocardial ablation was used for surgical treatment of 33 patients with ventricular tachycardia associated with coronary artery disease. Surgery was guided by roving-probe mapping in 14 patients and by computerized epicardial and computerized, left ventricular, endocardial, multielectrode mapping in 19 patients. In the latter group, the anatomic correlation between sites of the earliest epicardial activation (EA-EPI) and those of the earliest endocardial activation (EA-ENDO) was found to be consistent in the apical region.

Intrapericardial trauma: surgical experience.

From 1975 to 1987, 19 patients (pts) were operated on for a traumatic lesion of the heart or of the ascending aorta. There were 15 males and four females with a mean age of 42 years. Twelve lesions (Group I) were penetrating and seven (Group II) blunt.

Termination of sustained ventricular tachycardia with a new antitachycardia pacemaker: role of the nonautomatic mode to follow pacemaker function.

The use of an antitachycardia pacemaker for the treatment of recurrent, drug resistant nonsyncopal sustained ventricular tachycardia in a 28-year-old patient is described. The report emphasizes the role of electrocardiographic recording during manual activation of the tachycardia response in an outpatient setting. The follow-up covers 12 months with 26 spontaneous tachycardia episodes forcing the patient to go to an emergency room to monitor tachycardia termination.

Activities, family relationships and feelings about aging in a multicultural elderly sample.

This study looked at ethnic and gender differences in activities, family relationships, and feelings about aging in 128 American Indian, Anglo, and Hispanic adults over sixty. Reading, visiting, and watching television were the most popular activities for all subjects, with a number of sex and ethnic differences appearing. Most subjects reported improved relationships with their families on various dimensions after turning sixty.

Differential effects of abrupt cycle length changes on the refractoriness of accessory pathway, His-Purkinje system, atrial and ventricular myocardium in Wolff-Parkinson-White syndrome.

We compared the response of the accessory pathway (AP), the atrial myocardium, the His-Purkinje system (HPS) and the ventricular myocardium during steady state (constant cycle length) and following an abrupt alteration in cycle length in 23 patients with Wolff-Parkinson-White syndrome. The durations of the anterograde and retrograde refractory periods were measured during constant drive cycle lengths of 600 and 400 ms (Method I) and during an abrupt change in cycle length of either short-to-long (400 to 600 ms) (Method II) or long-to-short (600 to 400 ms) (Method III) just before the extra stimulus. The mean durations of the anterograde effective refractory periods of the APs were 295 +/- 43, 243 +/- 39 and 273 +/- 37 ms at 600, 400 and 400 to 600 ms cycle lengths, respectively.

Catheter recording of left atrial activation from left pulmonary artery in the Wolff-Parkinson-White syndrome: validation of the technique with intraoperative mapping results.

Accurate localization of accessory pathways (AP) in the Wolff-Parkinson-White (WPW) syndrome requires detailed atrial mapping. Coronary sinus catheterization is so far the most accurate method of left atrial mapping, but it can be technically difficult in some patients. We evaluated the feasibility of left atrial mapping from the left pulmonary artery in 24 patients with WPW syndrome.