Severity of coronary artery disease in black and white male veterans and likelihood of revascularization.

Background: Many reports in the literature have found the use of invasive cardiac procedures in black patients to be less common than in white patients. These reports tend to have small numbers of black patients compared with white patients or rely on the information contained in claims or administrative data.

Methods And Results: Cardiac catheterization reports were reviewed in a Veterans Administration hospital that serves a large number of black patients.

Body mass index and coronary artery disease in African-Americans.

There are limited data available concerning the influence of obesity, a major cardiovascular disease risk factor, in relationship to coronary artery disease (CAD). This is of considerable importance to African-Americans since African-Americans have one of the world's highest CAD mortality rates coupled with the fact that obesity is extremely prevalent in this population. The present study assessed the relationship between body mass index and CAD in African-Americans undergoing coronary angiography.

Coronary arteriographic findings in black patients and risk markers for coronary artery disease.

Coronary arteriographic results are reported in 1535 black patients: 751 men (mean age 57 +/- 11) and 784 women (mean age 59 +/- 11). Among the black men 19%, 15%, 21%, and 4% had single-, double-, and triple-vessel and left main disease, respectively. Among the black women there were 12%, 10%, 15%, and 3% with similar involvement.

Rib fractures complicating median sternotomy.

The postoperative chest radiographs of 100 consecutive patients undergoing median sternotomy were reviewed for the presence of acute rib fractures. The majority of patients underwent coronary artery bypass grafting. Thirteen patients sustained 15 fractures.

Cardiovascular surgery in blacks.

The available information concerning cardiovascular surgery in blacks is very limited and incomplete. Those few reports that do exist seem to show that the usual indications for surgery, preoperative findings, and final results can be expected. Acquired heart disease is as important a cause of mortality in African Americans as in others and is amenable to surgical intervention.

Cardiovascular care in the urban melting pot.

The widespread prevalence of cardiovascular diseases does not spare poor or heterogeneous urban communities. Since the inflationary spiral of health care costs has continued unabated, it will require intentional and creative maneuvers to preserve and develop new or existing programs which do not deny ready access to quality care for all classes. It is the opinion of the author that the present health care system promotes indifference on the part of health care providers and the purveyors of technology.

Coronary artery disease in black Americans 1920-1960: the shaping of medical opinion.

Current opinions regarding the prevalence of coronary artery disease in black Americans are conflicting. Some physicians believe that the prevalence of coronary artery disease in black Americans is less than that in the general population; some find no difference; still others argue that the high prevalence of risk factors, such as hypertension, should result in a higher prevalence of coronary artery disease in black Americans. This article will not attempt to resolve these conflicts but instead will review some of the medical literature that may have influenced prevailing opinions.

Anomalous coronary artery originating from the left anterior descending artery and ending in a blind aneurysm.

To the authors' knowledge this is the first report of an anomalous coronary artery originating from the left anterior descending artery and ending in a blind aneurysm.

Management of a recalcitrant periprosthetic fluid collection.

Axillofemoral bypass grafts have been in common use for more than 20 years in the treatment of severe aortoiliac occlusive disease in poor-risk patients. A persistent periprosthetic fluid collection is an unusual complication of this procedure. We describe a technique by which a tense periprosthetic collection was kept successfully decompressed by the construction of a "window" from the cavity to the peritoneum.

Coronary artery bypass grafting in a predominately black group of patients.

The preoperative profiles of a predominately non-white group of patients undergoing coronary artery bypass grafting were reviewed. Data were obtained from a retrospective analysis of medical records of 163 patients operated on at Howard University Hospital between July 1983 and July 1986. The analysis was carried out primarily to determine whether patients requiring myocardial revascularization were somehow different from their non-black counterparts.

Tricuspid stenosis in prosthetic valve endocarditis. Diagnosis by Doppler echocardiography.

Valvular stenosis is an uncommon finding in bacterial endocarditis involving native cardiac valves. Prosthetic valve endocarditis, however, is more commonly associated with obstruction. Bioprosthetic cardiac valves may be particularly prone to this complication.

Partial atrioventricular canal in association with Ebstein's anomaly. Echocardiographic diagnosis and surgical correction.

Echocardiography was used to diagnose the presence of both Ebstein's anomaly and partial atrioventricular canal in the case of a 20-year-old man who presented for evaluation of supraventricular tachyarrhythmias. The diagnosis was confirmed at surgery with successful surgical repair.

A comparison of synthetic absorbable suture with synthetic nonabsorbable suture for construction of tracheal anastomoses.

This study compares the use of synthetic absorbable suture (SAS, Vicryl) with that of synthetic nonabsorbable suture (SNS, Ticron) for construction of cervical tracheal anastomoses in the dog. Fourteen mongrel dogs underwent resection of one to four tracheal rings. Paired tracheal anastomoses were constructed, using 10 SAS or 10 SNS.

Anorectal abscess.

A five year retrospective review of anorectal abscesses included 181 admissions in which all but five were explained by the anal glandular hypothesis of causation. Delays in treatment occurred because of misdiagnosis, attempts at nonoperative management and inhospital procrastination. These abscesses are notorious for the recurrence rate after treatment.