Recurrent coronary artery fistula.

A patient with a large fistula from the left circumflex coronary artery to the coronary sinus that recurred in spite of proximal and distal ligation is presented. It suggests that ligation is not an adequate procedure for large coronary fistulae. Division and oversewing should be done whenever feasible.

Acute coronary hemodynamic response to cigarette smoking in patients with coronary artery disease.

The acute changes in coronary blood flow and coronary resistance that occur in response to cigarette smoking have not been accurately determined. To define the factors that affect this response, coronary sinus blood flow was measured in 16 patients (group I) with coronary artery disease and in 6 patients (group II) without angiographically detectable coronary disease. Seven patients (group IA) had severe (greater than or equal to 75%) proximal left coronary lesions and nine patients (group IB) had significant distal lesions with 50% or less proximal stenoses.

Effect of intravenous dipyridamole on regional coronary blood flow with 1-vessel coronary artery disease: evidence against coronary steal.

The effects of i.v. dipyridamole were studied in 9 patients with isolated total left anterior descending coronary artery (LAD) obstruction, in 6 patients with isolated 90 to 99% diameter reduction of the LAD and in 10 patients with normal coronary arteries and normal left ventricular function.

Acute myocardial infarction with normal coronary arteries. In vivo demonstration of coronary thrombosis during the acute episode.

Two cases with acute myocardial infarction are presented. Both had thrombotic occlusion of the infarct-related artery. Following successful thrombolysis with streptokinase, coronary angiography was normal.

Large V waves in the pulmonary capillary wedge pressure tracing without mitral regurgitation: the influence of the pressure/volume relationship on the V wave size.

We have previously demonstrated that a large V wave in the pulmonary capillary wedge tracing may occur in the absence of mitral regurgitation. This study evaluates the role of left atrial and pulmonary vein compliance on such a finding. We studied 11 patients with coronary disease, without clinical or angiographic mitral regurgitation.

Angiographic study of the infarct-related coronary artery in the chronic stage of acute myocardial infarction.

We and others have demonstrated a high prevalence of total coronary occlusion during the acute phase of myocardial infarction (MI). This study reports the angiographic appearance of the infarct-related artery (IRA) in 130 patients with a history of MI, who underwent cardiac catheterization 2 weeks to more than 12 months afterwards. The IRA was the left anterior descending in 47%, the right coronary artery in 50%, and the circumflex in 3% of cases.

Association of coronary artery disease and valvular heart disease in Chile.

This study analyzes the prevalence of coronary artery disease (CAD) among patients with rheumatic valvular heart disease (VHD) in Chile. Coronary angiography was performed in all patients referred to cardiac catheterization with VHD who were over age 50 years and who had angina or ECG signs of ischemia. A total of 100 patients entered the study.

Endogenous proteolysis of membrane-bound red cell cytochrome-b5 reductase in adults and newborns: its possible relevance to the generation of the soluble "methemoglobin reductase".

The problem of the low activity of so-called methemoglobin reductase in red cells from newborns was reinvestigated in view of our current knowledge of this enzyme, i.e., (1) its being cytochrome-b5 reductase and (2) its presence in two forms: soluble and membrane-bound.

Effects of chronic tobacco smoking on the coronary circulation.

The effects of chronic smoking on the coronary circulation were studied by evaluating the coronary vascular reserve in 12 chronic smokers (group 1) and 10 nonsmokers (group 2). All patients were referred to cardiac catheterization for evaluation of chest pain and were found to have normal coronary and left ventricular angiograms. Coronary vascular reserve was measured by analyzing the hyperemic response to selective coronary injection of contrast agent.

Can noninvasive exercise test criteria identify patients with left main or 3-vessel coronary disease after a first myocardial infarction?

This study attempts to determine whether exercise treadmill testing with clinical, electrocardiographic, and thallium-201 myocardial perfusion imaging data can identify which patients have left main or 3-vessel (anatomically high-risk) coronary artery disease (CAD) after their first transmural myocardial infarct (MI). Twelve exercise test criteria for high-risk disease were compared in 40 patients referred for cardiac catheterization; 34 had a history of chest pain and 17 had angiographically defined high-risk CAD. A thallium image defect outside the vascular distribution of the MI was the most reliable criterion to distinguish patients with high-risk CAD (p = 0.

Coronary vascular reserve in left ventricular hypertrophy secondary to chronic aortic regurgitation.

Coronary vascular reserve was studied in 11 patients with severe chronic aortic regurgitation (AR). Nineteen patients with the chest pain syndrome and normal findings on cardiac catheterization served as control subjects. Resting coronary sinus flow and contrast-agent-induced hyperemia were measured by continuous thermodilution.

Determinants of ventricular tachycardia in patients with coronary artery disease and ventricular aneurysm. Clinical, hemodynamic, and angiographic factors.

Many patients with coronary artery disease (CAD) in whom ventricular tachycardia (VT) develops have transmural scars or frank aneurysms. However, only a minority of patients with ventricular aneurysms go on to develop VT. To determine which factors are associated with the development of VT in patients with aneurysms, we retrospectively reviewed the records of 154 patients with CAD and segments of akinesia or dyskinesia, or both, on left ventriculography.

Elevated NAD(P) glycohydrolase activity: a possible enzymatic marker for malignancy in Burkitt's lymphoma cells.

A comparative analysis of enzymatic activities has been performed on 47 human continuous lymphoid lines: 22 tumors derived from Burkitt's lymphoma lines, 6 other lymphomatous long-term cultures, and 19 nonmalignant ties determined on the cell extracts. 4 showed no significant differences between the various lines. They included adenosine diphosphoribose incorporation, glucose-6-phosphate dehydrogenase, cyclic-AMP phosphodiesterase, and glutathione reductase.

Coronary collateral function during exercise.

A totally occluded coronary vessel subtending a noninfarcted, entirely collateral-dependent myocardial region (NIECDMR) provides an opportunity to assess collateral perfusion during exercise stress. Collateral function was determined by analysis of exercise thallium-201 myocardial perfusion images from 31 patients who had at least one NIECDMR (total 41 NIECDMRs) documented during catheterization. Twenty-two of 41 NIECDMRs manifested exercise-induced perfusion defects and 19 were normally perfused.

Angina pectoris before and after myocardial infarction. Angiographic correlations.

Clinical, hemodynamic, and angiographic data were examined in 97 consecutive patients who underwent catheterization within two years of documented acute transmural myocardial infarction. The patients were divided according to the absence or presence of angina pectoris prior to myocardial infarction (groups 1 and 2). Group 1 had more females, was younger, and had a greater prevalence of one-vessel coronary artery disease.