Subject(s)
Angioplasty, Balloon , Coronary Disease/therapy , Adult , Female , Humans , Male , Middle AgedABSTRACT
Early experience with repeat transcutaneous transluminal coronary angioplasty (TTCA) in 9 coronary patients is reviewed. The interval between the first and the repeat TTCA varied between 1 and 12 months averaging 4.9 +/- 4.7 months. Repeat dilatation of the anterior interventricular branch was performed in 7 patients, that of the right coronary artery, in 1, and that of the circumflex artery, in 1. All repeat operations were successful. Changes in the degree of stenosis and the mean arterial blood pressure gradient were actually similar in both dilatations.
Subject(s)
Angioplasty, Balloon , Coronary Disease/therapy , Coronary Angiography , Coronary Disease/diagnostic imaging , Female , Humans , Male , Middle Aged , Recurrence , Time FactorsABSTRACT
Transcutaneous transluminal coronary angioplastics (TTCA) was performed in 28 coronary heart disease patients (8 patients had stable and 5 others labile angina, 15 presented acute myocardial infarction, AMI). The patients with AMI received intracoronary thrombolytic treatment prior to TTCA. Successful dilatation was performed in one patient with narrowing of the main trunk of the left coronary artery, in 14 of 21 patients with the stenosis of the anterior interventricular branch and in 5 of 6 patients with the narrowing of the right coronary artery. In three cases TTCA was carried out in the presence of the occluded coronary artery, with two patients benefiting from the operation. In 5 patients with AMI in whom an attempt to dilate the lumen of the coronary artery was unsuccessful, emergency surgery for aorto-coronary shunting was conducted. This operation was also performed in the planned order in 2 angina patients. In 7 patients the failure of TTCA was explained by the impossibility to pass the dilatary sound through the stenosis of the coronary artery and in 1 case by the failure to enter the ostium of the left coronary artery with the guiding catheter.
Subject(s)
Angina Pectoris/therapy , Angina, Unstable/therapy , Angioplasty, Balloon , Myocardial Infarction/therapy , Adult , Aged , Coronary Vessels , Female , Follow-Up Studies , Humans , Male , Middle Aged , Myocardial ContractionABSTRACT
Transcutaneous transluminal coronary angioplastics was performed in 8 patients with acute myocardial infarction. In five patients dilatation of the coronary artery was carried out after intracoronary thrombolytic therapy and in the 3 others without the preliminary infusion of streptokinase. The method proved effective in 6 out of the 8 patients: the diameter of stenosis of the coronary artery decreased on the average from 70.4 +/- 3.9 to 23.5 +/- 12.9%, the area of stenosis reduced from 91.1 +/- 2.3 to 40.8 +/- 12.9%. Control angiography conducted in 4-5 weeks showed that in all five patients examined, the effect of the dilatation persisted. An improvement of the contractile function of the left ventricle was also observed.
Subject(s)
Angioplasty, Balloon , Coronary Vessels , Myocardial Infarction/therapy , Adult , Angioplasty, Balloon/methods , Calcium Channel Blockers/therapeutic use , Combined Modality Therapy , Coronary Angiography , Evaluation Studies as Topic , Fibrinolytic Agents/therapeutic use , Follow-Up Studies , Humans , Male , Middle AgedABSTRACT
The intracoronary administration of nitroglycerin and streptokinase was assigned to 95 patients with acute myocardial infarction. In 69 (79.3%) out of the 87 occluded coronary arteries the antegrade blood flow was restored. After the thrombolysis, aortocoronary shunting was performed in 26 patients and transcutaneous transluminal coronary angioplastic surgery in five patients. In 71 patients control angiographic examination was carried out 17-185 days later. It was revealed that in 73.7% of drug-treated patients, the antegrade blood flow was retained for an average of 37 days. Patients with the intact coronary blood flow after the thrombolysis exhibited a positive pattern of the parameters of left ventricular contractile function which was especially expressed following aortocoronary bypassing. In cases of thrombolysis failure or reocclusion, left ventricular contractility had a negative profile.
Subject(s)
Myocardial Infarction/drug therapy , Nitroglycerin/administration & dosage , Streptokinase/administration & dosage , Adult , Aged , Coronary Vessels/drug effects , Drug Therapy, Combination , Female , Humans , Infusions, Intra-Arterial , Male , Middle Aged , Myocardial Contraction/drug effects , Regional Blood Flow/drug effectsABSTRACT
Urgent selective coronarography followed by intracoronary infusion of nitroglycerin and streptokinase (2000-4000 U/min) was performed in 24 patients with acute myocardial infarction. Mechanical recanalization of an occluded coronary artery was also performed in two patients. The coronary artery supplying the infarcted area was occluded in 22 patients while 2 patients had third-degree stenosis. Following intracoronary drug infusion, antegrade flow was recovered completely in 16 of 22 occluded coronary arteries (72.7%). All patients, however, retained acute coronary arterial stenosis around former occlusions. Aortal-coronary shunting was performed within 1 to 20 days in 6 patients.
Subject(s)
Coronary Vessels/drug effects , Myocardial Infarction/drug therapy , Streptokinase/administration & dosage , Adult , Drug Therapy, Combination , Female , Humans , Infusions, Intra-Arterial , Male , Middle Aged , Nitroglycerin/administration & dosageABSTRACT
The results of urgent coronarography and ventriculography in 95 patients with pre-infarction state and acute myocardial infarction are analyzed. It is established that from the beginning of the acute anginal attack till the end of coronarography 13 h 40 min (average) have elapsed. In 13 patients angiographically normal coronaries have been found, 2 of them had myocardial infarction. It is recorded that in patients with pre-infarction state and acute myocardial infarction the affection of the coronaries is more severe than in those with stable angina pectoris. Coronary vessels fit for revascularization of the myocardium were found in 71.4% of patients. Disorders of contractility of the left ventricle were seen in 81.6% of cases.
