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A R Grüntzig

Publications and source records attributed to A R Grüntzig.

7 recordsLinked to original sources
PubMed1987

Relation of coronary artery stenosis and pressure gradient to exercise-induced ischemia before and after coronary angioplasty.

The purpose of this investigation was to evaluate the relation of coronary artery stenosis and associated pressure gradient to the magnitude of exercise-induced left ventricular dysfunction in patients with single vessel coronary artery disease. The percent stenosis and minimal cross-sectional area were measured before and after percutaneous transluminal coronary angioplasty and compared with radionuclide measurements of left ventricular function before and after angioplasty in 41 patients with proximal left anterior descending coronary artery lesions, providing 82 points of comparison. The gradient could be measured for 75 comparisons. Forty stenoses less than 50% were associated with a mean left ventricular exercise ejection fraction of 0.66 +/- 0.08 (mean +/- SD), 25 stenoses from 50 to 75% with a mean ejection fraction of 0.59 +/- 0.12 and 17 stenoses greater than 75% with a mean ejection fraction of 0.49 +/- 0.08. Thirty-five stenoses with a gradient less than 20 mm Hg were associated with a mean ejection fraction of 0.65 +/- 0.09, 24 with a gradient from 20 to 50 mm Hg with a mean ejection fraction of 0.58 +/- 0.13 and 16 with a gradient greater than 50 mm Hg with a mean ejection fraction of 0.53 +/- 0.10. These data document a relation between the magnitude of coronary artery stenosis and associated gradient to exercise-induced left ventricular dysfunction in homogeneous patient groups. However, discordance of these variables occurs commonly in individual patients.

Adult↗
PubMed1985

[Percutaneous transluminal coronary angioplasty: results after a 5-year follow-up period].

In the first series of 50 patients in whom percutaneous transluminal coronary angioplasty (PTCA) was attempted, the procedure was successful in 32. 23/32 patients were followed up clinically over 62.2 +/- 5.6 (SD) months. Repeated non-invasive laboratory tests were carried out in 15/23 patients. Moreover, 11/15 patients were restudied by arteriography at the end of the follow-up period. Early recurrence of the stenosis occurred in 5/32 patients (16%) and was again successfully treated by a second PTCA in 2. 3 patients underwent surgery as requested. 22/23 (95%) remained symptom-free during the follow-up period. The results of the non-invasive laboratory tests were in close agreement with the clinical findings. Coronary arteriography performed at the end of the follow-up period revealed an excellent lasting effect of PTCA in 8/11 patients. 2 showed a slight progression of the three stenoses treated by PTCA, and in 1 patient late recurrence of the stenosis was suspected since he had been symptom-free up to 2 weeks prior to restudy. Thus, in patients who are suitable for PTCA, this treatment is of long-lasting effect and represents an excellent alternative to coronary artery bypass surgery.

Adult↗
PubMed1979

Nonoperative dilatation of coronary-artery stenosis: percutaneous transluminal coronary angioplasty.

In percutaneous transluminal coronary angioplasty, a catheter system is introduced through a systemic artery under local anesthesia to dilate a stenotic artery by controlled inflation of a distensible balloon. Over the past 18 months, we have used this technic in 50 patients. The technic was successful in 32 patients, reducing the stenosis from a mean of 84 to 34 per cent (P less than 0.001) and the coronary-pressure gradient from a mean of 58 to 19 mm Hg (P less than 0.001). Twenty-nine patients showed improvement in cardiac function during follow-up examination. Because of acute deterioration in clinical status, emergency bypass was later necessary in five patients; three showed electrocardiographic evidence of infarcts. Patients with single-vessel disease appear to be most suitable for the procedure, and a short history of pain indicates the presence of a soft (distensible) atheroma likely to respond to dilatation. We estimate that only about 10 to 15 per cent of candidates for bypass surgery have lesions suitable for this procedure. A prospective randomized trial will be necessary to evaluate its usefulness in comparison with surgical and medical management.

Adult↗