Biomedical subjects
Publications and source records attributed to C B Kourouklis.
We describe a patient in whom calcific pulmonary vascular stenosis was diagnosed at the age of 84 years. Valve stenosis was relieved by percutaneous transluminal pulmonary valvuloplasty. To our knowledge, PTPV performed at this age has not been previously reported.
A 60-year-old man with a single left coronary artery associated with an annuloaortic ectasia and a ventricular septal defect is described. He presented with severe heart failure and underwent open-heart surgery during which all these entities were confirmed.
STUDY OBJECTIVE: The aim of the study was to determine whether moderate reduction in regional myocardial blood flow is related to epicardial ST segment depression and to the changes in grade and extent induced in this variable by antianginal drugs. DESIGN: Blood flow through the anterior descending coronary artery was reduced to 25-30% of control in open chest dogs, using a cuff flow meter as a monitor, and glyceryl trinitrate, propranolol and nifedipine were infused 60 min later. Regional left ventricular blood flow was measured with 15 mu radioactive microspheres and electrocardiograms were recorded from the epicardial surface of the anterior left ventricular wall before and after administration of the drugs. EXPERIMENTAL SUBJECTS: 20 adult male greyhounds were used, weighing 19-24 kg. MEASUREMENTS AND RESULTS: Under control conditions there was a poor correlation between ST segment depression and regional flow. Neither glyceryl trinitrate nor nifedipine had any significant effect on ST segment depression in sites overlying zones with a flow range of 80-105% of normal flow. On the other hand, glyceryl trinitrate, but not nifedipine, decreased ST segment depression in sites overlying the central ischaemic zone (35-80% of control posterior wall flow). With propranolol, mean ST depression was decreased significantly in sites overlying the central ischaemic zone (35-80% of control flow), but not in sites overlying zones with flows ranging from 80-105% of normal. Propranolol reduced blood flow to all zones. CONCLUSIONS: Epicardial ST segment depression is unreliable for the quantitative exploration of the grade and extent of myocardial ischaemia.
Coronary angiograms of 309 consecutive patients undergoing coronary angiography were reviewed to investigate the blood supply to the sinus node area. Blood was supplied from the right coronary artery in 59% of cases, from the left coronary artery in 38%, and from both coronary arteries in 3%. The posterior sinus node artery was demonstrated in 32 patients (27% of the 119 patients with the sinus node artery originating from the left circumflex and 10.5% of all patients).