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Biomedical subjects

D Luke Glancy

Publications and source records attributed to D Luke Glancy.

At least 19 recordsLinked to original sources
PubMed2004

Stenting of atherosclerotic stenoses in anomalously arising coronary arteries.

This description of five cases brings to 37 the total number of reported patients in whom atherosclerotic lesions of anomalously arising coronary arteries have been stented. One-half of these have been right coronary arteries arising from the left sinus of Valsalva, followed in frequency by branches of single coronary arteries arising from solitary aortic ostia and left circumflex arteries arising from the right sinus of Valsalva or from the proximal portion of the right coronary artery. Proper guide-catheter selection, essential for successful stenting, usually matches the guide's configuration to the sinus of Valsalva from which the anomalous artery originates rather than to the final distribution of the coronary artery.

Adult↗
PubMed2003

Percutaneous stenting of anastomotic stenoses in tubular interposition grafts used to repair aortic coarctation in adults.

Stenting is the usual treatment for recoarctation following resection with direct end-to-end anastomosis. We describe for the first time stenting to relieve anastomotic stenoses in tubular interposition grafts, which are used to repair approximately 10% of coarctations. Success in these two adults expands further the spectrum of large conduits that may be relieved of stenosis by stenting.

Adult↗
PubMed2002

Right coronary artery arising from the pulmonary trunk in a 63-year-old man.

Unlike anomalous origin of the left coronary artery (CA) from the pulmonary trunk (PT), right CA from the PT, a rare congenital malformation, may present in adulthood. We herein describe a man with anomalous origin of the right CA from the PT who presented with angina and syncope at age 63.

Angina Pectoris↗
PubMed2002

ECG discrimination between right and left circumflex coronary arterial occlusion in patients with acute inferior myocardial infarction: value of old criteria and use of lead aVR.

STUDY OBJECTIVES: Prior studies have proposed several ECG criteria for identifying the culprit artery in patients with acute inferior myocardial infarction (MI). We applied each criterion to our patients to assess its utility. In doing so, we discovered a previously unreported, but highly useful, criterion utilizing lead aVR. STUDY DESIGN: Retrospective review. PATIENTS: Thirty consecutive patients with symptoms of acute MI, ST-segment elevation in the inferior ECG leads, an appropriate rise and fall of creatine kinase and troponin I levels, and coronary arteriography within 7 days of the onset of symptoms. MEASUREMENTS: The ECG recorded within 24 h of the onset of symptoms that had the most prominent ST-segment changes was analyzed. In the 12 standard leads and in lead V(4)R, ST-segment elevation or depression was measured 0.06 s after the J point. RESULTS: Four previously described criteria were useful in identifying the right coronary artery (RCA) or the left circumflex coronary artery (LCX) as the culprit: ST-segment elevation in lead I, ST-segment more or less elevated in lead II than in lead III, ST-segment elevation >or= 0.5 mm in lead V(4)R, and various combinations of ST-segment elevation or depression in leads V(1) and V(2). A new criterion was found to be at least as useful as any previously described: the presence and amount of ST-segment depression in lead aVR. CONCLUSIONS: At least five different ST-segment criteria help to identify the RCA or the LCX as the culprit artery in patients with acute inferior MI. One of these, the amount of ST-segment depression in lead aVR, has not been reported previously and needs validation in a larger study.

Coronary Angiography↗
PubMedDate not supplied

Clinical case of the month. Chest pain, diaphoresis, and dyspnea in a hypertensive 53-year-old man.

Aortic dissection is a life-threatening condition requiring urgent diagnosis and treatment. The initial challenge for the physician lies in distinguishing aortic dissection from more common conditions such as myocardial infarction that also are characterized by chest pain. Subsequent management depends on imaging techniques that define whether just the descending aorta is affected or its more proximal portions as well. Mortality and morbidity are high, especially when the ascending aorta is involved.

Aortic Dissection↗
PubMedDate not supplied

Risk factors among medically indigent women < or = 45 years old with angiographically proven obstructive coronary arterial disease.

BACKGROUND: Risk factors for angiographically proven coronary arterial disease (CAD) have not been assessed in a large cohort of young medically indigent women, who are known to have more CAD than better educated and more affluent women. METHODS: In a 2-year period, 165 medically indigent women < or = 45 years old underwent coronary arteriography for symptoms suggesting CAD. We compared the prevalence of risk factors in the 100 with obstructive CAD with the prevalence in the 65 with non-obstructive or no CAD. RESULTS: Both groups had high prevalences of all of the standard risk factors. Compared to the 65 without, the 100 with obstructive CAD more often smoked, had diabetes mellitus, had a family history of CAD, and more often had had a myocardial infarct. CONCLUSION: CAD in medically indigent young women is not rare and is best predicted by symptoms, smoking, and diabetes mellitus.

Adult↗
PubMedDate not supplied

Congenitally bicuspid aortic valves in adults.

The congenitally bicuspid aortic valve occurs in more than 1% of the population. Although it may never cause difficulty and first be discovered at autopsy, more often it results in some hemodynamic abnormality. Its clinical manifestations are varied, and its early recognition is essential if we are to prevent the dreaded complication of infective endocarditis.

Adult↗