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Biomedical subjects

H D McIntosh

Publications and source records attributed to H D McIntosh.

At least 19 recordsLinked to original sources
PubMed1979

Aortocoronary bypass grafting in the management of patients with coronary artery disease.

There is widespread agreement that aortocoronary bypass grafting generally lessens the symptoms and functional limitations of patients with angina pectoris. Evidence for prolongation of life or prevention of myocardial infarction, arrhythmias and ventricular dysfunction is inconclusive. Harmful effects associated with surgical management of coronary artery disease can be documented in terms of operative mortality, perioperative myocardial infarction, graft occlusion and progression of occlusive disease in the native circulation. In this review of published experience, the accomplishments and the limitations of myocardial revascularization are considered in various clinical settings. Critical assessment of evolving information leads to the conclusion that widespread application of this procedure beyond the alleviation of symptoms refractory to medical therapy is not justified by present data.

Angina Pectoris↗
PubMed1978

Benefits from aortocoronary bypass graft.

The first aortocoronary bypass graft (ACBG) for coronary heart disease (CHD) was performed in 1964. From 1967 to the summer of 1977, between 250,000 and 300,000 such procedures were performed in this country. With such extensive experience, the patient might expect that most questions regarding the effectiveness of the procedure in the treatment of CHD would have been answered. Unfortunately, this is not the case. After a decade of experience, all that is truly known about the procedure is that for most patients, it does improve the quality of life and, if present practices continue, will add greatly to the cost of medical care in this country. It appears that there is still a need for more randomized, controlled studies.

Arrhythmias, Cardiac↗
PubMed1978

The first decade of aortocoronary bypass grafting, 1967-1977. A review.

Despite a decade of experience with aortocoronary bypass grafting embracing 300,000 or more operations, indications for its use remain controversial. The controversy persists because of a lack of adequate controls with which to compare the clinical course of operated patients; only 1248 have been reported who have been studied in a carefully controlled and random manner. Benefit has been claimed frequently by comparing the course of patients treated surgically with medically treated patients followed the decade before. Such comparisons are not valid in view of the well documented changes in the natural history of coronary artery disease that have been occurring during the last decade. Despite a low operative mortality and rate of graft closure, available data in the literature do not indicate that initial symptomatic improvement necessarily persists, or that myocardial infarctions, arrhythmias, or congestive heart failure will be prevented, or that life will be prolonged in the vast majority of operated patients.

Angina Pectoris↗
PubMed1975

The incidence and clinical implications of coronary artery spasm.

The total incidence of coronary artery spasm during coronary angiography has been reported to be between 0.26% and 0.93%. The rarity of this phenomenon has been invoked to minimize its clinical significance. Review of a one-year experience in our catheterization laboratory showed that coronary spasm occurred in eight of 274 coronary angiograms (2.93%). In three instances, spasm could not be ascribed to catheter tip irrigation, and was considered to be spontaneous. Since multiple factors during coronary arteriography might inhibit the occurrence of coronary spasm, it is believed that the incidence of spontaneous spasm may be higher than can be documented during angiography. Coronary spasm may have important clinical significance in various chest pain syndromes and greater methodical attention should be directed toward this phenomenon.

Adult↗