Measuring myocardial damage.
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Biomedical subjects
Publications and source records attributed to R A Clugston.
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This study was conducted to establish the validity of left-sided cardiac output measurement with a Swan-Ganz catheter and assess its accuracy in estimating mitral valve area (MVA) by the Gorlin formula. The use of right-sided cardiac output after balloon mitral valvotomy (BMV) can give inaccurate measurements for Gorlin-derived MVA because of the atrial septal defect (ASD) created during the procedure. The left-sided cardiac output was measured with a Swan-Ganz catheter (proximal port in the left atrium and then in the left ventricle, and distal port in the ascending aorta) in 10 consecutive patients before and after BMV. Gorlin-derived MVA cardiac output by this method was compared with (1) Gorlin-derived MVA by means of right-sided cardiac output with and without balloon occlusion of the ASD and (2) MVA measured by echocardiography. Before BMV, a close agreement with a good correlation between left-sided and right-sided cardiac output was found (r = 0.83, p = 0.006). Furthermore, Gorlin-derived MVA by cardiac output with either method was comparable with valve area by echo. After BMV, left-sided cardiac output correlated well (r = 0.92, p = 0.0002) and was comparable with right-sided cardiac output with occlusion of the ASD (mean difference 0.17 +/- 0.49 L/min, p = 0.3) but was significantly lower than the value obtained with open ASD (mean difference 0.93 +/- 0.77 L/min, p = 0.004). Comparison of the correspondent MVAs yielded similar results. Gorlin-derived MVA with left-sided cardiac output and MVA by echo were also similar.(ABSTRACT TRUNCATED AT 250 WORDS)
Conventional techniques of coronary angioplasty for lesions at coronary bifurcations are well documented, are sometimes cumbersome, and have inherent limitations. We describe a technique for sequential atherectomy at coronary bifurcations. Further evaluation is needed to determine the overall safety, efficacy, applicability and durability of sequential directional atherectomy at coronary bifurcations.
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Cardiac function in a 75-year-old woman with primary amyloidosis and a restrictive cardiomyopathy deteriorated markedly after the occurrence of high-grade atrioventricular block. Atrial synchronous cardiac pacing, which was unreported previously in this setting, produced a marked improvement in cardiac performance.