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Query: UMLS:C0002962 (angina)
 21,142 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 40-year-old patient with moderate factor IX deficiency (Christmas disease) underwent quadruple saphenous vein coronary bypass grafts for angina and severe coronary atherosclerosis involving the left and right main, left anterior descending, and circumflex coronary arteries. Excessive bleeding was prevented by infusion of factor IX concentrates during and after the operation. The surgical procedure and total body perfusion were carried out in the same manner as in patients without a hemorrhagic disorder. The patient was discharged after 13 days of hospitalization. He is doing well at the time of this publication and has returned to work.
J Thorac Cardiovasc Surg 1979 Apr
PMID:Coronary bypass in a patient with hemophilia B, or Christmas disease. Case report. 31 96

Until recnetly, coronary arterial perfusion was one of the best methods to protect myocardium during aortic valve replacement. However, the insertion of perfusion cannulas may produce immediate traumatic lesions and late stenosis of the coronary arteries, with grave consequences. Two patients with normal coronary arteries prior to operation developed obstruction of the maximal left main coronary artery following aortic replacement. One of these patients represents the first case of iatrogenic coronary arterial stenosis in which the aortic valve was replaced with a porcine bioprosthesis. Accelerating angina pectoris and ventricular arrhythmias were the presenting clinical manifestations. Aorta-coronary bypass grafting to the left anterior descending and circumflex coronary arteries was successfully performed in one patient, while the other patient died before investigative procedures could be undertaken. Any patient whose aortic valve has been replaced and who develops angina pectoris a few months after operation should be suspected of having developed stenosis of the proximal coronary artery. Coronary angiography should be perfomed promptly. Once the lesion is recognized, the operaiton should be performed posthaste because these lesions are life threatening owing to their proximal location and rapid evolution.
J Thorac Cardiovasc Surg 1979 May
PMID:Iatrogenic coronary artery stenosis following aortic valve replacement. 31 74

To assess the operative mortality and long-term results in patients undergoing repeat revascularization for recurrent angina, we analyzed 48 consecutive patients operated upon at New York University Medical Center between 1970 and 1978. Between January, 1970, and July, 1973, 15 patients underwent repeat revascularization with five operative deaths (33 percent). Thirty-three patients underwent similar operations from July, 1973, to July, 1978, with only one operative death (3 percent). Technical factors and improved methods of myocardial protection during the operation directly influence this decrease in operative mortality rate. The indication for reoperation was incapacitating angina developing within 2 months of the inital operation in 18 patients (early failures) and after more than 2 months in 30 patients (late failures). The early failures were most commonly attributed to technical factors (33 percent) and graft occlusion by exuberant pericardial scarring (33 percent). The late failures were commonly related to the development of new native coronary lesions (47 percent) and selection of an incorrect site for distal anastomoses (23 percent). The prognostic and therapeutic implications of these findings will be discussed in detail. Angina was abolished or significantly decreased in 90 percent of the survivors, and there were only two late deaths occuring 18 and 20 months postoperatively. These data indicate that patients undergoing repeat myocardial revascularization can be operated upon with low operative mortality rates and symptomatic improvement comparable to that of patients undergoing coronary artery bypass for the first time.
J Thorac Cardiovasc Surg 1979 Jun
PMID:Angina following myocardial revascularization. Does time of recurrence predict etiology and influence results of operation? 31 65

Three patients with angina pectoris were studied before and after aortocoronary bypass surgery. Angiographic studies were performed with and without atrial pacing. Preoperative atrial pacing in all three patients resulted in angina and/or ST segment changes accompanied by regional left ventricular contractile abnormalities, decreased ejection fraction, as well as decreased left ventricular end-diastolic and stroke volumes. After surgery with all grafts patent, atrial pacing at similar heart rates did not produce an ischemic response. Left ventricular contractile pattern remained normal, and there was no change in ejection fraction though end-diastolic and stroke volumes decreased. These studies demonstrate that aortocoronary bypass surgery can abolish both the ischemic response and left ventricular dysfunction that accompany atrial pacing.
Cathet Cardiovasc Diagn 1979
PMID:Atrial pacing induced left ventricular dysfunction: reversibility after aortocoronary bypass surgery. 31 53

Percutaneous transluminal dilatation (PTD) of coronary stenosis is performed by means of a balloon-tipped catheter introduced from a peripheral artery. PTD was attempted in 56 patients; stenosis was successfully dilated in 38 patients (68%). The method failed in 18 patients: in 6 (11%) of them an abrupt closure of the stenosed artery or a beginning infarction necessitated an emergency revascularization. There were no serious complications or deaths; one patient developed a transmural infarction in spite of the immediate bypass grafting. PTD was also successful in 6 out of 9 patients with recurrent angina following previous coronary bypass grafting. Intraoperative dilatation by coronary arteriotomy was attempted in 6 patients, but the results were inconclusive. PTD is a new method of treatment of coronary artery disease; it represents an addition rather than an alternative to coronary bypass grafting. The decision for PTD should be made jointly by cardiologist and surgeon; the ideal patient has a short history of angina with narrow, proximal stenosis without any calcifications. Cardiosurgical standby is mandatory during PTD; the results are best and the risk lowest in patients with single vessel disease.
Thorac Cardiovasc Surg 1979 Jun
PMID:Percutaneous transluminal dilatation of coronary artery stenosis. 31 12

Thallium-201 myocardial scintigraphy, which has been shown accurate in the assessment of myocardial perfusion, was employed in the evaluation of 34 patients after coronary artery bypass surgery. In 28 patients (82.4%), there was a clear correspondence in the postoperative studies between the defects shown on scintigraphy and the coronary artery stenosis documented by arteriography. Thallium imaging after coronary artery bypass revealed an increased or newly developed scintigraphic defect in eight of 10 patients with recurrent angina. Follow-up arteriography in these 10 patients revealed occlusion or stenosis of the bypass graft in five, perioperative myocardial infarction in two, and increased stenosis of a preoperatively less occluded artery in two. In 24 patients with postoperative clinical improvement or relief of angina, 201Tl scintigraphy revealed complete normalization of thallium uptake in three, improvement of uptake in 17, and unchanged uptake defects in four.
Cardiovasc Radiol 1979 Nov
PMID:Noninvasive perfusion control by thallium-201 myocardial scintigraphy after coronary artery bypass surgery. 31 55

Among patients consecutively admitted to a coronary care unit (CCU) without a subsequent diagnosis of acute myocardial infarction (AMI), a subgroup fo unstable angina was selected, defined as continued episodes of angina at rest during a 48-hour period, despite medical treatment in the CCU. During a four-year period, 15 patients fulfilled these criteria. Eight patients were medically treated, seven of whom developed an AMI with three subsequent deaths. Six of the infarcts occurred within eight days of admission. In six patients, fulfilling the criteria, surgical treatment was performed. Angiography and surgery in this group were associated with low incidences of myocardial infarction, late infarction and death. In one patient, surgery was declined due to unfavourable anatomical conditions. This patient subsequently developed an AMI and died. It is concluded that the combination of recent onset of angina and continued episodes of angina at rest, despite medical treatment, selects a high risk subgroup of unstable angina. Acute coronary angiography and surgery ought to be considered in this subgroup.
Scand J Thorac Cardiovasc Surg 1979
PMID:A high risk subgroup of patients with unstable angina pectoris treated medically or surgically. 31 85

A follow-up study of 132 patients with stable angina pectoris, who underwent a bypass operation during the period 1970-1976, is presented. The survival curves and mortality rates for this group and for 180 patients, who had previously undergone indirect revascularization, are given. At the first follow-up after bypass operation, 87% of the patients were subjectively improved, 72% of the vein grafts were patent and 85% of the patients had at least one graft patent. A positive correlation was found between patent grafts and subjective improvement. A similar correlation between subjective and objective improvement (exercise test) was not found.
Scand J Thorac Cardiovasc Surg 1979
PMID:Surgical treatment of angina pectoris. A follow-up study with special reference to clinical results after bypass. 31 86

Forty-two patients with acute coronary insufficiency (high risk subgroup) were randomly assigned to urgent coronary bypass surgery or to initial medical therapy followed by elective coronary bypass at four months if indicated at that time for relief of incapacitation angina pectoris. Coronary bypass performed on an urgent basis offered no advantage in preventing early myocardial infarction or death. The acute illness was resolved without permanent complications in most patients by either urgent bypass surgery or intensive medical therapy. The functional capacity at four months as assessed by objective testing was much greater in the urgent surgical group. Elective bypass surgery was carried out at that point in about half of the medical patients due to persistent incapacitating angina. Later serious complications have continued to occur in the medical patients but have not occurred up to the present time in the urgent surgical patients.
Cardiovasc Clin 1977
PMID:Medical vs. urgent surgical therapy for acute coronary insufficiency: a randomized study. 33 70

It is apparent that coronary artery disease is extremely common. As many as 15 percent of young men have significant disease of at least one major coronary artery. Each year approximately 1 percent of middle aged men will develop symptoms of coronary disease. The standard risk factors identify people with a greater risk of developing symptoms. The overall mortality rate of symptomatic patients is about 4 to 5 percent per year in patients with all types of angina pectoris and in survivors of acute myocardial infarction. In symptomatic patients it is possible to identify groups with a risk a dying as low as 1 percent per year and other groups with a risk of dying of 25 to 50 percent per year by simple, noninvasive techniques. However the most powerful predictors of survival in asymptomatic or symptomatic patients are the severity of the coronary artery disease and damage to the left ventricle.
Cardiovasc Clin 1977
PMID:Expected course of patients with coronary artery disease. 33 71


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