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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between 1979 and 1988, 656 patients were operated upon for abdominal aortic aneurysm. Elective operation was performed in 287 patients (44%) and acute operation in 369 patients. A ruptured aneurysm was found in 218 patients (33%). Patients with arteriosclerotic heart disease, hypertension, impaired renal function or chronic pulmonary disease showed an increased perioperative mortality. Development of postoperative cardiac and renal complications could not be related to previous cardiac or renal diseases. The major postoperative complications were renal failure in 81 patients (12%), pulmonary insufficiency in 77 patients (11%) and cardiac complications in 96 patients (13%). Failure of one or more organs occurred in 153 patients (23%) and the mortality rate for patients with multiorgan failure was 68%. Complications leading to reoperation occurred in 93 patients (14%). The perioperative mortality was 18.8%. The mortality for elective cases was 4.8%, for symptomatic cases 17.2% and 37% for ruptured aneurysms. The five-year survival rate was 48% for ruptured aneurysms, 70% for symptomatic cases and 75% for elective cases. After six months the life expectancy in these three groups of patients were identical and comparable to the expected survival for a sex and age matched control population.
J Cardiovasc Surg (Torino)
PMID:Surgery for abdominal aortic aneurysms. A survey of 656 patients. 193 27

Increased pulmonary blood flow and pulmonary hypertension are frequent problems in infants with congenital heart disease. Although the use of pulmonary artery banding to limit pulmonary blood flow has decreased, the procedure may still be beneficial in certain forms of complex heart disease. The ability to noninvasively relieve the obstruction caused by the band may significantly reduce later operative complexity or even avoid reoperation entirely. The present study evaluated the effectiveness of a balloon-dilatable pulmonary artery band. Twenty 1-week-old dogs had a band of an absorbable suture material (Vicryl; Ethicon, Inc., Somerville, N.J.) placed around the main pulmonary artery. Eight dogs underwent angioplasty 6 months after band placement and also underwent follow-up catheterizations 3 and 6 months after angioplasty. Balloon angioplasty acutely reduced both the right ventricle-pulmonary artery pressure gradient (from 37 +/- 7 mm Hg to 3 +/- 1 mm Hg, p less than 0.001) and the right ventricular systolic pressure (from 62 +/- 8 mm Hg to 32 +/- 2 mm Hg, p less than 0.01). At follow-up the gradient remained low, measuring 4 +/- 1 mm Hg at 3 months and 3 +/- 1 mm Hg at 6 months. Twelve dogs did not undergo balloon dilatation until 12 months after band placement to determine whether any obstruction persisted and whether the band could be relieved after long-term placement. These 12 dogs had progressive increases in right ventricle-pulmonary artery gradient, from 27 +/- 3 mm Hg at 6 months to 43 +/- 4 mm Hg at 12 months. Ten of these dogs underwent dilation 1 year after pulmonary artery band placement. This dilation significantly reduced the right ventricular outflow tract gradient (from 43 +/- 4 mm Hg to 1 +/- 1 mm Hg, p less than 0.001). The remaining two dogs underwent successful partial dilation of the band 12 months after placement. This study demonstrated that a pulmonary artery band of absorbable suture material maintains effective right ventricular outflow tract obstruction for at least 1 year. Additionally, the effect of the pulmonary band can be successfully and persistently relieved.
J Thorac Cardiovasc Surg 1991 Nov
PMID:A balloon-dilatable pulmonary artery band in the dog. Results at one year. 194 98

Low osmolal contrast agents (LOCA) are measurably superior to high osmolal contrast agents (HOCA) in a number of properties. However, LOCA are substantially more expensive than HOCA, and universal use of LOCA for cardiac angiography would strain the health care budget. Therefore, the choice to use LOCA in place of HOCA should be based on clinically important differences. Review of available published data suggests that HOCA can be used safely and effectively for cardiac angiography in patients with mild or moderately severe heart disease. When HOCA are used, those that do not bind calcium should be chosen as they cause fewer clinically important adverse reactions than those that do bind calcium. Use of LOCA may offer added safety in high risk patients, although to date, this conclusion has not been proved with clinical experience. Nonionic LOCA may be safer to use than ionic LOCA.
Cathet Cardiovasc Diagn 1991 Apr
PMID:Choice of contrast agents for cardiac angiography: review and recommendations based on clinically important distinctions. 203 73

Catheter guidance in a critically ill neonate can be difficult and hazardous. A new technique of directing a catheter based on the interaction of magnetic fields is described. A strong external permanent magnet is moved across the body surface to control the magnetic tip of a catheter in the body. We report on the first clinical case of such a heart catheterization in a neonate with complex congenital heart disease. This method can also be used for other invasive investigations in the neonatal period.
Cathet Cardiovasc Diagn 1991 Apr
PMID:Heart catheterization in a neonate by interacting magnetic fields: a new and simple method of catheter guidance. 203 79

Contrary to early impressions of blacks' relative immunity to CHD, it is now clear that African Americans experience greater mortality from CHD than whites. The natural history of CHD differs between blacks and whites in three important respects: First, greater prevalence of established risk factors among blacks suggests that they may be at greater risk for heart disease than their white counterparts. Second, health care seeking differences are evident between blacks and whites, leading to lower rates of identification of early disease and slower seeking of services for acute events. However, risk factor differences and health care seeking behaviors do not appear to account for all of the differences in the natural history of heart disease between the ethnic groups, such as survival rate differences during treatment. Economic factors appear to account for only a portion of these differences in risk factors and health care seeking. Beyond differences in risk factors and health care seeking, other, as yet undetermined, factors seem to be involved. These unknown influences could include physiologic, behavioral, and/or psychologic differences.
Cardiovasc Clin 1991
PMID:Risk factors and the natural history of coronary heart disease in blacks. 204 11

The available information concerning cardiovascular surgery in blacks is very limited and incomplete. Those few reports that do exist seem to show that the usual indications for surgery, preoperative findings, and final results can be expected. Acquired heart disease is as important a cause of mortality in African Americans as in others and is amenable to surgical intervention. Surgical mortality is easily attributable to the usual iatrogenic variables or comorbid disease. At present it is uncertain whether the incidence of inoperable disease or problems of access to health care are responsible for the low rate of utilization by blacks. A more accurate account will become available when large-volume programs begin to report their results.
Cardiovasc Clin 1991
PMID:Cardiovascular surgery in blacks. 204 14

Intraoperative echocardiography is gaining increasing acceptance in the assessment of the surgical repair of congenital heart defects. Because of its ideal imaging location, intraoperative transesophageal echocardiography (TEE) has been especially helpful in evaluating pulmonary venous return and the integrity of the left atrioventricular valve following mitral valvuloplasty, complete atrioventricular valve repair and correction of complex congenital heart disease. It has not been routinely used in infants and small children because of a prohibitively large probe size. We report the successful use of a recently developed "pediatric" TEE probe capable of Doppler and color flow imaging in two patients less than 7 years of age. No complications were encountered. Recommendations regarding optimal probe imaging positions in infants are provided.
J Cardiovasc Surg (Torino)
PMID:Application of intraoperative transesophageal echocardiography in infants and small children. 205 26

A fourteen year old boy with Rubinstein-Taybi-syndrome presented with a severe congenital subvalvular fibrous aortic stenosis with associated aortic regurgitation. Transthoracic echocardiographic imaging and left heart angiography showed a transvalvular peak systolic pressure gradient of 90 mmHg and a regurgitant fraction of 30%. The surgical treatment consisted of resection of the subvalvular fibrous tissue and subsequent aortic valvuloplasty. Intraoperative transesophageal echocardiography revealed a wide systolic opening of the aortic valve and good coaptation of the aortic valve leaflets in diastole. Two-dimensional color-coded and contrast echocardiography were successfully used to confirm a satisfactory reconstruction. Transesophageal echocardiography therefore represents a valuable tool in the assessment of the morphologic and haemodynamic status, especially in rare cases of congenital heart disease in older children.
J Cardiovasc Surg (Torino)
PMID:Aortic valve reconstruction in Rubinstein-Taybi-syndrome: the valuable aid of transesophageal echocardiography. 205 29

The presence of ventricular arrhythmias mark an individual with underlying structural heart disease as a candidate at high risk for sudden cardiac death. It is still unknown whether suppression of those ventricular arrhythmias by all drugs will in fact prevent sudden cardiac death. Therefore, the efficacy of an antiarrhythmic drug at present must be defined as only its pharmacologic activity that relates to its ability to reduce the frequency of ventricular arrhythmias rather than to a potential beneficial effect on patient outcome. Ventricular arrhythmias can be differentiated using a prognostic classification into those that are benign, potentially lethal, or lethal. Benign and potentially lethal ventricular arrhythmias undergo a high degree of spontaneous variability, and therefore the degree of frequency suppression needed to differentiate drug suppression from spontaneous variability must be carefully considered. It therefore is important to establish the mean ventricular premature complex frequency per hour over at least 24 hours at baseline using quantitative continuous ambulatory electrocardiographic (Holter) monitoring. To eliminate spontaneous variability, a repeat Holter monitoring session after the initiated therapy has reached steady state should show at least a 75% reduction in the mean VPC/hr frequency and at least a 90% suppression in the number of beats in the form of nonsustained ventricular tachycardia (NSVT). Exercise testing is a complementary technique and is best suited for patients with NSVT developing during exercise testing from either a "catecholamine" or an "ischemic" mechanism.(ABSTRACT TRUNCATED AT 250 WORDS)
Cardiovasc Drugs Ther 1990 Jun
PMID:Determination of antiarrhythmic drug efficacy in the treatment of ventricular arrhythmias. 207 77

Percutaneous endomyocardial biopsy was performed for the diagnosis of various heart disorders in 160 consecutive patients in Belgrade, Yugoslavia. Tissue specimens were taken from the left ventricle in 150 patients and from the right ventricule in 10. To determine the clinical merit of endomyocardial biopsy, patients were divided into six groups based upon the existing clinical findings, including cardiomyopathy, myocarditis, specific heart muscle disease, alcohol-induced heart disease, major dysrhythmias, and other diagnoses. The clinical value of endomyocardial biopsy was gauged by the number of diagnoses that were histologically confirmed by the procedure. We combined the percentages of histologically suspected clinical diagnoses with those of completely changed clinical diagnoses and found that endomyocardial biopsy provided useful information in 70.6% of cases. Nonspecific histological findings were found in 25.6% of cases. The biopsy proved to be of no clinical value in only 3.8% of the cases. Although some investigators still object to the overall clinical usefulness of diagnostic endomyocardial biopsy, our findings help to underscore the value of this procedure for making an accurate diagnosis.
Am J Cardiovasc Pathol 1990
PMID:Diagnostic endomyocardial biopsy findings in 160 consecutive patients: the Yugoslavian experience. 209 27


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