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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors report a rare case in which a large cerebral arteriovenous malformation (AVM) located in the left parietooccipital region presented with venous ischemia in the contralateral hemisphere. A 74-year-old man was admitted to the hospital because he was experiencing a loss of appetite, disorientation, and left hemiparesis. Computerized tomography scans revealed a low-density area in the right temporal lobe. Angiography demonstrated a large AVM in the left parietooccipital lobe and dilation, stagnation, and meanders of cortical veins in the contralateral hemisphere. The authors speculated that the elevated sinus pressure caused by a huge venous return of blood from the AVM produced venous ischemia in the contralateral hemisphere.
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PMID:Large cerebral arteriovenous malformation presenting with venous ischemia in the contralateral hemisphere. Case report. 1240 94

Besides the surgeon's experience, there is no objective method to detect whether the retrograde cannula is inserted correctly before injecting the cardioplegia and measuring the coronary sinus pressure after the aorta cross-clamp. Repositioning of the retrograde cannula once extracorporeally is not always an easy maneuver and may include the risk of venous air suction. Manual detection of the cannula's position may jeopardize the stability of an ischemic heart (Ann Thorac Surg 50(6) (1990) 882; J Cardiothorac Vasc Anesth 5(6) (1991) 646; Ann Thorac Surg 52(4) (1991) 879). Determining the retrograde cannula position avoiding unnecessary prolongation of the ischemia would allow a better protection of the heart. To our knowledge such a method has not yet been published.
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PMID:How to determine the correct placement of the retrograde cardioplegia catheter. 1766 51

Refractory angina is a chronic condition characterized by the presence of disabling symptoms due to severe obstructive coronary artery disease that is not improved by a combination of medical therapy and percutaneous or surgical revascularization. Mortality rates associated with this condition are quite low in clinically stable patients on optimal medical therapy, but rehospitalization rates remain high. This mandates the need for new therapies targeting an improvement of symptoms in this population, taking into account also the potential impact in terms of healthcare and costs. The increase in coronary sinus pressure seems to reduce myocardial ischemia leading to a redistribution of blood flow to the ischemic territories. The coronary sinus Reducer is a percutaneous implantable device, made of a stainless steel hourglass-shaped stent, designed to achieve controlled narrowing of the coronary sinus and to increase its upstream pressure. In various studies, the Reducer was safely implanted percutaneously via the right jugular vein in patients with refractory angina who were not amenable to revascularization and was associated with an improvement in anginal symptoms and ischemia. These results support further evaluation of the Reducer as an alternative treatment for patients with chronic refractory angina who are not candidates for coronary revascularization.
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PMID:[Innovative therapies for the treatment of refractory angina: the Reducer, a percutaneous device to narrow the coronary sinus]. 2657 76


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