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

1. The results of a clinical study of two patients who exhibited transitory donor limb ischemia without angiographic evidence of donor limb occlusive arterial disease following femoral-femoral bypass has been reported. 2. Although the circulation seemed to have been diminished in the donor limb following creation of a femoral-femoral bypass, the acute development of ischemia, there may have been other causes for the donor limb ischemia.
J Cardiovasc Surg (Torino)
PMID:Possible femoral "steal" syndrome following femoral-femoral bypass. 88 99

A possible protective effect of glucocorticoids on the ischemic myocardium was investigated in in situ dog hearts subjected to regional ischemia and in isolated rat hearts subjected to global ischemia. In the whole-animal preparation, the left anterior descending coronary artery (LAD) was occluded for 3 hours, or for 2 1/2 hours followed by 30 minutes of reperfusion. Dexamethasone phosphate was randomly administered (20 mg. per kilogram intravenously) after 15 minutes of ischemia. Its effects were studied on the following: (1) myocardial cell membrane integrity, using electron microscopic examination of tissue biopsies treated with colloidal lanthanum; (2) myocardial water content, measuring the wet/dry weight of myocardial tissue; (3) ischemic injury, by a count of fuchsinophilic cells at light microscopy. In isolated rat hearts, ischemia was produced by a 60 per cent reduction of coronary flow. Randomized hearts were perfused for 2 hours with dexamethasone, 15 mg. per milliliter in buffered salt solution. Study included determination of tissue water content and coronary vascular resistance. Lanthanum was confined to the extracellular spaces in normal dog myocardium, but it was found all intracellularly after 3 hours of ischemia or after reperfusion. This was associated with morphologic changes characteristic of irreversible cell injury. In the hearts treated with dexamethasone, lanthanum remained excluded from the cells, water content was less (p less than 0.005), and fuchsinophilia less severe (p less than 0.005). Likewise, water content was less (p less than 0.005) and the increase in coronary vascular resistance resulting from ischemia less severe (p less than 0.005) in the dexamethasone-treated isolated rat hearts. Thus dexamethasone administered in pharmacologic doses, early, appeared to stabilize the cell membrane, limit myocardial edema, and reduce the severity of injury, both during ischemia and upon reperfusion.
J Thorac Cardiovasc Surg 1976 Oct
PMID:Glucocorticoid protection of the myocardial cell membrane and the reduction of edema in experimental acute myocardial ischemia. 96 99

Canine left lower lobes which were subjected to 3 hours of warm ischemia in an atelectatic condition were compared to lobes which had not been stored. During short-term reimplantation studies, the injured lobes were characterized by marked weight gain, diminution in blood flow, increased vascular resistance, and peak airway pressure. The ventilation/perfusion ratios were high and considerable dead-space ventilation was present. Hypoxic vasoconstriction occurred in both control and stored lobes, and shunt determinations did not vary because of the low blood flows observed. Some or all of these physiological changes may serve to develop a simple screening method to evaluate techniques of pulmonary preservation.
J Thorac Cardiovasc Surg 1976 Nov
PMID:Warm ischemic injury of the lung. 97 18

Severe myocardial tissue damage may results from the use of prolonged ischemic arrest during cardiac surgery. A number of experimental and clinical studies have been reported in which various protective agents have been infused into the coronary vessels before the onset of ischemia in an attempt to reduce or delay this damage. Although these agents are undoubtedly able to protect the ischemic myocardium, their efficacy may be considerably reduced or enhanced by the composition of the medium in which these agents are dissolved. In experiments with a rat heart model of bypass and ischemic arrest, we found that lactate-based media are detrimental to optimal tissue protection.
J Thorac Cardiovasc Surg 1976 Dec
PMID:Myocardial protection during bypass and arrest. A possible hazard with lactate-containing infusates. 99 38

Subendocardial ischemia with consequent subendocardial necrosis is a frequent cause of death after cardiopulmonary bypass. The problem is caused by an inequity in the oxygen requirements of the subendocardium and the available blood supply. We have developed a means of detecting ischemia early in the postperfusion period. Using an analogue computer, we determine the endocardial viability ratio (EVR). This value may decrease before either systemic or central venous pressure changes. Thus the ratio can reflect early the danger of subendocardial ischemia. Another advantage is that equipment now common in coronary care units can be used to determine the EVR.
J Thorac Cardiovasc Surg 1975 Jan
PMID:A clinical method for detecting subendocardial ischemia after cardiopulmonary bypass. 107 88

The high mortality rate associated with revascularization for stenosis of the left main coronary artery and impairment of the left ventricle (classes III and IV) has been significantly reduced by a twofold approach: combating hypotension during induction of anesthesia and preventing ischemia resulting from anoxic arrest, often needed to facilitate the insertion of the left coronary anastomoses. These two goals have been successfully achieved by (1) a readiness to institute circulatory assist by means of femoral-to-femoral cardiopulmonary bypass and (2) augmentation of coronary flow through immediate insertion of a vein graft between the aorta and right coronary artery, if the anatomy permits.
J Thorac Cardiovasc Surg 1975 Mar
PMID:Revascularization of the stenotic left main coronary artery and impaired left ventricle. 107 66

The effect of aorta-coronary bypass surgery on left ventricular function was evaluated in 39 patients by cardiac catheterization and recording of the systolic time intervals (STI) before and an average of 4.5 months following myocardial revascularization. All patients were in sinus rhythm, had normal QRS intervals on the electrocardiogram, and had taken no medication for at least 3 weeks prior to the study. The STI was unchanged postoperatively in patients with the following characteristics: freedom from angina; heart rate not more than 15 beats greater than the preoperative level; all grafts patent; and no progression of disease in coronary arteries. Deterioration in left ventricular function after operation as represented by shortened left ventricular ejection time, (LVET) prolonged pre-ejection period (PEP), and increased ratio of PEP/LVET was found in patients with the following characteristics: persistent angina; heart rate more than 14 beats faster than the preoperative level; occlusion of any grafts; progression of disease in the coronary arteries; evidence for postoperative myocardial infarction. Worsening of left ventricular performance as determined by STI was more apparent in patients with occluded grafts and no collateral circulation than in those with occluded grafts and collateral circulation which may have offered protection against ischemia. These investigations supported the use of STI in assessing changes in left ventricular function after coronary bypass and, by inference, in assessing the status of the graft.
J Thorac Cardiovasc Surg 1976 Aug
PMID:The assessment of function of left ventricle and patency of aorta-coronary bypass after operation. A study of systolic time intervals. 108 90

Blunt injuries to branches of the aortic arch are not unusual and must be considered in any patient surviving deceleration or crush injury. Review of 36 case reports, including own own case, revealed 22 injuries to the innominate artery (4 with injuries to other arch branches), seven to the right subclavian, seven to the left subclavian, and eleven associated injuries to the thoracic aorta. Thirty patients (83 per cent) survived. Mediastinal widening (92 per cent) was the most frequent manifestation of vascular injury and is an indication for immediate aortography to delineate the entire thoracic aorta. Distal circulation was clinically decreased in less than 50 per cent, with symptomatic ischemia in only a few instances. Death was due to associated head injury in 3 of 6 cases. Earlier operation would have avoided exsanguination (one death) and late complications of false aneurysm or vascular insufficiency (10 patients).
J Thorac Cardiovasc Surg 1975 Apr
PMID:Blunt injuries to branches of the aortic arch. 109 Jul 87

In congestive heart failure, patients appear to have alimited ability to dilate their resistance vessels in skeletal muscle in response to a metabolic stimulus. This is true whether the metabolic stimulus is ischemia, dynamic, or static exercise. The mechanism for this limited arteriolar capacity is at least twofold; an increased sodium content of the vessels as well as an increased tissue pressure which is seen in edematous states. This can be considered a positive compensatory mechanism in that it helps to maintain systemic arterial pressure during exercise when the cardiac output fails to increase normally. If the resistance vessels were to dilate normally, then in the face of a limited cardiac output, exercise syncope would be expected to occur...
Prog Cardiovasc Dis
PMID:Abnormalities in the regional circulations accompanying congestive heart failure. 110 32

Echocardiography has many attributes that are desirable for diagnostic and research studies in acute myocardial infarction patients. It does not alter the physiologic state being evaluated, is relatively inexpensive, and does not interfere with other hospital procedures. For these reasons, the test may be repeated frequently and used to monitor the changes after acute infarction. Useful information about left ventricular volume, diastolic pressure, and segmental wall motion may be obtained. Because echocarciographic estimates of stroke volume, ejection fraction, and velocity of circumferential fiber shortening are based on motion seen in only one "ice-pick" view of the heart, it is likely that they will be less reliable in patients with asynergy of contraction. Although a definite diagnosis of acute myocardial infarction cannot be made by echocardiography, abnormalities of wall motion may occur very early and support a clinical impression of infarction. An echocardiogram may also reveal changes suggesting ischemia or infarction (abnormal motion) in patients who have atypical chest pain and no other objective evidence of coronary artery disease.
Cardiovasc Clin 1975
PMID:Applications of echocardiography in acute myocardial infarction. 110 66


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