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Query: UMLS:C0042373 (vascular disease)
 17,070 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From 1972 to 1979, 142 aortofemoral bypass grafts were carried out with 5 failures. In 3 of the cases the etiological factor appeared to be hypoplasia of the vessels. After reviewing the charts and arteriograms of the other patients, a further 9 cases in the hypoplastic category were collected. The mean age of the patients was 57 years, all were smokers and 3 were diabetic. Three patients had hyperlipidemia. The 12 patients falling into the hypoplastic group had mean diameter of the aorta of 1.1 cm. The diameter of the femoral artery was 3 mm. From the aortograms done on 20 patients without evidence of vascular disease, the average diameter of the aorta was 1.97 cm. In 20 patients with aorto iliac disease the aorta measured 1.9 cm and the common femoral artery 9 mm. A comparison was made of the ratio of the aorta to the transverse diameter of the vertebral body. In the hypoplastic patient the percentage was 22% and in patients with aorto iliac disease 39.5%. Hypoplasia appears to involve both the aorta and the distal vessels. Although variations in the size of the aorta and its branches are common, these patients with hypoplastic vessels appear to form a distinct group. This group of patients are high risk in terms of surgery. The importance of pre-operative diagnosis is stressed and a method of diagnosing the situation pre-operatively is described.
J Cardiovasc Surg (Torino)
PMID:Preoperative diagnosis and management of the hypoplastic vessel syndrome. 665 79

This report documents the results of therapy in 23 patients treated for malignant thymoma between 1944 and 1979. Of the group, 22 patients had neoplasms which invaded mediastinal structures; six had distant metastases. Four patients had myasthenia gravis and one had erythroid hypoplasia associated with collagen vascular disease. No deaths were associated with primary therapy, which included an operative procedure in all cases. Follow-up ranged from 4 months to 18 years (mean 5.63 +/- 1.03 years, SEM). Fifteen patients died, with postoperative survival times ranging from 4 months to 18 years (mean 3.8 +/- 1.27 years). Five patients were alive without recurrence from 3 to 11 years postoperatively (mean 6.8 +/- 1.36 years), and three patients were alive with recurrence or distant metastases from 4 to 17 years postoperatively (mean 10.75 +/- 2.66 years). Differences in survival on the basis of tumor cell type were not statistically significant. Therapeutic groups were analyzed for 5 year survivors, tumor deaths within 5 years of therapy, deaths due to other causes, deaths due to tumor after 5 years, those presently alive, and longest known survivor. The data suggest that complete surgical excision offers the best chance of long-term survival when compared to partial resection plus irradiation (p less than 0.05). No statistical significance could be demonstrated between the groups who had complete resection with versus without postoperative irradiation. There also was no statistically significant difference between the group of patients receiving irradiation following partial excision of most of their tumor and the group receiving irradiation following only biopsy of the lesion. This observation suggests there is no value in so-called "debulking procedures" and suggests that irradiation may be of value in local control of thymoma. Perpetual surveillance is necessary since late recurrence is common.
J Thorac Cardiovasc Surg 1984 Feb
PMID:Management of patients with malignant thymoma. 669 21

Sixty patients undergoing surgical reconstruction by classical or modified methods for aorto-iliac vascular disease were studied as to postoperative sexual function. Preoperative impotence was present in approximately half of the patients with abdominal aortic occlusion. Although internal iliac arterial blood flow was regarded as an important factor in sexual function, only a slight correlation was noted between circulatory insufficiency and postoperative sexual dysfunction. Preservation of both trunks or the left trunk of the hypogastric nerve led to a marked decrease in the incidence of ejaculation disturbances. We concluded preservation of the hypogastric nerve was more beneficial than maintenance of internal iliac arterial blood flow.
J Cardiovasc Surg (Torino)
PMID:Sexual function after aorto-iliac vascular reconstruction. Which is more important, the internal iliac artery or hypogastric nerve? 670 71

A pulsed Doppler velocimeter with an adjustable range gated time system and a double transducer probe has been used to measure velocity and volume flow in follow-up studies of 100 patients with extra-cranial cerebro-vascular disease. The patient material was subgrouped according to whether the disease involved the carotid or vertebral arteries unilaterally or bilaterally. The results showed an unexpected and unexplained trend towards an improvement in mean volume blood flow in the common carotid arteries over the course of 1 year except in those patients who initially presented with four vessel disease in whom there was a trend towards deterioration. In contrast to this spectral analysis of the blood velocity flow showed evidence of deterioration with an increase in flow disturbance and damping. This deterioration was observed either in the vessel originally found with disease or by involvement of an additional vessel showing evidence of disease at the time of follow-up. The deterioration in sonagram appearance was statistically significant in the two and four vessel disease groups (0.025 greater than P greater than 0.01) the remaining two groups showed a similar trend towards deterioration but the numbers of patients in these two groups was probably too small to attain statistical significance.
Cardiovasc Res 1984 Apr
PMID:Blood volume flow and sonagram disturbance in diseased common carotid arteries: one year follow-up. 671 48

In 28 patients with congenital heart disease with a shunt and pulmonary hypertension, lung biopsy specimens were taken during a banding procedure of the pulmonary artery; then, in the same patients, lung tissue became available during correction of the cardiac defect some years later. In this way the regression of pulmonary vascular changes could be studied. Medial hypertrophy appeared to have a prominent tendency to regression. With intimal lesions, regression depended to a large extent on the type of lesion. Intimal thickening based on longitudinal smooth muscle tissue was almost completely reversible. Post-thrombotic intimal fibrosis was also potentially reversible. In plexogenic pulmonary arteriopathy, the earlier lesions, particularly cellular intimal proliferation, showed regression. Concentric-laminar intimal fibrosis regressed as long as it was mild, that is, occluding less than one fifth of the average arterial lumen. If more severe, there was no tendency to regression and often it even progressed. Changes like fibrinoid necrosis and plexiform lesions are ominous because of their tendency to progression. Since preoperative open lung biopsies now are often undertaken for evaluation of hypertensive pulmonary vascular disease, when corrective operability is dubious, these findings may serve as a guide in reporting on such biopsy specimens.
J Thorac Cardiovasc Surg 1984 Jun
PMID:Reversibility of plexogenic pulmonary arteriopathy following banding of the pulmonary artery. 672 10

The major chronic vascular diseases of the upper extremity are (1) subclavian artery occlusions, (2) thoracic outlet syndrome, and (3) angiospastic disease of the hand. Central subclavian artery lesions ease of the hand. Central subclavian artery lesions can have either hemodynamic consequences (subclavian steal syndrome) or, by peripheral embolization, can provoke ischemic symptoms of the hand. Costoclavicular narrowing can cause functional or fixed stenosis of the subclavian artery and can also involve the vein or brachial plexus. Symptoms due to pressure on the brachial plexus are most frequent, but embolization to the peripheral vessels may also occur. Angiospastic disease, the most frequent lesion of upper extremity vessels, comprises three types: Raynaud's disease, in which there are intermittent attacks of coldness and discoloration without evidence of occlusion on the angiogram; asphyxia manus et digitorum in which the attacks are also intermittent but there is morphologic evidence of occlusion; and digitus moriens or mortuus, in which there is a painful, permanent discoloration. All investigations of chronic vascular disease of the upper extremity should begin with arch aortography and then proceed to a selective catheterization of the vessels that are presumed to be involved.
Cardiovasc Intervent Radiol 1980
PMID:Chronic vascular disease of the upper extremity: radiologic and clinical features. 698 96

Age-related changes in left ventricular wall thickness were studied in 92 autopsy specimens of complete transposition of the great arteries (TGA) and in 189 normal hearts. By means of morphologic and clinical hemodynamic criteria, three groups were defined: Group II, TGA with intact ventricular septum (low left ventricular pressure): Group II, TGA with ventricular septal defect but without pulmonary stenosis (systemic left ventricular pressure combined with volume overload); and Group III, TGA with ventricular septal defect and pulmonary stenosis (systemic left ventricular pressure). At birth, the left ventricular thickness for the three groups did not significantly differ from normal. In group I, the left ventricular thickness remained constant with age up to 4 years and, accordingly, was significantly less after 4 months of age than that both in normals and in Groups II and III. In those Group II specimens from patients without irreversible pulmonary vascular disease, the left ventricular thickness was similar to that of normal hearts. The left ventricular thickness in Group III increased, with age in a manner similar to that of normal hearts. If left ventricular wall thickness correlates with potential ventricular function, then this measurement, combined with other clinical data, may help to predict the ability of the left ventricle to perform systemic work following one of the arterial switch operations. Sequential determinations of wall thickness may be attained noninvasively by echocardiography.
J Thorac Cardiovasc Surg 1982 Jul
PMID:Left ventricular wall thickness in complete transposition of the great arteries. 708 46

We performed correction of intracardiac lesions in 10 patients with coarctation. All cardiovascular lesions were corrected except coarctation. Six patients had a large left-to-right shunt though a ventricular septal defect (VSD), two patients had left ventricular outflow obstruction, two patients had mitral insufficiency, and one patient had mitral stenosis. Arterial perfusion was through the ascending aorta. Urine output was 6.0 +/- 1.5 cc/kg/hr during cardiopulmonary bypass. There was no morbidity related to cardiopulmonary bypass or inadequate perfusion of the lower body, and left ventricular failure did not occur. One patient with Taussig-Bing abnormality and pulmonary vascular disease died postoperatively of right ventricular failure. Intracardiac repair with aortic perfusion in the presence of coarctation is a safe alternative to coarctation repair or combined procedures.
J Thorac Cardiovasc Surg 1981 Apr
PMID:Cardiopulmonary bypass in the presence of uncorrected coarctation. 720 67

Recurrence of persistence of heart failure in patients after mitral and aortic valve replacement is a difficult diagnostic problem. Clinical evaluation and noninvasive tests cannot always distinguish poor left ventricular function from paraprosthetic leak or persistent pulmonary vascular disease. Full evaluation by cardiac catheterisation may then be necessary but is difficult because of the inaccessibility of the left ventricle. Under these circumstances, left ventriculography by direct transapical puncture is an alternative to crossing the prosthesis by a catheter and may be the only way of obtaining diagnostic information. We describe our experience of left ventriculography by percutaneous transapical passage of a flexible angiographic catheter (as distinct from a rigid angiographic needle) in 15 such patients (on 16 occasions). Non-fatal complications occurred in three patients. The information thus obtained allowed a clinical decision to be made and distinguished the inoperable from the operable group. Surgery was subsequently performed in seven patients with beneficial results.
Cathet Cardiovasc Diagn 1981
PMID:Percutaneous left ventricular angiography. 732 38

Pulmonary vascular disease (PVD) was histologically evaluated and its severity was expressed as an index of PVD in 14 autopsied and eight biopsied cases of complete transposition of the great arteries (TGA) in patients more than 6 months of age. The index varied from 1.0 to 2.3 in six patients who had survived complete surgical repair and ranged from 2.3 to 3.3 in five patients who had died of PVD postoperatively. Consequently, an index of 2.2 could be regarded as an upper limit of PVD for complete surgical repair. The index was significantly correlated to some hemodynamic factors. From the regression equation, the value 2.2 of histologic index could be translated into the clinical factors concerning hemodynamics. We consider that patients with pulmonary vascular resistance of less than 10.6 units . m2, and pulmonary arterial mean pressure less than 51 mm Hg, are suitable candidates for complete surgical repair in TGA, if more than 6 months of age. Thus histologic assessment of PVD in a lung biopsy as an indication for total correction of TGA with pulmonary hypertension appears to be useful in patients who are in borderline hemodynamic condition or in whom the hemodynamics could not be evaluated although pulmonary hypertension was suspected.
J Thorac Cardiovasc Surg 1980 Jun
PMID:Indication for total correction of complete transposition of the great arteries with pulmonary hypertension. 737 8


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