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

The postoperative pathology observed in 17 patients with complete atrioventricular canal, who died following total correction is described. In 3 patients, in whom valve replacement was necessary, the death was due to late prosthetic dysfunction. Out of 14 patients who underwent plastic repair, 4 died from undetected residual cardiac anomalies, which in 2 cases were associated with pulmonary obstructive vascular disease, 3 from unexplained myocardial infarction, 3 from inadequate postoperative care and 4 from pulmonary obstructive vascular disease which presented as an isolated finding. An analysis of the incidence of pulmonary obstructive vascular disease in these patients disclosed that it can develop before one year of age in some patients with Down syndrome.
G Ital Cardiol 1982
PMID:Postoperative pathology of congenital heart disease. I. Complete atrio-ventricular canal. 622 35

Prostacyclin, the labile prostanoid product of arachidonic acid metabolism in vascular endothelium, is the most potent known inhibitor of platelet aggregation and is highly effective in relaxing vascular smooth muscle. Its production is probably critically important in the maintenance of an intact vasculature. Although there is some evidence that prostacyclin circulates as a hormone, it is probably most important as a locally active agent in preventing thrombosis and maintaining patent vessels. Several factors can influence prostacyclin production, the most important of which probably act locally at sites of vessel wall injury. The most promising therapeutic approaches toward using prostacyclin's beneficial effects in vascular disease may lie in the use of drugs aimed at increasing prostacyclin production. Among these are thromboxane synthesis inhibitors, which act by diverting prostaglandin endoperoxides through the prostacyclin synthetase pathway, and lipoxygenase inhibitors, which might act chiefly by preventing formation of metabolites capable of inhibiting prostacyclin synthetase.
Am J Cardiol 1983 Jul 20
PMID:Prostanoids in platelet-vascular interactions. 634 50

To determine whether coronary thrombi can be detected scintigraphically after acute myocardial infarction, 24 patients were studied with a new method employing indium-111-labeled platelets and technetium-99m-labeled red blood cells. Nine patients with suspected infarction were evaluated initially within 9 hours of the onset of symptoms and again 18 to 24 hours after onset. Eight patients with neurologic symptoms but without overt cardiac disease and seven patients with angina but without infarction served as unmatched control subjects. Foci of net indium accumulation were detected after image processing that incorporated subtraction of blood pool activity. Carotid and pulmonary artery reference regions, in which blood pool activity is high and active platelet deposition unlikely, were used to correct digitized cardiac scintigrams for indium-111 platelet activity in the blood pool. In patients with infarction, distinct foci of net indium accumulation were present in regions corresponding to the coronary artery supplying ischemic zones. This occurred in seven of eight patients at the time of the earliest evaluation (5.6 +/- 3.3 hours [mean +/- SD] after the onset of symptoms) and in eight of nine patients at the time of subsequent imaging (23.6 +/- 1.9 hours after onset). Only 1 of the 15 control patients exhibited a cardiac focus of net indium accumulation. The percent of indium excess (100 [total indium-111 activity-blood pool indium-111 activity]/blood pool indium-111 activity) within the cardiac region measured (+/- SD) 16.8 +/- 11.6% in all patients with myocardial infarction (19.1 +/- 11.2% in those with visually identified foci) compared with 0.4 +/- 4.3% in control patients (p less than 0.001). This method permits early detection and sequential assessment of coronary artery thrombi. It should permit improved characterization of the role of platelets in the pathogenesis of acute manifestations of coronary vascular disease and improved evaluation of interventions designed to prevent or lyse coronary thrombi.
J Am Coll Cardiol 1984 Nov
PMID:Scintigraphic detection of coronary artery thrombi in patients with acute myocardial infarction. 638 35

The various therapeutic trials conducted throughout the world demonstrate the benefit of treatment even for a moderate elevation of diastolic pressure (90 or 95 mmHg). At this level of hypertension, treatment is more preventative than curative. This article discusses the benefits and the costs on the individual and collective scale in the context of two opposed strategies: mass treatment after a certain level of blood pressure or treatment of subjects at high risk of cardio-vascular disease. To achieve a collective benefit, all of the hypertensives defined in this way need to be detected, treated and followed-up in the long-term. Stimulation of the present medical system would appear to be more effective and less costly than the creation of specialized structures.
Ann Cardiol Angeiol (Paris) 1984 Jan
PMID:[Multicenter trials in the treatment of arterial hypertension. Socioeconomic repercussions]. 642 Dec 24

The hemodynamic and clinical responses to calcium channel blockade with verapamil and nifedipine were compared with those of hydralazine in 12 patients with pulmonary hypertension secondary to obliterative pulmonary vascular disease. All three drugs produced a marked and similar decrease in pulmonary vascular resistance; however, this was accompanied by a significant increase in cardiac index with hydralazine (+0.71 liter/min per m2, p less than 0.01), no change in cardiac index with nifedipine and a significant decrease in cardiac index with verapamil (-0.25 liter/min per m2, p less than 0.05). Mean pulmonary artery pressure decreased markedly with both calcium channel blocking drugs (-16.0 mm Hg with verapamil and -14.5 mm Hg with nifedipine, both p less than 0.01), but this was associated with a concomitant increase in mean right atrial pressure (+6.2 mm Hg with verapamil and +4.4 mm Hg with nifedipine, both p less than 0.01); neither variable changed after hydralazine. Hence, right ventricular performance (as reflected by right ventricular stroke work index) deteriorated during treatment with both calcium channel blocking drugs, despite the decrease in resistance to right ventricular ejection; in contrast, right ventricular stroke work index increased after hydralazine. The unfavorable hemodynamic effects of calcium channel blockade were accompanied by severe adverse clinical events, including profound hypotension and cardiogenic shock during acute drug administration and the exacerbation of right heart failure during long-term treatment. These deleterious responses to verapamil and nifedipine are likely the result of a direct depressant effect exerted by these drugs on right ventricular function independent of their pulmonary vasodilatory actions.
J Am Coll Cardiol 1984 Nov
PMID:Adverse hemodynamic and clinical effects of calcium channel blockade in pulmonary hypertension secondary to obliterative pulmonary vascular disease. 649 Oct 82

Pulmonary vascular structure was analyzed using quantitative morphometric techniques in lung biopsy (n = 17) and/or postmortem specimens (n = 18) from 23 patients aged 18 days to 13 years, with truncus arteriosus (TA) type I or II. All 14 patients younger than age 1 year, showed abnormal extension of muscle and an increase in pulmonary arterial medial thickness (p less than 0.01 in 18 of 24 biopsy and autopsy specimens), whereas 6 showed intimal proliferation. Structural abnormalities were usually potentially reversible, even in 5 infants with a pulmonary arteriolar resistance of greater than or equal to 8 units X m2. Abnormalities were more severe in 9 patients aged 3.5 to 13 years, 6 with medial atrophy and 4 with pulmonary arteriolar resistance of greater than 8 units X m2 that also showed intimal fibrosis, with or without plexiform lesions or hyalinized arteries. Findings indicate that biopsy specimens are helpful in assessing the severity of pulmonary vascular disease, and are representative of the entire pulmonary vascular bed (avoiding the lingula); however, interpretation can be difficult if a biopsy specimen is taken of only the peripheral intraacinar arteries, distal to the most damaged vessels. An intracardiac repair is recommended by 6 months, at which time severe pulmonary arterial medial hypertrophy and intimal proliferation can be expected to prejudice the repair.
Am J Cardiol 1984 Dec 01
PMID:Pulmonary vascular disease in children with truncus arteriosus. 650 5

At the Hospital for Sick Children, London, between Jan. 1965 and Jan. 1980, 98 patients, ranging in age from 22 days to 20.8 years (mean = 29.6 months), with a clinical diagnosis of transposition of the great arteries (TGA) associated with a ventricular septal defect (VSD) found at cardiac catheterization, underwent Mustard procedure at the atrial level, whether or not associated with the VSD closure. Twenty-nine other patients, with irreversible obstructive pulmonary vascular disease in whom a "palliative" Mustard was performed, have been excluded from this report. At operation, in 8 cases, the VSD was found to have closed spontaneously during the interval between the cardiac catheterization and the surgical repair, while, in 13 patients, the VSD was judged to be too small to influence the hemodynamic results and, accordingly, was left open. In 35 cases the VSD was closed with mattress stitches buttressed with dacron pledgets and in 42 patients a dacron patch was used. The defects were accessible through the tricuspid valve in all but 10 cases. There were 24 early deaths (24%) and these did not correlate either with the year of operation or with the age at the time of operation. The mortality rate was higher in the cases who had required previous pulmonary artery banding (37%), than in those who had not (21.5%), but this difference was not statistically significant. The early results were related to the size of the VSD. In the 21 patients in whom the VSD was partially or completely closed, the early mortality was 9.5%.(ABSTRACT TRUNCATED AT 250 WORDS)
G Ital Cardiol 1983 Dec
PMID:[Indications for the surgical correction of patients with transposition of the great arteries associated with an interventricular defect. Analysis of 98 cases operated on using the Mustard technic]. 667 95

A 62-year-old male with severe claudication and rest pain of the left leg resulting from a totally occluded superficial femoral artery and a 95% stenosis of the deep femoral artery was treated with laser angioplasty after attempts at surgical revascularization were unsuccessful. A 200 mu silica fiber was inserted through a catheter and advanced into the lesion using 2 watts of delivered energy from an argon laser source. The fiber was then withdrawn from the lesion using 7 watts of energy to enlarge the lumen. No complications occurred, and posterior tibial blood flow was reestablished, as shown by Doppler flow measurements and resolution of clinical symptoms. We report a new technique of transcatheter fiberoptic-directed argon laser radiation (laser angioplasty) for the treatment of occlusive vascular disease.
Clin Cardiol 1984 Jan
PMID:Salvage of an ischemic limb by laser angioplasty: description of a new technique. 670 89

Plain chest x-rays, twelve-lead electrocardiograms, and M-mode echocardiograms were analyzed in 50 control patients and 79 consecutive patients with pulmonary hypertension documented at cardiac catheterization in order to determine the relative values of these noninvasive techniques as screening tests in detecting pulmonary hypertension. The sensitivity and specificity of selected findings previously described as being associated with pulmonary hypertension were calculated for each test. All test results were found to have sensitivities too low to function as satisfactory noninvasive screening techniques. Most findings were highly specific for pulmonary hypertension when present. Patients with pulmonary vascular disease were detected more frequently than those with pulmonary hypertension due to pulmonary venous congestion.
Clin Cardiol 1984 Mar
PMID:Noninvasive detection of pulmonary hypertension. 670 99

A model for testing transluminal recanalization techniques was developed. Human atherosclerotic arteries were transplanted in dogs and evaluated by angiographic and histologic study within a 12-week period. An inflammatory response was most intense within the first 2 weeks. By 12 weeks, no inflammation was noted. The model has several advantages: (1) The pathologic characteristics are those of a human coronary artery. (2) Thrombus formation is frequent, with progression to a well organized dense fibrocellular vascular occlusion within 4 to 12 weeks. (3) The arterial occlusion resembles human vascular disease. (4) The vascular occlusions are readily accessible with standard catheterization technique. (5) The model is easy to produce within a short period. This model has been used to evaluate laser recanalization of vascular obstructions.
Am J Cardiol 1984 Jul 01
PMID:A new model for investigation of transluminal recanalization: human atherosclerotic coronary artery xenografts. 674 14


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