Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0151744 (myocardial ischemia)
 31,282 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Using a new diagnostic ultrasonographic apparatus for tomographic imagings during surgery, we attempted to image the coronary arteries to delineate vascular lesions. Twenty patients were studied, including four with ischemic heart disease, eight with valvular disease, and eight with congenital anomalies. A T-shaped, 7.5 MHz electronically-focused linear array scanner sterilized with formalin gas was placed directly over the exposed surface of the heart. Echocardiograms of the coronary systems were obtained in the following selected planes. Plane 1: With the scanner probe on the main pulmonary artery, the main trunk of the left coronary artery (LMT) was imaged; Planes 2 and 3: Tomographic imaging of the left anterior descending artery (LAD) was accomplished with the probe of the scanner applied to the anterior interventricular sulcus; Planes 4 and 5: For imaging the right coronary artery (RCA), the scanner probe was placed over the right atrioventricular groove. The LMT and its branches (LAD and the circumflex branch, Cx) were readily visualized echocardiographically in plane 1 in nearly all cases examined. Satisfactory imagings of the RCA were also easily achieved in planes 4 and 5. Nevertheless, attempts to image the LAD in planes 2 and 3 entailed some difficulty. Echograms of adult patients were of higher intensity and brighter, with an increased prominence of the intima of the coronary arteries, compared to those of children. The echocardiographic features in coronary artery stenosis were remarkably consistent with the angiographic findings in respect to the location of stenotic lesions. Advantages of echographic observations of the coronary arteries using this noninvasive procedure lie not only in providing accurate information as to the site of stenosis but in delineating the morphologic features of the vessel wall, as well. Using this procedure optimal sites for vascular graft sutures in cases requiring aorto-coronary bypass surgery may be appropriately selected, hence this is a valuable diagnostic aid to increase the safety of surgical procedures.
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PMID:[Coronary artery imagings by intraoperative two-dimensional echocardiography]. 387 60

A 69-year-old man was referred to us with the diagnosis of abdominal aortic aneurysm (7 cm in diameter). Additionally his coronary arteriogram showed severe stenosis (LMT 75% and #6 99% delay). Because his ascending aorta was calcified severely, double CABG (LITA to LAD and RGEA to PL) was carried out in hypothermic ventricular fibrillation. Abdominal aortic aneurysm was replaced thereafter while the patient was still on cardiopulmonary bypass. His postoperative courses was satisfactory. In cases requiring early operation for both myocardial ischemia and abdominal aortic aneurysm, one stage operation was recommended. When atherosclerotic changes in the ascending aorta were severe, in situ arterial bypass grafting for ischemic heart disease under hypothermic ventricular fibrillation was useful.
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PMID:[One stage operation for ischemic heart disease and abdominal aortic aneurysm with ascending aortic calcification]. 855 12

Study was made on the operative results, risk factors, and late results of coronary artery bypass grafting (CABG) for acute myocardial infarction (AMI) conducted at our hospital. The subjects of the present study were 70 cases of AMI who underwent CABG during a period of five years from January 1991 to December 1995. They were composed of 61 males and 9 females whose mean age was 61.9 years. LMT disease was observed in 13 cases and preoperative shock in 18 cases. The mean aortic cross-clamp time was 64 minutes with the mean extracorporeal circulation time being 134 minutes and the mean number of grafts being 2.5. The mean preoperative-postoperative peak creatine kinase was 4479 IU/L. The number of operative deaths was 14 with a mortality rate of 20%. When compared with elective cases of CABG conducted during the same period with a mortality rate of 2.7%, the operative result of AMI was poor. The mortality rate by risk factor was 40% for age of 70 years or more, 46.2% for complication of LMT disease, 52.9% for preoperative shock, 58.3% for preoperative C.I. of less than 2.0, 80% for postoperative C.I. of less than 2.0, 28.2% for conduct of postoperative circulatory support, and 42.1% for peak creatine kinase of 5000 IU/L or more. Aortic cross-clamp time and reperfusion time (interval from onset of AMI to aortic declamp) were found not to be risk factors. Late death accounted for 5 cases including one case of cardiac death due to suspected AMI. Survival rate excluding operative deaths and hospital deaths was 98% in one year and 83.9% in five years. When compared to non cardiacevent cases, the survival rate of positive cardiac event cases was significantly poor. The operative results of severe myocardial ischemia cases represented by cases of complication of LMT disease were poor and it is considered that improvement of intraoperative myocardial protection and aggressive use of postoperative circulatory support are necessary in the future. The survival cases of those who could endure surgery was comparatively satisfactory, but when cardiac event developed, prognosis was poor and thus more rigid follow-up is considered to be necessary.
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PMID:[Study on risk factors and late results of coronary artery bypass grafting for acute myocardial infarction]. 925 30

We retrospectively analysed the perioperative course of 22 patients who underwent emergency CABG for severe left main trunk lesion. The causes of LMT lesion were spontaneous acute myocardial infarction in 14 patients and failed coronary intervention and coronary angiography in 8 patients. IABP was used preoperatively in all patients and additional coronary perfusion catheter were induced for two patients and PCPS was for one patient. Overall incidence in-hospital operative mortality was 22.7% (5/22), four of them were due to cardiac related causes and one of them was due to acute renal failure. Postoperative level of max CPK enzyme was significantly higher in death cases compared to survivors, 6,330 +/- 3,649 versus 1,299 +/- 1,417 IU/dl. We considered that the most important factors in surgical strategy for acute coronary syndrome with LMT lesion were as follows: improvement of hemodynamics with mechanical cardiac support by IABP or/and PCPS, protection of broad myocardial ischemia using coronary perfusion catheter and urgent surgical revascularization by emergency CABG.
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PMID:[Emergency CABG for patients with LMT lesion treated by mechanical cardiac support]. 1044 50

We performed redo-off-pump coronary artery bypass grafting( OPCAB) via a left thoracotomy using the PAS-Port system for proximal vein graft anastomoses in a patient with posterolateral myocardial ischemia. The patient was a 76-year-old man who had undergone coronary artery bypass grafting (CABG)[ left internal thoracic artery( LITA)-left anterior descending artery( LAD), saphenous vein graft(SVG)-posterior descending artery( 4PD), and SVG-postero-lateral branch( PL)] 14 years previously. Coronary angiogram showed that the LITA-LAD graft was patent but that the SVG-PL, left main trunk( LMT) and proximal right coronary artery(RCA) were occluded, and that there were 90% stenoses of LAD #7 and SVG-4PD anastomotic site. With catheter intervention therapy, stenosis of the SVG-#4PD was dilated. We then performed revascularization from the descending aorta to the second diagonal (D2) and PL with a saphenous vein graft via left thoracotomy using off-pump technique. To avoid descending aortic clamping, we used the PAS-Port system for proximal anastomosis. The postoperative course was uneventful and the patient was discharged on postoperative day 28. A redo-CABG is thought to be with high risk. Our procedure, however is safe and useful and can be an option for redo-CABG in the posterolateral area.
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PMID:[Reoperative off-pump coronary revascularization via left thoracotomy using the PAS-Port system to the descending thoracic aorta: report of a case]. 2237 3