Improvement of Myocardial Perfusion: Thrombolysis, Angioplasty, Bypass Surgery

ISBN-13: 9789401087292 / Angielski / Miękka / 2014 / 366 str.

J. Meyer; Raimund Erbel; H. J. Rupprecht

Opis

This book contains the manuscripts of the majority of the papers given during the symposium 'Improvement of Myocardial Perfusion' which was held from Sep- tember 27-29,1984 in Mainz/Germany. It has been the purpose of this meeting to focus the interest of scientifically and clinically interested cardiologists on the new developments in this field. We therefore chose the subtitle 'Medical-Mechanical -Surgical Approach'. The medical improvements in myocardial perfusion have been brought about by the application of streptokinase, urokinase and tissue-type plasminogen ac- tivator in the first hours after the onset of an acute myocardial infarction. The different modes of application and the possibilities to evaluate and eventually to quantify the results of these treatments were addressed during the first part of the meeting. The mechanical way to improve perfusion nowadays mainly consists of the application of intracoronary balloon angioplasty. Although since 1977 the treat- ment has become a routine method, several questions are still open such as the exact mode of action, the reaction of the vessel wall, the optimal pressure and balloon size as well as the long term results and the prevention of restenosis.

Spis treści

I. Acute myocardial infarction.- 1. Systemic streptolysis of acute myocardial infarction.- 2. Efficacy of BRL 26921, a new fibrinolytic agent for intravenous infusion, in acute myocardial infarction.- 3. Coronary venous retroperfusion support of reperfusion following acute coronary occlusion.- 4. Elevation of coronary sinus pressure improves myocardial protection.- 5. Improvement of myocardial perfusion and enhancement of washout during coronary artery occlusion by intermittent pressure controlled coronary sinus occlusions.- 6. Medical-mechanical treatment of myocardial infarction.- 7. Autopsy findings in 14 patients with myocardial infarction treated with thrombolysis or combined thrombolysis and PTCA.- 8. Thrombolytic therapy in myocardial infarction: are fibrinolytic drugs comparable, and similarly effective?.- 9. Coronary thrombolysis with tissue-type plasminogen activator (t-PA).- 10. Financial background of PTCR and PTCA and regional distribution of cardiac catheterization laboratories in the Federal Republic of Germany.- II. Evaluation of improvement of myocardial perfusion.- 11. Natural history of coronary artery stenosis.- 12. ECG and reperfusion.- 13. Intracoronary myocardial scintigraphy during intracoronary thrombolysis.- 14. Opposite ends of the intervention spectrum: effects of intracoronary thrombolysis on long-term survival and LV function — Detection of early CAD by non-invasive positron imaging.- 15. Improvement of myocardial perfusion by thrombolysis evaluation of left-ventricular function by two-dimensional echocardiography.- 16. Right ventricular infarction: echocardiographic and hemodynamic feature.- 17. Limitation of myocardial necrosis by thrombolysis during acute myocardial infarction.- III. Percutaneous transluminal coronary angioplasty.- >A. Pathophysiology.- 18. Pathophysiology of transluminal angioplasty.- 19. Does angioplasty improve or accelerate atherosclerosis?.- B. Myocardial function during PTCA.- 20. Elective PTCA of totally occluded coronary arteries not associated with acute myocardial infarction: short and long-term results.- 21. Acute changes of myocardial function by PTCA. Evaluation by two-dimensional echocardiography.- 22. Coronary sinus potassium and pH during percutaneous transluminal angioplasty: temporal relation to contractility and action potential duration.- 23. Validity of myocardial scintigraphy, measurement of pulmonary artery pressure and intravenous digital subtraction angiocardiography in the evaluation of the effect of PTCA.- 24. Monitoring of myocardial ischaemia during PTCA improved sensitivity with 12-lead ECG.- 25. Results of percutaneous transluminal coronary angioplasty assessed by TL-201 perfusion scintigraphy.- 26. Automated computer-assisted quantitative assessment of stenosis geometry and hemodynamics pre and post PTCA.- 27. Relationship of the occlusion pressure during PTCA to collaterals.- 28. Changes in creatine phosphokinase after coronary angioplasty.- 29. Antiischemic properties of intracoronary diltiazem.- 30. Cardio-computertomography for assessing regional myocardial perfusion abnormalities in coronary heart disease.- 31. Clinical significance of microsphere myocardial scintigraphy in coronary artery disease.- C. Clinical results.- 32. Current aspects of transluminal coronary angioplasty.- 33. Treatment of unstable angina by transluminal coronary angioplasty PTCA.- 34. Coronary angioplasty in multivessel disease.- 35. Effect of coronary occlusion during percutaneous transluminal angioplasty on systolic and diastolic left ventricular function.- 36. Restenosis following successful coronary angioplasty (PTCA): the result of inadequate dilatation? — Relation between primary success and late results.- 37. Results of repetitive controls after successful transluminal coronary angioplasty.- 38. Long-term results after angioplasty of stenosed coronary artery bypass grafts.- 39. In vitro studies to investigate the possibility of protective intracoronary perfusion during percutaneous transluminal coronary angioplasty (PTCA).- 40. Haemodynamic and haemorheology effects of intracoronary perfusion during percutaneous transluminal coronary angioplasty (PTCA).- 41. Improved tolerance of intracoronary balloon inflation with a modified Grüntzig balloon angioplasty catheter.- 42. Pressure transmission characteristics of the Grüntzig superlow-profile catheter.- 43. Increased hemolysis during coronary perfusion via angioplasty catheters as a result of side-hole jet effect.- IV. Coronary artery surgery.- 44. Intraoperative angioplasty in the treatment of coronary artery disease.- 45. Treatment of coronary artery stenosis by laser technique.- 46. Reoperative myocardial revascularization.- 47. Aortocoronary polygrafting and coronary endarterectomy in diffuse CAD.- 48. Coronary artery bypass in the elderly.- 49. Combination of valve replacement and coronary bypass.- 50. Cardiac valve replacement and simultaneous myocardial revascularization.- 51. Bypass surgery for stenosis and occlusion of the left main coronary artery.- 52. Bypass surgery adjacent to streptolysis therapy.- 53. Emergency bypass operation after PTCA.- 54. Massive coronary artery spasm with resultant myocardial infarction after ACVB — surgery. A case report.- Index of subjects.