Abstract：
:Transmyocardial laser revascularization, a new surgical technique, is being tested in patients with chronic obstructive coronary artery disease that is refractory to conventional revascularization techniques and to maximal medical therapy. During the operation, which is performed on the beating heart through a left thoracotomy, a high-energy CO2 laser is used to bore transmural channels (1 mm in diameter) into the left ventricle. Each high-energy laser pulse is delivered during end diastole and transects the heart within 10 to 60 msec. The operation is based on the theory that blood will flow directly from the left ventricle into the channels and then into the myocardial vascular plexus. Restoring perfusion should alleviate ischemia in potentially viable myocardium and improve ventricular function. Recently, one of our patients died 3 months after transmyocardial laser revascularization of causes unrelated to the operation. Histologic analysis enabled us to obtain, for the 1st time, anatomic evidence of patent laser channels. Routine staining of cardiac tissue with hematoxylin and eosin revealed multiple patent channels, running perpendicular to and interconnecting with the native vasculature. Although reactive fibrous scar tissue had caused narrowing of the original laser tract, the channels had endothelialized and they contained red blood cells. These findings suggest that the laser channels were functional. We report this interesting case and briefly discuss the anatomic and physiologic phenomena involved in establishing camerosinusoidal blood flow by use of transmyocardial laser revascularization.
journal_name
Tex Heart Inst Jjournal_title
Texas Heart Institute journalauthors
Cooley DA,Frazier OH,Kadipasaoglu KA,Pehlivanoglu S,Shannon RL,Angelini Psubject
Has Abstractpub_date
1994-01-01 00:00:00pages
220-4issue
3eissn
0730-2347issn
1526-6702journal_volume
21pub_type
杂志文章abstract：:The year 2016 was the 180th anniversary of Wilhelm Ebstein's birth and the 150th anniversary of his description of the congenital tricuspid valve malformation that came to be known as Ebstein anomaly. We present a brief history of the life and work of Dr. Wilhelm Ebstein. Despite his distinguished career, he is seemin...
journal_title：Texas Heart Institute journal
pub_type： 传,历史文章,杂志文章,评审
doi：10.14503/THIJ-16-6063
更新日期：2017-06-01 00:00:00
abstract：:The benefit of defibrillator therapy has been well established for patients with LV dysfunction (ejection fraction less than 35%), coronary artery disease, NSVT, and inducible and nonsuppressible ventricular tachycardia. Implantable cardioverter-defibrillator therapy is also indicated for all CHF patients in NYHA func...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章,评审
doi：
更新日期：1999-01-01 00:00:00
abstract：:Understanding plaque formation in patients at risk for coronary artery disease-the leading cause of morbidity and death in the world-enables physicians to better determine whether and how to treat these individuals. We used computed tomographic angiography to quantitatively evaluate the progression of nonculprit coron...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-16-5805
更新日期：2017-10-01 00:00:00
abstract：:We describe the case of a patient with osteogenesis imperfecta tarda (Lobstein's syndrome) and mitral valve insufficiency. The course after mitral valve replacement was complicated by rupture of the left ventricular posterior wall, which caused massive bleeding and sudden death. The pathologic findings and the operati...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1999-01-01 00:00:00
abstract：:Hemangiomas of the heart are extremely rare. The prognosis is quite variable, because this benign tumor may grow, involute, or stop growing; therefore, resection is usually the treatment of choice. In patients with tumors of the left atrium, percutaneous balloon mitral valvulotomy is generally contraindicated. Yet for...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2010-01-01 00:00:00
abstract：:Acquired long QT syndrome is typically caused by medications, electrolyte disturbances, bradycardia, or catastrophic central nervous system events. We report a case of myocardial infarction-related acquired long QT syndrome in a 58-year-old woman that had no clear cause and progressed to torsades de pointes requiring ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-18-6872
更新日期：2020-04-01 00:00:00
abstract：:Assessing thromboembolic risk is crucial for proper management of patients with atrial fibrillation. Left atrial volume is a promising predictor of cardiac thrombosis. To determine whether left atrial volume can predict left atrial appendage thrombus in patients with atrial fibrillation, we conducted a prospective stu...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-17-6290
更新日期：2020-04-01 00:00:00
abstract：:Left ventricular assist device (LVAD)-supported patients are evaluated routinely with use of transthoracic echocardiography. Values of left ventricular unloading in this unique patient population are needed to evaluate LVAD function and assist in patient follow-up. We introduce a new M-mode measurement, the slope of t...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-13-3604
更新日期：2014-06-01 00:00:00
abstract：:We have reviewed the clinical presentations, courses, and outcomes of 90 patients seen at Texas Children's Hospital from 1983 through 2008 who had an isolated cleft of the mitral valve without some form of endocardial cushion defect. Additional congenital cardiac defects were present in 61 of the 90 patients, 35 of wh...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2009-01-01 00:00:00
abstract：:Coronary obstruction, a rare complication of transcatheter aortic valve replacement, can be fatal. Few data exist on this phenomenon, and, to date, authors have reported only single coronary lesions. We present a case in which 2 coronary arteries obstructed immediately after transapical transcatheter aortic valve repl...
journal_title：Texas Heart Institute journal
pub_type：
doi：10.14503/THIJ-17-6497
更新日期：2020-02-01 00:00:00
abstract：:Interventionalists encounter widely different coronary anatomies during left main coronary artery stenting. Optimal percutaneous coronary intervention in left main disease necessitates stents that achieve adequate apposition and adapt to frequently disparate diameters in the same lesion, without the need for overexpan...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-17-6190
更新日期：2017-10-01 00:00:00
abstract：:Influenza causes cardiac and pulmonary complications that can lead to death. Its effect on the conduction system, first described a century ago, has long been thought to be fairly benign. We report 2 cases of high-grade atrioventricular block associated with acute influenza infection. Both patients-a 50-year-old woman...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-18-6658
更新日期：2020-06-01 00:00:00
abstract：:Anomalous origin of the right coronary artery from the pulmonary artery, a rare congenital cardiac defect, is typically not diagnosed during infancy. On the other hand, Turner syndrome is usually diagnosed early, and it is classically associated with bicuspid aortic valve and aortic coarctation. Individuals with Turne...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-17-6521
更新日期：2019-06-01 00:00:00
abstract：:Amiodarone therapy for the treatment of arrhythmias has been found to have severe side effects. Although the drug has been prescribed in Europe for more than 20 years, it has only recently been used in the United States as an investigational drug, and has been found to cause pulmonary toxicity, as well as other major ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1984-06-01 00:00:00
abstract：:We report 4 consecutive cases in which the double-patch technique was used to repair an inferior postinfarction ventricular septal rupture. The ventricular septal perforation was closed directly by stitching, with the same sutures, 2 autologous pericardial patches onto both sides of the affected septum, through only a...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2005-01-01 00:00:00
abstract：:Cardiogenic shock after acute myocardial infarction is associated with a high mortality rate despite modern reperfusion methods and intra-aortic balloon pump support. For myocardial infarction patients in cardiogenic shock that is refractory to intra-aortic ballon pump counterpulsation and pressors (severe refractory ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2007-01-01 00:00:00
abstract：:Regardless of the diabetic status of patients with coronary artery disease, hyperglycemia and hypoglycemia are adversely associated with cardiovascular events. The relationship between glucose levels and increased mortality risk in acute myocardial infarction has been shown through various glucose metrics; however, th...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2013-01-01 00:00:00
abstract：:We report the case of a 65-year-old man who presented with an infrarenal aortic aneurysm in association with a congenital right pelvic kidney vascularized by 2 aortic arteries, 1 of which arose from the aneurysmal aorta and the other from the common right iliac artery. Successful surgery consisted of excising the aneu...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章,评审
doi：
更新日期：1997-01-01 00:00:00
abstract：:Carcinoid tumors are rare neuroendocrine malignancies that typically originate from the gastrointestinal tract. Patients who are diagnosed with carcinoid heart disease generally have poor prognoses because of advanced metastases during staging and few therapeutic options. We present the case of a 61-year-old woman wit...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-13-3314
更新日期：2014-10-01 00:00:00
abstract：:Lambl's excrescences are filiform fronds that occur at sites of valve closure. They originate as small thrombi on endocardial surfaces (where the valve margins contact) and have the potential to embolize to distant organs. We describe the case of a 61-year-old woman who presented with repeated episodes of stroke. She ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章,评审
doi：
更新日期：2007-01-01 00:00:00
abstract：:Few orthotopic heart transplantations have been performed in patients infected with the human immunodeficiency virus since the first such case was reported in 2001. Since that time, advances in highly active antiretroviral therapy have resulted in potent and durable suppression of the causative human immunodeficiency ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：10.14503/THIJ-14-4746
更新日期：2016-02-01 00:00:00
abstract：:A 58-year-old man presented with chest pain and tightness and was diagnosed with a Q-wave anterior myocardial infarction. He then developed pulseless ventricular arrhythmias, which were treated with repeated direct-current shocks and intravenous amiodarone. He underwent emergency cardiac catheterization: stents were d...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2011-01-01 00:00:00
abstract：:Malignant metastases to the heart and pericardium, which occur far more often than do primary cardiac neoplasms, typically lead to fatal outcomes. The phyllodes tumor is a rare, predominantly benign fibroepithelial breast neoplasm with variable malignancy potential. Herein, we describe the case of a 35-year-old woman ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章,评审
doi：
更新日期：2011-01-01 00:00:00
abstract：:Because of the rarity of isolated, nonrheumatic, noninfective tricuspid valvular disease, the long-term results of treatment by tricuspid valve replacement are uncertain. From June 1967 to April 1986, we implanted 23 biological or mechanical tricuspid valve prostheses in 20 patients for nonrheumatic, noninfective endo...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1990-01-01 00:00:00
abstract：:Herein, we present the case of a 22-year-old man who sustained a gunshot wound to a persistent sciatic artery. Endovascular stent management of the arterial injury obviated the need for surgical repair and revascularization in the presence of acute trauma. We believe this to be the 1st report of a completely endovascu...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章,评审
doi：
更新日期：2009-01-01 00:00:00
abstract：:A 55-year-old woman presented with dyspnea on exertion due to a right internal mammary artery-to-superior vena cava arteriovenous fistula that occurred after pacemaker lead extraction with a laser sheath. The fistula was successfully repaired by placing a covered stent in the right internal mammary artery. In this unu...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2012-01-01 00:00:00
abstract：:Severe diffuse obstruction of the coronary arteries was diagnosed in an 18-month-old girl who presented with signs and symptoms of severe congestive cardiomyopathy. Most reported cases of myocardial infarction in neonates or infants have been secondary to obstruction of a single major coronary artery owing to thrombos...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：1987-12-01 00:00:00
abstract：:From January 2002 through June 2004, 17 patients (2% of all coronary cases) were treated with off-pump coronary artery bypass grafting combined with percutaneous coronary intervention. There were 13 men and 4 women, whose ages ranged from 54 to 78 years (mean, 63.1 +/- 20.9 yr). Preoperative angiography revealed 2-ves...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章
doi：
更新日期：2006-01-01 00:00:00
abstract：:We investigated cosmetic outcomes of the midline sternotomy incision. A randomized clinical trial was conducted in 60 patients who underwent surgery through a midline sternotomy incision. Patients were divided into groups A (n=30) and B (n=30). In addition, the incision line was also divided into 2 regions (upper and ...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章,随机对照试验
doi：
更新日期：2005-01-01 00:00:00
abstract：:A multidisciplinary team approach with focused objectives characterizes research at Baylor College of Medicine into the causes, prevention, and treatment of atherosclerotic disease. Current clinical activities range from programs to modify lifestyle for the primary prevention of coronary artery disease to a large, ang...
journal_title：Texas Heart Institute journal
pub_type： 杂志文章,评审
doi：
更新日期：1994-01-01 00:00:00
