Mayo Clinic proceedings
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Count rates observed at end-diastole and end-systole in the region of the left ventricle on gated radionuclide angiograms were correlated with corresponding estimates by biplane contrast angiography of left ventricular volumes in 37 patients. When count rates were normalized for number of cardiac cycles processed, time per frame, isotope decay, and count rate observed in venous blood after equilibrium, there was a strong correlation between normalized left ventricular count rate and contrast angiographic volume, whether the venous sample was counted in a well counter or with the use of the same gamma camera. The latter technique was judged easier and more accurate. ⋯ Interobserver variability of both the radionuclide and the contrast angiographic estimate of the left ventricular volume was similar. Changes in left ventricular stroke volume induced by sublingual administration of nitroglycerin as measured by the radionuclide method correlated reasonably with corresponding changes in stroke volume measured by the dye-dilution method. It is concluded that left ventricular volumes obtained noninvasively by the radionuclide technique were accurate and were subject to the same interobserver variability as the contrast angiographic technique.
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Mayo Clinic proceedings · Sep 1981
Case ReportsIntra-aortic balloon counterpulsation as adjunct to aneurysmectomy in high-risk patients.
Patients with severe coronary artery disease that is not amenable to coronary artery bypass surgery face formidable risks when major aortic surgery becomes necessary. In this report we present such a patient, who successfully underwent abdominal aortic aneurysm resection and graft replacement with the prophylactic use of intra-aortic balloon counterpulsation. The use of intra-aortic balloon counterpulsation at the time of surgery has the potential of improving cardiac function in patients with left ventricular dysfunction and favorably influencing the perioperative and postoperative mortality in these patients. Its use also appears worthy of trial in patients with ruptured abdominal aortic aneurysm and shock, in the hope that it will result in improved survival in these patients.
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Clinical and histopathologic features of 15 cases of diffuse fasciitis with eosinophilia are reviewed. The patients experienced an inflammatory scleroderma-like illness without Raynaud's phenomenon or internal organ involvement. Polyarthritis and carpal tunnel syndrome were observed. ⋯ Histopathologic features are discussed, as is their relationship to other forms of localized scleroderma. None of the 12 patients treated with corticosteroids has had complete resolution of the skin changes after a median follow-up of 10 months. Unusual associated diseases--acute myelomonocytic leukemia and an evolving myeloproliferative disorder--were observed in two patients.