A. Tambe

Angina pectoris and slow flow velocity of dye in coronary arteries—A new angiographic finding

Abstract The coronary arteriograms of 6 patients with the anginal syndrome revealed a normal coronary arterial tree. This finding was associated with a strikingly slow flow rate of the angiographic dye through the major vessels. This feature is discussed in detail and a theory of small vessel disease is suggested. The purpose of this paper is to bring into focus a new angiographic finding. Its cause is hypothesized and requires clarification by further studies which should include accurate flow measurements, metabolic determinations, and myocardial biopsics.

Internal Mammary Artery Bypass Graft—Long-term Patency Rate and Follow-up

Abstract Between December, 1968, and January, 1974, 814 internal mammary artery and 351 saphenous vein bypass graft procedures were performed in 628 patients. Operative mortality during the past 3 years has been 1.7%. Internal mammary artery bypasses were performed to the anterior descending, circumflex, obtuse marginal, distal right, and posterior descending right coronary arteries. Ninety-one patients having 137 internal mammary artery and 32 saphenous vein grafts were studied angiographically 12 to 36 months postoperatively. All but 2 internal mammary artery bypasses were patent, a patency rate of 98.5%; 27 of the 32 saphenous vein bypasses in this group were patent (84.3%). The majority of the internal mammary artery bypasses were to distal coronary arteries, while the saphenous veins were used primarily for proximal anastomosis. Cineangiographic volume/flow studies were also performed. The average flow in the more distal internal mammary artery bypasses was 61 ml. per minute as compared with 91 ml. per minute in the proximal saphenous vein grafts.

Meticulous Repair of the Arteriotomy in Prevention of Thrombosis Following Left Cardiac Catheterization and Coronary Arteriography

* Associate, Marie L. Coakley Cardiovascular Laboratory, Saint Vincents Charity Hospital, Cleveland, Ohio 44115. † Associate, Marie L. Coakley Cardiovascular Laboratory, Saint Vincents Charity Hospital, Cleveland, Ohio 44115. ‡ Director, Marie L. Coakley Cardiovascular Laboratory, Saint Vincents Charity Hospital, Cleveland, Ohio 44115. Catheterization of the left cardiac chambers and of the aorta can be accomplished by various techniques,l, 2 which, with the exception of the transseptal method3 and of the percutaneous puncture of the left ventricle,4 require the introduction of a catheter into a peripheral artery. Selective coronary arteriography can be performed only via a peripheral artery.5, s Percutaneous arterial puncture followed by catheter replacement of the needle 2. s, 7 has been advocated as the method of choice, but arteriotomy of the surgically exposed vessel is preferred by others.1, 5, 8 This report deals with the precise care of the arteriotomy, and its importance in preventing thrombosis of the catheterized vessel.