By Bernhard Meier
Professor Meier attracts upon one of many world's best collections of illustrative fabric to illustrate the sensible program of interventional methods in dealing with coronary artery illness. concentrating on ten fundamental strategies, the writer, joined via a professional workforce of members, describes the major phases of every approach, the potential problems and contra-indications and the way they need to be controlled. extra tables and diagrams help the textual content and current the reader with a 'master category' at the most crucial ideas, as given via one of many world's major professionals within the box. those positive aspects make this the main authoritative, precious, and present source in this topic on hand.
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Additional info for An Atlas of Investigation and Therapy: Interventional Cardiology
To date their use, which is quite cumbersome and not without risk, is not uncommon particularly in angioplasty of old degenerated vein grafts. However, it is clearly acceptable not to use these devices at all and their final position in coronary angioplasty will depend on the outcome of randomized trials with different indications. 17 persiflages the current value of devices for coronary angioplasty. Among the ADP and GP IIb/IIIa antagonists, the thienopyridine copidogrel will probably dominate in the future.
2). Refractoriness to medical therapy usually indicates progression of the disease. At this point, the use of more aggressive therapies, such as alcohol ablation of the septum or surgical septal myectomy are indicated. Dual-chamber pacing for symptomatic relief and reduction of outflow tract obstruction has been used previously, but is not recommended at present for general use. However, insertion of implantable cardioverter-defibrillators is strongly advised in high-risk patients with a family history of sudden cardiac death, severe LV hypertrophy with nonsustained or sustained ventricular tachyarrhythmias, or syncopes.
15 Male patient (54 years) with atypical chest pain and a negative thallium stress test. The coronary angiogram shows a nonsignificant lesion in the proximal left anterior descending coronary artery (arrows, A) in a left (top) and right (bottom) anterior oblique projection. The ventricular function is normal (top: end-diastole; bottom: end-systole; B). Exactly 1 month later, the patient suffers an acute anterior myocardial infarction which he survives. However, his left ventricular function is completely ruined (top: end-diastole; bottom: end-systole; C) and the patient subsequently requires heart transplantation.