Broken Guidewire Fragment

Advances in technology and greater operator experience have increased the success rate of percutaneous coronary intervention while lowering the complication rates. The broken guidewire is a rare complication of percutaneous coronary intervention. We present this rare complication in a patient who was medically treated.     

Guidewire Facilitation of Internal Mammary Artery Cannulation

With the advent of widespread use of the internal mammary artery for coronary revascularization, high quality delineation of this conduit during angiography is necessary. We describe herein a safe, easy method to selectively cannulate the internal mammary artery based on a steerable angioplasty guidewire technique.     

Atrial Septal Defect Measurement with a Guidewire Loop

A practical, simple and cheap technique using a guidewire loop for transvenous measurement of the size of a patent foramen ovate is presented. We applied this device in four patients without complication. To clear a suspected cause of paradoxical embolism was the indication of this procedure. Sizes between 16 and 4 mm were documented. We conclude that this technique may be of value in determining criteria for surgical closure or for the evaluation of transcatheter obliteration in hemodynamically nonrelevant atrial septal defects.     

Escape from strange repellers

In a dynamical system described by a map, it may be that a “strange” sets of points is left invariant under the mapping. The set is a repeller if points placed in its neighborhood move away. An escape rate is defined to describe this motion. An alternative method of evaluating the escape rate, based on the consideration of repulsive cycles, is proposed. In the several cases examined numerically and analytically, the escape rate is shown to agree with the proposed formula.     

Guidewire snap causing left main coronary occlusion during coronary angioplasty

The case of a 34-year-old female patient is presented. During attempted left anterior descending coronary angioplasty, the exchange guidewire (0.018 inch, 300 cm) snapped and the distal 20 cm of the wire caused immediate thrombotic occlusion of both the left anterior descending and circumflex arteries. The resulting complication was treated by emergency bypass surgery.     

醛固酮逃逸和心血管疾病

长期使用血管紧张素转换酶抑制剂 (ACEI)治疗慢性充血性心力衰竭 (CHF)、原发性高血压 (EH )等心血管疾病后存在血浆醛固酮逃逸现象 (aldosteroneescape)。本文概述了醛固酮的病理生理作用与醛固酮逃逸的可能机制 ,讨论了醛固酮逃逸对CHF、EH、冠心病 (CHD)产生的不利影响以及干预对策。