By Nico H. J. Pijls, Bernard De Bruyne (auth.)

ISBN-10: 9048153980

ISBN-13: 9789048153985

ISBN-10: 940159564X

ISBN-13: 9789401595643

A little bit greater than years after the 1st version, we're happy to put up the second one version of this booklet. greater than half the chapters were reworked and accomplished because the results of technical advancements and lately obtained scientific facts. in the course of those years, the variety of coronary strain measurements played all over the world either in the course of diagnostic and interventional strategies has elevated nearly exponentially. many of the preliminary difficulties linked to this new technique were conquer. Many colleagues have explored new learn avenues and in lots of catheterization laboratories the tactic has matured from a study toy to a medical device. Classical symptoms resembling the intermediate stenosis and advice of PTCA or stent implantation, were principally prolonged and coronary strain size has confirmed to be priceless in multi vessel illness, diffuse illness, lengthy and serial stenosis, after myocardial infarction, and in lots of different diagnostic and interventional occasions encountered within the catheterization laboratory. really without notice, this method has additionally enforced the binds with our surgical colleagues within the choice of sufferers appropriate for minimum invasive surgical procedure or hybride revascularization. additionally in light and intermediate left major sickness, there's a function for coronary strain dimension within the means of selection making. we want to specific our gratitude to all these many colleagues who relied on and utilized this new strategy for the good thing about their sufferers. Aalst, Eindhoven, Bernard De Bruyne. Nico H. J. Pijls. March, 2000. desk of Contents (overview) 1 1.

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Some of the shortcomings of Doppler-derived coronary flow velocity reserve, can be overcome by calculating relative flow velocity reserve (RFVR) as recently shown in an elegant study by Baumgart et a1 148 • Provided that microvascular disorders are equally distributed through the myocardium, RFVR is more stenosis-specific than absolute CFVR and less sensitive to hemodynamic variations. Reliable calculation of RFVR, however, is only possible if a truly normal reference artery is present. 6). Besides the fact that RFVR measurement is not possible in all patients, a major disadvantage is that for obtaining this index 4 measurements should be performed: resting and hyperemic blood flow velocity in the stenotic vessel and resting and hyperemic blood flow velocity in the (normal) reference vessel whereas the same information can be obtained by a pressure wire by one measurement only.

In: Cardiovascular Dynamics and Models 1988. Eds. Brun P. Chadwick RS, Levy BI, lNSERM, Paris: 65-76. 19. Roberts JT, Weam JT. Quantitative changes in the capillary-muscle relationship in human hearts during normal growth and hypertrophy. Am Heart J 1941 ;21: 617-633. 20. Gerdes AM, Kasten FH. Morphometric study of endomyocardium and epimyocardium of the left ventricle in adult dogs. Am J Anat 1980; 159:389-394. 21. Schaper W, Ito WD. Molecular mechanisms of coronary collateral vessel growth. Circ Res 1996;79:911-919.

Therefore, the precise knowledge of plaque composition could bear prognostic infonnation not provided by angiography nor by coronary flow assessment and could influence the therapeutic strategyS2. While some authors have observed a high prevalence of soft plaques with fewer intralesional calcium deposits in unstable syndromes, others observed similar echographic characteristics of the plaque in stable and unstable syndromesS3 ,S4. (3) New insights in the mechanisms of coronary interventions. The structural changes associated with balloon angioplasty, atherectomy, and stent deployment, as well as the mechanisms of immediate complications of coronary interventions have been better understood by the use of intravascular ultrasounds5~.

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Coronary Pressure by Nico H. J. Pijls, Bernard De Bruyne (auth.)

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