a comprehensive and real picture of the complexities of ischemic heart disease, both to the person who deals in day to day practice with its problems, as well as to the This book presents a comprehensive picture of is chemic heart disease to those who, either as practition student and resident who tries to develop firm concepts ers or students, deal with the varied facets of this com regarding the varied states observed in this common plex subject. It has meaning to the fields of clinical condition. cardiology, radiology, thoracic surgery, and pathology. After an introductory chapter on the anatomy of the coronary blood vessels, there follows a chapter on coro nary arteriography. The latter considers techniques, in dications, examples of normal and abnormal patterns, and complications of this procedure. Specific chapters deal with variations in the sites of origin and distribution of coronary arteries, both as seen angiographically and anatomically. Congenital anomalies of the coronary arteries which may engender states of ischemic heart disease are presented. The principal thrust of the work concerns the main arena of ischemic heart disease, namely, coronary ath erosclerosis. The pathology of coronary atherosclerosis is presented in conjunction with the results of anatomic and angiographic studies. Major chapters discuss the subjects of angina pecto ris, acute myocardial infarction, healed myocardial in farction, surgical "revascularization" with indications and the postoperative states, and the surgical treatment of myocardial infarction and its sequelae.
Inhalt
1 Anatomy of the Coronary Vessels.- The Right Arterial System.- The Right Coronary Artery.- The Left Arterial System.- The Main Left Coronary Artery.- The Anterior Descending Coronary Artery.- The Left Circumflex Coronary Artery.- The Atrial Arterial Supply.- From the Left Coronary System.- From the Right Coronary System.- The Conus Artery.- The Veins.- 2 Coronary Arteriography.- Techniques.- History of Coronary Angiography at the University of Minnesota.- Selective Catheterization: Percutaneous Puncture of the Subclavian Artery.- Selective Left Coronary Catheterization: Percutaneous Transfemoral Approach.- Selective Right Coronary Catheterization: Percutaneous Transfemoral Approach.- Procedure for Transfemoral Coronary Arteriography.- Left Ventriculometry.- Cine Imaging.- Advantages and Disadvantages of Cine Recording.- Cut Film Imaging of the Coronary Arteries.- Regional Myocardial Blood Flow Measurements and Radioisotopic Imaging.- Electrocardiographic Changes during Selective Coronary Arteriography.- Complications.- Injection of Air.- Dissection of the Coronary Artery.- Coronary Dissection without Occlusion.- Occlusion after Dissection.- Embolic Occlusion of the Coronary Arteries.- Wedge Injections.- Indications.- Angiographic Projections.- Frontal Projection of Left Coronary Artery.- Right Coronary Arteriogram in Frontal Projection.- Right Anterior Oblique Projection.- Right Anterior Oblique Projection of Right Coronary Artery.- Left Anterior Oblique Projection of Left Coronary Artery.- Left Anterior Oblique Projection of Right Coronary Artery.- Lateral Projection of Left Coronary Artery.- Lateral Projection of Right Coronary Artery.- Multiple Views.- Angiographic Identifications during Systole and Diastole.- Myocardial Bridges.- Pseudomyocardial Bridge.- Measurements of the Coronary Arteries.- Angiographic Assessment of Coronary Artery Disease.- Nature of Obstructive Lesions.- Spasm of the Coronary Arteries.- Coronary Arteries without Identifiable Lesions.- Minimal Obstructive Disease.- Moderate Stenosis.- Severe Stenosis in Intermediate Segment of Right Coronary Artery.- Multiple Lesions in Left Coronary System.- Severe Stenosis in Small Branches.- Occlusion in Two Vessels.- Identification of Obstructive Lesions.- Progression of Lesions.- Delay in Opacification and Clearing.- Administration of Nitrites.- Collateral Circulation.- Bridging Anastomosis.- Kugel's Artery.- Intercoronary Anastomoses with Left Anterior Descending and Posterior Descending.- Septal Collaterals to the Right Coronary Artery.- Occlusion of the Right Coronary Artery with Collaterals from the Left Anterior Descending and Left Circumflex Arteries.- Collaterals to the Right Coronary Artery through Atrial Branches.- Occlusion of Distal Right Coronary Artery with Collaterals from Septal Branches of the Left Anterior Descending Artery.- Segmental Occlusion and Intercoronary Collaterals.- Occlusion of the Left Anterior Descending Artery: Dual Collateral Supply from the Conus Artery and Muscular Branches of Right Coronary Artery.- From Conus Artery and Right Muscular Branches to the Left Anterior Descending Artery.- Collateral Flow to the Left Anterior Descending Artery through Branches of the Posterior Descending Artery Arising from the Left Circumflex.- Collaterals from Left Circumflex to Right Coronary Artery.- Left Circumflex: Source of Collaterals to Occluded Right Coronary and Left Anterior Descending Arteries.- Muscular Branch: Source of Collaterals to Occluded Distal Right Coronary and Left Anterior Descending Arteries.- Collateral Flow to the Moderator Bands of the Right Ventricle.- The Left Coronary Branchless Tree Appearance.- 3 Variations in Levels of Origin of the Coronary Arteries.- Normal.- Abnormal.- Congenital High Takeoff of the Right Coronary Artery.- Acquired High Takeoff of Coronary Arteries.- High Takeoff: Angiographic Observations.- Illustrative Cases.- High Takeoff of Right Coronary Artery: Sudden Death.- Low Origin of Right Coronary Artery: Angiographic Demonstration.- 4 Variations in Sites of Origin of the Coronary Arteries.- Origins of the Left Circumflex Coronary Artery from the Right Aortic Sinus.- Anatomy.- Angiography.- Origin of the Left Circumflex Coronary Artery from the Right Coronary Artery.- Anatomy and Aortography.- Selective Angiography.- Complications following Aortic Valve Replacement.- Complications Associated with Removal of Left Atrial Myxoma.- Origin of the Anterior Descending Coronary Artery from the Right Coronary Artery.- Without Congenital Heart Disease.- In the Tetralogy of Fallot.- Independent Origins of the Anterior Descending and Circumflex Coronary Arteries from the Left Aortic Sinus.- Anatomy.- Angiography.- Origin of the Right Coronary Artery from the Posterior (Noncoronary) Sinus.- Origin of Both Coronary Arteries from the Right Aortic Sinus.- Arteriographie Demonstration.- Origin of Both Coronary Arteries from the Left Aortic Sinus.- 5 Hypoplasia of the Coronary Arteries.- Right Coronary System.- Right Coronary Artery.- Posterior Descending Artery.- Left Coronary System.- Anterior Descending Artery.- Circumflex Artery.- Circumflex and Short Posterior Descending Arteries.- 6 Variations in the Length of the Left Coronary Artery.- Normal Left Coronary Artery.- Unusually Long Left Coronary Artery.- Short Left Coronary Artery.- Angiographic Demonstration.- Associated with Hypoplasia of the Right Coronary Artery.- Complications following Coronary Perfusion: Postoperative Acute Myocardial Infarction.- 7 Single Coronary Ostium in the Aorta.- Single Coronary Artery.- Entire Coronary System Arising from the Aorta.- True Single Coronary Artery.- Single Coronary Artery Bifurcating into Right and Left Coronary Arteries.- Atresia of a Coronary Ostium.- Origin of One of Two Coronary Arteries from the Pulmonary Trunk.- Origin of the Right Coronary Artery from the Pulmonary Trunk: Arteriographie Demonstration.- Origin of the Left Coronary Artery from the Pulmonary Trunk: Arteriographie Demonstration.- Origin of the Left Coronary Artery from the Right Pulmonary Artery.- 8 Abnormal Communications of the Coronary Arteries.- Communication of the Right Coronary Artery with the Coronary Sinus.- Communication of the Left Circumflex Coronary Artery with the Coronary Sinus.- Communication of the Right Coronary Artery with the Right Ventricle.- Comm…