The restoration of blood supply to the myocardium. (From Dorland, 28th ed)
Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion.
Diversion of blood flow through a circuit located outside the body but continuous with the bodily circulation.
Arteries originating from the subclavian or axillary arteries and distributing to the anterior thoracic wall, mediastinal structures, diaphragm, pectoral muscles and mammary gland.
Coronary artery bypass surgery on a beating HEART without a CARDIOPULMONARY BYPASS (diverting the flow of blood from the heart and lungs through an oxygenator).
Direct myocardial revascularization in which the internal mammary artery is anastomosed to the right coronary artery, circumflex artery, or anterior descending coronary artery. The internal mammary artery is the most frequent choice, especially for a single graft, for coronary artery bypass surgery.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
Pathological processes of CORONARY ARTERIES that may derive from a congenital abnormality, atherosclerotic, or non-atherosclerotic cause.
An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels.
Dilation of an occluded coronary artery (or arteries) by means of a balloon catheter to restore myocardial blood supply.
NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).
Arteries originating from the subclavian or axillary arteries and distributing to the anterior thoracic wall, mediastinal structures, diaphragm, pectoral muscles, mammary gland and the axillary aspect of the chest wall.
A condition caused by occlusion of terminal aorta, the primary branches of the ABDOMINAL AORTA, as in aortoiliac obstruction. Leriche syndrome usually occurs in males and is characterized by IMPOTENCE, absence of a pulse in the femoral arteries, weakness and numbness in the lower back, buttocks, hips, and lower limbs.
Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.
Radiography of the vascular system of the heart muscle after injection of a contrast medium.
Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs.
Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.
The period following a surgical operation.
Elements of limited time intervals, contributing to particular results or situations.
Injection of air or a more slowly absorbed gas such as nitrogen, into the PLEURAL CAVITY to collapse the lung.
The symptom of paroxysmal pain consequent to MYOCARDIAL ISCHEMIA usually of distinctive character, location and radiation. It is thought to be provoked by a transient stressful situation during which the oxygen requirements of the MYOCARDIUM exceed that supplied by the CORONARY CIRCULATION.
The use of photothermal effects of LASERS to coagulate, incise, vaporize, resect, dissect, or resurface tissue.
A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (CORONARY ARTERY DISEASE), to obstruction by a thrombus (CORONARY THROMBOSIS), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (MYOCARDIAL INFARCTION).
Microsurgical revascularization to improve intracranial circulation. It usually involves joining the extracranial circulation to the intracranial circulation but may include extracranial revascularization (e.g., subclavian-vertebral artery bypass, subclavian-external carotid artery bypass). It is performed by joining two arteries (direct anastomosis or use of graft) or by free autologous transplantation of highly vascularized tissue to the surface of the brain.
The vein which drains the foot and leg.
Narrowing or constriction of a coronary artery.
Application of positive pressure to the inspiratory phase of spontaneous respiration.
A congenital defect in which the heart is located on the right side of the THORAX instead of on the left side (levocardia, the normal position). When dextrocardia is accompanied with inverted HEART ATRIA, a right-sided STOMACH, and a left-sided LIVER, the combination is called dextrocardia with SITUS INVERSUS. Dextrocardia may adversely affect other thoracic organs.
Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.
The direct continuation of the brachial trunk, originating at the bifurcation of the brachial artery opposite the neck of the radius. Its branches may be divided into three groups corresponding to the three regions in which the vessel is situated, the forearm, wrist, and hand.
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
A long, narrow, and flat bone commonly known as BREASTBONE occurring in the midsection of the anterior thoracic segment or chest region, which stabilizes the rib cage and serves as the point of origin for several muscles that move the arms, head, and neck.
An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
The period before a surgical operation.
Making an incision in the STERNUM.
Care given during the period prior to undergoing surgery when psychological and physical preparations are made according to the special needs of the individual patient. This period spans the time between admission to the hospital to the time the surgery begins. (From Dictionary of Health Services Management, 2d ed)
Surgical union or shunt between ducts, tubes or vessels. It may be end-to-end, end-to-side, side-to-end, or side-to-side.
A vital statistic measuring or recording the rate of death from any cause in hospitalized populations.
Precordial pain at rest, which may precede a MYOCARDIAL INFARCTION.
A condition in which the LEFT VENTRICLE of the heart was functionally impaired. This condition usually leads to HEART FAILURE; MYOCARDIAL INFARCTION; and other cardiovascular complications. Diagnosis is made by measuring the diminished ejection fraction and a depressed level of motility of the left ventricular wall.
The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)
Patient care procedures performed during the operation that are ancillary to the actual surgery. It includes monitoring, fluid therapy, medication, transfusion, anesthesia, radiography, and laboratory tests.
Stents that are covered with materials that are embedded with chemicals that are gradually released into the surrounding milieu.
Research techniques that focus on study designs and data gathering methods in human and animal populations.
An episode of MYOCARDIAL ISCHEMIA that generally lasts longer than a transient anginal episode that ultimately may lead to MYOCARDIAL INFARCTION.
A procedure to stop the contraction of MYOCARDIUM during HEART SURGERY. It is usually achieved with the use of chemicals (CARDIOPLEGIC SOLUTIONS) or cold temperature (such as chilled perfusate).
A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery.
The amount of BLOOD pumped out of the HEART per beat, not to be confused with cardiac output (volume/time). It is calculated as the difference between the end-diastolic volume and the end-systolic volume.
Recurrent narrowing or constriction of a coronary artery following surgical procedures performed to alleviate a prior obstruction.
A class of statistical methods applicable to a large set of probability distributions used to test for correlation, location, independence, etc. In most nonparametric statistical tests, the original scores or observations are replaced by another variable containing less information. An important class of nonparametric tests employs the ordinal properties of the data. Another class of tests uses information about whether an observation is above or below some fixed value such as the median, and a third class is based on the frequency of the occurrence of runs in the data. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed, p1284; Corsini, Concise Encyclopedia of Psychology, 1987, p764-5)
The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed)
The veins and arteries of the HEART.
The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.
Operative procedures for the treatment of vascular disorders.
A hypoperfusion of the BLOOD through an organ or tissue caused by a PATHOLOGIC CONSTRICTION or obstruction of its BLOOD VESSELS, or an absence of BLOOD CIRCULATION.
Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.
Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY.
Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure.
A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.
Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic.
The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods.
I'm sorry for any confusion, but "Brazil" is not a medical term or concept, it is a country located in South America, known officially as the Federative Republic of Brazil. If you have any questions related to health, medicine, or science, I'd be happy to help answer those!
Controlled physical activity which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used.
The period of confinement of a patient to a hospital or other health facility.
A family of percutaneous techniques that are used to manage CORONARY OCCLUSION, including standard balloon angioplasty (PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY), the placement of intracoronary STENTS, and atheroablative technologies (e.g., ATHERECTOMY; ENDARTERECTOMY; THROMBECTOMY; PERCUTANEOUS TRANSLUMINAL LASER ANGIOPLASTY). PTCA was the dominant form of PCI, before the widespread use of stenting.
The degree to which BLOOD VESSELS are not blocked or obstructed.
Reconstruction or repair of a blood vessel, which includes the widening of a pathological narrowing of an artery or vein by the removal of atheromatous plaque material and/or the endothelial lining as well, or by dilatation (BALLOON ANGIOPLASTY) to compress an ATHEROMA. Except for ENDARTERECTOMY, usually these procedures are performed via catheterization as minimally invasive ENDOVASCULAR PROCEDURES.
Agents that affect the rate or intensity of cardiac contraction, blood vessel diameter, or blood volume.
Use of a balloon catheter for dilation of an occluded artery. It is used in treatment of arterial occlusive diseases, including renal artery stenosis and arterial occlusions in the leg. For the specific technique of BALLOON DILATION in coronary arteries, ANGIOPLASTY, BALLOON, CORONARY is available.
The hollow, muscular organ that maintains the circulation of the blood.
The span of viability of a tissue or an organ.
The region of the lower limb in animals, extending from the gluteal region to the FOOT, and including the BUTTOCKS; HIP; and LEG.
A macrolide compound obtained from Streptomyces hygroscopicus that acts by selectively blocking the transcriptional activation of cytokines thereby inhibiting cytokine production. It is bioactive only when bound to IMMUNOPHILINS. Sirolimus is a potent immunosuppressant and possesses both antifungal and antineoplastic properties.
A nonparametric method of compiling LIFE TABLES or survival tables. It combines calculated probabilities of survival and estimates to allow for observations occurring beyond a measurement threshold, which are assumed to occur randomly. Time intervals are defined as ending each time an event occurs and are therefore unequal. (From Last, A Dictionary of Epidemiology, 1995)
Narrowing or occlusion of the RENAL ARTERY or arteries. It is due usually to ATHEROSCLEROSIS; FIBROMUSCULAR DYSPLASIA; THROMBOSIS; EMBOLISM, or external pressure. The reduced renal perfusion can lead to renovascular hypertension (HYPERTENSION, RENOVASCULAR).
Drugs or agents which antagonize or impair any mechanism leading to blood platelet aggregation, whether during the phases of activation and shape change or following the dense-granule release reaction and stimulation of the prostaglandin-thromboxane system.
Pathological processes involving any one of the BLOOD VESSELS in the vasculature outside the HEART.
The therapy of the same disease in a patient, with the same agent or procedure repeated after initial treatment, or with an additional or alternate measure or follow-up. It does not include therapy which requires more than one administration of a therapeutic agent or regimen. Retreatment is often used with reference to a different modality when the original one was inadequate, harmful, or unsuccessful.
Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.
The removal of a limb or other appendage or outgrowth of the body. (Dorland, 28th ed)
An alternative to amputation in patients with neoplasms, ischemia, fractures, and other limb-threatening conditions. Generally, sophisticated surgical procedures such as vascular surgery and reconstruction are used to salvage diseased limbs.
A procedure to increase the flow of blood to the MYOCARDIUM by creating transmural channels in the heart wall via the application of laser pulses to epicardial or endocardial surfaces.
The return of a sign, symptom, or disease after a remission.
Obstruction of flow in biological or prosthetic vascular grafts.
Statistical models used in survival analysis that assert that the effect of the study factors on the hazard rate in the study population is multiplicative and does not change over time.
Pathological processes which result in the partial or complete obstruction of ARTERIES. They are characterized by greatly reduced or absence of blood flow through these vessels. They are also known as arterial insufficiency.
Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols.
Obstruction of the flow in the SPLANCHNIC CIRCULATION by ATHEROSCLEROSIS; EMBOLISM; THROMBOSIS; STENOSIS; TRAUMA; and compression or intrinsic pressure from adjacent tumors. Rare causes are drugs, intestinal parasites, and vascular immunoinflammatory diseases such as PERIARTERITIS NODOSA and THROMBOANGIITIS OBLITERANS. (From Juergens et al., Peripheral Vascular Diseases, 5th ed, pp295-6)
The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers.
A method of computed tomography that uses radionuclides which emit a single photon of a given energy. The camera is rotated 180 or 360 degrees around the patient to capture images at multiple positions along the arc. The computer is then used to reconstruct the transaxial, sagittal, and coronal images from the 3-dimensional distribution of radionuclides in the organ. The advantages of SPECT are that it can be used to observe biochemical and physiological processes as well as size and volume of the organ. The disadvantage is that, unlike positron-emission tomography where the positron-electron annihilation results in the emission of 2 photons at 180 degrees from each other, SPECT requires physical collimation to line up the photons, which results in the loss of many available photons and hence degrades the image.
Prolonged dysfunction of the myocardium after a brief episode of severe ischemia, with gradual return of contractile activity.
In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.
The inferior part of the lower extremity between the KNEE and the ANKLE.
Shock resulting from diminution of cardiac output in heart disease.
A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function.
Surgical insertion of BLOOD VESSEL PROSTHESES to repair injured or diseased blood vessels.
A catecholamine derivative with specificity for BETA-1 ADRENERGIC RECEPTORS. It is commonly used as a cardiotonic agent after CARDIAC SURGERY and during DOBUTAMINE STRESS ECHOCARDIOGRAPHY.
The main artery of the thigh, a continuation of the external iliac artery.
A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.
Coagulation of blood in any of the CORONARY VESSELS. The presence of a blood clot (THROMBUS) often leads to MYOCARDIAL INFARCTION.
Surgical excision, performed under general anesthesia, of the atheromatous tunica intima of an artery. When reconstruction of an artery is performed as an endovascular procedure through a catheter, it is called ATHERECTOMY.
A noninflammatory, progressive occlusion of the intracranial CAROTID ARTERIES and the formation of netlike collateral arteries arising from the CIRCLE OF WILLIS. Cerebral angiogram shows the puff-of-smoke (moyamoya) collaterals at the base of the brain. It is characterized by endothelial HYPERPLASIA and FIBROSIS with thickening of arterial walls. This disease primarily affects children but can also occur in adults.
Radiography of blood vessels after injection of a contrast medium.
The plan and delineation of prostheses in general or a specific prosthesis.
The continuation of the femoral artery coursing through the popliteal fossa; it divides into the anterior and posterior tibial arteries.
Conditional probability of exposure to a treatment given observed covariates.
Formation and development of a thrombus or blood clot in the blood vessel.
Conditions or pathological processes associated with the disease of diabetes mellitus. Due to the impaired control of BLOOD GLUCOSE level in diabetic patients, pathological processes develop in numerous tissues and organs including the EYE, the KIDNEY, the BLOOD VESSELS, and the NERVE TISSUE.
Unstable isotopes of thallium that decay or disintegrate emitting radiation. Tl atoms with atomic weights 198-202, 204, and 206-210 are thallium radioisotopes.
A symptom complex characterized by pain and weakness in SKELETAL MUSCLE group associated with exercise, such as leg pain and weakness brought on by walking. Such muscle limpness disappears after a brief rest and is often relates to arterial STENOSIS; muscle ISCHEMIA; and accumulation of LACTATE.
Percutaneous transluminal procedure for removing atheromatous plaque from the coronary arteries. Both directional (for removing focal atheromas) and rotational (for removing concentric atheromatous plaque) atherectomy devices have been used.
The anterior and posterior arteries created at the bifurcation of the popliteal artery. The anterior tibial artery begins at the lower border of the popliteus muscle and lies along the tibia at the distal part of the leg to surface superficially anterior to the ankle joint. Its branches are distributed throughout the leg, ankle, and foot. The posterior tibial artery begins at the lower border of the popliteus muscle, lies behind the tibia in the lower part of its course, and is found situated between the medial malleolus and the medial process of the calcaneal tuberosity. Its branches are distributed throughout the leg and foot.
Complete blockage of blood flow through one of the CORONARY ARTERIES, usually from CORONARY ATHEROSCLEROSIS.
Lack of perfusion in the EXTREMITIES resulting from atherosclerosis. It is characterized by INTERMITTENT CLAUDICATION, and an ANKLE BRACHIAL INDEX of 0.9 or less.
A group of pathological conditions characterized by sudden, non-convulsive loss of neurological function due to BRAIN ISCHEMIA or INTRACRANIAL HEMORRHAGES. Stroke is classified by the type of tissue NECROSIS, such as the anatomic location, vasculature involved, etiology, age of the affected individual, and hemorrhagic vs. non-hemorrhagic nature. (From Adams et al., Principles of Neurology, 6th ed, pp777-810)
Surgical insertion of BLOOD VESSEL PROSTHESES, or transplanted BLOOD VESSELS, or other biological material to repair injured or diseased blood vessels.
Electropositive chemical elements characterized by ductility, malleability, luster, and conductance of heat and electricity. They can replace the hydrogen of an acid and form bases with hydroxyl radicals. (Grant & Hackh's Chemical Dictionary, 5th ed)
The development of new BLOOD VESSELS during the restoration of BLOOD CIRCULATION during the healing process.
A branch of the abdominal aorta which supplies the kidneys, adrenal glands and ureters.
Summarizing techniques used to describe the pattern of mortality and survival in populations. These methods can be applied to the study not only of death, but also of any defined endpoint such as the onset of disease or the occurrence of disease complications.
Device constructed of either synthetic or biological material that is used for the repair of injured or diseased blood vessels.
VASCULAR DISEASES that are associated with DIABETES MELLITUS.
The hemodynamic and electrophysiological action of the left HEART VENTRICLE. Its measurement is an important aspect of the clinical evaluation of patients with heart disease to determine the effects of the disease on cardiac performance.
Use of infusions of FIBRINOLYTIC AGENTS to destroy or dissolve thrombi in blood vessels or bypass grafts.
A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.
A cyclodecane isolated from the bark of the Pacific yew tree, TAXUS BREVIFOLIA. It stabilizes MICROTUBULES in their polymerized form leading to cell death.
The ratio of maximum blood flow to the MYOCARDIUM with CORONARY STENOSIS present, to the maximum equivalent blood flow without stenosis. The measurement is commonly used to verify borderline stenosis of CORONARY ARTERIES.
Works about clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table.
The excision of the thickened, atheromatous tunica intima of a carotid artery.
Minimally invasive procedures, diagnostic or therapeutic, performed within the BLOOD VESSELS. They may be perfomed via ANGIOSCOPY; INTERVENTIONAL MAGNETIC RESONANCE IMAGING; INTERVENTIONAL RADIOGRAPHY; or INTERVENTIONAL ULTRASONOGRAPHY.
Platelet membrane glycoprotein complex important for platelet adhesion and aggregation. It is an integrin complex containing INTEGRIN ALPHAIIB and INTEGRIN BETA3 which recognizes the arginine-glycine-aspartic acid (RGD) sequence present on several adhesive proteins. As such, it is a receptor for FIBRINOGEN; VON WILLEBRAND FACTOR; FIBRONECTIN; VITRONECTIN; and THROMBOSPONDINS. A deficiency of GPIIb-IIIa results in GLANZMANN THROMBASTHENIA.
Univalent antigen-binding fragments composed of one entire IMMUNOGLOBULIN LIGHT CHAIN and the amino terminal end of one of the IMMUNOGLOBULIN HEAVY CHAINS from the hinge region, linked to each other by disulfide bonds. Fab contains the IMMUNOGLOBULIN VARIABLE REGIONS, which are part of the antigen-binding site, and the first IMMUNOGLOBULIN CONSTANT REGIONS. This fragment can be obtained by digestion of immunoglobulins with the proteolytic enzyme PAPAIN.
The circulation of blood through the CORONARY VESSELS of the HEART.
Procedures in which placement of CARDIAC CATHETERS is performed for therapeutic or diagnostic procedures.
The condition of an anatomical structure's being constricted beyond normal dimensions.
The use of ultrasound to guide minimally invasive surgical procedures such as needle ASPIRATION BIOPSY; DRAINAGE; etc. Its widest application is intravascular ultrasound imaging but it is useful also in urology and intra-abdominal conditions.
Endovascular procedure in which atheromatous plaque is excised by a cutting or rotating catheter. It differs from balloon and laser angioplasty procedures which enlarge vessels by dilation but frequently do not remove much plaque. If the plaque is removed by surgical excision under general anesthesia rather than by an endovascular procedure through a catheter, it is called ENDARTERECTOMY.
The vessels carrying blood away from the capillary beds.
Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.
Surgical removal of an obstructing clot or foreign material from a blood vessel at the point of its formation. Removal of a clot arising from a distant site is called EMBOLECTOMY.
Counterpulsation in which a pumping unit synchronized with the patient's electrocardiogram rapidly fills a balloon in the aorta with helium or carbon dioxide in early diastole and evacuates the balloon at the onset of systole. As the balloon inflates, it raises aortic diastolic pressure, and as it deflates, it lowers aortic systolic pressure. The result is a decrease in left ventricular work and increased myocardial and peripheral perfusion.
Narrowing or stricture of any part of the CAROTID ARTERIES, most often due to atherosclerotic plaque formation. Ulcerations may form in atherosclerotic plaques and induce THROMBUS formation. Platelet or cholesterol emboli may arise from stenotic carotid lesions and induce a TRANSIENT ISCHEMIC ATTACK; CEREBROVASCULAR ACCIDENT; or temporary blindness (AMAUROSIS FUGAX). (From Adams et al., Principles of Neurology, 6th ed, pp 822-3)
An effective inhibitor of platelet aggregation commonly used in the placement of STENTS in CORONARY ARTERIES.
The creation and display of functional images showing where the blood is flowing into the MYOCARDIUM by following over time the distribution of tracers injected into the blood stream.
Artery arising from the brachiocephalic trunk on the right side and from the arch of the aorta on the left side. It distributes to the neck, thoracic wall, spinal cord, brain, meninges, and upper limb.
Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.
Institutions specializing in the care of patients with heart disorders.
Fibrinolysin or agents that convert plasminogen to FIBRINOLYSIN.
Either of two large arteries originating from the abdominal aorta; they supply blood to the pelvis, abdominal wall and legs.

Geographic, demographic, and socioeconomic variations in the investigation and management of coronary heart disease in Scotland. (1/1367)

OBJECTIVE: To determine whether age, sex, level of deprivation, and area of residence affect the likelihood of investigation and treatment of patients with coronary heart disease. DESIGN, PATIENTS, AND INTERVENTIONS: Routine discharge data were used to identify patients admitted with acute myocardial infarction (AMI) between 1991 and 1993 inclusive. Record linkage provided the proportion undergoing angiography, percutaneous transluminal coronary angioplasty (PTCA), and coronary artery bypass grafting (CABG) over the following two years. Multiple logistic regression analysis was used to determine whether age, sex, deprivation, and area of residence were independently associated with progression to investigation and revascularisation. SETTING: Mainland Scotland 1991 to 1995 inclusive. MAIN OUTCOME MEASURES: Two year incidence of angiography, PTCA, and CABG. Results-36 838 patients were admitted with AMI. 4831 (13%) underwent angiography, 587 (2%) PTCA, and 1825 (5%) CABG. Women were significantly less likely to undergo angiography (p < 0.001) and CABG (p < 0.001) but more likely to undergo PTCA (p < 0.05). Older patients were less likely to undergo all three procedures (p < 0.001). Socioeconomic deprivation was associated with a reduced likelihood of both angiography and CABG (p < 0.001). There were significant geographic variations in all three modalities (p < 0.001). CONCLUSION: Variations in investigation and management were demonstrated by age, sex, geography, and socioeconomic deprivation. These are unlikely to be accounted for by differences in need; differences in clinical practice are, therefore, likely.  (+info)

One-year survival among patients with acute myocardial infarction complicated by cardiogenic shock, and its relation to early revascularization: results from the GUSTO-I trial. (2/1367)

BACKGROUND: Although 30-day survival is increased in patients with acute myocardial infarction complicated by cardiogenic shock who undergo coronary revascularization, the longer-term outcome in such patients and the duration of benefit from revascularization are unknown. METHODS AND RESULTS: We analyzed 30-day survivors of acute myocardial infarction in the Global Utilization of Streptokinase and Tissue-Plasminogen Activator for Occluded Coronary Arteries (GUSTO-I) trial and identified 36 333 who had not had cardiogenic shock (systolic blood pressure <90 mm Hg for >/=1 hour, group 1) and 1321 patients who had shock (group 2). Group 2 patients were older and sicker. At 1 year, 97.4% of group 1 patients were alive versus 88.0% of group 2 (P=0.0001). Among group 2 patients, 578 (44%) had undergone revascularization within 30 days (group 2A) and 728 (56%) had not (group 2B). Revascularization was not required by protocol but was selected by the attending physicians. At 1 year, 91.7% of group 2A patients were alive versus 85.3% of group 2B (P=0.0003). With the use of multivariable logistic regression analysis to adjust for differences in baseline characteristics of shock patients alive at 30 days, revascularization within 30 days was independently associated with reduced 1-year mortality (odds ratio 0.6, [95% confidence interval 0.4, 0.9], P=0.007). CONCLUSIONS: Most patients (88%) with acute myocardial infarction complicated by cardiogenic shock who are alive at 30 days survived at least 1 year. Shock patients who underwent revascularization within 30 days had improved survival at 1 year compared with shock patients who did not receive revascularization, even after adjustment for differences in baseline characteristics between the 2 groups.  (+info)

The transmyocardial laser revascularization international registry report. (3/1367)

AIMS: This report aimed to provide an analysis of the data submitted from Europe and Asia on transmyocardial laser revascularization. METHODS AND RESULTS: Prospective data was recorded on 967 patients with intractable angina not amenable to conventional revascularization in 21 European and Asian centres performing transmyocardial laser revascularization using the PLC Medical Systems CO2 laser. Patient characteristics, operative details and early complications following transmyocardial laser revascularization were recorded. The in-hospital death rate was 9.7% (95% confidence interval 7.8% to 11.6%). Other early complications were consistent with similar cardiothoracic surgical procedures. There was a decrease of two or more Canadian Cardiovascular Score angina classes in 47.3%, 45.4% and 34.0% of survivors at 3, 6 and 12 months follow-up, respectively (P=0.001 for each). Treadmill exercise time increased by 42 s at 3 months (P=0.008), 1 min 43 s at 6 months (P<0.001) and 1 min 50 s at 12 months (P<0.001) against pre-operative times of 6 min. CONCLUSION: Uncontrolled registry data suggest that transmyocardial laser revascularization may lead to a decrease in angina and improved exercise tolerance. It does, however, have a risk of peri-operative morbidity and mortality. Definitive results from randomized controlled trials are awaited.  (+info)

The relationship between periprocedural myocardial infarction and subsequent target vessel revascularization following percutaneous coronary revascularization: insights from the EPIC trial. Evaluation of IIb/IIIa platelet receptor antagonist 7E3 in Preventing Ischemic Complications. (4/1367)

OBJECTIVES: We sought to determine whether periprocedural myocardial infarction complicating percutaneous coronary revascularization is associated with subsequent clinical restenosis, as judged by the need for target vessel revascularization. BACKGROUND: Although myocardial enzyme elevation following angioplasty is associated with increased late mortality, its effect on subsequent clinical restenosis, as assessed by the need for late target vessel revascularization (TVR), is unknown. METHODS: Serial myocardial enzyme determinations were performed on 2,099 patients who underwent angioplasty or atherectomy in the Evaluation of IIb/IIIa platelet receptor antagonist 7E3 in Preventing Ischemic Complications (EPIC) trial. Thirty-day survivors were prospectively followed for three years for adverse clinical events including death and need for TVR. RESULTS: Within the study population, periprocedural creatine kinase (CK) elevation was a predictor of late mortality. Among patients with elevated CK, however, a paradoxical decrease in the need for late TVR was present. This relationship became progressively more profound as the magnitude of CK release increased. Late TVR occurred in 29.8% of patients with no CK elevation, 24.8% with CK elevation to >3 times normal, and 16.9% with >10 times elevation (hazard ratio 0.51, 95% CI 0.29, 0.91). CONCLUSIONS: In the EPIC study, patients with periprocedural MI were less likely to develop clinical restenosis as measured by the need for TVR. Mechanistically, although it is unlikely that CK elevation prevents vascular renarrowing per se, myocardial necrosis impairs the clinical manifestation of restenosis, thereby reducing the need for ischemia-driven TVR. This novel finding 1) highlights the potential discordance between angiographic and clinical measures of restenosis, and 2) has implications for clinical trials, as therapies that reduce periprocedural MI may be associated with a perceived excess of restenosis when measured by the need for TVR.  (+info)

13N-ammonia myocardial blood flow and uptake: relation to functional outcome of asynergic regions after revascularization. (5/1367)

OBJECTIVES: In this study we determined whether 13N-ammonia uptake measured late after injection provides additional insight into myocardial viability beyond its value as a myocardial blood flow tracer. BACKGROUND: Myocardial accumulation of 13N-ammonia is dependent on both regional blood flow and metabolic trapping. METHODS: Twenty-six patients with chronic coronary artery disease and left ventricular dysfunction underwent prerevascularization 13N-ammonia and 18F-deoxyglucose (FDG) positron emission tomography, and thallium single-photon emission computed tomography. Pre- and postrevascularization wall-motion abnormalities were assessed using gated cardiac magnetic resonance imaging or gated radionuclide angiography. RESULTS: Wall motion improved in 61 of 107 (57%) initially asynergic regions and remained abnormal in 46 after revascularization. Mean absolute myocardial blood flow was significantly higher in regions that improved compared to regions that did not improve after revascularization (0.63+/-0.27 vs. 0.52+/-0.25 ml/min/g, p < 0.04). Similarly, the magnitude of late 13N-ammonia uptake and FDG uptake was significantly higher in regions that improved (90+/-20% and 94+/-25%, respectively) compared to regions that did not improve after revascularization (67+/-24% and 71+/-25%, p < 0.001 for both, respectively). However, late 13N-ammonia uptake was a significantly better predictor of functional improvement after revascularization (area under the receiver operating characteristic [ROC] curve = 0.79) when compared to absolute blood flow (area under the ROC curve = 0.63, p < 0.05). In addition, there was a linear relationship between late 13N-ammonia uptake and FDG uptake (r = 0.68, p < 0.001) as well as thallium uptake (r = 0.76, p < 0.001) in all asynergic regions. CONCLUSIONS: These data suggest that beyond its value as a perfusion tracer, late 13N-ammonia uptake provides useful information regarding functional recovery after revascularization. The parallel relationship among 13N-ammonia, FDG, and thallium uptake supports the concept that uptake of 13N-ammonia as measured from the late images may provide important insight regarding cell membrane integrity and myocardial viability.  (+info)

Recovery of contractility of viable myocardium during inotropic stimulation is not dependent on an increase of myocardial blood flow in the absence of collateral filling. (6/1367)

OBJECTIVES: The purpose of this study was to determine whether contractile recovery induced by dobutamine in dysfunctioning viable myocardium supplied by nearly occluded vessels is related to an increase in blood flow in the absence of collaterals. BACKGROUND: Dobutamine is used to improve contractility in ventricular dysfunction during acute myocardial infarction. However, it is unclear whether a significant increase in regional blood flow may be involved in dobutamine effect. METHODS: Twenty patients with 5- to 10-day old anterior infarction and > or =90% left anterior descending coronary artery stenosis underwent 99mTc-Sestamibi tomography (to assess myocardial perfusion) at rest and during low dose (5 to 10 microg/kg/min) dobutamine echocardiography. Rest echocardiography and scintigraphy were repeated >1 month after revascularization. Nine patients had collaterals to the infarcted territory (group A), and 11 did not (group B). RESULTS: Baseline wall motion score was similar in both groups (score 15.9+/-1.3 vs. 17.4+/-2.0, p = NS), whereas significant changes at dobutamine and postrevascularization studies were detected (F[2,30] = 409.79, p < 0.0001). Wall motion score improved significantly (p < 0.001) in group A both at dobutamine (-5.3+/-2.2) and at postrevascularization study (-5.5+/-1.9), as well as in group B (-3.9+/-2.8 and -4.5+/-2.4, respectively). Baseline 99mTc-Sestamibi uptake was similar in both groups (62.9+/-9.7% vs. 60.3+/-10.4%, p = NS), whereas at dobutamine and postrevascularization studies a significant change (F[2,30] = 65.17, p < 0.0001) and interaction between the two groups (F[2,30] = 33.14, p < 0.0001) were present. Tracer uptake increased significantly in group A both at dobutamine (+ 10.9+/-7.9%, p < 0.001) and at postrevascularization study (12.1+/-8.7%, p < 0.001). Conversely, group B patients showed no change in tracer uptake after dobutamine test (-0.4+/-5.8, p = NS), but only after revascularization (+8.8+/-7.2%, p < 0.001). CONCLUSIONS: The increase in contractility induced by low dose dobutamine infusion in dysfunctional viable myocardium supplied by nearly occluded vessels occurs even in the absence of a significant increase in blood flow.  (+info)

Perioperative morbidity and mortality after transmyocardial laser revascularization: incidence and risk factors for adverse events. (7/1367)

OBJECTIVES: The purpose of this study was to describe the incidence and spectrum of perioperative cardiac and noncardiac morbidity and mortality after transmyocardial laser revascularization (TMR) and to identify predictors of these adverse clinical events. BACKGROUND: Clinical studies have demonstrated the efficacy of TMR for relieving angina pectoris, although no study to date has specifically addressed the associated perioperative morbidity and mortality. METHODS: Between October 1995 and August 1997, 34 consecutive patients with end-stage coronary artery disease (CAD) underwent isolated TMR. The majority of patients (94%) had class III or IV angina pectoris, and two patients (6%) had unstable symptoms preoperatively. Patient records were reviewed for fatal and nonfatal adverse cardiac and noncardiac events. RESULTS: Perioperative death occurred in two patients (5.9%) due to cardiogenic shock complicating acute myocardial infarction. Perioperative cardiac morbidity occurred in 16 patients (47.1%); noncardiac morbidity was seen in 12 patients (35.3%). Preoperative unstable angina was the only variable predictive of perioperative death (p = 0.005). Cardiac (p = 0.005) and noncardiac (p < 0.001) morbidity rates were significantly higher for the initial 15 patients undergoing the procedure. Other predictors of perioperative complications included lack of postoperative treatment with a furosemide infusion (p < or = 0.04) and preoperative unstable angina (p = 0.05). CONCLUSIONS: Perioperative mortality in patients undergoing isolated TMR is low. Transmyocardial laser revascularization patients are at higher risk for adverse perioperative cardiac and noncardiac events, likely reflecting the lack of immediate benefit from the procedure in the setting of severe CAD. These patients merit vigilant surveillance for adverse events and aggressive medical management in the perioperative period.  (+info)

Does coronary surgery prolong life in comparison with medical management? (8/1367)

This analysis attempts to utilize natural history controls to answer the question as to whether coronary surgery prolongs life in comparison to medical management. Selected natural history studies are compared and contrasted in an effort to obtain an average survival curve for patients with coronary artery disease comparable to those presently being operated. The Duke University Medical Center series of concurrent operated and non-operated patients is reviewed to demonstrate the difference of prognosis of patients with coronary artery disease and the complexities involved in answering the question. It is concluded that, on average, coronary surgery does not prolong life in comparison to medical management over the span of 2-5 years. There may be certain higher risk patients whose lives may be prolonged by aortocoronary bypass surgery but more patients and more prolonged follow-up are needed fully to answer the question.  (+info)

Myocardial revascularization is a medical term that refers to the restoration of blood flow to the heart muscle (myocardium), typically through a surgical or interventional procedure. This is often performed in patients with coronary artery disease, where the buildup of plaque in the coronary arteries restricts blood flow to the heart muscle, causing symptoms such as chest pain (angina) or shortness of breath, and increasing the risk of a heart attack (myocardial infarction).

There are two main types of myocardial revascularization:

1. Coronary artery bypass grafting (CABG): This is a surgical procedure in which a healthy blood vessel from another part of the body is used to create a detour around the blocked or narrowed coronary artery, allowing blood to flow more freely to the heart muscle.
2. Percutaneous coronary intervention (PCI), also known as angioplasty and stenting: This is a minimally invasive procedure in which a thin catheter is inserted into an artery in the groin or arm and threaded up to the blocked or narrowed coronary artery. A balloon is then inflated to widen the artery, and a stent may be placed to keep it open.

Both procedures aim to improve symptoms, reduce the risk of heart attack, and prolong survival in appropriately selected patients with coronary artery disease.

Coronary artery bypass surgery, also known as coronary artery bypass grafting (CABG), is a surgical procedure used to improve blood flow to the heart in patients with severe coronary artery disease. This condition occurs when the coronary arteries, which supply oxygen-rich blood to the heart muscle, become narrowed or blocked due to the buildup of fatty deposits, called plaques.

During CABG surgery, a healthy blood vessel from another part of the body is grafted, or attached, to the coronary artery, creating a new pathway for oxygen-rich blood to flow around the blocked or narrowed portion of the artery and reach the heart muscle. This bypass helps to restore normal blood flow and reduce the risk of angina (chest pain), shortness of breath, and other symptoms associated with coronary artery disease.

There are different types of CABG surgery, including traditional on-pump CABG, off-pump CABG, and minimally invasive CABG. The choice of procedure depends on various factors, such as the patient's overall health, the number and location of blocked arteries, and the presence of other medical conditions.

It is important to note that while CABG surgery can significantly improve symptoms and quality of life in patients with severe coronary artery disease, it does not cure the underlying condition. Lifestyle modifications, such as regular exercise, a healthy diet, smoking cessation, and medication therapy, are essential for long-term management and prevention of further progression of the disease.

Extracorporeal circulation (ECC) is a term used in medicine to describe the process of temporarily taking over the functions of the heart and lungs by using a machine. This allows the surgeon to perform certain types of surgery, such as open-heart surgery, on a still and bloodless operating field.

During ECC, the patient's blood is circulated outside the body through a pump and oxygenator. The pump helps to maintain blood flow and pressure, while the oxygenator adds oxygen to the blood and removes carbon dioxide. This allows the surgeon to stop the heart and arrest its motion, making it easier to perform delicate procedures on the heart and surrounding structures.

Extracorporeal circulation is a complex and high-risk procedure that requires careful monitoring and management by a team of healthcare professionals. It carries risks such as bleeding, infection, and injury to blood vessels or organs. However, when performed correctly, it can be a life-saving measure for patients undergoing certain types of surgery.

The mammary arteries are a set of blood vessels that supply oxygenated blood to the mammary glands, which are the structures in female breasts responsible for milk production during lactation. The largest mammary artery, also known as the internal thoracic or internal mammary artery, originates from the subclavian artery and descends along the inner side of the chest wall. It then branches into several smaller arteries that supply blood to the breast tissue. These include the anterior and posterior intercostal arteries, lateral thoracic artery, and pectoral branches. The mammary arteries are crucial in maintaining the health and function of the breast tissue, and any damage or blockage to these vessels can lead to various breast-related conditions or diseases.

Coronary artery bypass, off-pump refers to a surgical procedure used to treat coronary artery disease (CAD), which is the narrowing or blockage of the coronary arteries due to the buildup of fatty deposits called plaques. This procedure is also known as off-pump coronary artery bypass (OPCAB) or beating heart bypass surgery.

In a coronary artery bypass, off-pump procedure, the surgeon creates a new pathway for blood to flow around the blocked or narrowed portion of the coronary artery using a healthy blood vessel from another part of the body, such as the chest wall (internal mammary artery) or the leg (saphenous vein). This allows oxygen-rich blood to bypass the blockage and reach the heart muscle directly.

The key difference between on-pump and off-pump coronary artery bypass surgery is that in an off-pump procedure, the heart continues to beat during the operation, and no heart-lung machine (cardiopulmonary bypass) is used. This approach has several potential advantages over on-pump CABG, including reduced risks of bleeding, stroke, and kidney failure. However, it may not be suitable for all patients, particularly those with complex or extensive coronary artery disease.

Overall, coronary artery bypass, off-pump surgery is a safe and effective treatment option for many patients with CAD, and can help improve symptoms, quality of life, and long-term outcomes.

Internal mammary-coronary artery anastomosis is a surgical procedure in which the internal mammary artery (IMA) is connected to the coronary artery of the heart. This type of surgery, also known as internal thoracic artery-coronary artery bypass grafting (ITA CABG), is performed to improve blood flow to the heart muscle and reduce symptoms of coronary artery disease such as angina and shortness of breath.

The IMA is a small artery that branches off the subclavian artery and runs along the inside of the chest wall. It has several advantages over other conduits used for bypass grafting, including its size, length, and excellent long-term patency rates. The procedure involves harvesting the IMA through a small incision in the chest wall and then sewing it to the coronary artery using fine sutures.

The internal mammary-coronary artery anastomosis can be performed as a single bypass graft or in combination with other conduits such as the saphenous vein. The choice of conduit and number of grafts depends on various factors, including the location and severity of coronary artery disease, patient's age and overall health status.

Overall, internal mammary-coronary artery anastomosis is a safe and effective surgical procedure that has been shown to improve symptoms, quality of life, and survival in patients with coronary artery disease.

Treatment outcome is a term used to describe the result or effect of medical treatment on a patient's health status. It can be measured in various ways, such as through symptoms improvement, disease remission, reduced disability, improved quality of life, or survival rates. The treatment outcome helps healthcare providers evaluate the effectiveness of a particular treatment plan and make informed decisions about future care. It is also used in clinical research to compare the efficacy of different treatments and improve patient care.

Coronary artery disease (CAD) is a medical condition in which the coronary arteries, which supply oxygen-rich blood to the heart muscle, become narrowed or blocked due to the buildup of cholesterol, fatty deposits, and other substances, known as plaque. Over time, this buildup can cause the arteries to harden and narrow (a process called atherosclerosis), reducing blood flow to the heart muscle.

The reduction in blood flow can lead to various symptoms and complications, including:

1. Angina (chest pain or discomfort) - This occurs when the heart muscle doesn't receive enough oxygen-rich blood, causing pain, pressure, or discomfort in the chest, arms, neck, jaw, or back.
2. Shortness of breath - When the heart isn't receiving adequate blood flow, it can't pump blood efficiently to meet the body's demands, leading to shortness of breath during physical activities or at rest.
3. Heart attack - If a piece of plaque ruptures or breaks off in a coronary artery, a blood clot can form and block the artery, causing a heart attack (myocardial infarction). This can damage or destroy part of the heart muscle.
4. Heart failure - Chronic reduced blood flow to the heart muscle can weaken it over time, leading to heart failure, a condition in which the heart can't pump blood efficiently to meet the body's needs.
5. Arrhythmias - Reduced blood flow and damage to the heart muscle can lead to abnormal heart rhythms (arrhythmias), which can be life-threatening if not treated promptly.

Coronary artery disease is typically diagnosed through a combination of medical history, physical examination, and diagnostic tests such as electrocardiograms (ECGs), stress testing, cardiac catheterization, and imaging studies like coronary computed tomography angiography (CCTA). Treatment options for CAD include lifestyle modifications, medications, medical procedures, and surgery.

Coronary artery disease, often simply referred to as coronary disease, is a condition in which the blood vessels that supply oxygen-rich blood to the heart become narrowed or blocked due to the buildup of fatty deposits called plaques. This can lead to chest pain (angina), shortness of breath, or in severe cases, a heart attack.

The medical definition of coronary artery disease is:

A condition characterized by the accumulation of atheromatous plaques in the walls of the coronary arteries, leading to decreased blood flow and oxygen supply to the myocardium (heart muscle). This can result in symptoms such as angina pectoris, shortness of breath, or arrhythmias, and may ultimately lead to myocardial infarction (heart attack) or heart failure.

Risk factors for coronary artery disease include age, smoking, high blood pressure, high cholesterol, diabetes, obesity, physical inactivity, and a family history of the condition. Lifestyle changes such as quitting smoking, exercising regularly, eating a healthy diet, and managing stress can help reduce the risk of developing coronary artery disease. Medical treatments may include medications to control blood pressure, cholesterol levels, or irregular heart rhythms, as well as procedures such as angioplasty or bypass surgery to improve blood flow to the heart.

Coronary balloon angioplasty is a minimally invasive medical procedure used to widen narrowed or obstructed coronary arteries (the blood vessels that supply oxygen-rich blood to the heart muscle) and improve blood flow to the heart. This procedure is typically performed in conjunction with the insertion of a stent, a small mesh tube that helps keep the artery open.

During coronary balloon angioplasty, a thin, flexible catheter with a deflated balloon at its tip is inserted into a blood vessel, usually through a small incision in the groin or arm. The catheter is then guided to the narrowed or obstructed section of the coronary artery. Once in position, the balloon is inflated to compress the plaque against the artery wall and widen the lumen (the inner space) of the artery. This helps restore blood flow to the heart muscle.

The procedure is typically performed under local anesthesia and conscious sedation to minimize discomfort. Coronary balloon angioplasty is a relatively safe and effective treatment for many people with coronary artery disease, although complications such as bleeding, infection, or re-narrowing of the artery (restenosis) can occur in some cases.

Myocardial infarction (MI), also known as a heart attack, is a medical condition characterized by the death of a segment of heart muscle (myocardium) due to the interruption of its blood supply. This interruption is most commonly caused by the blockage of a coronary artery by a blood clot formed on the top of an atherosclerotic plaque, which is a buildup of cholesterol and other substances in the inner lining of the artery.

The lack of oxygen and nutrients supply to the heart muscle tissue results in damage or death of the cardiac cells, causing the affected area to become necrotic. The extent and severity of the MI depend on the size of the affected area, the duration of the occlusion, and the presence of collateral circulation.

Symptoms of a myocardial infarction may include chest pain or discomfort, shortness of breath, nausea, lightheadedness, and sweating. Immediate medical attention is necessary to restore blood flow to the affected area and prevent further damage to the heart muscle. Treatment options for MI include medications, such as thrombolytics, antiplatelet agents, and pain relievers, as well as procedures such as percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).

The Thoracic Arteries are branches of the aorta that supply oxygenated blood to the thoracic region of the body. The pair of arteries originate from the descending aorta and divide into several smaller branches, including intercostal arteries that supply blood to the muscles between the ribs, and posterior intercostal arteries that supply blood to the back and chest wall. Other branches of the thoracic arteries include the superior phrenic arteries, which supply blood to the diaphragm, and the bronchial arteries, which supply blood to the lungs. These arteries play a crucial role in maintaining the health and function of the chest and respiratory system.

Leriche syndrome, also known as Leriche's disease or Syndrome de Leriche, is a vascular condition that affects the infrarenal abdominal aorta and its major branches, including the common iliac and femoral arteries. It is characterized by a triad of symptoms: claudication (pain in the legs brought on by exercise), absent or diminished femoral pulses, and erectile dysfunction in men. This condition primarily affects males between 20 and 50 years old.

The primary cause of Leriche syndrome is atherosclerosis, which leads to the narrowing or occlusion (blockage) of the affected arteries. As a result, blood flow to the lower extremities is compromised, causing symptoms such as pain, numbness, and coolness in the legs. In severe cases, tissue loss or gangrene may occur due to insufficient blood supply.

Treatment for Leriche syndrome typically involves surgical intervention, such as endarterectomy (removal of the atherosclerotic plaque) or bypass grafting, to restore adequate blood flow to the lower extremities. In some cases, lifestyle modifications, like quitting smoking and controlling risk factors such as hypertension, diabetes, and hyperlipidemia, may be recommended to help manage the condition and prevent further progression of atherosclerosis.

Postoperative complications refer to any unfavorable condition or event that occurs during the recovery period after a surgical procedure. These complications can vary in severity and may include, but are not limited to:

1. Infection: This can occur at the site of the incision or inside the body, such as pneumonia or urinary tract infection.
2. Bleeding: Excessive bleeding (hemorrhage) can lead to a drop in blood pressure and may require further surgical intervention.
3. Blood clots: These can form in the deep veins of the legs (deep vein thrombosis) and can potentially travel to the lungs (pulmonary embolism).
4. Wound dehiscence: This is when the surgical wound opens up, which can lead to infection and further complications.
5. Pulmonary issues: These include atelectasis (collapsed lung), pneumonia, or respiratory failure.
6. Cardiovascular problems: These include abnormal heart rhythms (arrhythmias), heart attack, or stroke.
7. Renal failure: This can occur due to various reasons such as dehydration, blood loss, or the use of certain medications.
8. Pain management issues: Inadequate pain control can lead to increased stress, anxiety, and decreased mobility.
9. Nausea and vomiting: These can be caused by anesthesia, opioid pain medication, or other factors.
10. Delirium: This is a state of confusion and disorientation that can occur in the elderly or those with certain medical conditions.

Prompt identification and management of these complications are crucial to ensure the best possible outcome for the patient.

Coronary angiography is a medical procedure that uses X-ray imaging to visualize the coronary arteries, which supply blood to the heart muscle. During the procedure, a thin, flexible catheter is inserted into an artery in the arm or groin and threaded through the blood vessels to the heart. A contrast dye is then injected through the catheter, and X-ray images are taken as the dye flows through the coronary arteries. These images can help doctors diagnose and treat various heart conditions, such as blockages or narrowing of the arteries, that can lead to chest pain or heart attacks. It is also known as coronary arteriography or cardiac catheterization.

Cardiopulmonary bypass (CPB) is a medical procedure that temporarily takes over the functions of the heart and lungs during major heart surgery. It allows the surgeon to operate on a still, bloodless heart.

During CPB, the patient's blood is circulated outside the body with the help of a heart-lung machine. The machine pumps the blood through a oxygenator, where it is oxygenated and then returned to the body. This bypasses the heart and lungs, hence the name "cardiopulmonary bypass."

CPB involves several components, including a pump, oxygenator, heat exchanger, and tubing. The patient's blood is drained from the heart through cannulas (tubes) and passed through the oxygenator, where it is oxygenated and carbon dioxide is removed. The oxygenated blood is then warmed to body temperature in a heat exchanger before being pumped back into the body.

While on CPB, the patient's heart is stopped with the help of cardioplegia solution, which is infused directly into the coronary arteries. This helps to protect the heart muscle during surgery. The surgeon can then operate on a still and bloodless heart, allowing for more precise surgical repair.

After the surgery is complete, the patient is gradually weaned off CPB, and the heart is restarted with the help of electrical stimulation or medication. The patient's condition is closely monitored during this time to ensure that their heart and lungs are functioning properly.

While CPB has revolutionized heart surgery and allowed for more complex procedures to be performed, it is not without risks. These include bleeding, infection, stroke, kidney damage, and inflammation. However, with advances in technology and technique, the risks associated with CPB have been significantly reduced over time.

Follow-up studies are a type of longitudinal research that involve repeated observations or measurements of the same variables over a period of time, in order to understand their long-term effects or outcomes. In medical context, follow-up studies are often used to evaluate the safety and efficacy of medical treatments, interventions, or procedures.

In a typical follow-up study, a group of individuals (called a cohort) who have received a particular treatment or intervention are identified and then followed over time through periodic assessments or data collection. The data collected may include information on clinical outcomes, adverse events, changes in symptoms or functional status, and other relevant measures.

The results of follow-up studies can provide important insights into the long-term benefits and risks of medical interventions, as well as help to identify factors that may influence treatment effectiveness or patient outcomes. However, it is important to note that follow-up studies can be subject to various biases and limitations, such as loss to follow-up, recall bias, and changes in clinical practice over time, which must be carefully considered when interpreting the results.

The postoperative period is the time following a surgical procedure during which the patient's response to the surgery and anesthesia is monitored, and any complications or adverse effects are managed. This period can vary in length depending on the type of surgery and the individual patient's needs, but it typically includes the immediate recovery phase in the post-anesthesia care unit (PACU) or recovery room, as well as any additional time spent in the hospital for monitoring and management of pain, wound healing, and other aspects of postoperative care.

The goals of postoperative care are to ensure the patient's safety and comfort, promote optimal healing and rehabilitation, and minimize the risk of complications such as infection, bleeding, or other postoperative issues. The specific interventions and treatments provided during this period will depend on a variety of factors, including the type and extent of surgery performed, the patient's overall health and medical history, and any individualized care plans developed in consultation with the patient and their healthcare team.

In the field of medicine, "time factors" refer to the duration of symptoms or time elapsed since the onset of a medical condition, which can have significant implications for diagnosis and treatment. Understanding time factors is crucial in determining the progression of a disease, evaluating the effectiveness of treatments, and making critical decisions regarding patient care.

For example, in stroke management, "time is brain," meaning that rapid intervention within a specific time frame (usually within 4.5 hours) is essential to administering tissue plasminogen activator (tPA), a clot-busting drug that can minimize brain damage and improve patient outcomes. Similarly, in trauma care, the "golden hour" concept emphasizes the importance of providing definitive care within the first 60 minutes after injury to increase survival rates and reduce morbidity.

Time factors also play a role in monitoring the progression of chronic conditions like diabetes or heart disease, where regular follow-ups and assessments help determine appropriate treatment adjustments and prevent complications. In infectious diseases, time factors are crucial for initiating antibiotic therapy and identifying potential outbreaks to control their spread.

Overall, "time factors" encompass the significance of recognizing and acting promptly in various medical scenarios to optimize patient outcomes and provide effective care.

Artificial pneumothorax is a medical condition that is intentionally induced for therapeutic or diagnostic purposes. It involves the introduction of air or another gas into the pleural space, which is the potential space between the lungs and the chest wall. This results in the collapse of the lung on the side where the air was introduced, creating negative pressure that can help to relieve certain medical conditions.

Artificial pneumothorax is typically used as a treatment for pulmonary tuberculosis, although its use has become less common with the advent of more effective antibiotics and other treatments. It may also be used in rare cases to help collapse a lung that has been damaged or injured, making it easier to remove or repair.

The procedure for creating an artificial pneumothorax involves inserting a needle or catheter into the pleural space and introducing air or another gas. This can be done through the chest wall or through a tube that has been inserted into the lung. The amount of air introduced is carefully controlled to avoid over-inflation of the pleural space, which can cause complications such as tension pneumothorax.

While artificial pneumothorax is a useful medical procedure in certain circumstances, it carries risks and should only be performed by trained medical professionals in a controlled setting.

Angina pectoris is a medical term that describes chest pain or discomfort caused by an inadequate supply of oxygen-rich blood to the heart muscle. This condition often occurs due to coronary artery disease, where the coronary arteries become narrowed or blocked by the buildup of cholesterol, fatty deposits, and other substances, known as plaques. These blockages can reduce blood flow to the heart, causing ischemia (lack of oxygen) and leading to angina symptoms.

There are two primary types of angina: stable and unstable. Stable angina is predictable and usually occurs during physical exertion or emotional stress when the heart needs more oxygen-rich blood. The pain typically subsides with rest or after taking prescribed nitroglycerin medication, which helps widen the blood vessels and improve blood flow to the heart.

Unstable angina, on the other hand, is more severe and unpredictable. It can occur at rest, during sleep, or with minimal physical activity and may not be relieved by rest or nitroglycerin. Unstable angina is considered a medical emergency, as it could indicate an imminent heart attack.

Symptoms of angina pectoris include chest pain, pressure, tightness, or heaviness that typically radiates to the left arm, neck, jaw, or back. Shortness of breath, nausea, sweating, and fatigue may also accompany angina symptoms. Immediate medical attention is necessary if you experience chest pain or discomfort, especially if it's new, severe, or persistent, as it could be a sign of a more serious condition like a heart attack.

Laser therapy, also known as phototherapy or laser photobiomodulation, is a medical treatment that uses low-intensity lasers or light-emitting diodes (LEDs) to stimulate healing, reduce pain, and decrease inflammation. It works by promoting the increase of cellular metabolism, blood flow, and tissue regeneration through the process of photobiomodulation.

The therapy can be used on patients suffering from a variety of acute and chronic conditions, including musculoskeletal injuries, arthritis, neuropathic pain, and wound healing complications. The wavelength and intensity of the laser light are precisely controlled to ensure a safe and effective treatment.

During the procedure, the laser or LED device is placed directly on the skin over the area of injury or discomfort. The non-ionizing light penetrates the tissue without causing heat or damage, interacting with chromophores in the cells to initiate a series of photochemical reactions. This results in increased ATP production, modulation of reactive oxygen species, and activation of transcription factors that lead to improved cellular function and reduced pain.

In summary, laser therapy is a non-invasive, drug-free treatment option for various medical conditions, providing patients with an alternative or complementary approach to traditional therapies.

Myocardial ischemia is a condition in which the blood supply to the heart muscle (myocardium) is reduced or blocked, leading to insufficient oxygen delivery and potential damage to the heart tissue. This reduction in blood flow typically results from the buildup of fatty deposits, called plaques, in the coronary arteries that supply the heart with oxygen-rich blood. The plaques can rupture or become unstable, causing the formation of blood clots that obstruct the artery and limit blood flow.

Myocardial ischemia may manifest as chest pain (angina pectoris), shortness of breath, fatigue, or irregular heartbeats (arrhythmias). In severe cases, it can lead to myocardial infarction (heart attack) if the oxygen supply is significantly reduced or cut off completely, causing permanent damage or death of the heart muscle. Early diagnosis and treatment of myocardial ischemia are crucial for preventing further complications and improving patient outcomes.

Cerebral revascularization is a surgical procedure aimed at restoring blood flow to the brain. This is often performed in cases where there is narrowing or blockage of the cerebral arteries, a condition known as cerebrovascular disease. The most common type of cerebral revascularization is called carotid endarterectomy, which involves removing plaque buildup from the carotid artery in the neck to improve blood flow to the brain. Another type is extracranial-intracranial bypass, where a new connection is created between an external carotid artery and an intracranial artery to bypass a blockage.

The saphenous vein is a term used in anatomical description to refer to the great or small saphenous veins, which are superficial veins located in the lower extremities of the human body.

The great saphenous vein (GSV) is the longest vein in the body and originates from the medial aspect of the foot, ascending along the medial side of the leg and thigh, and drains into the femoral vein at the saphenofemoral junction, located in the upper third of the thigh.

The small saphenous vein (SSV) is a shorter vein that originates from the lateral aspect of the foot, ascends along the posterior calf, and drains into the popliteal vein at the saphenopopliteal junction, located in the popliteal fossa.

These veins are often used as conduits for coronary artery bypass grafting (CABG) surgery due to their consistent anatomy and length.

Coronary stenosis is a medical condition that refers to the narrowing of the coronary arteries, which supply oxygen-rich blood to the heart muscle. This narrowing is typically caused by the buildup of plaque, made up of fat, cholesterol, and other substances, on the inner walls of the arteries. Over time, as the plaque hardens and calcifies, it can cause the artery to become narrowed or blocked, reducing blood flow to the heart muscle.

Coronary stenosis can lead to various symptoms and complications, including chest pain (angina), shortness of breath, irregular heart rhythms (arrhythmias), and heart attacks. Treatment options for coronary stenosis may include lifestyle changes, medications, medical procedures such as angioplasty or bypass surgery, or a combination of these approaches. Regular check-ups and diagnostic tests, such as stress testing or coronary angiography, can help detect and monitor coronary stenosis over time.

Intermittent Positive-Pressure Breathing (IPPB) is a type of ventilatory support that involves the intermittent delivery of positive pressure to the airways and alveoli during inspiration, while allowing for expiration to occur passively. This technique is often used in medical settings to assist patients with respiratory insufficiency or failure, such as those with chronic obstructive pulmonary disease (COPD), neuromuscular disorders, or following surgery.

During IPPB, the patient breathes in through a mouthpiece or mask that is connected to a ventilator or breathing machine. The machine delivers positive pressure to the airways, which helps to inflate the lungs and improve oxygenation. The pressure can be adjusted to meet the needs of each individual patient, and the frequency and duration of breaths can also be controlled by the healthcare provider.

IPPB is typically used on a short-term basis, as a means of providing respiratory support while a patient's underlying condition improves. It may be used in conjunction with other therapies, such as bronchodilators or corticosteroids, to help improve lung function and reduce symptoms. While IPPB can be an effective tool for managing respiratory insufficiency, it is not without risks, and careful monitoring is required to ensure that it is used safely and effectively.

Dextrocardia is a medical condition in which the heart is positioned on the right side of the chest instead of the left side. This is a congenital condition, meaning it is present at birth. In people with dextrocardia, the heart's structure and function are usually normal, but the orientation of the heart within the chest is reversed.

There are two main types of dextrocardia:

1. Dextrocardia without visceral situs inversus: In this type, the heart is on the right side of the chest, but the other organs in the chest and abdomen are in their normal positions. This is a rare condition and can be associated with other congenital heart defects.
2. Dextrocardia with visceral situs inversus: In this type, the heart is on the right side of the chest, and the other organs in the chest and abdomen are mirrored or reversed from their normal positions. This is a less common form of dextrocardia and is often referred to as "situs inversus totalis."

It's important to note that while dextrocardia itself is not a life-threatening condition, people with this condition may have other heart defects or medical issues that require treatment. If you or someone you know has been diagnosed with dextrocardia, it's essential to consult with a healthcare professional for proper evaluation and management.

A stent is a small mesh tube that's used to treat narrow or weak arteries. Arteries are blood vessels that carry blood away from your heart to other parts of your body. A stent is placed in an artery as part of a procedure called angioplasty. Angioplasty restores blood flow through narrowed or blocked arteries by inflating a tiny balloon inside the blocked artery to widen it.

The stent is then inserted into the widened artery to keep it open. The stent is usually made of metal, but some are coated with medication that is slowly and continuously released to help prevent the formation of scar tissue in the artery. This can reduce the chance of the artery narrowing again.

Stents are also used in other parts of the body, such as the neck (carotid artery) and kidneys (renal artery), to help maintain blood flow and prevent blockages. They can also be used in the urinary system to treat conditions like ureteropelvic junction obstruction or narrowing of the urethra.

The radial artery is a key blood vessel in the human body, specifically a part of the peripheral arterial system. Originating from the brachial artery in the upper arm, the radial artery travels down the arm and crosses over the wrist, where it can be palpated easily. It then continues into the hand, dividing into several branches to supply blood to the hand's tissues and digits.

The radial artery is often used for taking pulse readings due to its easy accessibility at the wrist. Additionally, in medical procedures such as coronary angiography or bypass surgery, the radial artery can be utilized as a site for catheter insertion. This allows healthcare professionals to examine the heart's blood vessels and assess cardiovascular health.

Retrospective studies, also known as retrospective research or looking back studies, are a type of observational study that examines data from the past to draw conclusions about possible causal relationships between risk factors and outcomes. In these studies, researchers analyze existing records, medical charts, or previously collected data to test a hypothesis or answer a specific research question.

Retrospective studies can be useful for generating hypotheses and identifying trends, but they have limitations compared to prospective studies, which follow participants forward in time from exposure to outcome. Retrospective studies are subject to biases such as recall bias, selection bias, and information bias, which can affect the validity of the results. Therefore, retrospective studies should be interpreted with caution and used primarily to generate hypotheses for further testing in prospective studies.

The sternum, also known as the breastbone, is a long, flat bone located in the central part of the chest. It serves as the attachment point for several muscles and tendons, including those involved in breathing. The sternum has three main parts: the manubrium at the top, the body in the middle, and the xiphoid process at the bottom. The upper seven pairs of ribs connect to the sternum via costal cartilages.

Medical Definition:

"Risk factors" are any attribute, characteristic or exposure of an individual that increases the likelihood of developing a disease or injury. They can be divided into modifiable and non-modifiable risk factors. Modifiable risk factors are those that can be changed through lifestyle choices or medical treatment, while non-modifiable risk factors are inherent traits such as age, gender, or genetic predisposition. Examples of modifiable risk factors include smoking, alcohol consumption, physical inactivity, and unhealthy diet, while non-modifiable risk factors include age, sex, and family history. It is important to note that having a risk factor does not guarantee that a person will develop the disease, but rather indicates an increased susceptibility.

Prospective studies, also known as longitudinal studies, are a type of cohort study in which data is collected forward in time, following a group of individuals who share a common characteristic or exposure over a period of time. The researchers clearly define the study population and exposure of interest at the beginning of the study and follow up with the participants to determine the outcomes that develop over time. This type of study design allows for the investigation of causal relationships between exposures and outcomes, as well as the identification of risk factors and the estimation of disease incidence rates. Prospective studies are particularly useful in epidemiology and medical research when studying diseases with long latency periods or rare outcomes.

The preoperative period is the time period before a surgical procedure during which various preparations are made to ensure the best possible outcome for the surgery. This includes evaluating the patient's overall health status, identifying and managing any underlying medical conditions that could increase the risk of complications, obtaining informed consent from the patient, and providing preoperative instructions regarding medications, food and drink intake, and other aspects of preparation for the surgery.

The specific activities that occur during the preoperative period may vary depending on the type and complexity of the surgical procedure, as well as the individual needs and medical history of the patient. However, some common elements of the preoperative period include:

* A thorough medical history and physical examination to assess the patient's overall health status and identify any potential risk factors for complications
* Diagnostic tests such as blood tests, imaging studies, or electrocardiograms (ECGs) to provide additional information about the patient's health status
* Consultation with anesthesia providers to determine the appropriate type and dosage of anesthesia for the procedure
* Preoperative teaching to help the patient understand what to expect before, during, and after the surgery
* Management of any underlying medical conditions such as diabetes, heart disease, or lung disease to reduce the risk of complications
* Administration of medications such as antibiotics or anti-coagulants to prevent infection or bleeding
* Fasting instructions to ensure that the stomach is empty during the surgery and reduce the risk of aspiration (inhalation of stomach contents into the lungs)

Overall, the preoperative period is a critical time for ensuring the safety and success of surgical procedures. By taking a thorough and systematic approach to preparing patients for surgery, healthcare providers can help to minimize the risks of complications and ensure the best possible outcomes for their patients.

A sternotomy is a surgical procedure that involves making an incision through the sternum, also known as the breastbone. This type of incision allows surgeons to access the thoracic cavity, which contains the heart and lungs. Sternotomies are often performed during open-heart surgery or other procedures that require access to the heart or major blood vessels. After the procedure, the sternum is typically wired or stapled back together to allow for proper healing.

Preoperative care refers to the series of procedures, interventions, and preparations that are conducted before a surgical operation. The primary goal of preoperative care is to ensure the patient's well-being, optimize their physical condition, reduce potential risks, and prepare them mentally and emotionally for the upcoming surgery.

Preoperative care typically includes:

1. Preoperative assessment: A thorough evaluation of the patient's overall health status, including medical history, physical examination, laboratory tests, and diagnostic imaging, to identify any potential risk factors or comorbidities that may impact the surgical procedure and postoperative recovery.
2. Informed consent: The process of ensuring the patient understands the nature of the surgery, its purpose, associated risks, benefits, and alternative treatment options. The patient signs a consent form indicating they have been informed and voluntarily agree to undergo the surgery.
3. Preoperative instructions: Guidelines provided to the patient regarding their diet, medication use, and other activities in the days leading up to the surgery. These instructions may include fasting guidelines, discontinuing certain medications, or arranging for transportation after the procedure.
4. Anesthesia consultation: A meeting with the anesthesiologist to discuss the type of anesthesia that will be used during the surgery and address any concerns related to anesthesia risks, side effects, or postoperative pain management.
5. Preparation of the surgical site: Cleaning and shaving the area where the incision will be made, as well as administering appropriate antimicrobial agents to minimize the risk of infection.
6. Medical optimization: Addressing any underlying medical conditions or correcting abnormalities that may negatively impact the surgical outcome. This may involve adjusting medications, treating infections, or managing chronic diseases such as diabetes.
7. Emotional and psychological support: Providing counseling, reassurance, and education to help alleviate anxiety, fear, or emotional distress related to the surgery.
8. Preoperative holding area: The patient is transferred to a designated area near the operating room where they are prepared for surgery by changing into a gown, having intravenous (IV) lines inserted, and receiving monitoring equipment.

By following these preoperative care guidelines, healthcare professionals aim to ensure that patients undergo safe and successful surgical procedures with optimal outcomes.

Surgical anastomosis is a medical procedure that involves the connection of two tubular structures, such as blood vessels or intestines, to create a continuous passage. This technique is commonly used in various types of surgeries, including vascular, gastrointestinal, and orthopedic procedures.

During a surgical anastomosis, the ends of the two tubular structures are carefully prepared by removing any damaged or diseased tissue. The ends are then aligned and joined together using sutures, staples, or other devices. The connection must be secure and leak-free to ensure proper function and healing.

The success of a surgical anastomosis depends on several factors, including the patient's overall health, the location and condition of the structures being joined, and the skill and experience of the surgeon. Complications such as infection, bleeding, or leakage can occur, which may require additional medical intervention or surgery.

Proper postoperative care is also essential to ensure the success of a surgical anastomosis. This may include monitoring for signs of complications, administering medications to prevent infection and promote healing, and providing adequate nutrition and hydration.

Hospital mortality is a term used to describe the number or rate of deaths that occur in a hospital setting during a specific period. It is often used as a measure of the quality of healthcare provided by a hospital, as a higher hospital mortality rate may indicate poorer care or more complex cases being treated. However, it's important to note that hospital mortality rates can be influenced by many factors, including the severity of illness of the patients being treated, patient demographics, and the availability of resources and specialized care. Therefore, hospital mortality rates should be interpreted with caution and in the context of other quality metrics.

Unstable angina is a term used in cardiology to describe chest pain or discomfort that occurs suddenly and unexpectedly, often at rest or with minimal physical exertion. It is caused by an insufficient supply of oxygen-rich blood to the heart muscle due to reduced blood flow, typically as a result of partial or complete blockage of the coronary arteries.

Unlike stable angina, which tends to occur predictably during physical activity and can be relieved with rest or nitroglycerin, unstable angina is more severe, unpredictable, and may not respond to traditional treatments. It is considered a medical emergency because it can be a sign of an impending heart attack or other serious cardiac event.

Unstable angina is often treated in the hospital with medications such as nitroglycerin, beta blockers, calcium channel blockers, and antiplatelet agents to improve blood flow to the heart and prevent further complications. In some cases, more invasive treatments such as coronary angioplasty or bypass surgery may be necessary to restore blood flow to the affected areas of the heart.

Left ventricular dysfunction (LVD) is a condition characterized by the impaired ability of the left ventricle of the heart to pump blood efficiently during contraction. The left ventricle is one of the four chambers of the heart and is responsible for pumping oxygenated blood to the rest of the body.

LVD can be caused by various underlying conditions, such as coronary artery disease, cardiomyopathy, valvular heart disease, or hypertension. These conditions can lead to structural changes in the left ventricle, including remodeling, hypertrophy, and dilation, which ultimately impair its contractile function.

The severity of LVD is often assessed by measuring the ejection fraction (EF), which is the percentage of blood that is pumped out of the left ventricle during each contraction. A normal EF ranges from 55% to 70%, while an EF below 40% is indicative of LVD.

LVD can lead to various symptoms, such as shortness of breath, fatigue, fluid retention, and decreased exercise tolerance. It can also increase the risk of complications, such as heart failure, arrhythmias, and cardiac arrest. Treatment for LVD typically involves managing the underlying cause, along with medications to improve contractility, reduce fluid buildup, and control heart rate. In severe cases, devices such as implantable cardioverter-defibrillators (ICDs) or left ventricular assist devices (LVADs) may be required.

Risk assessment in the medical context refers to the process of identifying, evaluating, and prioritizing risks to patients, healthcare workers, or the community related to healthcare delivery. It involves determining the likelihood and potential impact of adverse events or hazards, such as infectious diseases, medication errors, or medical devices failures, and implementing measures to mitigate or manage those risks. The goal of risk assessment is to promote safe and high-quality care by identifying areas for improvement and taking action to minimize harm.

Intraoperative care refers to the medical care and interventions provided to a patient during a surgical procedure. This care is typically administered by a team of healthcare professionals, including anesthesiologists, surgeons, nurses, and other specialists as needed. The goal of intraoperative care is to maintain the patient's physiological stability throughout the surgery, minimize complications, and ensure the best possible outcome.

Intraoperative care may include:

1. Anesthesia management: Administering and monitoring anesthetic drugs to keep the patient unconscious and free from pain during the surgery.
2. Monitoring vital signs: Continuously tracking the patient's heart rate, blood pressure, oxygen saturation, body temperature, and other key physiological parameters to ensure they remain within normal ranges.
3. Fluid and blood product administration: Maintaining adequate intravascular volume and oxygen-carrying capacity through the infusion of fluids and blood products as needed.
4. Intraoperative imaging: Utilizing real-time imaging techniques, such as X-ray, ultrasound, or CT scans, to guide the surgical procedure and ensure accurate placement of implants or other devices.
5. Neuromonitoring: Using electrophysiological methods to monitor the functional integrity of nerves and neural structures during surgery, particularly in procedures involving the brain, spine, or peripheral nerves.
6. Intraoperative medication management: Administering various medications as needed for pain control, infection prophylaxis, or the treatment of medical conditions that may arise during the surgery.
7. Temperature management: Regulating the patient's body temperature to prevent hypothermia or hyperthermia, which can have adverse effects on surgical outcomes and overall patient health.
8. Communication and coordination: Ensuring effective communication among the members of the surgical team to optimize patient care and safety.

Drug-eluting stents (DES) are medical devices used in the treatment of coronary artery disease. They are small, flexible tubes that are coated with a medication that is slowly released (eluted) over time to prevent the formation of scar tissue and reduce the risk of renarrowing (restenosis) of the artery after it has been treated with angioplasty and stenting.

The stent is typically placed in a narrowed or blocked coronary artery during a percutaneous coronary intervention (PCI) procedure, such as angioplasty, to open up the blood vessel and improve blood flow to the heart muscle. The medication on the DES helps to prevent the growth of smooth muscle cells and the formation of scar tissue in the artery, which can cause restenosis and require additional treatments.

The most commonly used medications on DES are sirolimus, paclitaxel, zotarolimus, and everolimus. These drugs work by inhibiting the growth of smooth muscle cells and reducing inflammation in the artery. While DES have been shown to reduce the risk of restenosis compared to bare-metal stents, they also carry a small increased risk of late stent thrombosis (blood clots forming in the stent), which can lead to serious complications such as heart attack or stroke. Therefore, patients who receive DES are typically prescribed long-term antiplatelet therapy to reduce this risk.

Epidemiologic methods are systematic approaches used to investigate and understand the distribution, determinants, and outcomes of health-related events or diseases in a population. These methods are applied to study the patterns of disease occurrence and transmission, identify risk factors and causes, and evaluate interventions for prevention and control. The core components of epidemiologic methods include:

1. Descriptive Epidemiology: This involves the systematic collection and analysis of data on the who, what, when, and where of health events to describe their distribution in a population. It includes measures such as incidence, prevalence, mortality, and morbidity rates, as well as geographic and temporal patterns.

2. Analytical Epidemiology: This involves the use of statistical methods to examine associations between potential risk factors and health outcomes. It includes observational studies (cohort, case-control, cross-sectional) and experimental studies (randomized controlled trials). The goal is to identify causal relationships and quantify the strength of associations.

3. Experimental Epidemiology: This involves the design and implementation of interventions or experiments to test hypotheses about disease prevention and control. It includes randomized controlled trials, community trials, and other experimental study designs.

4. Surveillance and Monitoring: This involves ongoing systematic collection, analysis, and interpretation of health-related data for early detection, tracking, and response to health events or diseases.

5. Ethical Considerations: Epidemiologic studies must adhere to ethical principles such as respect for autonomy, beneficence, non-maleficence, and justice. This includes obtaining informed consent, ensuring confidentiality, and minimizing harm to study participants.

Overall, epidemiologic methods provide a framework for investigating and understanding the complex interplay between host, agent, and environmental factors that contribute to the occurrence of health-related events or diseases in populations.

Acute Coronary Syndrome (ACS) is a term used to describe a range of conditions associated with sudden, reduced blood flow to the heart muscle. This reduction in blood flow, commonly caused by blood clots forming in coronary arteries, can lead to damage or death of the heart muscle and is often characterized by symptoms such as chest pain, shortness of breath, and fatigue.

There are three main types of ACS:

1. Unstable Angina: This occurs when there is reduced blood flow to the heart muscle, causing chest pain or discomfort, but the heart muscle is not damaged. It can be a warning sign for a possible future heart attack.
2. Non-ST Segment Elevation Myocardial Infarction (NSTEMI): This type of heart attack occurs when there is reduced blood flow to the heart muscle, causing damage or death of some of the muscle cells. However, the electrical activity of the heart remains relatively normal.
3. ST Segment Elevation Myocardial Infarction (STEMI): This is a serious and life-threatening type of heart attack that occurs when there is a complete blockage in one or more of the coronary arteries, causing extensive damage to the heart muscle. The electrical activity of the heart is significantly altered, which can lead to dangerous heart rhythms and even cardiac arrest.

Immediate medical attention is required for anyone experiencing symptoms of ACS, as prompt treatment can help prevent further damage to the heart muscle and reduce the risk of complications or death. Treatment options may include medications, lifestyle changes, and procedures such as angioplasty or bypass surgery.

Induced heart arrest, also known as controlled cardiac arrest or planned cardiac arrest, is a deliberate medical intervention where cardiac activity is temporarily stopped through the use of medications or electrical disruption. This procedure is typically carried out during a surgical procedure, such as open-heart surgery, where the heart needs to be stilled to allow surgeons to work on it safely.

The most common method used to induce heart arrest is by administering a medication called potassium chloride, which stops the heart's electrical activity. Alternatively, an electrical shock may be delivered to the heart to achieve the same effect. Once the procedure is complete, the heart can be restarted using various resuscitation techniques, such as defibrillation or medication administration.

It's important to note that induced heart arrest is a carefully monitored and controlled medical procedure carried out by trained healthcare professionals in a hospital setting. It should not be confused with sudden cardiac arrest, which is an unexpected and often unpredictable event that occurs outside of a medical setting.

A reoperation is a surgical procedure that is performed again on a patient who has already undergone a previous operation for the same or related condition. Reoperations may be required due to various reasons, such as inadequate initial treatment, disease recurrence, infection, or complications from the first surgery. The nature and complexity of a reoperation can vary widely depending on the specific circumstances, but it often carries higher risks and potential complications compared to the original operation.

Stroke volume is a term used in cardiovascular physiology and medicine. It refers to the amount of blood that is pumped out of the left ventricle of the heart during each contraction (systole). Specifically, it is the difference between the volume of blood in the left ventricle at the end of diastole (when the ventricle is filled with blood) and the volume at the end of systole (when the ventricle has contracted and ejected its contents into the aorta).

Stroke volume is an important measure of heart function, as it reflects the ability of the heart to pump blood effectively to the rest of the body. A low stroke volume may indicate that the heart is not pumping efficiently, while a high stroke volume may suggest that the heart is working too hard. Stroke volume can be affected by various factors, including heart disease, high blood pressure, and physical fitness level.

The formula for calculating stroke volume is:

Stroke Volume = End-Diastolic Volume - End-Systolic Volume

Where end-diastolic volume (EDV) is the volume of blood in the left ventricle at the end of diastole, and end-systolic volume (ESV) is the volume of blood in the left ventricle at the end of systole.

Coronary restenosis is the re-narrowing or re-occlusion of a coronary artery after a previous successful procedure to open or widen the artery, such as angioplasty or stenting. This narrowing is usually caused by the excessive growth of scar tissue or smooth muscle cells in the artery lining, which can occur spontaneously or as a response to the initial procedure. Restenosis can lead to recurrent symptoms of coronary artery disease, such as chest pain or shortness of breath, and may require additional medical intervention.

Nonparametric statistics is a branch of statistics that does not rely on assumptions about the distribution of variables in the population from which the sample is drawn. In contrast to parametric methods, nonparametric techniques make fewer assumptions about the data and are therefore more flexible in their application. Nonparametric tests are often used when the data do not meet the assumptions required for parametric tests, such as normality or equal variances.

Nonparametric statistical methods include tests such as the Wilcoxon rank-sum test (also known as the Mann-Whitney U test) for comparing two independent groups, the Wilcoxon signed-rank test for comparing two related groups, and the Kruskal-Wallis test for comparing more than two independent groups. These tests use the ranks of the data rather than the actual values to make comparisons, which allows them to be used with ordinal or continuous data that do not meet the assumptions of parametric tests.

Overall, nonparametric statistics provide a useful set of tools for analyzing data in situations where the assumptions of parametric methods are not met, and can help researchers draw valid conclusions from their data even when the data are not normally distributed or have other characteristics that violate the assumptions of parametric tests.

Postoperative care refers to the comprehensive medical treatment and nursing attention provided to a patient following a surgical procedure. The goal of postoperative care is to facilitate the patient's recovery, prevent complications, manage pain, ensure proper healing of the incision site, and maintain overall health and well-being until the patient can resume their normal activities.

This type of care includes monitoring vital signs, managing pain through medication or other techniques, ensuring adequate hydration and nutrition, helping the patient with breathing exercises to prevent lung complications, encouraging mobility to prevent blood clots, monitoring for signs of infection or other complications, administering prescribed medications, providing wound care, and educating the patient about postoperative care instructions.

The duration of postoperative care can vary depending on the type and complexity of the surgical procedure, as well as the individual patient's needs and overall health status. It may be provided in a hospital setting, an outpatient surgery center, or in the patient's home, depending on the level of care required.

Coronary vessels refer to the network of blood vessels that supply oxygenated blood and nutrients to the heart muscle, also known as the myocardium. The two main coronary arteries are the left main coronary artery and the right coronary artery.

The left main coronary artery branches off into the left anterior descending artery (LAD) and the left circumflex artery (LCx). The LAD supplies blood to the front of the heart, while the LCx supplies blood to the side and back of the heart.

The right coronary artery supplies blood to the right lower part of the heart, including the right atrium and ventricle, as well as the back of the heart.

Coronary vessel disease (CVD) occurs when these vessels become narrowed or blocked due to the buildup of plaque, leading to reduced blood flow to the heart muscle. This can result in chest pain, shortness of breath, or a heart attack.

Hemodynamics is the study of how blood flows through the cardiovascular system, including the heart and the vascular network. It examines various factors that affect blood flow, such as blood volume, viscosity, vessel length and diameter, and pressure differences between different parts of the circulatory system. Hemodynamics also considers the impact of various physiological and pathological conditions on these variables, and how they in turn influence the function of vital organs and systems in the body. It is a critical area of study in fields such as cardiology, anesthesiology, and critical care medicine.

Vascular surgical procedures are operations that are performed to treat conditions and diseases related to the vascular system, which includes the arteries, veins, and capillaries. These procedures can be invasive or minimally invasive and are often used to treat conditions such as peripheral artery disease, carotid artery stenosis, aortic aneurysms, and venous insufficiency.

Some examples of vascular surgical procedures include:

* Endarterectomy: a procedure to remove plaque buildup from the inside of an artery
* Bypass surgery: creating a new path for blood to flow around a blocked or narrowed artery
* Angioplasty and stenting: using a balloon to open a narrowed artery and placing a stent to keep it open
* Aneurysm repair: surgically repairing an aneurysm, a weakened area in the wall of an artery that has bulged out and filled with blood
* Embolectomy: removing a blood clot from a blood vessel
* Thrombectomy: removing a blood clot from a vein

These procedures are typically performed by vascular surgeons, who are trained in the diagnosis and treatment of vascular diseases.

Ischemia is the medical term used to describe a lack of blood flow to a part of the body, often due to blocked or narrowed blood vessels. This can lead to a shortage of oxygen and nutrients in the tissues, which can cause them to become damaged or die. Ischemia can affect many different parts of the body, including the heart, brain, legs, and intestines. Symptoms of ischemia depend on the location and severity of the blockage, but they may include pain, cramping, numbness, weakness, or coldness in the affected area. In severe cases, ischemia can lead to tissue death (gangrene) or organ failure. Treatment for ischemia typically involves addressing the underlying cause of the blocked blood flow, such as through medication, surgery, or lifestyle changes.

A Severity of Illness Index is a measurement tool used in healthcare to assess the severity of a patient's condition and the risk of mortality or other adverse outcomes. These indices typically take into account various physiological and clinical variables, such as vital signs, laboratory values, and co-morbidities, to generate a score that reflects the patient's overall illness severity.

Examples of Severity of Illness Indices include the Acute Physiology and Chronic Health Evaluation (APACHE) system, the Simplified Acute Physiology Score (SAPS), and the Mortality Probability Model (MPM). These indices are often used in critical care settings to guide clinical decision-making, inform prognosis, and compare outcomes across different patient populations.

It is important to note that while these indices can provide valuable information about a patient's condition, they should not be used as the sole basis for clinical decision-making. Rather, they should be considered in conjunction with other factors, such as the patient's overall clinical presentation, treatment preferences, and goals of care.

Electrocardiography (ECG or EKG) is a medical procedure that records the electrical activity of the heart. It provides a graphic representation of the electrical changes that occur during each heartbeat. The resulting tracing, called an electrocardiogram, can reveal information about the heart's rate and rhythm, as well as any damage to its cells or abnormalities in its conduction system.

During an ECG, small electrodes are placed on the skin of the chest, arms, and legs. These electrodes detect the electrical signals produced by the heart and transmit them to a machine that amplifies and records them. The procedure is non-invasive, painless, and quick, usually taking only a few minutes.

ECGs are commonly used to diagnose and monitor various heart conditions, including arrhythmias, coronary artery disease, heart attacks, and electrolyte imbalances. They can also be used to evaluate the effectiveness of certain medications or treatments.

Intraoperative complications refer to any unforeseen problems or events that occur during the course of a surgical procedure, once it has begun and before it is completed. These complications can range from minor issues, such as bleeding or an adverse reaction to anesthesia, to major complications that can significantly impact the patient's health and prognosis.

Examples of intraoperative complications include:

1. Bleeding (hemorrhage) - This can occur due to various reasons such as injury to blood vessels or organs during surgery.
2. Infection - Surgical site infections can develop if the surgical area becomes contaminated during the procedure.
3. Anesthesia-related complications - These include adverse reactions to anesthesia, difficulty maintaining the patient's airway, or cardiovascular instability.
4. Organ injury - Accidental damage to surrounding organs can occur during surgery, leading to potential long-term consequences.
5. Equipment failure - Malfunctioning surgical equipment can lead to complications and compromise the safety of the procedure.
6. Allergic reactions - Patients may have allergies to certain medications or materials used during surgery, causing an adverse reaction.
7. Prolonged operative time - Complications may arise if a surgical procedure takes longer than expected, leading to increased risk of infection and other issues.

Intraoperative complications require prompt identification and management by the surgical team to minimize their impact on the patient's health and recovery.

Prognosis is a medical term that refers to the prediction of the likely outcome or course of a disease, including the chances of recovery or recurrence, based on the patient's symptoms, medical history, physical examination, and diagnostic tests. It is an important aspect of clinical decision-making and patient communication, as it helps doctors and patients make informed decisions about treatment options, set realistic expectations, and plan for future care.

Prognosis can be expressed in various ways, such as percentages, categories (e.g., good, fair, poor), or survival rates, depending on the nature of the disease and the available evidence. However, it is important to note that prognosis is not an exact science and may vary depending on individual factors, such as age, overall health status, and response to treatment. Therefore, it should be used as a guide rather than a definitive forecast.

Echocardiography is a medical procedure that uses sound waves to produce detailed images of the heart's structure, function, and motion. It is a non-invasive test that can help diagnose various heart conditions, such as valve problems, heart muscle damage, blood clots, and congenital heart defects.

During an echocardiogram, a transducer (a device that sends and receives sound waves) is placed on the chest or passed through the esophagus to obtain images of the heart. The sound waves produced by the transducer bounce off the heart structures and return to the transducer, which then converts them into electrical signals that are processed to create images of the heart.

There are several types of echocardiograms, including:

* Transthoracic echocardiography (TTE): This is the most common type of echocardiogram and involves placing the transducer on the chest.
* Transesophageal echocardiography (TEE): This type of echocardiogram involves passing a specialized transducer through the esophagus to obtain images of the heart from a closer proximity.
* Stress echocardiography: This type of echocardiogram is performed during exercise or medication-induced stress to assess how the heart functions under stress.
* Doppler echocardiography: This type of echocardiogram uses sound waves to measure blood flow and velocity in the heart and blood vessels.

Echocardiography is a valuable tool for diagnosing and managing various heart conditions, as it provides detailed information about the structure and function of the heart. It is generally safe, non-invasive, and painless, making it a popular choice for doctors and patients alike.

Medical survival rate is a statistical measure used to determine the percentage of patients who are still alive for a specific period of time after their diagnosis or treatment for a certain condition or disease. It is often expressed as a five-year survival rate, which refers to the proportion of people who are alive five years after their diagnosis. Survival rates can be affected by many factors, including the stage of the disease at diagnosis, the patient's age and overall health, the effectiveness of treatment, and other health conditions that the patient may have. It is important to note that survival rates are statistical estimates and do not necessarily predict an individual patient's prognosis.

I apologize, but "Brazil" is not a medical term or condition. It is the largest country in both South America and Latin America by land area and population. If you have any questions related to medical terminology or health concerns, please provide more information and I will do my best to help.

An exercise test, also known as a stress test or an exercise stress test, is a medical procedure used to evaluate the heart's function and response to physical exertion. It typically involves walking on a treadmill or pedaling a stationary bike while being monitored for changes in heart rate, blood pressure, electrocardiogram (ECG), and sometimes other variables such as oxygen consumption or gas exchange.

During the test, the patient's symptoms, such as chest pain or shortness of breath, are also closely monitored. The exercise test can help diagnose coronary artery disease, assess the severity of heart-related symptoms, and evaluate the effectiveness of treatments for heart conditions. It may also be used to determine a person's safe level of physical activity and fitness.

There are different types of exercise tests, including treadmill stress testing, stationary bike stress testing, nuclear stress testing, and stress echocardiography. The specific type of test used depends on the patient's medical history, symptoms, and overall health status.

"Length of Stay" (LOS) is a term commonly used in healthcare to refer to the amount of time a patient spends receiving care in a hospital, clinic, or other healthcare facility. It is typically measured in hours, days, or weeks and can be used as a metric for various purposes such as resource planning, quality assessment, and reimbursement. The length of stay can vary depending on the type of illness or injury, the severity of the condition, the patient's response to treatment, and other factors. It is an important consideration in healthcare management and can have significant implications for both patients and providers.

Percutaneous Coronary Intervention (PCI), also known as coronary angioplasty, is a non-surgical procedure that opens up clogged coronary arteries to improve blood flow to the heart. It involves inserting a thin, flexible catheter into an artery in the groin or wrist and guiding it to the blocked artery in the heart. A small balloon is then inflated to widen the narrowed or blocked artery, and sometimes a stent (a tiny mesh tube) is placed to keep the artery open. This procedure helps to restore and maintain blood flow to the heart muscle, reducing symptoms of angina and improving overall cardiac function.

Vascular patency is a term used in medicine to describe the state of a blood vessel (such as an artery or vein) being open, unobstructed, and allowing for the normal flow of blood. It is an important concept in the treatment and management of various cardiovascular conditions, such as peripheral artery disease, coronary artery disease, and deep vein thrombosis.

Maintaining vascular patency can help prevent serious complications like tissue damage, organ dysfunction, or even death. This may involve medical interventions such as administering blood-thinning medications to prevent clots, performing procedures to remove blockages, or using devices like stents to keep vessels open. Regular monitoring of vascular patency is also crucial for evaluating the effectiveness of treatments and adjusting care plans accordingly.

Angioplasty is a medical procedure used to open narrowed or blocked blood vessels, often referred to as coronary angioplasty when it involves the heart's blood vessels (coronary arteries). The term "angio" refers to an angiogram, which is a type of X-ray image that reveals the inside of blood vessels.

The procedure typically involves the following steps:

1. A thin, flexible catheter (tube) is inserted into a blood vessel, usually through a small incision in the groin or arm.
2. The catheter is guided to the narrowed or blocked area using real-time X-ray imaging.
3. Once in place, a tiny balloon attached to the tip of the catheter is inflated to widen the blood vessel and compress any plaque buildup against the artery walls.
4. A stent (a small mesh tube) may be inserted to help keep the blood vessel open and prevent it from narrowing again.
5. The balloon is deflated, and the catheter is removed.

Angioplasty helps improve blood flow, reduce symptoms such as chest pain or shortness of breath, and lower the risk of heart attack in patients with blocked arteries. It's important to note that angioplasty is not a permanent solution for coronary artery disease, and lifestyle changes, medications, and follow-up care are necessary to maintain long-term cardiovascular health.

Cardiovascular agents are a class of medications that are used to treat various conditions related to the cardiovascular system, which includes the heart and blood vessels. These agents can be further divided into several subcategories based on their specific mechanisms of action and therapeutic effects. Here are some examples:

1. Antiarrhythmics: These drugs are used to treat abnormal heart rhythms or arrhythmias. They work by stabilizing the electrical activity of the heart and preventing irregular impulses from spreading through the heart muscle.
2. Antihypertensives: These medications are used to lower high blood pressure, also known as hypertension. There are several classes of antihypertensive drugs, including diuretics, beta-blockers, calcium channel blockers, and angiotensin-converting enzyme (ACE) inhibitors.
3. Anticoagulants: These drugs are used to prevent blood clots from forming or growing larger. They work by interfering with the coagulation cascade, which is a series of chemical reactions that lead to the formation of a blood clot.
4. Antiplatelet agents: These medications are used to prevent platelets in the blood from sticking together and forming clots. They work by inhibiting the aggregation of platelets, which are small cells in the blood that help form clots.
5. Lipid-lowering agents: These drugs are used to lower cholesterol and other fats in the blood. They work by reducing the production or absorption of cholesterol in the body or increasing the removal of cholesterol from the bloodstream. Examples include statins, bile acid sequestrants, and PCSK9 inhibitors.
6. Vasodilators: These medications are used to widen blood vessels and improve blood flow. They work by relaxing the smooth muscle in the walls of blood vessels, causing them to dilate or widen. Examples include nitrates, calcium channel blockers, and ACE inhibitors.
7. Inotropes: These drugs are used to increase the force of heart contractions. They work by increasing the sensitivity of heart muscle cells to calcium ions, which are necessary for muscle contraction.

These are just a few examples of cardiovascular medications that are used to treat various conditions related to the heart and blood vessels. It is important to note that these medications can have side effects and should be taken under the guidance of a healthcare provider.

Angioplasty, balloon refers to a medical procedure used to widen narrowed or obstructed blood vessels, particularly the coronary arteries that supply blood to the heart muscle. This procedure is typically performed using a catheter-based technique, where a thin, flexible tube called a catheter is inserted into an artery, usually through the groin or wrist, and guided to the site of the narrowing or obstruction in the coronary artery.

Once the catheter reaches the affected area, a small balloon attached to the tip of the catheter is inflated, which compresses the plaque against the artery wall and stretches the artery, thereby restoring blood flow. The balloon is then deflated and removed, along with the catheter.

Balloon angioplasty is often combined with the placement of a stent, a small metal mesh tube that helps to keep the artery open and prevent it from narrowing again. This procedure is known as percutaneous coronary intervention (PCI) or coronary angioplasty and stenting.

Overall, balloon angioplasty is a relatively safe and effective treatment for coronary artery disease, although complications such as bleeding, infection, or re-narrowing of the artery can occur in some cases.

In medical terms, the heart is a muscular organ located in the thoracic cavity that functions as a pump to circulate blood throughout the body. It's responsible for delivering oxygen and nutrients to the tissues and removing carbon dioxide and other wastes. The human heart is divided into four chambers: two atria on the top and two ventricles on the bottom. The right side of the heart receives deoxygenated blood from the body and pumps it to the lungs, while the left side receives oxygenated blood from the lungs and pumps it out to the rest of the body. The heart's rhythmic contractions and relaxations are regulated by a complex electrical conduction system.

Tissue survival, in the context of medical and surgical sciences, refers to the ability of tissues to maintain their structural and functional integrity after being subjected to various stressors such as injury, surgery, ischemia (restriction in blood supply), or disease. The maintenance of tissue survival is crucial for ensuring proper healing, reducing the risk of complications, and preserving organ function.

Factors that contribute to tissue survival include adequate blood flow, sufficient oxygen and nutrient supply, removal of waste products, maintenance of a healthy cellular environment (pH, temperature, etc.), and minimal exposure to harmful substances or damaging agents. In some cases, therapeutic interventions such as hypothermia, pharmacological treatments, or tissue engineering strategies may be employed to enhance tissue survival in challenging clinical scenarios.

The term "lower extremity" is used in the medical field to refer to the portion of the human body that includes the structures below the hip joint. This includes the thigh, lower leg, ankle, and foot. The lower extremities are responsible for weight-bearing and locomotion, allowing individuals to stand, walk, run, and jump. They contain many important structures such as bones, muscles, tendons, ligaments, nerves, and blood vessels.

Sirolimus is a medication that belongs to a class of drugs called immunosuppressants. It is also known as rapamycin. Sirolimus works by inhibiting the mammalian target of rapamycin (mTOR), which is a protein that plays a key role in cell growth and division.

Sirolimus is primarily used to prevent rejection of transplanted organs, such as kidneys, livers, and hearts. It works by suppressing the activity of the immune system, which can help to reduce the risk of the body rejecting the transplanted organ. Sirolimus is often used in combination with other immunosuppressive drugs, such as corticosteroids and calcineurin inhibitors.

Sirolimus is also being studied for its potential therapeutic benefits in a variety of other conditions, including cancer, tuberous sclerosis complex, and lymphangioleiomyomatosis. However, more research is needed to fully understand the safety and efficacy of sirolimus in these contexts.

It's important to note that sirolimus can have significant side effects, including increased risk of infections, mouth sores, high blood pressure, and kidney damage. Therefore, it should only be used under the close supervision of a healthcare provider.

The Kaplan-Meier estimate is a statistical method used to calculate the survival probability over time in a population. It is commonly used in medical research to analyze time-to-event data, such as the time until a patient experiences a specific event like disease progression or death. The Kaplan-Meier estimate takes into account censored data, which occurs when some individuals are lost to follow-up before experiencing the event of interest.

The method involves constructing a survival curve that shows the proportion of subjects still surviving at different time points. At each time point, the survival probability is calculated as the product of the conditional probabilities of surviving from one time point to the next. The Kaplan-Meier estimate provides an unbiased and consistent estimator of the survival function, even when censoring is present.

In summary, the Kaplan-Meier estimate is a crucial tool in medical research for analyzing time-to-event data and estimating survival probabilities over time while accounting for censored observations.

Renal artery obstruction is a medical condition that refers to the blockage or restriction of blood flow in the renal artery, which is the main vessel that supplies oxygenated and nutrient-rich blood to the kidneys. This obstruction can be caused by various factors, such as blood clots, atherosclerosis (the buildup of fats, cholesterol, and other substances in and on the artery walls), emboli (tiny particles or air bubbles that travel through the bloodstream and lodge in smaller vessels), or compressive masses like tumors.

The obstruction can lead to reduced kidney function, hypertension, and even kidney failure in severe cases. Symptoms may include high blood pressure, proteinuria (the presence of protein in the urine), hematuria (blood in the urine), and a decrease in kidney function as measured by serum creatinine levels. Diagnosis typically involves imaging studies like Doppler ultrasound, CT angiography, or magnetic resonance angiography to visualize the renal artery and assess the extent of the obstruction. Treatment options may include medications to control blood pressure and reduce kidney damage, as well as invasive procedures like angioplasty and stenting or surgical intervention to remove the obstruction and restore normal blood flow to the kidneys.

Platelet aggregation inhibitors are a class of medications that prevent platelets (small blood cells involved in clotting) from sticking together and forming a clot. These drugs work by interfering with the ability of platelets to adhere to each other and to the damaged vessel wall, thereby reducing the risk of thrombosis (blood clot formation).

Platelet aggregation inhibitors are often prescribed for people who have an increased risk of developing blood clots due to various medical conditions such as atrial fibrillation, coronary artery disease, peripheral artery disease, stroke, or a history of heart attack. They may also be used in patients undergoing certain medical procedures, such as angioplasty and stenting, to prevent blood clot formation in the stents.

Examples of platelet aggregation inhibitors include:

1. Aspirin: A nonsteroidal anti-inflammatory drug (NSAID) that irreversibly inhibits the enzyme cyclooxygenase, which is involved in platelet activation and aggregation.
2. Clopidogrel (Plavix): A P2Y12 receptor antagonist that selectively blocks ADP-induced platelet activation and aggregation.
3. Prasugrel (Effient): A third-generation thienopyridine P2Y12 receptor antagonist, similar to clopidogrel but with faster onset and greater potency.
4. Ticagrelor (Brilinta): A direct-acting P2Y12 receptor antagonist that does not require metabolic activation and has a reversible binding profile.
5. Dipyridamole (Persantine): An antiplatelet agent that inhibits platelet aggregation by increasing cyclic adenosine monophosphate (cAMP) levels in platelets, which leads to decreased platelet reactivity.
6. Iloprost (Ventavis): A prostacyclin analogue that inhibits platelet aggregation and causes vasodilation, often used in the treatment of pulmonary arterial hypertension.
7. Cilostazol (Pletal): A phosphodiesterase III inhibitor that increases cAMP levels in platelets, leading to decreased platelet activation and aggregation, as well as vasodilation.
8. Ticlopidine (Ticlid): An older P2Y12 receptor antagonist with a slower onset of action and more frequent side effects compared to clopidogrel or prasugrel.

Peripheral Vascular Diseases (PVD) refer to a group of medical conditions that affect the blood vessels outside of the heart and brain. These diseases are characterized by a narrowing or blockage of the peripheral arteries, which can lead to reduced blood flow to the limbs, particularly the legs.

The primary cause of PVD is atherosclerosis, a buildup of fats, cholesterol, and other substances in and on the walls of the arteries, forming plaques that restrict blood flow. Other risk factors include smoking, diabetes, hypertension, high cholesterol levels, and a family history of vascular disease.

Symptoms of PVD can vary depending on the severity of the condition but may include leg pain or cramping during exercise (claudication), numbness or tingling in the legs, coldness or discoloration of the feet, sores or wounds that heal slowly or not at all, and in severe cases, gangrene.

PVD can increase the risk of heart attack and stroke, so it is essential to diagnose and treat the condition as early as possible. Treatment options include lifestyle changes such as quitting smoking, exercising regularly, and maintaining a healthy diet, medications to control symptoms and reduce the risk of complications, and surgical procedures such as angioplasty or bypass surgery to restore blood flow.

In medical terms, "retreatment" refers to the process of providing additional treatment or courses of therapy to an individual who has previously undergone a medical intervention but has not achieved the desired outcomes or has experienced a recurrence of symptoms. This may apply to various medical conditions and treatments, including dental procedures, cancer therapies, mental health treatments, and more.

In the context of dentistry, specifically endodontics (root canal treatment), retreatment is the process of repeating the root canal procedure on a tooth that has already been treated before. This may be necessary if the initial treatment was not successful in eliminating infection or if reinfection has occurred. The goal of retreatment is to preserve the natural tooth and alleviate any persistent pain or discomfort.

"Age factors" refer to the effects, changes, or differences that age can have on various aspects of health, disease, and medical care. These factors can encompass a wide range of issues, including:

1. Physiological changes: As people age, their bodies undergo numerous physical changes that can affect how they respond to medications, illnesses, and medical procedures. For example, older adults may be more sensitive to certain drugs or have weaker immune systems, making them more susceptible to infections.
2. Chronic conditions: Age is a significant risk factor for many chronic diseases, such as heart disease, diabetes, cancer, and arthritis. As a result, age-related medical issues are common and can impact treatment decisions and outcomes.
3. Cognitive decline: Aging can also lead to cognitive changes, including memory loss and decreased decision-making abilities. These changes can affect a person's ability to understand and comply with medical instructions, leading to potential complications in their care.
4. Functional limitations: Older adults may experience physical limitations that impact their mobility, strength, and balance, increasing the risk of falls and other injuries. These limitations can also make it more challenging for them to perform daily activities, such as bathing, dressing, or cooking.
5. Social determinants: Age-related factors, such as social isolation, poverty, and lack of access to transportation, can impact a person's ability to obtain necessary medical care and affect their overall health outcomes.

Understanding age factors is critical for healthcare providers to deliver high-quality, patient-centered care that addresses the unique needs and challenges of older adults. By taking these factors into account, healthcare providers can develop personalized treatment plans that consider a person's age, physical condition, cognitive abilities, and social circumstances.

Amputation is defined as the surgical removal of all or part of a limb or extremity such as an arm, leg, foot, hand, toe, or finger. This procedure is typically performed to remove damaged or dead tissue due to various reasons like severe injury, infection, tumors, or chronic conditions that impair circulation, such as diabetes or peripheral arterial disease. The goal of amputation is to alleviate pain, prevent further complications, and improve the patient's quality of life. Following the surgery, patients may require rehabilitation and prosthetic devices to help them adapt to their new physical condition.

Limb salvage is a medical term used to describe the surgical procedures and treatments aimed at preserving and restoring the functionality of a severely injured or diseased limb, rather than amputating it. The goal of limb salvage is to improve the patient's quality of life by maintaining their mobility, independence, and overall well-being.

Limb salvage may involve various surgical techniques such as vascular reconstruction, bone realignment, muscle flap coverage, and external fixation. These procedures aim to restore blood flow, stabilize bones, cover exposed tissues, and prevent infection. Additionally, adjuvant therapies like hyperbaric oxygen treatment, physical therapy, and pain management may be employed to support the healing process and improve functional outcomes.

Limb salvage is typically considered when a limb is threatened by conditions such as severe trauma, tumors, infections, or peripheral arterial disease. The decision to pursue limb salvage over amputation depends on factors like the patient's overall health, age, and personal preferences, as well as the extent of the injury or disease, potential for recovery, and likelihood of successful rehabilitation.

Transmyocardial laser revascularization (TMLR) is a surgical procedure that involves the use of a laser beam to create small channels in the heart muscle (myocardium). The goal of this procedure is to improve blood flow to the heart, particularly in patients with severe angina (chest pain) who have not responded to other treatments such as medications, angioplasty, or coronary artery bypass surgery.

During TMLR, a laser beam is directed through the chest wall and into the heart muscle, creating channels that penetrate approximately 1-2 millimeters into the myocardium. These channels are believed to stimulate the growth of new blood vessels and improve the delivery of oxygen and nutrients to the heart muscle.

TMLR is typically performed on an isolated portion of the heart, such as the left ventricle, during open-heart surgery. While some studies have suggested that TMLR may be beneficial in reducing angina symptoms and improving exercise capacity, its role in the treatment of coronary artery disease remains controversial. Some clinical trials have failed to show significant benefits compared to medical therapy alone, and the procedure is not widely performed.

Recurrence, in a medical context, refers to the return of symptoms or signs of a disease after a period of improvement or remission. It indicates that the condition has not been fully eradicated and may require further treatment. Recurrence is often used to describe situations where a disease such as cancer comes back after initial treatment, but it can also apply to other medical conditions. The likelihood of recurrence varies depending on the type of disease and individual patient factors.

Graft occlusion in the context of vascular surgery refers to the complete or partial blockage of a blood vessel that has been surgically replaced or repaired with a graft. The graft can be made from either synthetic materials or autologous tissue (taken from another part of the patient's body).

Graft occlusion can occur due to various reasons, including:

1. Thrombosis: Formation of a blood clot within the graft, which can obstruct blood flow.
2. Intimal hyperplasia: Overgrowth of the inner lining (intima) of the graft or the adjacent native vessel, causing narrowing of the lumen and reducing blood flow.
3. Atherosclerosis: Deposition of cholesterol and other substances in the walls of the graft, leading to hardening and narrowing of the vessel.
4. Infection: Bacterial or fungal infection of the graft can cause inflammation, weakening, and ultimately occlusion of the graft.
5. Mechanical factors: Kinking, twisting, or compression of the graft can lead to obstruction of blood flow.

Graft occlusion is a significant complication following vascular surgery, as it can result in reduced perfusion to downstream tissues and organs, leading to ischemia (lack of oxygen supply) and potential tissue damage or loss.

Proportional hazards models are a type of statistical analysis used in medical research to investigate the relationship between covariates (predictor variables) and survival times. The most common application of proportional hazards models is in the Cox regression model, which is named after its developer, Sir David Cox.

In a proportional hazards model, the hazard rate or risk of an event occurring at a given time is assumed to be proportional to the hazard rate of a reference group, after adjusting for the covariates. This means that the ratio of the hazard rates between any two individuals remains constant over time, regardless of their survival times.

Mathematically, the hazard function h(t) at time t for an individual with a set of covariates X can be expressed as:

h(t|X) = h0(t) \* exp(β1X1 + β2X2 + ... + βpXp)

where h0(t) is the baseline hazard function, X1, X2, ..., Xp are the covariates, and β1, β2, ..., βp are the regression coefficients that represent the effect of each covariate on the hazard rate.

The assumption of proportionality is crucial in the interpretation of the results from a Cox regression model. If the assumption is violated, then the estimated regression coefficients may be biased and misleading. Therefore, it is important to test for the proportional hazards assumption before interpreting the results of a Cox regression analysis.

Arterial occlusive diseases are medical conditions characterized by the blockage or narrowing of the arteries, which can lead to a reduction in blood flow to various parts of the body. This reduction in blood flow can cause tissue damage and may result in serious complications such as tissue death (gangrene), organ dysfunction, or even death.

The most common cause of arterial occlusive diseases is atherosclerosis, which is the buildup of plaque made up of fat, cholesterol, calcium, and other substances in the inner lining of the artery walls. Over time, this plaque can harden and narrow the arteries, restricting blood flow. Other causes of arterial occlusive diseases include blood clots, emboli (tiny particles that travel through the bloodstream and lodge in smaller vessels), inflammation, trauma, and certain inherited conditions.

Symptoms of arterial occlusive diseases depend on the location and severity of the blockage. Common symptoms include:

* Pain, cramping, or fatigue in the affected limb, often triggered by exercise and relieved by rest (claudication)
* Numbness, tingling, or weakness in the affected limb
* Coldness or discoloration of the skin in the affected area
* Slow-healing sores or wounds on the toes, feet, or legs
* Erectile dysfunction in men

Treatment for arterial occlusive diseases may include lifestyle changes such as quitting smoking, exercising regularly, and eating a healthy diet. Medications to lower cholesterol, control blood pressure, prevent blood clots, or manage pain may also be prescribed. In severe cases, surgical procedures such as angioplasty, stenting, or bypass surgery may be necessary to restore blood flow.

Patient selection, in the context of medical treatment or clinical research, refers to the process of identifying and choosing appropriate individuals who are most likely to benefit from a particular medical intervention or who meet specific criteria to participate in a study. This decision is based on various factors such as the patient's diagnosis, stage of disease, overall health status, potential risks, and expected benefits. The goal of patient selection is to ensure that the selected individuals will receive the most effective and safe care possible while also contributing to meaningful research outcomes.

Mesenteric vascular occlusion refers to the blockage or obstruction of the blood vessels that supply the intestines, specifically the mesenteric arteries and veins. This condition can result in insufficient blood flow to the intestines, leading to ischemia (inadequate oxygen supply) and potential necrosis (tissue death).

There are two primary types of mesenteric vascular occlusion:

1. Mesenteric arterial occlusion: This occurs when the mesenteric artery, which carries oxygenated blood from the heart to the intestines, becomes blocked. The most common causes include atherosclerosis (plaque buildup in the arteries), embolism (a clot or particle that travels from another part of the body and lodges in the artery), and thrombosis (a blood clot forming directly in the artery).
2. Mesenteric venous occlusion: This happens when the mesenteric vein, which returns deoxygenated blood from the intestines to the heart, becomes obstructed. The most common causes include thrombophlebitis (inflammation and clot formation in the vein), tumors, or abdominal trauma.

Symptoms of mesenteric vascular occlusion may include severe abdominal pain, nausea, vomiting, diarrhea, and bloody stools. Rapid diagnosis and treatment are crucial to prevent intestinal tissue damage and potential life-threatening complications such as sepsis or shock. Treatment options typically involve surgical intervention, anticoagulation therapy, or endovascular procedures to restore blood flow.

A registry in the context of medicine is a collection or database of standardized information about individuals who share a certain condition or attribute, such as a disease, treatment, exposure, or demographic group. These registries are used for various purposes, including:

* Monitoring and tracking the natural history of diseases and conditions
* Evaluating the safety and effectiveness of medical treatments and interventions
* Conducting research and generating hypotheses for further study
* Providing information to patients, clinicians, and researchers
* Informing public health policy and decision-making

Registries can be established for a wide range of purposes, including disease-specific registries (such as cancer or diabetes registries), procedure-specific registries (such as joint replacement or cardiac surgery registries), and population-based registries (such as birth defects or cancer registries). Data collected in registries may include demographic information, clinical data, laboratory results, treatment details, and outcomes.

Registries can be maintained by a variety of organizations, including hospitals, clinics, academic medical centers, professional societies, government agencies, and industry. Participation in registries is often voluntary, although some registries may require informed consent from participants. Data collected in registries are typically de-identified to protect the privacy of individuals.

Emission-Computed Tomography, Single-Photon (SPECT) is a type of nuclear medicine imaging procedure that generates detailed, three-dimensional images of the distribution of radioactive pharmaceuticals within the body. It uses gamma rays emitted by a radiopharmaceutical that is introduced into the patient's body, and a specialized gamma camera to detect these gamma rays and create tomographic images. The data obtained from the SPECT imaging can be used to diagnose various medical conditions, evaluate organ function, and guide treatment decisions. It is commonly used to image the heart, brain, and bones, among other organs and systems.

Myocardial stunning is a condition in cardiovascular medicine where the heart muscle (myocardium) temporarily loses its ability to contract effectively after being exposed to a brief, severe episode of ischemia (restriction of blood supply) or reperfusion injury (damage that occurs when blood flow is restored to an organ or tissue after a period of ischemia). This results in a reduction in the heart's pumping function, which can be detected using imaging techniques such as echocardiography.

The stunning phenomenon is believed to be caused by complex biochemical and cellular processes that occur during ischemia-reperfusion injury, including the generation of free radicals, calcium overload, inflammation, and activation of various signaling pathways. These changes can lead to the dysfunction of contractile proteins, mitochondrial damage, and altered gene expression in cardiomyocytes (heart muscle cells).

Myocardial stunning is often observed following procedures such as coronary angioplasty or bypass surgery, where blood flow is temporarily interrupted and then restored to the heart. It can also occur during episodes of unstable angina, acute myocardial infarction, or cardiac arrest. Although the stunning itself is usually reversible within a few days to several weeks, it may contribute to short-term hemodynamic instability and increased risk of adverse events such as heart failure, arrhythmias, or even death.

Management of myocardial stunning typically involves supportive care, optimizing hemodynamics, and addressing any underlying conditions that may have contributed to the ischemic episode. In some cases, medications like inotropes or vasopressors might be used to support cardiac function temporarily. Preventive strategies, such as maintaining adequate blood pressure, heart rate, and oxygenation during procedures, can help reduce the risk of myocardial stunning.

The Predictive Value of Tests, specifically the Positive Predictive Value (PPV) and Negative Predictive Value (NPV), are measures used in diagnostic tests to determine the probability that a positive or negative test result is correct.

Positive Predictive Value (PPV) is the proportion of patients with a positive test result who actually have the disease. It is calculated as the number of true positives divided by the total number of positive results (true positives + false positives). A higher PPV indicates that a positive test result is more likely to be a true positive, and therefore the disease is more likely to be present.

Negative Predictive Value (NPV) is the proportion of patients with a negative test result who do not have the disease. It is calculated as the number of true negatives divided by the total number of negative results (true negatives + false negatives). A higher NPV indicates that a negative test result is more likely to be a true negative, and therefore the disease is less likely to be present.

The predictive value of tests depends on the prevalence of the disease in the population being tested, as well as the sensitivity and specificity of the test. A test with high sensitivity and specificity will generally have higher predictive values than a test with low sensitivity and specificity. However, even a highly sensitive and specific test can have low predictive values if the prevalence of the disease is low in the population being tested.

In medical terms, the leg refers to the lower portion of the human body that extends from the knee down to the foot. It includes the thigh (femur), lower leg (tibia and fibula), foot, and ankle. The leg is primarily responsible for supporting the body's weight and enabling movements such as standing, walking, running, and jumping.

The leg contains several important structures, including bones, muscles, tendons, ligaments, blood vessels, nerves, and joints. These structures work together to provide stability, support, and mobility to the lower extremity. Common medical conditions that can affect the leg include fractures, sprains, strains, infections, peripheral artery disease, and neurological disorders.

Cardiogenic shock is a serious condition characterized by the inability of the heart to pump enough blood to meet the body's needs. It is a type of shock that originates from a primary cardiac dysfunction, such as severe heart muscle damage (myocardial infarction or heart attack), abnormal heart rhythms (arrhythmias), or acute valvular insufficiency.

In cardiogenic shock, the low cardiac output leads to inadequate tissue perfusion and oxygenation, resulting in multiple organ dysfunction and failure. Symptoms of cardiogenic shock include severe hypotension (low blood pressure), cool extremities, decreased urine output, altered mental status, and signs of congestive heart failure such as shortness of breath, cough, and peripheral edema.

Cardiogenic shock is a medical emergency that requires prompt diagnosis and immediate treatment, which may include medications to support blood pressure and heart function, mechanical assist devices, or even emergency heart transplantation in some cases.

Survival analysis is a branch of statistics that deals with the analysis of time to event data. It is used to estimate the time it takes for a certain event of interest to occur, such as death, disease recurrence, or treatment failure. The event of interest is called the "failure" event, and survival analysis estimates the probability of not experiencing the failure event until a certain point in time, also known as the "survival" probability.

Survival analysis can provide important information about the effectiveness of treatments, the prognosis of patients, and the identification of risk factors associated with the event of interest. It can handle censored data, which is common in medical research where some participants may drop out or be lost to follow-up before the event of interest occurs.

Survival analysis typically involves estimating the survival function, which describes the probability of surviving beyond a certain time point, as well as hazard functions, which describe the instantaneous rate of failure at a given time point. Other important concepts in survival analysis include median survival times, restricted mean survival times, and various statistical tests to compare survival curves between groups.

Blood vessel prosthesis implantation is a surgical procedure in which an artificial blood vessel, also known as a vascular graft or prosthetic graft, is inserted into the body to replace a damaged or diseased native blood vessel. The prosthetic graft can be made from various materials such as Dacron (polyester), PTFE (polytetrafluoroethylene), or bovine/human tissue.

The implantation of a blood vessel prosthesis is typically performed to treat conditions that cause narrowing or blockage of the blood vessels, such as atherosclerosis, aneurysms, or traumatic injuries. The procedure may be used to bypass blocked arteries in the legs (peripheral artery disease), heart (coronary artery bypass surgery), or neck (carotid endarterectomy). It can also be used to replace damaged veins for hemodialysis access in patients with kidney failure.

The success of blood vessel prosthesis implantation depends on various factors, including the patient's overall health, the location and extent of the vascular disease, and the type of graft material used. Possible complications include infection, bleeding, graft thrombosis (clotting), and graft failure, which may require further surgical intervention or endovascular treatments.

Dobutamine is a synthetic catecholamine used in medical treatment, specifically as a positive inotrope and vasodilator. It works by stimulating the beta-1 adrenergic receptors of the heart, thereby increasing its contractility and stroke volume. This results in an improved cardiac output, making dobutamine beneficial in treating heart failure, cardiogenic shock, and other conditions where heart function is compromised.

It's important to note that dobutamine should be administered under strict medical supervision due to its potential to cause adverse effects such as arrhythmias, hypotension, or hypertension. The dosage, frequency, and duration of administration are determined by the patient's specific condition and response to treatment.

The femoral artery is the major blood vessel that supplies oxygenated blood to the lower extremity of the human body. It is a continuation of the external iliac artery and becomes the popliteal artery as it passes through the adductor hiatus in the adductor magnus muscle of the thigh.

The femoral artery is located in the femoral triangle, which is bound by the sartorius muscle anteriorly, the adductor longus muscle medially, and the biceps femoris muscle posteriorly. It can be easily palpated in the groin region, making it a common site for taking blood samples, measuring blood pressure, and performing surgical procedures such as femoral artery catheterization and bypass grafting.

The femoral artery gives off several branches that supply blood to the lower limb, including the deep femoral artery, the superficial femoral artery, and the profunda femoris artery. These branches provide blood to the muscles, bones, skin, and other tissues of the leg, ankle, and foot.

The Chi-square distribution is a continuous probability distribution that is often used in statistical hypothesis testing. It is the distribution of a sum of squares of k independent standard normal random variables. The resulting quantity follows a chi-square distribution with k degrees of freedom, denoted as χ²(k).

The probability density function (pdf) of the Chi-square distribution with k degrees of freedom is given by:

f(x; k) = (1/ (2^(k/2) * Γ(k/2))) \* x^((k/2)-1) \* e^(-x/2), for x > 0 and 0, otherwise.

Where Γ(k/2) is the gamma function evaluated at k/2. The mean and variance of a Chi-square distribution with k degrees of freedom are k and 2k, respectively.

The Chi-square distribution has various applications in statistical inference, including testing goodness-of-fit, homogeneity of variances, and independence in contingency tables.

Coronary thrombosis is a medical condition that refers to the formation of a blood clot (thrombus) inside a coronary artery, which supplies oxygenated blood to the heart muscle. The development of a thrombus can partially or completely obstruct blood flow, leading to insufficient oxygen supply to the heart muscle. This can cause chest pain (angina) or a heart attack (myocardial infarction), depending on the severity and duration of the blockage.

Coronary thrombosis often results from the rupture of an atherosclerotic plaque, a buildup of cholesterol, fat, calcium, and other substances in the inner lining (endothelium) of the coronary artery. The ruptured plaque exposes the underlying tissue to the bloodstream, triggering the coagulation cascade and resulting in the formation of a thrombus.

Immediate medical attention is crucial for managing coronary thrombosis, as timely treatment can help restore blood flow, prevent further damage to the heart muscle, and reduce the risk of complications such as heart failure or life-threatening arrhythmias. Treatment options may include medications, such as antiplatelet agents, anticoagulants, and thrombolytic drugs, or interventional procedures like angioplasty and stenting to open the blocked artery. In some cases, surgical intervention, such as coronary artery bypass grafting (CABG), may be necessary.

Endarterectomy is a surgical procedure in which the inner lining of an artery (the endothelium) that has become thickened, damaged, or narrowed due to the buildup of fatty deposits, called plaques, is removed. This process helps restore normal blood flow through the artery and reduces the risk of serious complications such as stroke or limb loss.

The procedure typically involves making an incision in the affected artery, carefully removing the plaque and inner lining, and then closing the artery with sutures or a patch graft. Endarterectomy is most commonly performed on the carotid arteries in the neck, but it can also be done on other arteries throughout the body, including the femoral artery in the leg and the iliac artery in the pelvis.

Endarterectomy is usually recommended for patients with significant narrowing of their arteries who are experiencing symptoms such as pain, numbness, or weakness in their limbs, or who have a high risk of stroke due to carotid artery disease. The procedure is generally safe and effective, but like any surgery, it carries risks such as bleeding, infection, and damage to nearby nerves or tissues.

Moyamoya Disease is a rare, progressive cerebrovascular disorder characterized by the narrowing or occlusion (blockage) of the internal carotid artery and its main branches. The name "moyamoya" means "puff of smoke" in Japanese and describes the look of the tangle of tiny vessels formed to compensate for the blockage. Over time, these fragile vessels can become less effective or rupture, leading to transient ischemic attacks (mini-strokes), strokes, bleeding in the brain, or cognitive decline. The exact cause of moyamoya disease is unknown, but it may be associated with genetic factors and certain medical conditions such as Down syndrome, neurofibromatosis type 1, and sickle cell anemia. Treatment options include surgical procedures to improve blood flow to the brain.

Angiography is a medical procedure in which an x-ray image is taken to visualize the internal structure of blood vessels, arteries, or veins. This is done by injecting a radiopaque contrast agent (dye) into the blood vessel using a thin, flexible catheter. The dye makes the blood vessels visible on an x-ray image, allowing doctors to diagnose and treat various medical conditions such as blockages, narrowing, or malformations of the blood vessels.

There are several types of angiography, including:

* Cardiac angiography (also called coronary angiography) - used to examine the blood vessels of the heart
* Cerebral angiography - used to examine the blood vessels of the brain
* Peripheral angiography - used to examine the blood vessels in the limbs or other parts of the body.

Angiography is typically performed by a radiologist, cardiologist, or vascular surgeon in a hospital setting. It can help diagnose conditions such as coronary artery disease, aneurysms, and peripheral arterial disease, among others.

Prosthesis design is a specialized field in medical device technology that involves creating and developing artificial substitutes to replace a missing body part, such as a limb, tooth, eye, or internal organ. The design process typically includes several stages: assessment of the patient's needs, selection of appropriate materials, creation of a prototype, testing and refinement, and final fabrication and fitting of the prosthesis.

The goal of prosthesis design is to create a device that functions as closely as possible to the natural body part it replaces, while also being comfortable, durable, and aesthetically pleasing for the patient. The design process may involve collaboration between medical professionals, engineers, and designers, and may take into account factors such as the patient's age, lifestyle, occupation, and overall health.

Prosthesis design can be highly complex, particularly for advanced devices such as robotic limbs or implantable organs. These devices often require sophisticated sensors, actuators, and control systems to mimic the natural functions of the body part they replace. As a result, prosthesis design is an active area of research and development in the medical field, with ongoing efforts to improve the functionality, comfort, and affordability of these devices for patients.

The popliteal artery is the continuation of the femoral artery that passes through the popliteal fossa, which is the area behind the knee. It is the major blood vessel that supplies oxygenated blood to the lower leg and foot. The popliteal artery divides into the anterior tibial artery and the tibioperoneal trunk at the lower border of the popliteus muscle. Any damage or blockage to this artery can result in serious health complications, including reduced blood flow to the leg and foot, which may lead to pain, cramping, numbness, or even tissue death (gangrene) if left untreated.

A propensity score is a statistical concept used in epidemiology and biostatistics to reduce bias and confounding in observational studies. It is a predicted probability of being exposed to a certain treatment or intervention, based on a set of observed covariates or characteristics.

The propensity score is calculated by estimating the probability of exposure (i.e., treatment or intervention) for each individual in the study sample, using logistic regression or other statistical models. The resulting scores are then used to match individuals with similar propensities for exposure, creating a balanced comparison group that more closely resembles a randomized controlled trial.

Propensity score methods can help to account for confounding variables and improve the internal validity of observational studies, making them a useful tool in medical research where randomized controlled trials may not be feasible or ethical. However, it is important to note that propensity score matching is not a panacea and has its own limitations, such as the potential for unmeasured confounding and the need for sufficient sample size.

Thrombosis is the formation of a blood clot (thrombus) inside a blood vessel, obstructing the flow of blood through the circulatory system. When a clot forms in an artery, it can cut off the supply of oxygen and nutrients to the tissues served by that artery, leading to damage or tissue death. If a thrombus forms in the heart, it can cause a heart attack. If a thrombus breaks off and travels through the bloodstream, it can lodge in a smaller vessel, causing blockage and potentially leading to damage in the organ that the vessel supplies. This is known as an embolism.

Thrombosis can occur due to various factors such as injury to the blood vessel wall, abnormalities in blood flow, or changes in the composition of the blood. Certain medical conditions, medications, and lifestyle factors can increase the risk of thrombosis. Treatment typically involves anticoagulant or thrombolytic therapy to dissolve or prevent further growth of the clot, as well as addressing any underlying causes.

Diabetes complications refer to a range of health issues that can develop as a result of poorly managed diabetes over time. These complications can affect various parts of the body and can be classified into two main categories: macrovascular and microvascular.

Macrovascular complications include:

* Cardiovascular disease (CVD): People with diabetes are at an increased risk of developing CVD, including coronary artery disease, peripheral artery disease, and stroke.
* Peripheral arterial disease (PAD): This condition affects the blood vessels that supply oxygen and nutrients to the limbs, particularly the legs. PAD can cause pain, numbness, or weakness in the legs and may increase the risk of amputation.

Microvascular complications include:

* Diabetic neuropathy: This is a type of nerve damage that can occur due to prolonged high blood sugar levels. It commonly affects the feet and legs, causing symptoms such as numbness, tingling, or pain.
* Diabetic retinopathy: This condition affects the blood vessels in the eye and can cause vision loss or blindness if left untreated.
* Diabetic nephropathy: This is a type of kidney damage that can occur due to diabetes. It can lead to kidney failure if not managed properly.

Other complications of diabetes include:

* Increased risk of infections, particularly skin and urinary tract infections.
* Slow healing of wounds, which can increase the risk of infection and amputation.
* Gum disease and other oral health problems.
* Hearing impairment.
* Sexual dysfunction.

Preventing or managing diabetes complications involves maintaining good blood sugar control, regular monitoring of blood glucose levels, following a healthy lifestyle, and receiving routine medical care.

Thallium radioisotopes are radioactive isotopes or variants of the element thallium (Tl), which decays and emits radiation. Thallium has several radioisotopes, with the most commonly used being thallium-201 (^201Tl). This radioisotope is used in medical imaging, specifically in myocardial perfusion scintigraphy, to evaluate blood flow to the heart muscle. It decays by electron capture and emits gamma radiation with a half-life of 73 hours, making it suitable for diagnostic procedures.

It's important to note that handling and using radioisotopes require proper training and safety measures due to their ionizing radiation properties.

Intermittent claudication is a medical condition characterized by pain or cramping in the legs, usually in the calf muscles, that occurs during exercise or walking and is relieved by rest. This symptom is caused by insufficient blood flow to the working muscles due to peripheral artery disease (PAD), a narrowing or blockage of the arteries in the limbs. As the individual walks, the muscle demands for oxygen and nutrients increase, but the restricted blood supply cannot meet these demands, leading to ischemia (lack of oxygen) and pain. The pain typically subsides after a few minutes of rest, as the muscle's demand for oxygen decreases, allowing the limited blood flow to compensate. Regular exercise and medications may help improve symptoms and reduce the risk of complications associated with PAD.

Atherectomy, coronary, is a medical procedure used to treat narrowed or blocked coronary arteries due to the buildup of plaque (atherosclerosis). The goal of coronary atherectomy is to improve blood flow to the heart muscle by removing the obstructive material within the vessel.

During the procedure, a specialized catheter with a cutting device on its tip is inserted into a peripheral artery, usually in the groin or arm, and advanced to the affected coronary artery. The cutting device can be a rotating blade, a high-speed spinning burr, or a laser fiber that is used to shave, drill, or vaporize the plaque, respectively. The removed material is collected in a chamber within the catheter or washed away by blood flow.

There are different types of coronary atherectomy devices, including:

1. Directional atherectomy (DCA): A rotating blade cuts and removes the plaque in a targeted direction.
2. Rotational atherectomy (Rotablator): A high-speed spinning burr is used to abrade and pulverize the plaque into tiny particles that can be safely carried away by blood flow.
3. Laser atherectomy: A laser fiber is used to vaporize or break down the plaque into gaseous or small particle form.

Coronary atherectomy is typically performed in conjunction with angioplasty and stenting, as it helps prepare the narrowed artery for these procedures by creating a larger lumen and reducing the risk of complications like dissections or restenosis (re-narrowing). However, its use may be limited to specific cases due to the potential risks, such as vessel trauma, distal embolization, or perforation.

It is essential to consult with a medical professional for detailed information and personalized treatment recommendations regarding coronary atherectomy.

The tibial arteries are three major arteries that supply blood to the lower leg and foot. They are branches of the popliteal artery, which is a continuation of the femoral artery. The three tibial arteries are:

1. Anterior tibial artery: This artery runs down the front of the leg and supplies blood to the muscles in the anterior compartment of the leg, as well as to the foot. It becomes the dorsalis pedis artery as it approaches the ankle.
2. Posterior tibial artery: This artery runs down the back of the leg and supplies blood to the muscles in the posterior compartment of the leg. It then branches into the fibular (peroneal) artery and the medial and lateral plantar arteries, which supply blood to the foot.
3. Fibular (peroneal) artery: This artery runs down the outside of the leg and supplies blood to the muscles in the lateral compartment of the leg. It also provides branches that anastomose with the anterior and posterior tibial arteries, forming a network of vessels that helps ensure adequate blood flow to the foot.

Together, these arteries play a critical role in providing oxygenated blood and nutrients to the lower leg and foot, helping to maintain their health and function.

Coronary occlusion is the medical term used to describe a complete blockage in one or more of the coronary arteries, which supply oxygenated blood to the heart muscle. This blockage is usually caused by the buildup of fatty deposits, called plaques, inside the artery walls, a condition known as atherosclerosis. Over time, these plaques can rupture, leading to the formation of blood clots that completely obstruct the flow of blood through the coronary artery.

Coronary occlusion can lead to serious complications, such as a heart attack (myocardial infarction), angina (chest pain), or even sudden cardiac death, depending on the severity and duration of the blockage. Immediate medical attention is required in case of coronary occlusion to restore blood flow to the affected areas of the heart and prevent further damage. Treatment options may include medications, minimally invasive procedures like angioplasty and stenting, or surgical interventions such as coronary artery bypass grafting (CABG).

Peripheral Arterial Disease (PAD) is a medical condition characterized by the narrowing or blockage of arteries that supply blood to the extremities, most commonly the legs. This results in reduced blood flow, leading to symptoms such as leg pain, cramping, numbness, or weakness during physical activity, and in severe cases, tissue damage or gangrene. PAD is often indicative of widespread atherosclerosis, which is the hardening and narrowing of arteries due to the buildup of fatty deposits called plaques. It's important to note that early detection and management can help prevent serious complications.

A stroke, also known as cerebrovascular accident (CVA), is a serious medical condition that occurs when the blood supply to part of the brain is interrupted or reduced, leading to deprivation of oxygen and nutrients to brain cells. This can result in the death of brain tissue and cause permanent damage or temporary impairment to cognitive functions, speech, memory, movement, and other body functions controlled by the affected area of the brain.

Strokes can be caused by either a blockage in an artery that supplies blood to the brain (ischemic stroke) or the rupture of a blood vessel in the brain (hemorrhagic stroke). A transient ischemic attack (TIA), also known as a "mini-stroke," is a temporary disruption of blood flow to the brain that lasts only a few minutes and does not cause permanent damage.

Symptoms of a stroke may include sudden weakness or numbness in the face, arm, or leg; difficulty speaking or understanding speech; vision problems; loss of balance or coordination; severe headache with no known cause; and confusion or disorientation. Immediate medical attention is crucial for stroke patients to receive appropriate treatment and prevent long-term complications.

Vascular grafting is a surgical procedure where a vascular graft, which can be either a natural or synthetic tube, is used to replace or bypass a damaged or diseased portion of a blood vessel. The goal of this procedure is to restore normal blood flow to the affected area, thereby preventing tissue damage or necrosis due to insufficient oxygen and nutrient supply.

The vascular graft can be sourced from various locations in the body, such as the saphenous vein in the leg, or it can be made of synthetic materials like polytetrafluoroethylene (PTFE) or Dacron. The choice of graft depends on several factors, including the size and location of the damaged vessel, the patient's overall health, and the surgeon's preference.

Vascular grafting is commonly performed to treat conditions such as atherosclerosis, peripheral artery disease, aneurysms, and vasculitis. This procedure carries risks such as bleeding, infection, graft failure, and potential complications related to anesthesia. However, with proper postoperative care and follow-up, vascular grafting can significantly improve the patient's quality of life and overall prognosis.

In the context of medicine, there is no specific medical definition for 'metals.' However, certain metals have significant roles in biological systems and are thus studied in physiology, pathology, and pharmacology. Some metals are essential to life, serving as cofactors for enzymatic reactions, while others are toxic and can cause harm at certain levels.

Examples of essential metals include:

1. Iron (Fe): It is a crucial component of hemoglobin, myoglobin, and various enzymes involved in energy production, DNA synthesis, and electron transport.
2. Zinc (Zn): This metal is vital for immune function, wound healing, protein synthesis, and DNA synthesis. It acts as a cofactor for over 300 enzymes.
3. Copper (Cu): Copper is essential for energy production, iron metabolism, antioxidant defense, and connective tissue formation. It serves as a cofactor for several enzymes.
4. Magnesium (Mg): Magnesium plays a crucial role in many biochemical reactions, including nerve and muscle function, protein synthesis, and blood pressure regulation.
5. Manganese (Mn): This metal is necessary for bone development, protein metabolism, and antioxidant defense. It acts as a cofactor for several enzymes.
6. Molybdenum (Mo): Molybdenum is essential for the function of certain enzymes involved in the metabolism of nucleic acids, proteins, and drugs.
7. Cobalt (Co): Cobalt is a component of vitamin B12, which plays a vital role in DNA synthesis, fatty acid metabolism, and nerve function.

Examples of toxic metals include:

1. Lead (Pb): Exposure to lead can cause neurological damage, anemia, kidney dysfunction, and developmental issues.
2. Mercury (Hg): Mercury is highly toxic and can cause neurological problems, kidney damage, and developmental issues.
3. Arsenic (As): Arsenic exposure can lead to skin lesions, cancer, neurological disorders, and cardiovascular diseases.
4. Cadmium (Cd): Cadmium is toxic and can cause kidney damage, bone demineralization, and lung irritation.
5. Chromium (Cr): Excessive exposure to chromium can lead to skin ulcers, respiratory issues, and kidney and liver damage.

Physiologic neovascularization is the natural and controlled formation of new blood vessels in the body, which occurs as a part of normal growth and development, as well as in response to tissue repair and wound healing. This process involves the activation of endothelial cells, which line the interior surface of blood vessels, and their migration, proliferation, and tube formation to create new capillaries. Physiologic neovascularization is tightly regulated by a balance of pro-angiogenic and anti-angiogenic factors, ensuring that it occurs only when and where it is needed. It plays crucial roles in various physiological processes, such as embryonic development, tissue regeneration, and wound healing.

The renal artery is a pair of blood vessels that originate from the abdominal aorta and supply oxygenated blood to each kidney. These arteries branch into several smaller vessels that provide blood to the various parts of the kidneys, including the renal cortex and medulla. The renal arteries also carry nutrients and other essential components needed for the normal functioning of the kidneys. Any damage or blockage to the renal artery can lead to serious consequences, such as reduced kidney function or even kidney failure.

Life tables are statistical tools used in actuarial science, demography, and public health to estimate the mortality rate and survival rates of a population. They provide a data-driven representation of the probability that individuals of a certain age will die before their next birthday (the death rate) or live to a particular age (the survival rate).

Life tables are constructed using data on the number of deaths and the size of the population in specific age groups over a given period. These tables typically include several columns representing different variables, such as:

1. Age group or interval: The age range for which the data is being presented (e.g., 0-1 year, 1-5 years, 5-10 years, etc.).
2. Number of people in the population: The size of the population within each age group.
3. Number of deaths: The number of individuals who died during the study period within each age group.
4. Death rate: The probability that an individual in a given age group will die before their next birthday. It is calculated as the number of deaths divided by the size of the population for that age group.
5. Survival rate: The probability that an individual in a given age group will survive to a specific age or older. It is calculated using the death rates from earlier age groups.
6. Life expectancy: The average number of years a person is expected to live, based on their current age and mortality rates for each subsequent age group.

Life tables are essential in various fields, including insurance, pension planning, social security administration, and healthcare policy development. They help researchers and policymakers understand the health status and demographic trends of populations, allowing them to make informed decisions about resource allocation, program development, and public health interventions.

A blood vessel prosthesis is a medical device that is used as a substitute for a damaged or diseased natural blood vessel. It is typically made of synthetic materials such as polyester, Dacron, or ePTFE (expanded polytetrafluoroethylene) and is designed to mimic the function of a native blood vessel by allowing the flow of blood through it.

Blood vessel prostheses are used in various surgical procedures, including coronary artery bypass grafting, peripheral arterial reconstruction, and the creation of arteriovenous fistulas for dialysis access. The choice of material and size of the prosthesis depends on several factors, such as the location and diameter of the vessel being replaced, the patient's age and overall health status, and the surgeon's preference.

It is important to note that while blood vessel prostheses can be effective in restoring blood flow, they may also carry risks such as infection, thrombosis (blood clot formation), and graft failure over time. Therefore, careful patient selection, surgical technique, and postoperative management are crucial for the success of these procedures.

Diabetic angiopathies refer to a group of vascular complications that occur due to diabetes mellitus. Prolonged exposure to high blood sugar levels can damage the blood vessels, leading to various types of angiopathies such as:

1. Diabetic retinopathy: This is a condition where the small blood vessels in the retina get damaged due to diabetes, leading to vision loss or blindness if left untreated.
2. Diabetic nephropathy: In this condition, the kidneys' glomeruli (the filtering units) become damaged due to diabetes, leading to protein leakage and eventually kidney failure if not managed properly.
3. Diabetic neuropathy: This is a type of nerve damage caused by diabetes that can affect various parts of the body, including the legs, feet, and hands, causing numbness, tingling, or pain.
4. Diabetic cardiomyopathy: This is a condition where the heart muscle becomes damaged due to diabetes, leading to heart failure.
5. Diabetic peripheral arterial disease (PAD): In this condition, the blood vessels that supply the legs and feet become narrowed or blocked due to diabetes, leading to pain, cramping, or even gangrene in severe cases.

Overall, diabetic angiopathies are serious complications of diabetes that can significantly impact a person's quality of life and overall health. Therefore, it is crucial for individuals with diabetes to manage their blood sugar levels effectively and undergo regular check-ups to detect any early signs of these complications.

Left ventricular function refers to the ability of the left ventricle (the heart's lower-left chamber) to contract and relax, thereby filling with and ejecting blood. The left ventricle is responsible for pumping oxygenated blood to the rest of the body. Its function is evaluated by measuring several parameters, including:

1. Ejection fraction (EF): This is the percentage of blood that is pumped out of the left ventricle with each heartbeat. A normal ejection fraction ranges from 55% to 70%.
2. Stroke volume (SV): The amount of blood pumped by the left ventricle in one contraction. A typical SV is about 70 mL/beat.
3. Cardiac output (CO): The total volume of blood that the left ventricle pumps per minute, calculated as the product of stroke volume and heart rate. Normal CO ranges from 4 to 8 L/minute.

Assessment of left ventricular function is crucial in diagnosing and monitoring various cardiovascular conditions such as heart failure, coronary artery disease, valvular heart diseases, and cardiomyopathies.

Thrombolytic therapy, also known as thrombolysis, is a medical treatment that uses medications called thrombolytics or fibrinolytics to dissolve or break down blood clots (thrombi) in blood vessels. These clots can obstruct the flow of blood to vital organs such as the heart, lungs, or brain, leading to serious conditions like myocardial infarction (heart attack), pulmonary embolism, or ischemic stroke.

The goal of thrombolytic therapy is to restore blood flow as quickly and efficiently as possible to prevent further damage to the affected organ and potentially save lives. Commonly used thrombolytic drugs include alteplase (tPA), reteplase, and tenecteplase. It's essential to administer these medications as soon as possible after the onset of symptoms for optimal treatment outcomes. However, there are risks associated with thrombolytic therapy, such as an increased chance of bleeding complications, which must be carefully weighed against its benefits in each individual case.

Multivariate analysis is a statistical method used to examine the relationship between multiple independent variables and a dependent variable. It allows for the simultaneous examination of the effects of two or more independent variables on an outcome, while controlling for the effects of other variables in the model. This technique can be used to identify patterns, associations, and interactions among multiple variables, and is commonly used in medical research to understand complex health outcomes and disease processes. Examples of multivariate analysis methods include multiple regression, factor analysis, cluster analysis, and discriminant analysis.

Paclitaxel is a chemotherapeutic agent derived from the bark of the Pacific yew tree (Taxus brevifolia). It is an antimicrotubule agent that promotes the assembly and stabilization of microtubules, thereby interfering with the normal dynamic reorganization of the microtubule network that is essential for cell division.

Paclitaxel is used in the treatment of various types of cancer including ovarian, breast, lung, and pancreatic cancers. It works by inhibiting the disassembly of microtubules, which prevents the separation of chromosomes during mitosis, leading to cell cycle arrest and apoptosis (programmed cell death).

Common side effects of paclitaxel include neutropenia (low white blood cell count), anemia (low red blood cell count), alopecia (hair loss), peripheral neuropathy (nerve damage causing numbness or tingling in the hands and feet), myalgias (muscle pain), arthralgias (joint pain), and hypersensitivity reactions.

Fractional Flow Reserve (Myocardial) is a medical term used to describe the ratio of maximum blood flow through a stenosed (narrowed) coronary artery to the maximum flow that could be achieved if the artery were completely normal. It is a pressure-based index, which is measured during cardiac catheterization using a special wire that can measure pressure differences across a stenosis.

The FFR value ranges from 0 (no flow) to 1 (normal flow). An FFR value less than or equal to 0.80 is generally considered indicative of functionally significant coronary artery disease, which may benefit from revascularization (such as angioplasty or bypass surgery).

FFR is used in clinical practice to help guide decisions regarding the management of patients with coronary artery disease and has been shown to improve patient outcomes.

A randomized controlled trial (RCT) is a type of clinical study in which participants are randomly assigned to receive either the experimental intervention or the control condition, which may be a standard of care, placebo, or no treatment. The goal of an RCT is to minimize bias and ensure that the results are due to the intervention being tested rather than other factors. This design allows for a comparison between the two groups to determine if there is a significant difference in outcomes. RCTs are often considered the gold standard for evaluating the safety and efficacy of medical interventions, as they provide a high level of evidence for causal relationships between the intervention and health outcomes.

Carotid endarterectomy is a surgical procedure to remove plaque buildup (atherosclerosis) from the carotid arteries, which are the major blood vessels that supply oxygen-rich blood to the brain. The surgery involves making an incision in the neck, opening the carotid artery, and removing the plaque from the inside of the artery wall. The goal of the procedure is to restore normal blood flow to the brain and reduce the risk of stroke caused by the narrowing or blockage of the carotid arteries.

Endovascular procedures are minimally invasive medical treatments that involve accessing and repairing blood vessels or other interior parts of the body through small incisions or punctures. These procedures typically use specialized catheters, wires, and other tools that are inserted into the body through an artery or vein, usually in the leg or arm.

Endovascular procedures can be used to treat a wide range of conditions, including aneurysms, atherosclerosis, peripheral artery disease, carotid artery stenosis, and other vascular disorders. Some common endovascular procedures include angioplasty, stenting, embolization, and thrombectomy.

The benefits of endovascular procedures over traditional open surgery include smaller incisions, reduced trauma to surrounding tissues, faster recovery times, and lower risks of complications such as infection and bleeding. However, endovascular procedures may not be appropriate for all patients or conditions, and careful evaluation and consideration are necessary to determine the best treatment approach.

The platelet glycoprotein GPIIb-IIIa complex, also known as integrin αIIbβ3 or CD41/CD61, is a heterodimeric transmembrane receptor found on the surface of platelets and megakaryocytes. It plays a crucial role in platelet aggregation and thrombus formation during hemostasis and pathological conditions such as arterial thrombosis.

The GPIIb-IIIa complex is composed of two non-covalently associated subunits, GPIIb (αIIb or CD41) and IIIa (β3 or CD61). Upon platelet activation by various agonists like ADP, thrombin, or collagen, the GPIIb-IIIa complex undergoes a conformational change that allows it to bind fibrinogen, von Willebrand factor, and other adhesive proteins. This binding event leads to platelet aggregation and the formation of a hemostatic plug or pathological thrombus.

Inhibition of the GPIIb-IIIa complex has been a target for antiplatelet therapy in the prevention and treatment of arterial thrombosis, such as myocardial infarction and stroke. Several pharmacological agents, including monoclonal antibodies and small molecule antagonists, have been developed to block this complex and reduce platelet aggregation.

Immunoglobulin (Ig) Fab fragments are the antigen-binding portions of an antibody that result from the digestion of the whole antibody molecule by enzymes such as papain. An antibody, also known as an immunoglobulin, is a Y-shaped protein produced by the immune system to identify and neutralize foreign substances like bacteria, viruses, or toxins. The antibody has two identical antigen-binding sites, located at the tips of the two shorter arms, which can bind specifically to a target antigen.

Fab fragments are formed when an antibody is cleaved by papain, resulting in two Fab fragments and one Fc fragment. Each Fab fragment contains one antigen-binding site, composed of a variable region (Fv) and a constant region (C). The Fv region is responsible for the specificity and affinity of the antigen binding, while the C region contributes to the effector functions of the antibody.

Fab fragments are often used in various medical applications, such as immunodiagnostics and targeted therapies, due to their ability to bind specifically to target antigens without triggering an immune response or other effector functions associated with the Fc region.

Coronary circulation refers to the circulation of blood in the coronary vessels, which supply oxygenated blood to the heart muscle (myocardium) and drain deoxygenated blood from it. The coronary circulation system includes two main coronary arteries - the left main coronary artery and the right coronary artery - that branch off from the aorta just above the aortic valve. These arteries further divide into smaller branches, which supply blood to different regions of the heart muscle.

The left main coronary artery divides into two branches: the left anterior descending (LAD) artery and the left circumflex (LCx) artery. The LAD supplies blood to the front and sides of the heart, while the LCx supplies blood to the back and sides of the heart. The right coronary artery supplies blood to the lower part of the heart, including the right ventricle and the bottom portion of the left ventricle.

The veins that drain the heart muscle include the great cardiac vein, the middle cardiac vein, and the small cardiac vein, which merge to form the coronary sinus. The coronary sinus empties into the right atrium, allowing deoxygenated blood to enter the right side of the heart and be pumped to the lungs for oxygenation.

Coronary circulation is essential for maintaining the health and function of the heart muscle, as it provides the necessary oxygen and nutrients required for proper contraction and relaxation of the myocardium. Any disruption or blockage in the coronary circulation system can lead to serious consequences, such as angina, heart attack, or even death.

Cardiac catheterization is a medical procedure used to diagnose and treat cardiovascular conditions. In this procedure, a thin, flexible tube called a catheter is inserted into a blood vessel in the arm or leg and threaded up to the heart. The catheter can be used to perform various diagnostic tests, such as measuring the pressure inside the heart chambers and assessing the function of the heart valves.

Cardiac catheterization can also be used to treat certain cardiovascular conditions, such as narrowed or blocked arteries. In these cases, a balloon or stent may be inserted through the catheter to open up the blood vessel and improve blood flow. This procedure is known as angioplasty or percutaneous coronary intervention (PCI).

Cardiac catheterization is typically performed in a hospital cardiac catheterization laboratory by a team of healthcare professionals, including cardiologists, radiologists, and nurses. The procedure may be done under local anesthesia with sedation or general anesthesia, depending on the individual patient's needs and preferences.

Overall, cardiac catheterization is a valuable tool in the diagnosis and treatment of various heart conditions, and it can help improve symptoms, reduce complications, and prolong life for many patients.

Pathological constriction refers to an abnormal narrowing or tightening of a body passage or organ, which can interfere with the normal flow of blood, air, or other substances through the area. This constriction can occur due to various reasons such as inflammation, scarring, or abnormal growths, and can affect different parts of the body, including blood vessels, airways, intestines, and ureters. Pathological constriction can lead to a range of symptoms and complications depending on its location and severity, and may require medical intervention to correct.

Interventional ultrasonography is a medical procedure that involves the use of real-time ultrasound imaging to guide minimally invasive diagnostic and therapeutic interventions. This technique combines the advantages of ultrasound, such as its non-ionizing nature (no radiation exposure), relatively low cost, and portability, with the ability to perform precise and targeted procedures.

In interventional ultrasonography, a specialized physician called an interventional radiologist or an interventional sonographer uses high-frequency sound waves to create detailed images of internal organs and tissues. These images help guide the placement of needles, catheters, or other instruments used during the procedure. Common interventions include biopsies (tissue sampling), fluid drainage, tumor ablation, and targeted drug delivery.

The real-time visualization provided by ultrasonography allows for increased accuracy and safety during these procedures, minimizing complications and reducing recovery time compared to traditional surgical approaches. Additionally, interventional ultrasonography can be performed on an outpatient basis, further contributing to its appeal as a less invasive alternative in many clinical scenarios.

Atherectomy is a medical procedure in which the accumulated plaque or deposits in the inner lining of the artery (the endothelium) are removed using a specialized catheter with a cutting device on its tip. The goal of this procedure is to improve blood flow through the artery by physically removing the obstruction, as opposed to other procedures like angioplasty and stenting which use balloons and/or metal scaffolds to open up the artery.

There are several types of atherectomy devices available, including:

1. Directional atherectomy (DA): A rotating blade cuts and removes plaque from the artery wall into a collection chamber within the catheter.
2. Rotational atherectomy (RA): A high-speed burr-like device abrades and pulverizes the plaque, which is then carried away by blood flow.
3. Laser atherectomy: A laser beam vaporizes the plaque, turning it into gas that is absorbed or removed through irrigation.
4. Orbital atherectomy: A high-speed spinning diamond-coated crown abrades and removes plaque while minimizing the risk of damaging the artery wall.

Atherectomy can be an effective treatment option for peripheral arterial disease (PAD) and coronary artery disease (CAD), particularly in cases where angioplasty and stenting are not feasible or have failed. However, like any medical procedure, atherectomy carries certain risks, such as bleeding, infection, perforation of the artery, and distal embolization (the release of plaque particles downstream). Proper patient selection, careful technique, and close follow-up are essential for successful outcomes.

Veins are blood vessels that carry deoxygenated blood from the tissues back to the heart. They have a lower pressure than arteries and contain valves to prevent the backflow of blood. Veins have a thin, flexible wall with a larger lumen compared to arteries, allowing them to accommodate more blood volume. The color of veins is often blue or green due to the absorption characteristics of light and the reduced oxygen content in the blood they carry.

Logistic models, specifically logistic regression models, are a type of statistical analysis used in medical and epidemiological research to identify the relationship between the risk of a certain health outcome or disease (dependent variable) and one or more independent variables, such as demographic factors, exposure variables, or other clinical measurements.

In contrast to linear regression models, logistic regression models are used when the dependent variable is binary or dichotomous in nature, meaning it can only take on two values, such as "disease present" or "disease absent." The model uses a logistic function to estimate the probability of the outcome based on the independent variables.

Logistic regression models are useful for identifying risk factors and estimating the strength of associations between exposures and health outcomes, adjusting for potential confounders, and predicting the probability of an outcome given certain values of the independent variables. They can also be used to develop clinical prediction rules or scores that can aid in decision-making and patient care.

A thrombectomy is a medical procedure that involves the removal of a blood clot (thrombus) from a blood vessel. This is typically performed to restore blood flow in cases where the clot is causing significant blockage, which can lead to serious complications such as tissue damage or organ dysfunction.

During a thrombectomy, a surgeon makes an incision and accesses the affected blood vessel, often with the help of imaging guidance. Specialized tools are then used to extract the clot, after which the blood vessel is usually repaired. Thrombectomies can be performed on various blood vessels throughout the body, including those in the brain, heart, lungs, and limbs.

This procedure may be recommended for patients with deep vein thrombosis (DVT), pulmonary embolism (PE), or certain types of stroke, depending on the specific circumstances and the patient's overall health. It is generally considered when anticoagulation therapy or clot-dissolving medications are not sufficient or appropriate to treat the blood clot.

Intra-aortic balloon pumping (IABP) is a form of short-term mechanical circulatory support that is used in patients with cardiogenic shock or acute complications of coronary artery disease, such as acute mitral regurgitation or papillary muscle rupture. It involves the insertion of a specialized catheter into the aorta, which contains a sausage-shaped balloon at its tip.

The IABP is synchronized with the patient's ECG and inflates the balloon during diastole (when the heart relaxes) and deflates it during systole (when the heart contracts). By inflating the balloon during diastole, the IABP increases the diastolic pressure in the aorta, which improves coronary perfusion and myocardial oxygen supply. By deflating the balloon during systole, the IABP reduces afterload, which decreases the work of the left ventricle and improves cardiac output.

Overall, IABP can help to stabilize patients with acute heart failure or cardiogenic shock while more definitive treatments are being planned or implemented. However, it is not a long-term solution and carries risks such as infection, bleeding, and limb ischemia.

Carotid stenosis is a medical condition that refers to the narrowing or constriction of the lumen (inner space) of the carotid artery. The carotid arteries are major blood vessels that supply oxygenated blood to the head and neck. Carotid stenosis usually results from the buildup of plaque, made up of fat, cholesterol, calcium, and other substances, on the inner walls of the artery. This process is called atherosclerosis.

As the plaque accumulates, it causes the artery to narrow, reducing blood flow to the brain. Severe carotid stenosis can increase the risk of stroke, as a clot or debris from the plaque can break off and travel to the brain, blocking a smaller blood vessel and causing tissue damage or death.

Carotid stenosis is typically diagnosed through imaging tests such as ultrasound, CT angiography, or MRI angiography. Treatment options may include lifestyle modifications (such as quitting smoking, controlling blood pressure, and managing cholesterol levels), medications to reduce the risk of clots, or surgical procedures like endarterectomy or stenting to remove or bypass the blockage.

Ticlopidine is defined as a platelet aggregation inhibitor drug, which works by preventing certain types of blood cells (platelets) from sticking together to form clots. It is used to reduce the risk of stroke and heart attack in patients who have already had a stroke or have peripheral arterial disease.

Ticlopidine is a thienopyridine derivative that selectively inhibits platelet activation and aggregation by blocking the ADP (adenosine diphosphate) receptor on the platelet surface. This action prevents the formation of platelet plugs, which can lead to the development of blood clots in the arteries.

Ticlopidine is available in oral form as tablets and is typically taken twice daily. Common side effects include diarrhea, skin rash, and itching. More serious side effects, such as neutropenia (low white blood cell count), thrombotic thrombocytopenic purpura (TTP), and aplastic anemia, are rare but can be life-threatening.

Due to the risk of serious side effects, ticlopidine is usually reserved for use in patients who cannot tolerate or have failed other antiplatelet therapies, such as aspirin or clopidogrel. It is important to monitor patients taking ticlopidine closely for signs of adverse reactions and to follow the prescribing instructions carefully.

Myocardial perfusion imaging (MPI) is a non-invasive nuclear medicine test used to assess the blood flow to the heart muscle (myocardium). It typically involves the injection of a radioactive tracer, such as thallium-201 or technetium-99m sestamibi, into a vein. The tracer is taken up by healthy heart muscle in proportion to blood flow. A special camera then takes images of the distribution of the tracer within the heart, providing information about areas of reduced or blocked blood flow (ischemia) or scarred tissue (infarction). MPI can help diagnose coronary artery disease, assess the effectiveness of treatments, and determine prognosis.

The subclavian artery is a major blood vessel that supplies the upper limb and important structures in the neck and head. It arises from the brachiocephalic trunk (in the case of the right subclavian artery) or directly from the aortic arch (in the case of the left subclavian artery).

The subclavian artery has several branches, including:

1. The vertebral artery, which supplies blood to the brainstem and cerebellum.
2. The internal thoracic artery (also known as the mammary artery), which supplies blood to the chest wall, breast, and anterior mediastinum.
3. The thyrocervical trunk, which gives rise to several branches that supply the neck, including the inferior thyroid artery, the suprascapular artery, and the transverse cervical artery.
4. The costocervical trunk, which supplies blood to the neck and upper back, including the posterior chest wall and the lower neck muscles.

The subclavian artery is a critical vessel in maintaining adequate blood flow to the upper limb, and any blockage or damage to this vessel can lead to significant morbidity, including arm pain, numbness, weakness, or even loss of function.

A cohort study is a type of observational study in which a group of individuals who share a common characteristic or exposure are followed up over time to determine the incidence of a specific outcome or outcomes. The cohort, or group, is defined based on the exposure status (e.g., exposed vs. unexposed) and then monitored prospectively to assess for the development of new health events or conditions.

Cohort studies can be either prospective or retrospective in design. In a prospective cohort study, participants are enrolled and followed forward in time from the beginning of the study. In contrast, in a retrospective cohort study, researchers identify a cohort that has already been assembled through medical records, insurance claims, or other sources and then look back in time to assess exposure status and health outcomes.

Cohort studies are useful for establishing causality between an exposure and an outcome because they allow researchers to observe the temporal relationship between the two. They can also provide information on the incidence of a disease or condition in different populations, which can be used to inform public health policy and interventions. However, cohort studies can be expensive and time-consuming to conduct, and they may be subject to bias if participants are not representative of the population or if there is loss to follow-up.

Cardiac care facilities are healthcare institutions specifically designed to diagnose, treat, and manage cardiovascular diseases and conditions. These facilities offer a range of services that cater to patients with various heart-related issues, including but not limited to, coronary artery disease, heart failure, arrhythmias, and valvular heart disorders.

There are different levels of cardiac care facilities, each providing specialized care based on the patient's needs:

1. Cardiac Catheterization Laboratories (Cath Labs): These facilities specialize in performing invasive diagnostic and interventional procedures such as coronary angiography, angioplasty, and stenting to diagnose and treat heart conditions.
2. Coronary Care Units (CCUs) or Cardiac Critical Care Units (CVICUs): These units provide intensive care for patients who have experienced acute cardiovascular events such as heart attacks, unstable angina, or life-threatening arrhythmias. They are equipped with advanced monitoring systems and specialized staff to manage critically ill patients.
3. Telemetry Units: These units provide continuous electrocardiogram (ECG) monitoring for patients who are at risk of developing cardiac complications but do not require intensive care. Patients in telemetry units typically have conditions such as stable angina, heart failure, or arrhythmias.
4. Inpatient Cardiology Units: These wards provide general care for patients admitted with various heart conditions. They offer diagnostic services, medical management, and rehabilitation under the supervision of cardiologists and specialized nursing staff.
5. Outpatient Cardiology Clinics: These clinics provide consultations, follow-up care, and diagnostic services for patients with known or suspected heart diseases. They may also offer preventive care and education to promote heart health.
6. Cardiac Rehabilitation Programs: These programs focus on helping patients recover from cardiovascular events or procedures by providing exercise training, risk factor modification, and psychosocial support.

It is important to note that the specific services offered may vary between different facilities, and patients should consult with their healthcare providers to determine the most appropriate care setting for their needs.

Fibrinolytic agents are medications that dissolve or break down blood clots by activating plasminogen, which is converted into plasmin. Plasmin is a proteolytic enzyme that degrades fibrin, the structural protein in blood clots. Fibrinolytic agents are used medically to treat conditions such as acute ischemic stroke, deep vein thrombosis, pulmonary embolism, and myocardial infarction (heart attack) by restoring blood flow in occluded vessels. Examples of fibrinolytic agents include alteplase, reteplase, and tenecteplase. It is important to note that these medications carry a risk of bleeding complications and should be administered with caution.

The iliac arteries are major branches of the abdominal aorta, the large artery that carries oxygen-rich blood from the heart to the rest of the body. The iliac arteries divide into two branches, the common iliac arteries, which further bifurcate into the internal and external iliac arteries.

The internal iliac artery supplies blood to the lower abdomen, pelvis, and the reproductive organs, while the external iliac artery provides blood to the lower extremities, including the legs and feet. Together, the iliac arteries play a crucial role in circulating blood throughout the body, ensuring that all tissues and organs receive the oxygen and nutrients they need to function properly.

  • In this manuscript, we focus on the broad aviation medicine considerations that are required to optimally manage aircrew with established coronary artery disease in those without myocardial infarction or revascularisation (both pilots and non-pilot aviation professionals). (bmj.com)
  • Instantaneous wave-free ratio guided multi-vessel revascularisation during percutaneous coronary intervention for acute myocardial infarction (iMODERN). (monash.edu)
  • First Myocardial Resting or First Myocardial Revascularization for Cardiogenic Shock After Acute Myocardial Infarction-Related Cardiac Arrest? (maastrichtuniversity.nl)
  • Medical care for a disease or condition that predisposes children to acute myocardial infarction (AMI) is discussed more fully elsewhere (see Anomalous Left Coronary Artery from the Pulmonary Artery and Kawasaki Disease). (medscape.com)
  • The severity of myocardial infarction (MI) symptoms at presentation determines whether the patient is admitted to an intensive care unit (ICU) for aggressive medical management of congestive heart failure (CHF) before surgical revascularization. (medscape.com)
  • In this large, prospective cohort of women, active migraine with aura was associated with increased risk of major CVD, myocardial infarction, ischemic stroke, and death due to ischemic CVD, as well as with coronary revascularization and angina. (nih.gov)
  • ST-elevation myocardial infarction is commonly caused by intracoronary plaque rupture with thrombus formation and acute vessel closure in single coronary artery that is labelled as the culprit. (journalcra.com)
  • Groups were balanced at baseline with a mean age of 65 years, 48% were women, the mean LDL level was 139 mg/dL, 70% had a prior myocardial infarction (MI), and 46% had diabetes (including 20% with uncontrolled diabetes). (joulecma.ca)
  • Post-procedural anticoagulation after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: a multicent. (crtonline.org)
  • To reduce the risk of myocardial infarction, myocardial revascularization procedures, and cardiovascular mortality in adults with elevated low-density lipoprotein cholesterol (LDL-C) without clinically evident coronary heart disease (CHD). (nih.gov)
  • To reduce the risk of coronary death, myocardial infarction, myocardial revascularization procedures, stroke or transient ischemic attack, and slow the progression of coronary atherosclerosis in adults with clinically evident CHD. (nih.gov)
  • 2. History of recent myocardial infarction (attributed to coronary artery disease) or unstable angina within the previous 3 months 3. (nih.gov)
  • Diabetic patients with history of myocardial infarction or coronary revascularization 4. (nih.gov)
  • As previously discussed, the keys to achieving a good outcome in patients with cardiogenic shock are rapid diagnosis, prompt supportive therapy, and expeditious coronary artery revascularization in patients with myocardial ischemia and infarction. (medscape.com)
  • The diagnosis of acute myocardial infarction (MI) is aided by a variety of serum markers, which include creatine kinase (CK) and its subclasses, troponin, myoglobin, and LDH. (medscape.com)
  • Patients with acute myocardial infarction on admission were excluded. (bmj.com)
  • Main outcome measure Cardiovascular disease (myocardial infarction, stroke, coronary revascularisation, or cardiovascular death). (bmj.com)
  • The clinical unit is located at the Department of Cardiology and focuses on prospective studies of patients with ST-elevation myocardial infarction (STEMI) who are treated with primary percutaneous coronary intervention. (gu.se)
  • The primary endpoint was the first event of repeat revascularization, myocardial infarction, stroke, or cardiovascular mortality. (lu.se)
  • Cost Effectiveness of a CYP2C19 Genotype-Guided Strategy in Patients with Acute Myocardial Infarction: Results from the POPular Genetics Trial. (cdc.gov)
  • The majority of CVD events experienced were nonfatal myocardial infarction (MI), silent MI, and revascularization. (medscape.com)
  • The 2021 OMEMI trial (Omega-3 Fatty acids in Elderly with Myocardial Infarction) was a randomized clinical trial in which 1027 patients aged 70 to 82 years with recent (2 to 8 weeks) acute myocardial infarction were treated with 1.8 g of n-3 polyunsaturated fatty acids (PUFA) (930 mg eicosapentaenoic acid and 660 mg docosahexaenoic acid) or placebo (corn oil) daily in addition to standard of care. (msdmanuals.com)
  • The primary endpoint was a composite of nonfatal acute myocardial infarction, unscheduled revascularization, stroke, all-cause death, and heart failure hospitalization after 2 years. (msdmanuals.com)
  • This type of heart attack is called an ST segment elevation myocardial infarction (STEMI). (medlineplus.gov)
  • 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). (medlineplus.gov)
  • Intensive care and acute management of the infant with symptoms of coronary artery ischemia or injury are initially directed at reducing myocardial oxygen demands while administering oxygen, fluids, or blood products, providing endotracheal intubation, and correcting acid-base status and paralysis to reduce the work of breathing. (medscape.com)
  • Conversely, inotropic support may increase myocardial oxygen consumption significantly, which, in the presence of reduced myocardial blood flow, may worsen ischemia. (medscape.com)
  • Cardiac dysrhythmia secondary to preoperative myocardial ischemia or MI is likely. (medscape.com)
  • Angina pectoris is the result of myocardial ischemia caused by an imbalance between myocardial blood supply and oxygen demand. (medscape.com)
  • Myocardial ischemia--metabolic pathways and implications of increased glycolysis. (smw.ch)
  • Revascularization of chronic hibernating myocardium stimulates myocyte proliferation and partially reverses chronic adaptations to ischemia. (smw.ch)
  • Of 97 such patients, about 44% underwent CAD/ischemia testing by invasive angiography, myocardial functional imaging, or both. (medscape.com)
  • The findings "argue against performing routine evaluations to rule out coronary [disease] or myocardial ischemia as culprits in monomorphic VT storm" in patients without evidence of ACS, write Feras Alkhalaileh, MD, Heart and Vascular Institute, Cleveland Clinic, Ohio, and colleagues in their report published August 2 in JACC: Clinical Electrophysiology . (medscape.com)
  • The preclinical work focuses on animal models of myocardial ischemia-reperfusion injury, which is an experimental model for STEMI, as well as ex-vivo models of myocardial ischemia. (gu.se)
  • Coronary artery bypass grafting (CABG) was introduced in the 1960s as the first procedure for direct coronary artery revascularization and rapidly became one of the most common surgical procedures worldwide, with an overall total of more than 20 million operations performed. (perfusion.com)
  • 2021 ACC/AHA/SCAI guideline for coronary artery revascularization: executive summary: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. (medlineplus.gov)
  • Surgical myocardial revascularization without cardiopulmonary bypass (CPB) is not new, with the first consecutive series of patients appearing in the early eighties. (unifesp.br)
  • Atrial fibrillation is a common complication after procedures of myocardial revascularization, performed with or without cardiopulmonary bypass. (annalskemu.org)
  • However, much of this research received little attention because it was not considered nearly as promising as the emerging techniques involving direct myocardial revascularization, such as CABG and angioplasty. (medscape.com)
  • The primary outcome was a composite of cardiovascular death, nonfatal stroke, nonfatal MI, or coronary revascularization and was assessed after a median follow-up of 41 months. (joulecma.ca)
  • He is known to perform Percutaneous Myocardial Laser Revascularization, reported to be among the few cardiologists in the World to perform the procedure. (wikipedia.org)
  • The research included 114 patients 3 months after myocardial revascularization by coronary artery by-pass grafting or percutaneous coronary angioplasty. (bulmed.md)
  • Introduction Spain is one of the countries with the lowest rates of revascularisation and highest ratio of percutaneous coronary intervention (PCI) to coronary artery bypass grafting (CABG). (bmj.com)
  • Surgical revascularization may also be necessary in patients with Kawasaki disease who develop significant coronary stenoses or occlusion. (medscape.com)
  • Short-term use of oral digoxin, diuretics, and angiotensin-converting enzyme (ACE) inhibitors is common after surgical revascularization. (medscape.com)
  • Surgical revascularization is usually necessary in the event of AMI. (medscape.com)
  • Once the patient is stabilized, surgical revascularization is performed to create a patent coronary arterial distribution (see Anomalous Coronary Artery from the Pulmonary Artery: Surgical Perspective). (medscape.com)
  • Prospective studies were carried out in a group of 100 patients qualified for the surgical myocardial revascularisation in the planned course. (psychiatriapolska.pl)
  • View of Comorbidities in Patients before Surgical Myocardial Revascularization: Current State of the Problem. (org.ua)
  • Twenty-year experience with skeletonized bilateral internal thoracic arteries for surgical myocardial revascularization. (c3m-nice.fr)
  • The first attempts at improving myocardial blood supply were designed to increase collateral circulation from extracardiac sources. (medscape.com)
  • Transmyocardial laser revascularization (TMLR) is based on the use of a high-powered carbon dioxide or other laser that interjects a strong energy pulse into the left ventricle, vaporizing the ventricular muscle and creating a transmural channel with a 1-mm diameter. (medscape.com)
  • The current study aimed to evaluate the prognostic role of RDW in patients undergoing cardiac rehabilitation after myocardial revascularization and/or cardiac valve surgery. (uninsubria.it)
  • 492 patients (48%) underwent cardiac rehabilitation after myocardial revascularization, 371 (36%) after cardiac valve surgery, 102 (10%) after valve-plus-coronary artery by-pass graft surgery, 66 (6%) for other indications. (uninsubria.it)
  • Cardiac troponins T and I are widely used for the diagnosis of myocardial injury. (medscape.com)
  • Cardiac troponin-I (cTnI) is a biomarker of myocardial injury with implications for clinical outcomes. (thieme-connect.de)
  • There are several types of cardiovascular surgery: myocardial revascularization, correction of valvular diseases such as their repair or replacement, diseases of the aorta, correction of congenital heart disease, cardiac pacemaker implantation and heart transplant 1 . (bvsalud.org)
  • Although coronary artery bypass grafting (CABG) is effective in many patients, some are not candidates for direct revascularization procedures. (medscape.com)
  • The aim of the paper is to define a relationship between the anxiety level and depression intensification, as well as to define the impact of: age, sex, education level and family situation on the anxiety level and depression intensification in the pre- and postoperative period in patients subjected to myocardial revascularisation (CABG). (psychiatriapolska.pl)
  • The aim of this study was to determine whether revascularisation of an infarct-related artery chronic total occlusion (IRA-CTO) has a modulatory effect on myocardial scar composition. (pcronline.com)
  • Acidosis can have a particularly deleterious effect on myocardial function. (medscape.com)
  • These initial data supported attempts to improve myocardial perfusion by creating mechanisms for a direct flow of blood from the ventricular cavity to the myocardium, thus mimicking the anatomy of the reptilian heart, in which much of the myocardium is perfused with blood directly from the ventricular cavity. (medscape.com)
  • The aims of premedication are to minimize myocardial oxygen demands by reducing heart rate and systemic arterial pressure and to improve myocardial blood flow with vasodilators. (medscape.com)
  • Bempedoic acid provides a reduction in nonfatal MI and the need for coronary revascularization without changing mortality. (joulecma.ca)
  • Delay in revascularization is associated with increased mortality rate in patients with severe left ventricular dysfunction and viable myocardium on fluorine 18-fluorodeoxyglucose positron emission tomography imaging. (smw.ch)
  • Predictive factors of in-hospital mortality and ofsevere perioperative complications in myocardial revascularization surgery. (bvsalud.org)
  • In order to clear up these problems we carried out a prospective single-centre study including a total of 151 patients suffering from ischaemic heart diseases with a left ventricular ejection fraction of less than 35%, who were subjected to endovascular myocardial revascularization. (angiolsurgery.org)
  • This is a unique, first-time report of three consecutive patients presenting with myocardial scar-related recurrent ventricular tachycardia (rVT) on a background of ischaemic cardiomyopathy. (pcronline.com)
  • IRA-CTO PCI may positively modify the size and composition of myocardial scar associated with rVT in the context of ischaemic cardiomyopathy. (pcronline.com)
  • The simultaneous thrombotic occlusions of more than one coronary artery in the setting of STEMI is a rare entity, which is not fully addressed in the current STEMI guidelines, although more recent studies suggest a benefit of complete revascularization compared to culprit vessel-only treatment in the setting of STEMI. (journalcra.com)
  • Postoperative Atrial Fibrillation After Conventional and Beating Heart Myocardial Revascularization: Is there a culprit? (annalskemu.org)
  • Regional myocardial perfusion also may be improved, but this has not been convincingly confirmed on thallium scintigraphy. (medscape.com)
  • In 1968, Sen et al described marked improvements in patients with chronic angina following transmyocardial revascularization. (medscape.com)
  • However, by means of transcutaneous coronary intervention (TCI) it is not always possible to perform complete anatomical myocardial revascularization. (angiolsurgery.org)
  • The subject concerning the necessity of complete myocardial revascularization, changes of anatomy and physiology of the heart, clinical state of patients with a low left ventricular ejection fraction after endovascular intervention has not been sufficiently explored. (angiolsurgery.org)
  • In contrast, monomorphic VT storm is likely caused by myocardial scar, which revascularization cannot treat. (medscape.com)
  • As reported, 10% of the cohort underwent coronary angiography after presentation with monomorphic VT storm, 26% had CT or PET myocardial functional imaging, and 9% had both tests. (medscape.com)
  • Monomorphic VT later recurred in four of the five patients, who then underwent coronary revascularization. (medscape.com)
  • Genetics, coronary artery disease, and myocardial revascularization: will novel genetic risk scores bring new answers? (cdc.gov)
  • As previous studies have revealed, postoperative chylothorax is a rare complication of cardiothoracic surgery procedures, especially myocardial revascularization [1-4]. (who.int)
  • Off-pump coronary surgery is an alternative method of myocardial revascularization that should be considered for every patient. (unifesp.br)
  • Off-pump myocardial revascularization represents an important development in coronary artery surgery. (unifesp.br)
  • Nor did they significantly affect the likelihood or outcomes of preablation revascularization or 2-year survival. (medscape.com)
  • This figure represents an overall applicability of 30.8% considering a total of 12,553 revascularization procedures performed during this time. (unifesp.br)
  • Objectives To investigate the changes and trends in the two revascularisation procedures between 1998 and 2017 in Spain. (bmj.com)
  • through close monitoring of cholesterol, blood glucose, farction or revascularization or death due to CHD. (cdc.gov)
  • the preference of this technique over conventional revascularization should be based on the surgeon's own experience, on the patient's preoperative condition and on the coronary anatomy. (unifesp.br)
  • Right ventricular dysfunction (RVD) appears to be an independent predictor of exercise intolerance, but its influence on patients' exercise capacitiy in the early period after myocardial revascularization remains unclear. (bulmed.md)
  • There was a 23% reduction in MI, which was statistically significant, and there was a 19% reduction in coronary revascularization. (medscape.com)
  • Results We observed a 2.2-fold increase in the rate of any type of myocardial revascularisation per million inhabitants-year: 357 (1998) to 776 (2017). (bmj.com)
  • There is controversy regarding advantages, risks, and usefulness of this method of myocardial revascularization. (unifesp.br)
  • On this ground, promising seems to be a method of endovascular myocardial revascularization, which is associated with a minimal number of intraoperative and postoperative complications. (angiolsurgery.org)