H EART disease, especially coronary artery disease, continues to be one of the foremost problems in medicine today. A good estimate is that about one third of those who die from heart disease in the United States do so from a primary coronary insufficiency related to atherosclerosis as the dominant factor, one third die from primary coronary insufficiency associated with cardiac hypertrophy and...

OBJECTIVES To determine the prevalence of echocardiographic abnormalities and identify associated clinical and laboratory features in a large systemic lupus erythematosus (SLE) cohort. METHODS Patients fulfilling ACR criteria for SLE underwent a transthoracic echocardiogram (TTE) between January 2005 and June 2006. Variables used as potential correlates included age, sex, ethnicity, lupus dur...

OBJECTIVE To assess the results of a technical modification of tricuspid valvuloplasty in Ebstein's anomaly. METHODS From November 1993 to August 2002, 21 patients with Ebstein's anomaly of the tricuspid valve, with ages ranging from 20 months to 37 years (mean, 23 years), underwent a new technique of tricuspid valvuloplasty. This technique consisted of total or almost total detachment of the...

AIM While the incidence of rheumatic heart disease has declined dramatically over the last half-century, the number of valve surgeries has not changed. This study was undertaken to define the most common type of valvular heart disease requiring surgery today, and determine in-hospital surgical mortality and length-of-stay (LOS) for isolated aortic or mitral valve surgery in a United States tert...

OBJECTIVES To prove whether different indications for valve sparing aortic root reconstruction may have an impact on the outcome and longevity of the repair. METHODS From July 1993 to March 2003, the reimplantation technique for valve sparing aortic root reconstruction was applied to 232 patients. In 44 patients, indication for operation was acute aortic dissection type A (AADA). These patien...

BACKGROUND Head and neck movements may cause vascular compression that produces a syndrome of vertebrobasilar insufficiency. Vertebrobasilar circulation was examined noninvasively in two patients who were able to provoke these symptoms repeatedly on demand. CASE DESCRIPTIONS Blood flow velocities in the basilar artery (case 1) and both posterior cerebral arteries (both cases) were measured co...

BACKGROUND It has been proposed by Zamboni and colleagues that multiple sclerosis is caused by chronic cerebrospinal venous insufficiency, a term used to describe ultrasound-detectable abnormalities in the anatomy and flow of intra- and extracerebral veins. We conducted a meta-analysis of studies that reported the frequency of chronic cerebrospinal venous insufficiency among patients with and t...

Adrenal insufficiency is caused by either primary adrenal failure (mostly due to autoimmune adrenalitis) or by hypothalamic-pituitary impairment of the corticotropic axis (predominantly due to pituitary disease). It is a rare disease, but is life threatening when overlooked. Main presenting symptoms such as fatigue, anorexia, and weight loss are non-specific, thus diagnosis is often delayed. Th...

Background The stentless porcine aortic root prosthesis (SPAR) has been described as a suitable valve for right ventricular outflow tract reconstruction (RVOTR). Indiana University Methodist Hospital in Indianapolis, began using this RVOTR 1998. This study reports medium-term to late- term outcomes of the pulmonary position. Methods A retrospective chart review was conducted p...

The ambulatory electrocardiographic (ECG) monitor is a device developed approximately 30 years ago to detect, locate and document hemodynamic insufficiency states in target organs with compromised regional arterial circulations. These insufficiency states are usually silent until they are suddenly precipitated by secondary remote, hemodynamically significant cardiac arrhythmias, hypotensive sta...