No abstract

The Cardiovascular Angiography Analysis System (CAAS) has been completely redesigned and transferred to a modern platform. The user-friendly environment together with a number of image processing techniques and tools allow easy and fast analysis of cardiovascular angiographic images. These images are obtained either on-line by means of a frame grabber hooked on the video output of the X-ray equipment or off-line by digitising 35-mm cine film frames. In addition, images can be acquired more directly by means of a network link. Images stored on disk in different formats, including MS-DOS, can also be analysed. Accurate and reliable quantitative analysis of coronary stenoses and assessment of their related functional significance may offer the clinician a tool in a stratification of patients at risk. The semireal-time environment will make it possible for the cardiologist to quickly respond to the results of recanalisation procedures while the patient is still in the catheterisation laboratory. The addition of a video front end makes the system available to all clinically relevant X-ray imaging equipment. A detailed comparison with the former CAAS on the basis of analysis of 40 arterial segments in routinely acquired cineangiograms demonstrated no statistically significant differences between the two analysis systems. Repeated analysis of the same segments yielded inter- and intraobserver variabilities for the obstruction diameter of 0.096 and 0.108 mm, respectively. For the computed reference diameter the values are 0.099 and 0.096 mm, respectively, and for the percentage diameter stenosis 4.67 and 5.37%, respectively.

Precise placement of the Tulip filter is feasible by either access route and the device appears mechanically stable. Further observations are needed to confirm that safe filter removal is practical up to 10 days after its insertion.

Supraventricular arrhythmias continue to complicate the postoperative course of patients following coronary artery bypass grafting. In a randomized, open, controlled trial we assessed the value of two different beta-blocking agents in the prevention and treatment of these arrhythmias. Of 151 consecutive patients undergoing coronary artery surgery, 39 were treated with metoprolol and 41 were treated with sotalol (a beta blocker with class III antiarrhythmic properties). Fifty patients served as a control group and received no prophylactic therapy. Twenty-one patients were eliminated from the study for various reasons, making a final total of 130 in the study group. In the metoprolol group 15.3% of patients developed supraventricular tachycardia SVT after coronary artery surgery, which was significantly less (p less than 0.05) than the incidence observed in the control group. However, in the group of patients receiving sotalol, 2.4% developed SVT (p less than 0.01 compared with the control group). Of 18 patients in the control group who developed SVT after randomization, 10 received sotalol and 4 metoprolol to terminate the arrhythmia. The mean time of termination of SVT after drug administration was 2.4 +/- 1.8 hours for treatment with sotalol and 13.6 +/- 9.8 hours for treatment with metoprolol. We conclude that sotalol significantly reduces the incidence of supraventricular tachycardia in the early period after coronary artery bypass surgery.