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Quantitative studies of left ventricular function using 2-dimensional echocardiography have been limited because of a lack of computerized methods to automatically analyze the echocardiographic images. Previous computer efforts have been directed at digitizing the video output of the 2-D echocardiogram, but this digitizing method has significant limitations. A direct digitization method that produces improvement in signal-to-noise ratio and, subsequently, improved automatic detection of endocardial and epicardial borders, was developed. With definition of these edges, left ventricular global and regional analysis is possible frame by frame so that dynamic changes in cardiac function may be assessed throughout the cardiac cycle. Further technologic advances in 2-D echocardiographic acquisition and image processing should allow computer processing of 2-D echocardiographic data in real time.

Carotid artery reconstruction surgery for atherosclerotic lesions of the extracranial cerebral circulation has become the most common peripheral vascular operation. A better understanding of the indications for operative intervention, enhanced monitoring during surgery, and more precise management of intraoperative anesthesia have all decreased the risks associated with internal carotid endarterectomy (ICA). In an effort to evaluate the safety and efficacy of extracranial carotid reconstructive surgery, we reviewed 3028 operations performed in 2198 patients during the past decade (1977-1986). Operation was recommended because of hemispheric symptoms in 59% of cases. Fourteen percent were advised to have endarterectomy because of an asymptomatic, significant ICA stenosis. Postoperative hemiparesis occurred in 24 patients (1.1%) and was associated with thrombosis at the operative site in 18 patients. Antiplatelet drugs utilized during the last four years were effective in preventing thrombosis at the operative site. Operative mortality during the decade was 1.2%. Follow-up has ranged from one to. 104 months with 86% of the patients alive and 87% symptom free.