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3. Thrombolysis with recombinant tissue plasminogen activator in late saphenous vein graft thrombosis

Author

Blanck, Zalmen, Cheirif, Jorge, Blick, David R., Harris, Scott L., and Heibig, Jacques

Subjects
Coronary artery bypass -- Complications, Coronary heart disease -- Care and treatment, Tissue plasminogen activator -- Health aspects, Coronary artery bypass -- Case studies, Health, Activase -- Health aspects
Abstract

Coronary bypass procedures replace one or more coronary arterial segments with grafts from veins or arteries. However, after five years, vein grafts tend to become blocked by thromboses (clots) and by formation of fatty plaques due to atherosclerosis. A case is reported of successful treatment of a late occurrence of vein graft thrombosis. Twelve years after bypass surgery, a 77-year-old man began having chest pain (angina) at rest and during exercise. Following determination by cardiac catheterization that several coronary arteries were stenosed (constricted), with extensive thrombosis in the vein grafts, the patient was treated with recombinant tissue plasminogen activator (rt-PA), a synthetic protein which breaks up clots. This therapy removed the obstruction in the vein graft, and the remaining constriction was decreased by balloon angioplasty, a catheterization technique. No complications ensued, and the patient recovered normally. The study suggests that systemic thrombolytic therapy with rt-PA may become an important treatment of late coronary graft thrombosis because of the increasing numbers of patients undergoing bypass surgery; further study is needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1990

9. Arteriographic Demonstration of Coronary Artery Spasm during Thrombolysis

Author

Karim, Amin H., Bennett, William, Silver, Saul J., Kleiman, Neal S., Goodman, Dennis, and Heibig, Jacques

Subjects
cardiovascular system, cardiovascular diseases, Case Reports
Abstract

A 60-year-old man with an acute inferior-wall myocardial infarction was noted, on arteriography, to have an occluded distal right coronary artery. The vessel was reopened with intravenous tissue plasminogen activator; during resolution of the clot, spasm was observed arteriographically but was successfully treated with intracoronary nitroglycerin. Follow-up arteriography showed a normal right coronary artery. The significance of this case lies in the fact that we were able to document the occurrence of spasm during coronary thrombolysis; such documentation supports the hypothesis that spasm may be a factor in the initiation of coronary thrombosis.

Published
1988

14. Cardiovascular surgery in Saudi Arabia

Author

Beall, Arthur C., primary, Guinn, Gene A., additional, Mattox, Kenneth L., additional, Lawrie, Gerald M., additional, Whisennand, Hartwell S., additional, Feteih, Nizar, additional, Heibig, Jacques, additional, Fawsy, Mohammed E., additional, Tabbaa, Rashid, additional, Mardini, Mohammed, additional, and DeBakey, Michael E., additional

Published
1981
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