Primary percutaneous coronary aspiration of thrombus from infarct related artery

We are reporting the case of a 48-year-old man hypertensive, and smoker presenting with acute inferoposterior ST elevation myocardial infarction [STEMI] with right ventricular infarction. He underwent diagnostic angiogram which revealed total occlusion of mid right coronary artery [RCA] by thrombus. Multiple runs of aspiration were performed using Export Aspiration Catheter-6F and thrombus was aspirated from RCA. Postaspiration stenting was deferred due to absence of any significant obstructive lesion. Some thrombus had migrated to distal right posteriolateral branch [RPLB]. He was started on glycoprotein [GP] IIb IIIa inhibitors which had to stopped after a few hours due to upper gastrointestinal bleed. After 48 hours a re-look angiogram demonstrated good flow in RCA with resolution of the residual thrombus

frequency of HBV, HCV and HIV in patients undergoing percutaneous mitral valvuloplasty

Objective: Determine the frequency of Hepatitis B, C and HIV in patients undergoing mitral valvuloplasty with multitrack balloon catheters

Methods: This was a cross sectional study in which 100 consecutive patients of both sexes underwent percutaneous Mitral Valvuloplasty with multi track balloons catheters at the National Institute of Cardiovascular Diseases Karachi from January 2003 to December, 2004. The Viral markers of Hepatitis B Surface Antigen and Antibodies against Hepatitis C and HIV was done in all patients undergoing PTMC prior to procedure

Results: Out of 100 patients undergoing PTMC with multi track balloon catheters, 78 patients were females while 22 of them were males. Screening of these patients showed that 14% of them were Sero positive for HBV while 8% positive for HCV. None of screened patients were HIV positive

Conclusion: 1] The frequency of hepatitis B, C and HIV in patients undergoing PTMC [14% and 8%], as compared to normal population [2.56% for HBsAg] and [5.31% for anti-HCV] respectively. 2] In our country most of patients are non-affording and we have to reuse balloon catheters, so it should be mandatory to screen hepatitis B, C and HIV before undergoing invasive procedures. Balloon used in seropositive patients should be discarded. 3] National guidelines regarding reuse of various hardwire and other preventive measures are mandatory for patient's safety