Percutaneous transluminal angioplasty versus cononary artery bypass grafting in patients with depressed left ventricular function

The aim of this study was to compare clinical and functional status after coronary artery bypass grafting or percuraneous coronary angioplxty [PTCA]. The study included 96 patients; 86 patients were males and 10 patients were females with age ranged from 28 years to 66 years [mean of 29]. The patients were divided into two groups, group I undergoing CABG and group II undergoing PTCA. Assessment of global left ventricular function via measuring ejection fraction by modified Simpson's role technique and regional systolic function by dividing the left ventricular into 16 segments as documented by ASE was carried out. LV function indices improved slightly significant or non- significantly in CABG group than PTCA and both groups had the same survival rate. The need for intervention was more in PTCA group. In-hospital mortality was more in CABG group, anginal attacks and need for anti ischemic medications were more prevalent in PTCA group. There was no significant difference between both groups regarding quality of life. The study concluded that CABG does not appear to be associated with unacceptable morbidity. Patients with graftable vessels and reduced EF should not be denied CABG on the basis of their reduced LV function, for many of these patients CABG is probably the most appropriate treatment

Flow convergence region as a method for evaluation of mitral valve area in mitral stenosis

The aim of this study was to assess the feasibility and accuracy of flow convergence region method [FCR] to the accepted techniques in assessing mitral valve area [MVA]. The study was carried out on 40 patients with rheumatic mitral stenosis [MS]; 20 patients were in sinus rhythm [SR] and 20 had AF. Ten patients had isolated MS, ten had combined MS and mitral regurgitation [MR], seven had MS and aortic regurgitation [AR] and thirteen had MS, MR and AR. All regurgitant lesions were mild. MVAs were estimated by flow convergence region [FCR], planimetry and pressure half time [PHT] using transthoracic echocardiography [TTE] and by FCR and PHT using transesophageal echocardiography [TEE]. The results showed that the mean MVA values determined by different methods both in TTE and TEE did not differ significantly. MVA values were determined by FCR, correlated significantly with those obtained by planimetry and PHT using TTE. Also, MVAs were determined by FCR correlated significantly with those obtained by PHT using TEE. There was a highly significant correlation between TTE and TEE measurements of FCR as well as TTE and TEE measurement of PHT. The feasibility of estimation of MVA by FCR was 100% by both TTE and TEE