ABSTRACT
To determine the frequency of atheromatous coronary artery disease in patients with myocardial bridge. Descriptive study. AFIC/NIHD Rawalpindi from September 2010 to November 2010. Patients undergoing MSCT angiography for diagnosis of CAD having an abnormal finding were included. Patients with history of prior coronary artery bypass grafting [CABG], coronary stenting and with chronic total occlusions were excluded. Computed Tomographic [CT] examinations were performed with a dual-source CT scanner. Scanning parameters: detector collimation, 2 x 32 x 0.6 mm; slice collimation, 2 x 64 x 0.6 mm; gantry rotation time, 330 milliseconds; tube current-time product, 350 mAs per rotation and tube potential 120 kV. Reconstructions done and data transmitted to workstations and analyzed. Myocardial bridge [MB] was diagnosed and evaluated when an intramuscular segment of LAD artery was visualized on axial, volume rendered and multiplanar reformation [MPR] images. Out of 232 patients 32% had MB. Males were three times more likely to have Myocardial bridge [MB]. Mid and distal LAD showed 54% and 45% MBs respectively. Fourteen percent had evidence of atherosclerosis proximal to MB segment. Mean length and depth of MB segment was 18mm and 1.8mm respectively. Superficial type was most common [44%], followed by deep type [33%] while RV type was least common [23%].Frequency of patients with myocardial bridge having concomitant atheromatous coronary artery disease was 14%
ABSTRACT
Observation of different computed tomography findings in patients suffering from pulmonary embolism. All patients who underwent computed tomography for pulmonary embolism and had positive findings of pulmonary embolism, were included in the study. Armed Forces Institute of Cardiology/ National Institute of Heart Disease, between April 2009 and October 2010. Patients on mechanical ventilation were excluded from the study. CT pulmonary angiograms were obtained with 64 slice dual source computed tomography [DSCT] machine [Somatom definition] from Siemens. Before scanning breath holding was taught. A craniocaudal acquisition was obtained with a collimation of 64 x 0.6 mm and a pitch of 1.2-1.4. Total number of patients included in the study were 34 with mean age 50 years. The mean of Score by Miller was 10 +/- 5.532 and the mean percentage obstruction by method of Miller was 62.5%. The mean of Score by Qanadli was 19.62 +/- 12.32 and the mean percentage obstruction by method of Qanadli was 49.04%. The mean of Score by Mastora was 54.53 +/- 33.27 and the mean percentage obstruction by method of Mastora was 35.18%. Calculated mean and SD of right ventricular [RV] diameters was 44 +/- 7.75mm, left ventricular [LV] diameter was 32 +/- 8.06mm, RV/LV ratio was 1.508 +/- 0.58 mm, main pulmonary artery [PA] luminal diameter was 29 +/- 4.16mm, ascending aorta size was 32.46 +/- 5.14mm, PA/Aorta ratio was 0.913 +/- 0.188mm, Azygos Vein diameter was 11.14 +/- 1.88mm and superior vena cava [SVC] diameter [at azygos arch] was 18.93 +/- 3.37 mm. Correlation between methods was generally significant. Reflux of contrast injection was noted in 24 out of 34 patients, leftward bowing of inter-ventricular septum was observed in 21 patients, pleural effusion was noted in 10 patients and pericardial effusion was seen in only 3 patients. CT pulmonary angiography has emerged as a reliable non invasive tool for not only confirmation of diagnosis of pulmonary embolism in short time but also gives valuable information about prognosis of these critically ill patients. Further it can provide accurate follow up of thrombolytic therapy and can help plan an interventional strategy
Subject(s)
Humans , Male , Female , Pulmonary Embolism/diagnostic imaging , Multidetector Computed TomographyABSTRACT
The purpose of this study was to evaluate the frequency of incidental extra-cardiac findings on MSCTcoronary angiography. Patients undergoing MSCT angiography were included. Coronaries were interpreted with limited field of view [FOV] reconstructions. Reconstruction using larger FOV were used to examine and detect extra-cardiac incidental findings. All extra-cardiac structures were reviewed systematically. Patients were divided in two groups on basis of age, younger 50 years. Out of 307 patients included in the study,87 [28%] had extra-cardiac incidental findings. Patients in the older age group i.e., more than 50 years were significantly [p = 0.004] more likely to have incidental findings. Most common finding was pericardial fat pad. Most of the findings were not of clinical significance. Only 2 pulmonary nodules were detected. Extra-cardiac findings are commonly detected on MSCT cardiac scans especially in older patients with larger FOV reconstructions. Most of the findings are of minor clinical significance, only few are important. Routine screening of cardiac scans for extra-cardiac incidental findings is not mandatory
ABSTRACT
Failure of Saphenous vein grafts [SVG], an almost universally used conduit in coronary artery bypass grafting [CABG] patients, is a common problem. Distal embolization during percutaneous coronary intervention [PCI] of SVG can have serious consequences. Use of embolization protection devices [EPD] has resulted in lesser incidence of such complications. Spider Rx is a distal protection filter device, experience and results of use of this device are presented. This study was conducted at the interventional cardiology department of Armed Forces Institute of Cardiology National Institute of Heart Diseases during a period from Feb 2007 to May 2009. All patients having indications for PCI, angina CCS class I to IV, to vein grafts more than three years after CABG was included. Patients with acute myocardial infarction and totally occluded SVGs were excluded. No flow or slow flow phenomenon and pre and post procedure CKMB, at six and twenty four hours, levels were measured. Spider RX distal embolization protection is easy to use and its use resulted in embolization protection comparable to that of other devices reported in literature