ABSTRACT
Background: Aim of our study was to predict the effect of subvalvular changes on mitral valve leaflets excursion in a patient with mitral stenosis following percutaneous trans-venous mitral commissurotomy. Methods: Total of 60 patients of severe mitral stenosis were enrolled in the study. Transthoracic echocardiography was done on the day before percutaneous trans-venous mitral commissurotomy and 24-48 hours after percutaneous trans-venous mitral commissurotomy. Subvalvular area, anterior and posterior leaflets excursion were recorded. Results: Following percutaneous trans-venous mitral commissurotomy there were significant increase in anterior leaflet excursion from 1.8 ± 0.2 to 2.2 ± 0.2cm (p=<0.001), posterior leaflet excursion from 1.5±0.2to1.8 ± 0.2cm (p<0.001) . Subvalvular splitting areas was from 0.8 ± 0.2 to1.2 ± 0.2cm²(p=<0.001). Pulmonary arterial systolic pressure and left atrial diameter were significantly reduced respectively 55.6 ± 19.5 vs. 31.6 ± 9.5 mmHg,(p < 0.001) and 4.3 ± 0.6 cm vs. 3.8 ± 0.6 cm (p < 0.001). Post percutaneous trans-venous mitral commissurotomy subvalvular splitting area was found to be the predictor of increased excursion of both anterior and posterior mitral leaflets. Conclusion: percutaneous trans-venous mitral commissurotomy is associated with immediate significant changes in mitral valve morphology in terms of splitting of fused mitral commissures, increased valve leaflets excursion and splitting of the subvalvular structures. Post percutaneous trans-venous mitral commissurotomy subvalvular splitting area was found to be the predictor of increased excursion of both anterior and posterior mitral leaflets.
ABSTRACT
Background: The purpose of the study was to find the effect of loading dose of atorvastatin on the reduction of myocardial injury resulting from percutaneous coronary intervention (PCI). Methods: A total 100 consecutive patients were included in this study of which 50 patients were in the group I who were treated with a loading dose of atorvastatin and the rest 50 patients were in the group II who were treated without the loading dose of atorvastatin.The occurrence of myocardial injury was measured by serum cTn-I level in patients undergoing PCI with or without loading dose of atorvastatin.
ABSTRACT
Ventricular septal rupture is a rare complication of acute myocardial infarction with important hemodynamic consequences. Without a rapid diagnosis and correction by surgical intervention, the short-term mortality of these patients is higher than 90%. Early diagnosis is based on clinical examination and transthoracic echocardiography. Transcatheter closure of ventricular septal rupture in selected patients may save lives. We report a patient with ventricular septal rupture in acute myocardial infarction that was closed by an Amplatzer device
ABSTRACT
Objectives: Coronary collaterals appear to play important role in coronary artery disease morbidity and mortality. In this study it was intended to determine whether hypertension is associated with development of coronary collaterals in patients with severe coronary artery disease. Methods: This was an observational cross-sectional study carried out in the department of cardiology of National Institute of Cardiovascular Diseases, Dhaka, Bangladesh during the period from October 2010 to June 2011. A total of 334 patients were examined to include in the study. Among them 118 patient of severe coronary artery disease (CAD) were included who fulfilled the inclusion and exclusion criteria. From where 63 patients were CAD with hypertension (Group -I) and 55 patients were CAD without hypertension (Group -II). Based on Rentrop Grading the study patients were divided in two groups, patients with poor collaterals (Grade 0& 1) and good collaterals (Grade 2&3). Data compared the coronary collaterals in hypertensive patients with those without hypertension with severe coronary artery disease. Results: The data showed that good collateral circulations were higher with duration of hypertension. The difference were statistically significant in duration <5 years and duration >10 years in both groups (p<0.05). The pattern of vessel involvement in double vessel disease and triple vessel disease (p <.001) and dyslipidemia (p<0.004) appeared to be significant predictor of hypertension controlling for other factors in the model. People with hypertension are around four times more likely to have good collateral circulation, multiple vessel disease and around 12 times more likely to have dyslipidemia. Conclusion: It is concluded that the patients of hypertension develop higher grades of coronary collaterals which increases with duration of hypertension in patients of severe coronary artery disease. Involvements of coronary arteries were more extensive in patients of hypertension with coronary artery disease.