Frequency of same day discharge and its feasibility after transradial percutaneous coronary intervention

To observe the frequency of same day discharge and its feasibility after transradial percutaneous coronary intervention [PCI]. This study was conducted at the Coronary Care Unit and Angiography ward of the Punjab Institute of Cardiology, Lahore from January 2007 to June 2007. Non-probability purposive sampling technique was used to enroll 100 subjects. A total of 790 PCIs were performed from January 2007 to June 2007 at the Punjab Institute of Cardiology, Lahore via transradial approach. Out of these 790 patients, one hundred patients [12.66%] had same-day discharge after transradial PCI. These patients were evaluated and information was obtained regarding entry site complications and adverse cardiovascular events at the time of discharge and at one month follow up after the procedure. Out of 100 patients, who had same day discharge, 2[2%] patients had hematoma at the time of discharge, 1[1%] had asymptomatic loss of radial pulse and 6[6%] patients had weak but palpable radial artery. At one month follow up 4[4%] patients had asymptomatic loss of radial pulse. However, none of these patients had major access site complications which required blood transfusion or admission to the hospital. Only 1[1%] patient had repeat coronary angiogram for chest pain, which revealed patent stent and TIMI III flow in distal vessel. One patient had repeat PCI but it was done to another vessel and previously placed stent was patent. There was no death and none of the patients underwent coronary artery bypass grafting [CABG]. The radial artery is the route of choice for most coronary procedures. The radial approach virtually eliminates access site complications after PCI, and allows rapid mobilization of the patient. Same-day discharge after radial PCI is a safe and feasible strategy

In hospital outcome of acute inferior wall Myocardial Infarction with or without right ventricular infarction

Patients of acute inferior wall MI with concomitant right ventricular infarction is considered as high risk patients because of associated high morbidity and mortality. Total of 50 patients were enrolled for seven days of hospital stay. They were divided into two groups; one with only acute inferior wall MI and the other with acute inferior wall MI associated right ventricular involvemen. The fatality rate was 33.3% with right ventricle involvement compared with 2.6% without right ventricle involvement. [p=0.003].The major cause of death was cardiogenic shock. Complications were as follow; cardiogenic shock [p=0.012], Tricuspid regurgitation [p=0.04], AV Block [p=0.04], tachyarrhythmia [p=0.077] and VSD in both groups. The conclusion was that right ventricle involvement was an independent predictor of prognosis in patients with acute inferior wall myocardial infarction