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Elkoumy A, Jose J, Gunasekaran S, Kumar A, Srinivas BC, Manjunath CN, Ravindranath KS, Parekh M, Chandra P, Kapoor R, Abdelshafy M, Seth A, Agrawal P, Mathur A, Rao RS, Elzomor H, Sadanada KS, Kumar V, Arsang-Jang S, Mehrotra S, Raghuraman B, Khanolkar U, Premchand RK, Chopra M, Krishna P, Mehta H, Gupta R, Kumar V, Boopathy N, Baumbach A, Serruys PW, Soliman O. Angiographic quantification of aortic regurgitation following myval octacor implantation; independent core lab adjudication. Int J Cardiol 2023; 382:68-75. [PMID: 37028710 DOI: 10.1016/j.ijcard.2023.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND The balloon expandable Myval transcatheter heart valve (THV) showed encouraging results regarding residual aortic regurgitation (AR) from multiple observational studies. The newly designed Myval Octacor has been introduced recently, aiming for a reduction in AR and improved performance. OBJECTIVES The focus of this study is to report the incidence of AR using the validated quantitative Videodensitometry angiography technology (qLVOT-AR%) in the first in human use of the Myval Octacor THV system. METHODOLOGY We report on the first in human use of the Myval Octacor THV system in 125 patients in 18 Indian centres. Independent retrospective analysis of the final aortograms following implantation of the Myval Octacor was performed using the CAAS-A-Valve software. AR is reported as a regurgitation fraction. The previously validated cutoff values have been used to identify ≥moderate AR (RF% >17%), mild (6% < RF% ≤17%), and none or trace AR (RF% ≤ 6%). RESULTS Final aortogram was analysable for 103 patients (84.4%) among the 122 available aortograms. 64 (62%) patients, had tricuspid aortic valve (TAV), 38 (37%) with bicuspid AV (BAV), and one with unicuspid AV. The median absolute RF% was 2% [1, 6], moderate or more AR incidence was 1.9%, mild AR in 20.4%, and none or trace AR in 77.7%. The two cases with RF% >17% were in the BAV group. CONCLUSION The initial results of Myval Octacor using quantitative angiography-derived regurgitation fraction demonstrated a favourable outcome regarding residual AR, possibly due to improved device design. Results must be confirmed in a larger randomised study, including other imaging modalities.
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Affiliation(s)
- Ahmed Elkoumy
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, University of Galway, H91 V4AY Galway, Ireland; Islamic Center of Cardiology, Al-Azhar University, Nasr City, Cairo 11651, Egypt
| | - John Jose
- Department of Cardiology, Christian Medical College & Hospital, Vellore 632004, India
| | | | - Asish Kumar
- Department of Cardiology, Meitra Hospital, Calicut, Kerala 673005, India
| | - B C Srinivas
- Sri Jayadeva Institute of Cardiovascular Sciences and Research, Jayanagar, Bengaluru 560041, India
| | - C N Manjunath
- Sri Jayadeva Institute of Cardiovascular Sciences and Research, Jayanagar, Bengaluru 560041, India
| | - K S Ravindranath
- Sri Jayadeva Institute of Cardiovascular Sciences and Research, Jayanagar, Bengaluru 560041, India
| | - Maulik Parekh
- Sir H. N. Reliance Foundation Hospital and Research Centre, Girgaon, Mumbai, Maharashtra 400004, India
| | | | | | - Mahmoud Abdelshafy
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, University of Galway, H91 V4AY Galway, Ireland
| | - Ashok Seth
- Fortis Escorts Heart Institute, New Delhi 110025, India
| | | | - Atul Mathur
- Fortis Escorts Heart Institute, New Delhi 110025, India
| | | | - Hesham Elzomor
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, University of Galway, H91 V4AY Galway, Ireland
| | - K S Sadanada
- Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysuru, Karnataka 570016, India
| | - Vijay Kumar
- Madras Medical Mission Hospital, Chennai, Tamil Nadu 600037, India
| | - Shahram Arsang-Jang
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, University of Galway, H91 V4AY Galway, Ireland; CÚRAM, SFI Research Centre for Medical Devices, H91 W2TY Galway, Ireland
| | - Sanjay Mehrotra
- Narayana Institute of Cardiac Sciences, Bengaluru, Karnataka 560099, India
| | | | - Uday Khanolkar
- Narayana Institute of Cardiac Sciences, Bengaluru, Karnataka 560099, India
| | | | - Manik Chopra
- Narayana Hospital (NH), Ahmedabad, Gujarat 380023, India
| | - Prem Krishna
- P S Govindaswami (PSG), Coimbatore 641004, India
| | - Haresh Mehta
- S. L. Raheja Hospital - Fortis, Mumbai, Maharashtra 400016, India
| | - Rahul Gupta
- Apollo Hospital, Navi Mumbai, Maharashtra 400614, India
| | - Viveka Kumar
- Max Hospital, Saket, New Delhi, Delhi 110017, India
| | | | - Andreas Baumbach
- William Harvey Research Institute, Queen Mary University of London and Barts Heart Centre, London EC1M 6BQ, UK
| | - Patrick W Serruys
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, University of Galway, H91 V4AY Galway, Ireland; CÚRAM, SFI Research Centre for Medical Devices, H91 W2TY Galway, Ireland
| | - Osama Soliman
- Discipline of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and CORRIB Core Lab, University of Galway, H91 V4AY Galway, Ireland; CÚRAM, SFI Research Centre for Medical Devices, H91 W2TY Galway, Ireland.
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Premchand RK, Samnani N. Case report on interaction of warfarin with herbal medicine “kadha”. IHJ Cardiovascular Case Reports (CVCR) 2021. [PMCID: PMC8184357 DOI: 10.1016/j.ihjccr.2021.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
With the increase in the number of COVID-19 cases worldwide, and a lack of proper preventive and therapeutic treatment, herbal medicine is frequently used by many people to increase the immune status of the body. We describe a case of a 56 year-old-man stabilized on warfarin (7 mg daily) from 12 years, experienced an elevated international normalized ratio (INR) of 5.45 after the consumption of an Indian traditional herbal drink “kadha” as a precautionary measure to prevent COVID-19 infection.
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Premchand RK, Kumar YS. A Report of Successful Procedural, Clinical, and Angiographic Outcomes with a Tapered Stent of a Patient in Naturally Tapered Coronary Vessel. J Clin Diagn Res 2017; 11:OD06-OD07. [PMID: 28273994 DOI: 10.7860/jcdr/2017/22241.9288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 09/23/2016] [Indexed: 11/24/2022]
Abstract
In cases involving stenosis or occlusions in major parts of a long vessel, natural tapering of coronary vessels may create dilemma in deciding the optimal stent size during percutaneous coronary intervention. In this regard, tapered stents have been developed recently. Herein, we present a case of 67-year-old male patient with triple vessel disease including two tandem lesions in naturally tapered Left Anterior Descending (LAD) artery. The patient received a 3.0-2.5x60 mm Sirolimus-eluting BioMime Morph stent (Meril life Sciences, Gujarat, India) in the mid-distal LAD lesion along with conventional stent implantations in other two lesions. The procedure was successful and good coronary flow was obtained after revascularization. The patient remained asymptomatic thereafter. At one year, angiographic follow-up revealed good flow and no restenosis in the LAD vessel. We are of opinion that using tapered stents with decremented diameter may offer the advantages of excellent adaptation to vessel size, vessel tapering, and good apposition in patients with long coronary lesions in tapered vessels.
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Affiliation(s)
- Rajendra Kumar Premchand
- Director and Consultant Interventional Cardiologist, Department of Cardiology, Krishna Institute of Medical Sciences Ltd , Secunderabad, Telangana, India
| | - Yerra Shiv Kumar
- Consultant Interventional Cardiologist, Department of Cardiology, Mahaveer Hospital , Hyderabad, Telangana, India
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Premchand RK, Garipalli R, Padmanabhan TNC, Manik G. Percutaneous closure of post-myocardial infarction ventricular septal rupture - A single centre experience. Indian Heart J 2016; 69 Suppl 1:S24-S27. [PMID: 28400035 PMCID: PMC5388014 DOI: 10.1016/j.ihj.2016.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 06/21/2016] [Accepted: 10/18/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Post-infarction ventricular septal rupture (VSR) is a rare but lethal mechanical complication of an acute myocardial infarction (AMI). Survival to 1 month without intervention is 6%. Given high surgical mortality, transcatheter closure has emerged as a potential strategy in selected cases. Indian data on percutaneous device closure of post AMI-VSR is scarce hence we report our single-centre experience with ASD occluder device (Amplatzer and lifetech) for closure of post-AMI VSR. METHODS AND RESULTS In this single-centre, retrospective, cohort study, patients who underwent transcatheter closure of post-MI VSR between 2005 and 2015 at KIMS Hospital were included. Primary outcome was mortality rate at 30 days. Seven patients were included in the study (mean age, 58.29±9.8 years). 5 patients had anterior wall myocardial infarction (AWMI) & 2 had inferior wall myocardial infarction (IWMI). None of the patients received thrombolytic therapy. Device was successfully placed in 5 patients (71.4%) with minimal residual shunt in 2 patients (40%). Out of 7 cases 2 patients survived (29% survival rate) and are doing well on follow up at 1 and 5 years respectively. Cardiogenic shock, IWMI and serpigenious form of VSR were associated with poor outcomes. Delayed revascularization (PCI) was associated with better outcomes. CONCLUSION Percutaneous closure is a potential technique in a selected group of patients. The presence of cardiogenic shock, IWMI and serpigeneous form of VSR constitutes important risk factors for mortality. Device implantation is in general successful with few procedure-related complications and should be applied on a case-by-case basis.
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Affiliation(s)
| | | | | | - Geetesh Manik
- Krishna Institute of Medical Sciences, Hyderabad, India
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5
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Premchand RK, Bhaskar Rao B, Partani K. A rare case of acquired aortopulmonary fistula with bicuspid aortic valve: report of successful surgical repair. BMJ Case Rep 2014; 2014:bcr-2014-207374. [PMID: 25406218 DOI: 10.1136/bcr-2014-207374] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
An acquired aortopulmonary fistula is a rare and usually fatal phenomenon. Rarer still are reports of successful surgical repair of aortopulmonary fistulae. We present the case of a 48-year-old hypertensive man who presented with congestive cardiac failure. Examination revealed a bicuspid aortic valve and a large aneurysm of the arch of the aorta, which was communicating with the main pulmonary artery. The diagnosis of acquired aortopulmonary fistula was made using transthoracic echocardiography findings and confirmed by CT. The patient was successfully managed by surgery, with an uneventful postoperative recovery, with control of congestive cardiac failure. At 1-year follow-up, the patient had Class I symptoms.
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Affiliation(s)
| | - Bolleneni Bhaskar Rao
- Department of Cardiothoracic and Cardiovascular Surgery, Krishna Institute of Medical Sciences (KIMS), Secunderabad, India
| | - Kaustubh Partani
- Department of Cardiology, Krishna Institute of Medical Sciences (KIMS), Secunderabad, India
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Bhuvaneswaran JS, Premchand RK, Iyengar SS, Rajeev Khare, Chabra CB, Padmanabhan TNC, Sharma SK, Jain A, Pandian SA, Rajdev S, Modi N, Kumar V. Tenecteplase in the treatment of acute pulmonary thrombo-embolism. J Thromb Thrombolysis 2010; 31:445-8. [PMID: 20972606 DOI: 10.1007/s11239-010-0524-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This is a retrospective study documenting the use of tenecteplase in 41 cases of suspected or confirmed pulmonary embolism receiving in-hospital tenecteplase as per weight-adjusted dosing in addition to standard heparin and oral anticoagulant therapy. The presenting symptoms of dyspnoea, chest pain, hemoptysis and syncope were found in 40 (97.56%), 19 (46.34%), 6 (14.63%) and 9 (21.95%) patients, respectively. There was one case of mortality who was a 26 yrs old female of postpartum pulmonary thrombo-embolism with severe hypotension, cyanosis, bilateral crepitations in lungs and pulmonary hypertension. In the 40 survived patients, there was alleviation of dyspnoea and hemoptysis in all patients. Significant reduction in tachycardia (P < 0.0001) and increase in the oxygen saturation (SaO₂) (P < 0.0001) were seen at discharge as compared to at the time of presentation. Eighteen patients had hypotension which recovered in all patients till the time of discharge (P < 0.0001). There was a significant reduction in right ventricular systolic pressure in all 18 patients who underwent 2-D echocardiography both before and after the tenecteplase therapy. Resolution of pulmonary embolism on CT pulmonary angiography was documented in only two patients. No bleeding events or any other adverse events were reported during this study. The present study suggests favourable efficacy of tenecteplase in patients with suspected or confirmed acute pulmonary embolism. Although no major adverse events were noted, a large prospective study on the use of tenecteplase in pulmonary embolism is suggested.
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Affiliation(s)
- J S Bhuvaneswaran
- Department of Cardiology, PSG Hospitals, P.B. No. 1674, Peelamedu, Coimbatore 641004, India.
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Lefèvre T, Louvard Y, Loubeyre C, Dumas P, Piéchaud JF, Krol M, Benslimane A, Premchand RK, Morice MC. A randomized study comparing two guidewire strategies for angioplasty of chronic total coronary occlusion. Am J Cardiol 2000; 85:1144-7, A9. [PMID: 10781769 DOI: 10.1016/s0002-9149(00)00713-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chronic total coronary occlusions were more frequently crossed using the Crosswire as a primary guidewire strategy than with the conventional strategy. This strategy resulted in a lower number of guidewires being used, a trend toward shorter procedural and fluoroscopy times, and decreased use of contrast media.
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Affiliation(s)
- T Lefèvre
- Institut Cardiovasculaire Paris Sud, Massy, France
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8
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Lefèvre T, Louvard Y, Morice MC, Dumas P, Loubeyre C, Benslimane A, Premchand RK, Guillard N, Piéchaud JF. Stenting of bifurcation lesions: classification, treatments, and results. Catheter Cardiovasc Interv 2000. [PMID: 10700058 DOI: 10.1002/(sici)1522-726x(200003)49:3<274::aid-ccd11>3.0.co;2-n] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Percutaneous transluminal balloon coronary angioplasty (PTCA) of coronary bifurcations is associated with a low success rate, high rate of complications, and high incidence of target vessel revascularization (TVR). The strategy of systematic coronary stenting in bifurcation lesions involving a side branch >/= 2.2 mm in diameter was prospectively evaluated in a single-center observational study during a 35-month inclusion period. All patients meeting these criteria were consecutively included. Bifurcation lesions and treatment were predefined in the study. The study included 366 patients (12.1% of PTCA) with 373 bifurcation lesions, mean age 63.7 +/- 11.6 years, 79.2% male, 46.7% with unstable angina, and 8.3% acute MI. The left anterior descending/diagonal bifurcation was involved in 55.2% of cases, circumflex/marginal 22. 2%, PDA/PLA 10.4%, left main bifurcation in 6.8%, and others 5.4%. The main branch (2.78 +/- 0.42 mm reference diameter) was stented in 96.3% of cases and the side branch (2.44 +/- 0.43 mm) in 63.2% (the two branches were stented in 59.5% of cases). Procedural success was obtained in 96.3% in both branches and 99.4% in the main branch. At1-month follow-up, The major cardiac event rate (MACE) was 4.8% (death 1.1%, emergency CABG 0.6%, Q-wave MI 0.9%, acute or subacute closure 1.4%, repeat PTCA 1.1%, and non-Q-wave MI 2.3%). At 7-month follow-up, the total MACCE rate was 21.6%, including a TVR rate of 17.2%. Analysis of the 7-month outcome according to two study periods (period I, 1 January 1996 to 31 August 1997, 182 patients; period II, 1 September 1997 to 30 June 1998, 127 patients) showed that the TVR rate decreased from 20.6% to 13.8% (P = 0.04) and the MACE rate from 29.2% to 17.1% (P < 0.01) in period I and II, respectively. This was associated by univariate analysis with an increasing use of tubular stents deployed in the main branch (94.2% vs. 59.1%, P < 0.001) and kissing balloon inflation after coronary stenting (75.4% vs. 18.1%, P < 0.001). Bifurcation lesions are frequent. Procedural success of coronary stenting is high with a low rate of in-hospital MACE. TVR rate at follow-up is relatively low. In-hospital and follow-up results are influenced not only by the learning curve but also by the use of tubular stents in the main branch and final kissing balloon inflation.
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Affiliation(s)
- T Lefèvre
- Institut Cardiovasculaire Paris Sud, Institut Hospitalier Jacques Cartier, Massy, France
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9
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Lefèvre T, Louvard Y, Morice MC, Dumas P, Loubeyre C, Benslimane A, Premchand RK, Guillard N, Piéchaud JF. Stenting of bifurcation lesions: classification, treatments, and results. Catheter Cardiovasc Interv 2000; 49:274-83. [PMID: 10700058 DOI: 10.1002/(sici)1522-726x(200003)49:3<274::aid-ccd11>3.0.co;2-n] [Citation(s) in RCA: 297] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Percutaneous transluminal balloon coronary angioplasty (PTCA) of coronary bifurcations is associated with a low success rate, high rate of complications, and high incidence of target vessel revascularization (TVR). The strategy of systematic coronary stenting in bifurcation lesions involving a side branch >/= 2.2 mm in diameter was prospectively evaluated in a single-center observational study during a 35-month inclusion period. All patients meeting these criteria were consecutively included. Bifurcation lesions and treatment were predefined in the study. The study included 366 patients (12.1% of PTCA) with 373 bifurcation lesions, mean age 63.7 +/- 11.6 years, 79.2% male, 46.7% with unstable angina, and 8.3% acute MI. The left anterior descending/diagonal bifurcation was involved in 55.2% of cases, circumflex/marginal 22. 2%, PDA/PLA 10.4%, left main bifurcation in 6.8%, and others 5.4%. The main branch (2.78 +/- 0.42 mm reference diameter) was stented in 96.3% of cases and the side branch (2.44 +/- 0.43 mm) in 63.2% (the two branches were stented in 59.5% of cases). Procedural success was obtained in 96.3% in both branches and 99.4% in the main branch. At1-month follow-up, The major cardiac event rate (MACE) was 4.8% (death 1.1%, emergency CABG 0.6%, Q-wave MI 0.9%, acute or subacute closure 1.4%, repeat PTCA 1.1%, and non-Q-wave MI 2.3%). At 7-month follow-up, the total MACCE rate was 21.6%, including a TVR rate of 17.2%. Analysis of the 7-month outcome according to two study periods (period I, 1 January 1996 to 31 August 1997, 182 patients; period II, 1 September 1997 to 30 June 1998, 127 patients) showed that the TVR rate decreased from 20.6% to 13.8% (P = 0.04) and the MACE rate from 29.2% to 17.1% (P < 0.01) in period I and II, respectively. This was associated by univariate analysis with an increasing use of tubular stents deployed in the main branch (94.2% vs. 59.1%, P < 0.001) and kissing balloon inflation after coronary stenting (75.4% vs. 18.1%, P < 0.001). Bifurcation lesions are frequent. Procedural success of coronary stenting is high with a low rate of in-hospital MACE. TVR rate at follow-up is relatively low. In-hospital and follow-up results are influenced not only by the learning curve but also by the use of tubular stents in the main branch and final kissing balloon inflation.
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Affiliation(s)
- T Lefèvre
- Institut Cardiovasculaire Paris Sud, Institut Hospitalier Jacques Cartier, Massy, France
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10
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Loubeyre C, Premchand RK, Lefèvre T, Louvard Y, Dumas P, Piechaud JF, Lanore JJ, Porta MC, Capitani GA, Morice MC. [Immediate revascularization by angioplasty and coronary stents in patients over age 80 with myocardial infarction]. Arch Mal Coeur Vaiss 2000; 93:21-6. [PMID: 11227714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
The aim of this study was to assess the results of revascularisation by angioplasty and stenting in octogenarians in the acute phase of myocardial infarction. One hundred and four patients over 80 years of age were identified between January 1995 and April 1995 out of 906 patients admitted within 24 hours of the onset of myocardial infarction. The average age was 85 +/- 4 years with a female predominance (63.4%) and a high incidence of cardiogenic shock (28.8%). Ninety eight patients underwent angioplasty with coronary stenting in 81 patients (82.6%) within 39 +/- 35 min of hospital admission. A primary success was obtained in 96% of cases with restitution of TIMI 3 flow in 83.6% of cases. Hospital mortality was 26.5%, highly influenced by the presence of cardiogenic shock (60.7% versus 12.8% without shock). Univariate analysis showed cardiogenic shock (p < 0.0001) and ejection fraction (p = 0.009) to be predictive of mortality, and a tendency in favour of TIMI 3 flow (p = 0.07) and stent implantation (p = 0.09). Complications were rare: 1% of minor cerebrovascular accidents and 4% of vascular complications. There were no cases of emergency bypass surgery and only one patient had a recurrence of ischaemia at 30 days. The authors conclude that the results at 1 month in a high risk group of octogenarians seem to be in favour of an invasive management with coronary stenting in the acute phase of myocardial infarction.
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Affiliation(s)
- C Loubeyre
- Institut cardiovasculaire Paris Sud, hôpital Claude-Galien, 20, route de Boussy, 91480 Quincy-sous-Sénart
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Premchand RK, Lefèvre T, Louvard Y, Morice MC. Rescue left main angioplasty on first post-operative day of coronary artery bypass graft surgery ischemia. J Invasive Cardiol 1999; 11:688-90. [PMID: 10745465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Percutaneous revascularization has been used for the treatment of post-coronary bypass graft ischemia. This report illustrates the use of emergency left main coronary artery stenting in protected left main on the first post-operative day for management of perioperative coronary artery bypass graft surgery ischemia.
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Affiliation(s)
- R K Premchand
- Institut Cardiovasculaire Paris Sud, 6 avenue du Noyer Lambert, 91300 Massy, France
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12
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Premchand RK, Loubeyre C, Lefevre T, Benslimane A, Louvard Y, Morice MC. Tortuous internal mammary artery angioplasty: accordion effect with limitation of flow. J Invasive Cardiol 1999; 11:372-4. [PMID: 10745554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Mechanical straightening of a tortuous vessel during angioplasty has been well described. It can be mistaken for thrombus, dissection or spasm. This report presents a case in which straightening of vessel due to stiff guide wire results in accordion effect and flow limitation.
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Affiliation(s)
- R K Premchand
- Institut Cardiovasculaire Paris Sud, Institut Hospitalier Jacques Cartier, 6 avenue du Noyer Lambert, 91300 Massy, France.
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Premchand RK, Allam VK, Padmanabhan TN, Mullapudi VR, Jaishankar S. Anomalous origin of left anterior descending coronary artery from pulmonary artery in addition to anomalous origin of left circumflex coronary artery from right aortic sinus--a case report. Indian Heart J 1998; 50:77-9. [PMID: 9583294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- R K Premchand
- Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad
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Premchand RK, Chakravarthi PTN, Allam VK, Sadasivan J, Rao DS. Nonsurgical Retrieval of Ruptured, Fractured Intra-Aortic Balloon Catheter. Asian Cardiovasc Thorac Ann 1997. [DOI: 10.1177/021849239700500212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The possibility of rupture of an intra-aortic balloon has been theorized since its introduction and confirmed by recent reports. Few incidents of fracture of an intra-aortic balloon catheter have been reported and in most of these cases the entrapped balloons were removed surgically. We report the successful nonsurgical removal of a ruptured, fractured intra-aortic balloon catheter.
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Affiliation(s)
| | | | - Vasanth Kumar Allam
- Department of Cardiology Nizam's Institute of Medical Sciences Hyderabad, India
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Premchand RK, Arora R, Sudhan R, Allam VK, Chakravarthi PTN, Prabhala RG, Sadasivan J. Traumatic Pseudoaneurysm of the Left Ventricle. Asian Cardiovasc Thorac Ann 1996. [DOI: 10.1177/021849239600400413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A pseudoaneurysm of the left ventricle developed in an 11-year-old boy following a trivial blunt trauma to the chest wall. This was detected by echocardiography 3 months after the injury. An echocardiogram performed 2 weeks after the injury demonstrated intact chambers. The false aneurysm resulted from myocardial contusion with subsequent gradual rupture of the left ventricle without coronary artery occlusion. The patient underwent a successful surgical repair. This case demonstrates the need for careful follow-up of all patients sustaining blunt chest trauma.
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Affiliation(s)
- Rajendra Kumar Premchand
- Department of Cardiology and Department of Cardiothoracic Surgery Nizam's Institute of Medical Sciences Hyderabad, India
| | - Rakesh Arora
- Department of Cardiology and Department of Cardiothoracic Surgery Nizam's Institute of Medical Sciences Hyderabad, India
| | - Rakesh Sudhan
- Department of Cardiology and Department of Cardiothoracic Surgery Nizam's Institute of Medical Sciences Hyderabad, India
| | - Vasantha Kumar Allam
- Department of Cardiology and Department of Cardiothoracic Surgery Nizam's Institute of Medical Sciences Hyderabad, India
| | | | - Raja Gopal Prabhala
- Department of Cardiology and Department of Cardiothoracic Surgery Nizam's Institute of Medical Sciences Hyderabad, India
| | - Jaishankar Sadasivan
- Department of Cardiology and Department of Cardiothoracic Surgery Nizam's Institute of Medical Sciences Hyderabad, India
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