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Rashidi F, Bilehjani E, Mousavi-Aghdas SA, Parvizi R. Massive primary pulmonary artery rhabomyosarcoma: A case report. Rom J Intern Med 2024; 62:67-74. [PMID: 38044271 DOI: 10.2478/rjim-2023-0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Pulmonary artery sarcomas (PAS) are rare tumours causing an insidiously progressive obstruction of the pulmonary circulation. The clinical presentation is often indistinguishable from chronic thromboembolic pulmonary hypertension (CTEPH). However, the atypical appearance of a heterogeneous filling defect in CT pulmonary angiography (CTPA) should prompt further investigation. CASE PRESENTATION A previously healthy young man presented with massive haemoptysis, acute respiratory distress, and progressive exertional dyspnea since the year before. Echocardiography demonstrated severe right ventricular dysfunction and highly probable pulmonary hypertension. CTPA revealed an extensive filling defect with an appearance concerning PAS. Due to syncopal episodes at rest, the patient underwent urgent pulmonary artery endarterectomy (PEA). A massive tree-like tumour was excised as a result. Post-operatively, reperfusion injury and refractory pulmonary oedema mandated extracorporeal membrane oxygenation (ECMO). Unfortunately, ECMO was complicated with massive haemolysis and acute kidney injury. The patient succumbed to multi-organ failure. Through tissue analysis established a diagnosis of embryonal rhabdomyosarcoma. DISCUSSION Unfortunately, the patient had not reached out for his worsening dyspnea. PASs should not be mistaken for a thrombus and anticoagulation should be avoided. The urgent condition precluded biopsy and tissue diagnosis. Similarly, neoadjuvant chemotherapy was not feasible. Post-operatively, reperfusion injury and pulmonary oedema ensued, which mandated ECMO. This complication should be anticipated preoperatively. There is a need for more data on PASs to establish a consensus for management.
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Affiliation(s)
- Farid Rashidi
- Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Eissa Bilehjani
- Cardiovascular Research Center, Madani Heart Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Ali Mousavi-Aghdas
- Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rezayat Parvizi
- Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Parvizi R, Bilehjani E, Mahmoudian B, Koohi A, Shojaan H, Ansarin K, Rashidi F. Single-Center Experience of Pulmonary Endarterectomy for Chronic Thromboembolic Pulmonary Hypertension: The Results from the Tabriz University Medical Sciences (TUMS) CTEPH Program. Thorac Cardiovasc Surg 2023; 71:407-412. [PMID: 36657456 DOI: 10.1055/s-0042-1760204] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Pulmonary endarterectomy (PEA) remains the preferred and potentially curative option for patients with chronic thromboembolic pulmonary hypertension (CTEPH). This study aimed to report the results of PEA for CTEPH in a tertiary center in Tabriz, Iran. METHODS We analyzed the results of 42 CTEPH patients undergoing PEA, who were enrolled in the Tabriz University of Medical Sciences (TUMS-CTEPH) from January 2016 to October 2020. The main outcome measures included the New York Heart Association (NYHA) functional classification, the 6-Minute Walk Distance, hemodynamic measures in right heart catheterization, morbidity, and mortality. RESULTS There was a significant improvement in the NYHA function class (2.6 ± 0.5 vs 1.1 ± 0.34), mean pulmonary arterial pressure (47.1 ± 13 vs 27.9 ± 8 mm Hg), cardiac output (4.3 ± 1.06 vs 5.9 ± 1.2 L/min), and pulmonary vascular resistance (709.4 ± 297.5 vs 214 ± 77 dyn s/cm5). Fifteen patients (35%) developed complications. The most common complication (10 [23%]) was reperfusion injury. Also, postsurgical mortality was 4% during hospital admission and 1-year follow-up. CONCLUSION This is the first single-center report of PEA from Iran. Post-PEA and 1-year survival were acceptable as a referral center. PEA can be performed safe with low mortality. Greater awareness of PEA and patients' access to experienced CTEPH centers are important issues.
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Affiliation(s)
- Rezayat Parvizi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Eisa Bilehjani
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Babak Mahmoudian
- Medical Radiation Sciences Research Team, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ata Koohi
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hooriah Shojaan
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Khalil Ansarin
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farid Rashidi
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Hariri A, Shervani-Tabar MT, Parvizi R. Laser-Produced Cavitation Bubble Behavior in Newtonian and Non-Newtonian Liquid Inside a Rigid Cylinder: Numerical Study of Liquid Disc Microjet Impact Using OpenFOAM. Micromachines (Basel) 2023; 14:1416. [PMID: 37512727 PMCID: PMC10385214 DOI: 10.3390/mi14071416] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/20/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023]
Abstract
This study employs OpenFOAM to analyze the behavior of a single laser-produced cavitation bubble in a Newtonian/non-Newtonian fluid inside a rigid cylinder. This research aimed to numerically calculate the impact of liquid disc microjet resulting from the growth and collapse of the laser-produced bubble to the cylinder wall to take advantage of the cavitation phenomenon in various industrial and medical applications, such as modeling how to remove calcification lesions in coronary arteries. In addition, by introducing the main study cases in which a single bubble with different initial conditions is produced by a laser in the center/off-center of a cylinder with different orientations relative to the horizon, filled with a stationary or moving Newtonian/Non-Newtonian liquid, the general behavior of the bubble in the stages of growth and collapse and the formation of liquid disk microjet and its impact is examined. The study demonstrates that the presence of initial velocity in water affects the amount of microjet impact proportional to the direction of gravity. Moreover, the relationship between the laser energy and the initial conditions of the bubble and the disk microjet impact on the cylinder wall is expressed.
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Affiliation(s)
- Amirhossein Hariri
- Department of Mechanical Engineering, University of Tabriz, Tabriz 5166616471, Iran
| | | | - Rezayat Parvizi
- Department of Cardiac Surgery, Shahid Madani Heart Hospital, Tabriz University of Medical Sciences, Tabriz 5163639889, Iran
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4
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Toufan Tabrizi M, Parvizi R, Javanshir E. Vegetation Formation and Aortitis as a Possible Sequela of COVID-19 in a Patient with an Aortic Stent: A Case Report. J Tehran Heart Cent 2023; 18:218-223. [PMID: 38146409 PMCID: PMC10748656 DOI: 10.18502/jthc.v18i3.14117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/07/2023] [Accepted: 06/03/2023] [Indexed: 12/27/2023] Open
Abstract
Bacteria, especially staphylococcal groups, cause aortic graft infection. Infection stems from synthetic materials that repair aneurysms or artery blockages. Aortic stent infection and vegetation formation are rare, and heterogeneous presentations and ambiguous findings in routine diagnostic modalities render the diagnosis challenging. A 25-year-old man with a history of catheter-based aortic stenting for hypertension associated with severe aortic coarctation was referred to our tertiary care hospital. Five months before the presentation, the patient had been infected with COVID-19, but he recovered after mild symptoms. Nevertheless, 3 months later, he developed erythematous lesions, progressive anorexia, epigastric pain, fever, and weakness. The results of blood tests, blood cultures, transthoracic echocardiography, plain chest radiography, computed tomography angiography, and electrocardiography were unremarkable. We found severe infectious aortitis, crescent thickness surrounding the aorta, pseudoaneurysm development, and a mass with dimensions of 17 mm×8 mm within the aortic stent on transesophageal echocardiography (TEE). Broad-spectrum antibiotic therapy was initiated, and the patient was transferred to the operating room, where the infected stent and adhesive vegetation were removed. The patient recovered remarkably after the surgery and was discharged. At 6 months' follow-up, he was in good condition. Our findings highlight the significance of maintaining vigilance and a high level of clinical suspicion for the possibility of vegetation formation and aortitis as the possible sequelae of COVID-19, particularly in patients with an implanted stent. Furthermore, we strongly suggest TEE in patients with implanted stents to detect vegetation and aortitis.
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Affiliation(s)
| | - Rezayat Parvizi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elnaz Javanshir
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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5
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Roshanravan N, Tarighat F, Pahlavan S, Parvizi M, Banisefid E, Abolhasani S, Hadi A, Parvizi R. Novel Aortic Valve Replacement Technique for Reducing Complete Heart Block. J Tehran Heart Cent 2023; 18:177-182. [PMID: 38146406 PMCID: PMC10748663 DOI: 10.18502/jthc.v18i3.14112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 06/07/2022] [Accepted: 01/26/2023] [Indexed: 12/27/2023] Open
Abstract
Background Aortic valve replacement (AVR) may complicate conduction abnormalities and require permanent pacemaker (PPM) implantation. New techniques that lessen this challenge may lead to the development of new approaches. Our objective was to evaluate the contemporary incidence of early postoperative PPM implantation in patients undergoing isolated AVR and root disease with the standard AVR surgical technique compared with the novel suture AVR technique. Methods The clinical data of 354 patients (250 male, 104 female) who underwent surgery for isolated AVR and root disease in different referral cardiology departments in Tabriz, Iran, over 4 years were analyzed. Patients with preoperative significant conduction abnormalities were excluded from the study. The patients were evaluated for in-hospital mortality, postoperative PPM implantation, and their stay in the ICU after surgery. Results The mean age of the patients was 52.46±16.13 years. Totally, 183 patients (51.7%) were operated on with the new suture AVR technique. In-hospital mortality was lower in this group than in the group that underwent the "classic" surgical technique (2.5% vs 3.7%). PPM implantation was required in 3 patients (0.8%) after the novel suture AVR technique, whereas it was needed in 12 patients (3.4%) in the other group (P=0.024). The mortality rate was 9 patients (2.5%) in group 1 and 13 patients (3.7%) in group 2, which was not statistically significant (P=0.296). According to the logistic regression, the survival rate in the group operated on with the classical surgical method was 0.27 times higher than that in the patients operated on with the new method. Conclusion Permanent complete AV block is a critical complication after AVR surgery. A lower PPM requirement and higher survival in patients operated on with the new method was the main finding of this study. New techniques with lower PPM requirements may be suitable for cardiac surgery.
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Affiliation(s)
- Neda Roshanravan
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Faezeh Tarighat
- Student Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sara Pahlavan
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, Tehran, Iran
| | - Mahdi Parvizi
- Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Erfan Banisefid
- Students’ Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Somayeh Abolhasani
- Department of Biochemistry, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Amir Hadi
- Halal Research Center of IRI, Food and Drug Administration, Ministry of Health and Medical Education, Tehran, Iran
- Ministry of Health and Medical Education, Tehran, Iran
| | - Rezayat Parvizi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Mohammadian R, Tarighatnia A, Sharifipour E, Nourizadeh E, Parvizi R, Applegate CT, Nader ND. Carotid artery stenting prior to coronary artery bypass grafting in patients with carotid stenosis: Clinical outcomes. Interv Neuroradiol 2023; 29:30-36. [PMID: 35331026 PMCID: PMC9893238 DOI: 10.1177/15910199221067665] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Management of patients undergoing coronary artery bypass grafting (CABG) with obstructive disease of the carotid arteries is still a matter of debate. We compared the results of staged carotid artery stenting (CAS) before CABG in patients with carotid lesions. MATERIALS AND METHOD Patients with significant carotid artery disease who were deemed to simultaneously suffer from an obstructive coronary artery disease requiring CABG from 2008 to 2018 were screened and enrolled in this study. We performed a staged CAS in cases with ≥60% stenosis and neurological symptoms or asymptomatic patients with ≥80% carotid artery stenosis. Patients with bilateral carotid lesions received sequential CAS within three weeks. Six weeks after the CAS procedure, all patients underwent CABG. RESULTS A total of 142 patients were included. Eighty-five of these had neurological symptoms, while the remaining 40% were asymptomatic. Thirty-one patients underwent sequential CAS for bilateral lesions. The cerebrovascular event (CVE) following CAS (3 patients) and CABG (3 patients) was 4.2%. There was only a single case of mortality in this cohort. Although it was not statistically significant, CVE after CABG was more frequent in patients with bilateral carotid disease. CONCLUSIONS Our results showed that staged CAS could be performed with minimal adverse outcomes in patients suffering from a simultaneous occlusive disease of carotids and coronary arteries before CABG. Bilateral CAS will further decrease cerebrovascular events and could be performed consequently or concomitantly.
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Affiliation(s)
- Reza Mohammadian
- Radiology Department, East Clinical University Hospital, Stradins
University, Riga, Latvia
| | - Ali Tarighatnia
- Department Interventional Radiology, Aalinasab Hospital, ISSO,
Tabriz, Iran
| | - Ehsan Sharifipour
- Neuroscience Research Center, Qom University of Medical Sciences, Qom
University of Medical Sciences, Qom, Iran
| | | | - Rezayat Parvizi
- Cardiovascular Research Center, Tabriz University of Medical
Sciences, Shahid Madani Heart Center, Tabriz, Iran
| | - Camille T. Applegate
- Jacobs School of Medicine and Biomedical
Sciences, 955 Main Street, Buffalo, NY 14203, USA
| | - Nader D. Nader
- Dept. of Anesthesiology & Surgery, Jacobs School of Medicine and Biomedical
Sciences, UB-Gateway Building, 77 Goodell Street, Suite 550, Buffalo, NY
14203
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7
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Azargoshasb T, Parvizi R, Bozorgzadeh F, Navid HA, Heidari H. Smart green CQD@SiO 2 hybrid coated optical fiber manifesting dual versatile absorptive and MIP features towards epinephrine detection. Nanoscale Adv 2023; 5:459-470. [PMID: 36756270 PMCID: PMC9846438 DOI: 10.1039/d2na00687a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/21/2022] [Indexed: 06/18/2023]
Abstract
For the first time, in this study, a novel optical fiber biosensor is proposed and developed via coating only one smart functional layer of silica-supported carbon dots realizing the concepts of both lossy mode resonance (LMR) and molecularly imprinted polymer (MIP) for epinephrine detection. The carbon quantum dots (CQDs) are prepared using a green synthesis method and then treated with a molecularly imprinted polymer (MIP) strategy. Under ultrasonic irradiation, a SiO2 shell was stabilized on the surface of the CQDs to graft and to provide the LMR/MIP functional layer onto the curved optical fiber surface. Accurate structural and morphological characterization confirmed the carbon quantum dot agents and also the SiO2 supporting shells on the optical fiber, while spectroscopic analysis confirms the formation of the imprinted polymer and desirable absorbance characteristics. The experimental and numerical sensing studies revealed that the proposed sensing probe allows the rapid adsorption/desorption of epinephrine to the sensing films and highly permeable coating for studying the influence of effective parameters. Under the optimal experimental conditions, the sensitivity of the proposed LMR-based optical fiber sensor is reported to be 0.37 nm μM-1 with a correlation coefficient of 0.99. So, sensitive detection of epinephrine at a low concentration can be guaranteed with a 0.72 mM LOD.
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Affiliation(s)
- T Azargoshasb
- Department of Laser and Optical Engineering, University of Bonab Bonab 5551761167 Iran
| | - R Parvizi
- Department of Physics, College of Sciences, Yasouj University Yasouj 75914-353 Iran
- James Watt School of Engineering, University of Glasgow Glasgow G12 8QQ UK
| | - F Bozorgzadeh
- Physics Department, College of Sciences, Shiraz University Shiraz Iran
| | - H Ali Navid
- Department of Laser and Optical Engineering, University of Bonab Bonab 5551761167 Iran
| | - H Heidari
- James Watt School of Engineering, University of Glasgow Glasgow G12 8QQ UK
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8
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Roshanravan N, Shabestari AN, Alamdari NM, Ostadrahimi A, Separham A, Parvizi R, Jafarabadi MA, Ghodrat M, Akbarzadeh M, Naemi M, Ghazi MKK, Hadi A, Ghaffari S. A novel inflammatory signaling pathway in patients with slow coronary flow: NF-κB/IL-1β/nitric oxide. Cytokine 2021; 143:155511. [PMID: 33839001 DOI: 10.1016/j.cyto.2021.155511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 02/26/2021] [Accepted: 03/19/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE The slow coronary flow (SCF) was identified as delayed opacification of epicardial coronary arteries in the absence of stenotic lesion. Metabolic syndrome (MetS), oxidative stress, and inflammation may be possible known insulting factors for the pathogenesis of SCF. This investigation aimed to assess the relationship between some inflammatory markers, oxidative stress parameters and MetS components with SCF phenomenon. METHODS A total of 35 patients with SCF and 35 subjects with normal coronary flow (NCF) were included in the study. We assessed some inflammatory markers (IL-1β, IL-18, TNF-α, and NF-κB mRNA expression in peripheral blood mononuclear cells (PBMCs)). Moreover, blood samples of the participants were tested for total antioxidant capacity (TAC), glutathione peroxidase (GPX) and nitric oxide (NO) levels using enzyme-linked immunosorbent assay (ELISA). Diagnosis of MetS was based on the National Cholesterol Education Program's Adult Treatment Panel III report (ATPIII) criteria, 2005. Diagnostic criteria for coronary flow rates of all subjects were documented by thrombolysis in myocardial infarction (TIMI) frame count method. RESULTS SCF patients had significantly higher prevalence of MetS (46%, p = 0.048).We found that the level of TAC was significantly higher in the NCF group (p = 0.006). Furthermore, the NO concentration was significantly lower in SCF groups (p = 0.001). A significant incremental difference was detected in IL-1β (fold change 2.82 ± 0.31, p < 0.05) and NF-κB (fold change 4.62 ± 0.32, p < 0.05) mRNA expression in the SCF group when compared with its level in the NCF group. Furthermore, according to logistic regression analysis, there were significant associations between IL-1β, NF-κB expression levels and the incidence of SCF (p < 0.05). CONCLUSION Based on the findings of this study, the pathogenesis of the SCF phenomenon may be closely associated with metabolic syndrome and inflammation. The NF-κB/IL-1β/nitric oxide & MetS signaling pathway might be considered as potential therapeutic targets in the management of SCF patients but further researches is required to guarantee these findings.
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Affiliation(s)
- Neda Roshanravan
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Namazi Shabestari
- Department of Geriatric Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Naimeh Mesri Alamdari
- Students Research Committee, School of Health, Iran University of Medical Science, Tehran, Iran
| | - Alireza Ostadrahimi
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Separham
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rezayat Parvizi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Mahshid Ghodrat
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Moloud Akbarzadeh
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Stem Cell And Regenerative Medicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Naemi
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Amir Hadi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Samad Ghaffari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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9
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Ashkavand Z, Sadeghi E, Parvizi R, Zare M. Developed Low-Temperature Anionic 2H-MoS 2/Au Sensing Layer Coated Optical Fiber Gas Sensor. ACS Appl Mater Interfaces 2020; 12:34283-34296. [PMID: 32614567 DOI: 10.1021/acsami.0c05108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Carboxyl-functionalized molybdenum disulfide (COOH-MoS2) nanosheets were prepared through a facile low-temperature hydrothermal method. The phase transformation of metallic-1T to 2H-semiconductor COOH-MoS2 nanosheets was conducted through introducing Au thin film on the unclad optical fiber as a sensing layer in a low temperature. The developed structure successfully refined the loss of the semiconducting properties and poor adhesion of COOH-MoS2 on the unclad polymer optical fiber, which provided limited semiconductor potential as the sensing layers on the optical fiber surfaces. The sensing performance of the as-prepared structure was tested for quantitative detection of three different volatile organic carbons (VOCs) of ethanol, propanol, and methanol gases as well as cross-sensitivity to relative humidity. The operating principle was based on intensity variation of the evanescent wave in the sensing region. The response of the proposed sensing system shows maximum response and better linearity (R2 = 0.999) to methanol at room temperature. Finally, the comparative experimental cross-sensitivity to relative humidity and methanol was also studied to evaluate the potential of sensing range.
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Affiliation(s)
- Z Ashkavand
- Department of Physics, College of Sciences, Yasouj University, Yasouj 75914-353, Iran
| | - E Sadeghi
- Department of Physics, College of Sciences, Yasouj University, Yasouj 75914-353, Iran
| | - R Parvizi
- Department of Physics, College of Sciences, Yasouj University, Yasouj 75914-353, Iran
| | - M Zare
- Department of Physics, College of Sciences, Yasouj University, Yasouj 75914-353, Iran
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10
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Alizadeh Ghavidel A, Mirzaaghayan M, Yousefnia MA, Asdaghpour E, Baghaei Tehrani R, Jalilifar N, Radmehr H, Shirzad M, Austine N, Ahmadi H, Ahmadi ZH, Afrasiabi Rad A, Amirghofran A, Amin A, Ansari Aval Z, Babazadeh K, Bakhshandeh A, Baharestani B, Parvizi R, Jadbabaei A, Jahangirifard A, Hoseini S, Hekmat M, Heidari A, Shabani M, Sadeghipour P, Salehi M, Ziabakhsh Tabari S, Abbasi M, Gholampour Dahaki M, Firouzi A, Laali M, Mandegar MH, Mirmohammadsadeghi M, Navvabi Shirazi M, Nikpajooh A. Iranian Society of Cardiac Surgeons COVID-19 task force version II, restarting elective surgeries. J Cardiovasc Thorac Res 2020; 12:158-164. [PMID: 33123320 PMCID: PMC7581843 DOI: 10.34172/jcvtr.2020.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/08/2020] [Accepted: 07/10/2020] [Indexed: 12/16/2022] Open
Abstract
Given the nature of heart disease and the importance of continuing heart surgery during the pandemic and its aftermath and in order to provide adequate safety for the surgical team and achieve the desired result for patients, as well as the optimal use of ICU beds, the medical team, blood, blood products, and personal protective equipment, it is essential to change the usual approach during the pandemic. There are still a lot of evidences and experiences needed to produce the perfect protocol. Some centers may have a special program for their centers during this period of epidemics that can be respected and performed. Generally, in pandemic conditions, the use of non-surgical approaches is preferred if similar outcomes can be obtained.
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Affiliation(s)
- Alireza Alizadeh Ghavidel
- Heart Valve Disease Research Center, Rajaei Cardiovascular Medical & Research Center, Iran University of Medical Science, Tehran Iran
| | - Mohammadreza Mirzaaghayan
- Department of Cardiac Surgery, Tehran Children Hospital, Tehran University of Medical Science, Tehran Iran
| | | | | | - Ramin Baghaei Tehrani
- Department of Cardiac Surgery, Shahid Moddares Hospital, Shahid Beheshti University of Medical Science, Tehran Iran
| | - Naser Jalilifar
- Department of Cardiac Surgery, Rasoul Akram Hospital, Iran University of Medical Science, Tehran, Iran
| | - Hasan Radmehr
- Department of Cardiac Surgery, Tehran Children Hospital, Tehran University of Medical Science, Tehran Iran
| | - Mahmoud Shirzad
- Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Science, Tehran Iran
| | - Nicholas Austine
- Editoral Office, Iranian Society of Cardiac Surgeons, Tehran, Iran
| | - Hosein Ahmadi
- Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Science, Tehran Iran
| | - Zargham Hossein Ahmadi
- Department of Cardiac Surgery, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Science, Tehran Iran
| | - Abbas Afrasiabi Rad
- Cardiovascular Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Ahmadali Amirghofran
- Department of Cardiac Surgery, Shahid Faghihi Hospital, shiraz University of Medical Science, Shiraz, Iran
| | - Ahmad Amin
- Department of Cardiology, Rajaei Cardiovascular Medical & Research Center, Iran University of Medical Science, Tehran Iran
| | - Zahra Ansari Aval
- Department of Cardiac Surgery, Shahid Moddares Hospital, Shahid Beheshti University of Medical Science, Tehran Iran
| | - Kamran Babazadeh
- Department of Cardiac Surgery, Milad General Hospital, Tehran, Iran
| | - Alireza Bakhshandeh
- Department of Cardiac Surgery, Imam Khomeini Medical Center, Tehran University of Medical Science, Tehran Iran
| | - Bahador Baharestani
- Department of Cardiac Surgery, Rajaei Cardiovascular Medical & Research Center, Iran University of Medical Science, Tehran Iran
| | - Rezayat Parvizi
- Cardiovascular Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Amirnaser Jadbabaei
- Department of Cardiac Surgery, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Science, Tehran Iran
| | - Alireza Jahangirifard
- Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Hoseini
- Heart Valve Disease Research Center, Rajaei Cardiovascular Medical & Research Center, Iran University of Medical Science, Tehran Iran
| | - Manouchehr Hekmat
- Department of Cardiac Surgery, Shahid Moddares Hospital, Shahid Beheshti University of Medical Science, Tehran Iran
| | - Amanollah Heidari
- Department of Cardiac Surgery, Golestan Hospital, Ahvaz University of Medical Science, Ahvaz Iran
| | - Minoosh Shabani
- Department of Infectious Disease, Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parham Sadeghipour
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Salehi
- Department of Cardiac Surgery, Imam Khomeini Medical Center, Tehran University of Medical Science, Tehran Iran
| | - Shervin Ziabakhsh Tabari
- Department of Cardiac Surgery, Fatemeh Zahra Hospital, Mazandaran University of Medical Science, Sari Iran
| | - Mohammad Abbasi
- Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Science, Mashhad Iran
| | - Maziar Gholampour Dahaki
- Department of Cardiac Surgery, Rajaei Cardiovascular Medical & Research Center, Iran University of Medical Science, Tehran Iran
| | - Ata Firouzi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mojgan Laali
- Department of Cardiac Surgery, La pitié-salpetrier Hospital, Paris, France
| | - Mohammad Hosein Mandegar
- Department of Cardiac Surgery, Shariati hospital, Tehran University of Medical Science, Tehran Iran
| | - Mohsen Mirmohammadsadeghi
- Department of Cardiac Surgery, Shahid Chamran Hospital, Isfahan University of Medical Science, Isfahan Iran
| | | | - Akbar Nikpajooh
- Department of Social Medicine, Rajaei Cardiovascular Medical & Research Center, Iran University of Medical Science, Tehran Iran
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11
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Rashidi F, Parvizi R, Bilejani E, Mahmoodian B, Rahimi F, Koohi A. Evaluation of the Incidence of Chronic Thromboembolic Pulmonary Hypertension 1 Year After First Episode of Acute Pulmonary Embolism: A Cohort Study. Lung 2020; 198:59-64. [PMID: 31894412 DOI: 10.1007/s00408-019-00315-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 10/15/2019] [Accepted: 12/23/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Chronic thromboembolic pulmonary hypertension (CTEPH) is an important complication after acute pulmonary embolism (PE) with considerable morbidity and mortality. The aim of this study was to estimate the CTEPH incidence in a cohort after the first occurrence of PE. METHODS We conducted a 1-year follow-up cohort study between 2015 and 2018 to assess the incidence of CTEPH in 474 patients with their first acute episode of PE. For the diagnosis of CTEPH, patients with unexplained persistent dyspnea during follow-up underwent transthoracic echocardiography, right heart catheterization, ventilation-perfusion lung scanning, and CT pulmonary angiography. RESULTS Overall, 317 patients were included in the study. The mean age of the patients was 56.5 ± 16 years. One hundred and three patients (32%) had exertional dyspnea at the 1-year follow-up. Patients with evidence of pulmonary hypertension (PH) on echocardiography underwent right heart catheterization. Eleven patients (18%) had no PH (mPAP < 25 mmHg); 47 patients (81%) had mPAP > 25 mmHg. Fifteen patients had PAWP > 15 mmHg, including those with underlying left heart problems or valvular diseases. There were 32 patients with PAH (mPAP > 25 mmHg and PVR > 3 WU) undergoing CTEPH studies; 22 patients (6.9%) had multiple segmental defects suggesting CTEPH on a perfusion scan. CONCLUSION The incidence of CTEPH observed in this study 1 year after the first episode of acute PE was approximately 6.9%. This incidence seems to be high in our population, and diagnostic and therapeutic strategies for the early identification of CTEPH are needed.
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Affiliation(s)
- Farid Rashidi
- Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. .,Tabriz University of Medical Sciences, Imam Reza General Hospital, 29 Bahaman St, Tabriz, Iran.
| | - Rezayat Parvizi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Eisa Bilejani
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Babak Mahmoodian
- Medical Radiation Sciences Research Team, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Rahimi
- Department of Radiology, Imam Reza Teaching Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ata Koohi
- Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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12
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Javanshir E, Sadat-Ebrahimi SR, Parvizi R, Toufan M, Sate H. Giant mass but small symptoms; huge thrombosis in the right atrium originating from the superior vena cava and protruding to the right ventricle: a case report. J Med Case Rep 2019; 13:312. [PMID: 31627731 PMCID: PMC6800504 DOI: 10.1186/s13256-019-2240-3] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 08/21/2019] [Indexed: 11/24/2022] Open
Abstract
Background Thrombosis of the superior vena cava with propagation to the right heart chambers can be seen in the presence of chronic indwelling catheters. Moreover, the idiopathic right atrial thrombi may become entrapped in Chiari’s networks, and idiopathic thrombosis of the superior vena cava may occur rarely because of the underlying coagulation disorders or malignancies. Case presentation A 43-year-old Iranian (Persian) woman was admitted to our hospital with palpitation of 2 years’ duration and mild to moderate dyspnea of 10 days’ duration. Her past medical history, basic laboratory test results, and cardiac enzyme measurements were unremarkable. Imaging studies revealed a 1.4-cm × 7.4-cm multilobulated, hypermobile mass in the right atrium, extending into the right ventricle, that appeared to be emanating from the superior vena cava. Moreover, partial filling defects were visible in the distal parts of both right and left pulmonary arteries extending to their branches, suggesting massive pulmonary emboli. The patient’s huge mass and emboli were removed by surgery, and pathologic evaluations confirmed that all of the specimens were thrombosis. A number of mutations known as risk factors of thrombosis were detected during genetic evaluations. However, mild symptoms of the patient along with a huge mass in the right atrium, thrombosis in the superior vena cava, and massive thromboembolism remained unexplained. Conclusion Huge and dangerous thrombosis inside the heart and superior vena cava can evolve without expected considerable symptoms. Also, detecting the underlying causes of these thromboses sometimes is not feasible by only checking the prevalent known risk factors. Therefore, comprehensive evaluations should be carried out in these patients.
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Affiliation(s)
- Elnaz Javanshir
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyyed-Reza Sadat-Ebrahimi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. .,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Rezayat Parvizi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehrnoosh Toufan
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hosein Sate
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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13
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Toufan-Tabrizi M, Parvizi R, Reshadati N, Shokouhi B. Left Atrial Malignant Fibrous Histiocytoma with Right Atrium Invasion. Caspian J Intern Med 2019; 10:228-230. [PMID: 31363403 PMCID: PMC6619481 DOI: 10.22088/cjim.10.2.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background: Primary cardiac tumors are rare (0.001 to 0.03%). Malignant tumors account for 25%, of which 75% are cardiac sarcomas. Case Persentation: Here, we report a case of a 57-year-old male with palpitation and history of left atrial (LA) myxoma resection presented to cardiology clinic for postsurgical follow up and transthoracic echocardiography revealed a large non-homogenous mass in LA with right atrium invasion, which was confirmed by trans-esophageal echocardiography. The patient underwent surgical resection of tumor and the pathological diagnosis was malignant fibrous histiocytoma (MFH). Conclusion: MFH could be asymptomatic and the diagnosis be established as a surgical or complementary examination. In patients with history of myxoma resection and cardiac masses, further evaluation is recommended.
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Affiliation(s)
| | - Rezayat Parvizi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Najmeh Reshadati
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behrooz Shokouhi
- Pathology Department, Tabriz University of Medical Sciences, Tabriz, Iran
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14
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Ghaderi S, Alidadiani N, Dilaver N, Heidari HR, Parvizi R, Rahbarghazi R, Soleimani-Rad J, Baradaran B. Letter to the editor regarding article, “Role of glycogen synthase kinase following myocardial infarction and ischemia–reperfusion”. Apoptosis 2019; 24:541. [DOI: 10.1007/s10495-019-01546-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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15
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Ghaderi S, Alidadiani N, Soleimani Rad J, Heidari HR, Dilaver N, Mansoori B, Rhabarghazi R, Parvizi R, Khaze Shahgoli V, Baradaran B. Construction and Development of a Cardiac Tissue-Specific and Hypoxia-Inducible Expression Vector. Adv Pharm Bull 2018; 8:29-38. [PMID: 29670836 PMCID: PMC5896393 DOI: 10.15171/apb.2018.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 12/02/2017] [Revised: 01/30/2018] [Accepted: 02/06/2018] [Indexed: 01/23/2023] Open
Abstract
Purpose: Cardiovascular gene therapy is a sophisticated approach, thanks to the safety of vectors, stable transgene expression, delivery method, and different layers of the heart. To date, numerous expression vectors have been introduced in biotechnology and biopharmacy industries in relation to genetic manipulation. Despite the rapid growth of these modalities, they must be intelligently designed, addressing the cardiac-specific transgene expression and less side effects. Herein, we conducted a pilot project aiming to design a cardiac-specific hypoxia-inducible expression cassette. Methods: We explored a new approach to design an expression cassette containing cardiac specific enhancer, hypoxia response elements (HRE), cardiac specific promoter, internal ribosome entry site (IRES), and beta globin poly A sequence to elicit specific and inducible expression of the gene of interest. Enhanced green fluorescent protein (eGFP) was sub-cloned by BglII and NotI into the cassette. The specificity and inducible expression of the cassette was determined in both mouse myoblast C2C12 and mammary glandular tumor 4T1 as 'twin' cells. eGFP expression was evaluated by immunofluorescence microscope and flow cytometry at 520 nm emission peak. Results: Our data revealed that the designed expression cassette provided tissue specific and hypoxia inducible (O2<1%) transgene expression. Conclusion: It is suggested that cardiac-specific enhancer combined with cardiac-specific promoter are efficient for myoblast specific gene expression. As well, this is for the first time that HRE are derived from three well known hypoxia-regulated promoters. Therefore, there is no longer need to overlap PCR process for one repeated sequence just in one promoter.
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Affiliation(s)
- Shahrooz Ghaderi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Molecular Medicine, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.,Student research committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Alidadiani
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Jafar Soleimani Rad
- Department of Anatomy, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Reza Heidari
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nafi Dilaver
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Behzad Mansoori
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Rhabarghazi
- Stem cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Applied Cell Sciences, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rezayat Parvizi
- Department of Cardiothoracic Surgery, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Behzad Baradaran
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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16
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Pourafkari L, Tajlil A, Ghaffari S, Parvizi R, Chavoshi M, Kolahdouzan K, Khaki N, Parizad R, Hobika GG, Nader ND. The frequency of initial misdiagnosis of acute aortic dissection in the emergency department and its impact on outcome. Intern Emerg Med 2017; 12:1185-1195. [PMID: 27592236 DOI: 10.1007/s11739-016-1530-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 08/27/2016] [Indexed: 11/26/2022]
Abstract
We determine the frequency of initial misdiagnosis and inappropriate treatment with antiplatelets/anticoagulants in the emergency department (ED) and the resultant clinical outcomes in patients with acute type A aortic dissection (AAOD). Medical records of patients with a final diagnosis of AAOD admitted from March 2004 through October 2015 to our tertiary-level heart hospital were evaluated. Patients with suspected dissection in ED were compared to those with initial misdiagnosis regarding demographics and clinical presentation, laboratory and echocardiographic findings. Our primary outcome was hospital mortality in two groups. Long-term mortality after discharge was our secondary outcome. Among 189 patients, 47 (24.8 %) were initially misdiagnosed and received antiplatelets/anticoagulants in ED (Group F), and 142 (75.1 %) were appropriately diagnosed in ED (Group T). The mean age in group F was 60.4 ± 15.0 vs. 57.4 ± 16.0 years in group T (p = 0.260). In group F, 70.2 % were male vs. 60.6 % in group T (p = 0.311). Hospital mortality was 48.9 % in group F vs. 43.7 % in group T (p = 0.645). Long-term mortality was significantly higher in group F (55.6 vs. 21.2 %, p = 0.007). Univariate hazard ratio (HR) of initial misdiagnosis for long-term mortality was 2.56 (95 % CI 1.08-6.06, p = 0.031). In multivariate Cox regression analysis with adjustment for age and type of management (surgical/medical), initial misdiagnosis lost its significance for predicting long-term mortality (HR 2.14, 95 % CI 0.89-5.13, p = 0.086). Initial misdiagnosis of AAOD is a common problem. Hospital mortality is not significantly affected by receiving antiplatelets/anticoagulants. Although long-term mortality is higher in patients with initial misdiagnosis, it is not an independent predictor for long-term mortality.
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Affiliation(s)
- Leili Pourafkari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Anesthesiology, School of Medicine and Biomedical Sciences, University at Buffalo, 77 Goodell Street Suite #550, Buffalo, NY, 14203, USA
| | - Arezou Tajlil
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samad Ghaffari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rezayat Parvizi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Kasra Kolahdouzan
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nasrin Khaki
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Raziyeh Parizad
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Geoffery G Hobika
- Department of Anesthesiology, School of Medicine and Biomedical Sciences, University at Buffalo, 77 Goodell Street Suite #550, Buffalo, NY, 14203, USA
| | - Nader D Nader
- Department of Anesthesiology, School of Medicine and Biomedical Sciences, University at Buffalo, 77 Goodell Street Suite #550, Buffalo, NY, 14203, USA.
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17
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Pourafkari L, Tajlil A, Ghaffari S, Chavoshi M, Kolahdouzan K, Parvizi R, Parizad R, Nader ND. Electrocardiography changes in acute aortic dissection-association with troponin leak, coronary anatomy, and prognosis. Am J Emerg Med 2016; 34:1431-6. [PMID: 27142756 DOI: 10.1016/j.ajem.2016.04.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 04/10/2016] [Accepted: 04/11/2016] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Electrocardiography (ECG) offers some information that may be used to prognosticate acute type A aortic dissection (AAOD) for short- and long-term mortality. METHODS We retrospectively analyzed the electrocardiograms of patients with AAOD admitted from March 2004 to March 2015. The frequency of ECG findings and their prognostic value on hospital and follow-up mortality were investigated. Findings pertaining to coronary involvement and troponin level were also examined. RESULTS A total of 120 men and 64 women were admitted. Acute ischemic changes were reported in 38.0%, whereas T inversion was the most common recorded abnormality, which occurred in 38.6%. Acute ST-elevation myocardial infarction was detected in 16.3%. Troponin increased in 36.6%; 21.9% of the patients underwent coronary angiography among which 70% were normal. Coronary involvement or troponin increase was not different in patients with acute ECG changes. During hospitalization, 45.7% of the patients died. In multivariate analyses, ST elevation in lead aVR was associated with higher hospital death (odds ratio, 5.30; 95% confidence interval, 1.09-25.73; P = .038), whereas QRS greater than 120 milliseconds was associated with long-term mortality (hazard ratio, 2.45; 95% confidence interval, 1.25-3.76; P = .006). CONCLUSION Acute ischemic ECG changes are common in AAOD, and a completely normal ECG is infrequently encountered. Acute ECG changes were not associated with the increased troponin or the presence of coronary lesions in angiography.
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Affiliation(s)
- Leili Pourafkari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Anesthesiology, University at Buffalo, Buffalo, NY 14214.
| | - Arezou Tajlil
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Samad Ghaffari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mohammadreza Chavoshi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Kasra Kolahdouzan
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Rezayat Parvizi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Raziyeh Parizad
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Nader D Nader
- Department of Anesthesiology, University at Buffalo, Buffalo, NY 14214.
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18
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Toufan M, Pourafkari L, Parvizi R, Shokouhi B, Nader ND. An unusual cause of severe tricuspid stenosis. Turk Kardiyol Dern Ars 2016; 44:89. [PMID: 26875140 DOI: 10.5543/tkda.2015.57513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Mehrnoush Toufan
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leili Pourafkari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rezayat Parvizi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behrouz Shokouhi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nader D Nader
- Department of Anesthesiology, University At Buffalo, NY, USA
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19
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Akbarzadeh F, Parvizi R, Safaie N, Karbalaei MM, Hazhir-Karzar B, Bagheri B. Freedom from atrial fibrillation after cox maze III ablation during follow-up. Niger Med J 2015; 56:59-63. [PMID: 25657496 PMCID: PMC4314862 DOI: 10.4103/0300-1652.149173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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] [Indexed: 11/30/2022] Open
Abstract
Background: Nearly 60% of patients undergoing mitral valve (MV) operations are affected by atrial fibrillation (AF). Cox Maze III ablation is one of the effective ways for restoring sinus rhythm for patients undergoing open heart surgery. The aim of present study was to evaluate efficacy of Maze III ablation procedure for restoring sinus rhythm among patients who had underwent open heart surgery. Materials and Methods: During present descriptive-analytic prospective study 114 patients with chronic AF had undergone open heart surgery for their valvular or coronary artery diseases in Educational-Medical centres of Tabriz University of Medical Sciences (Tabriz, Iran) 2006-2012, were included in the study. For all patients Maze III ablation was done. Patients were evaluated by 12 lead electrocardiography (ECG) and 24 hours ambulatory ECG monitoring after 3-6 years (mean 4.8) of follow-up. Result: Patients' rhythm before Cox Maze III surgery was chronic AF in all patients. All patients were discharged from operating room with sinus rhythm. During intensive care unit (ICU) hospitalization, rhythm of 34 patients changed to AF and 80 patients had sinus rhythm. Sixteen patients had undergone electrical cardioversion for restoring sinus rhythm which was successful in 12 patients. Ninety-two patients had sinus rhythm when discharged from the hospital. After termination of follow-up, freedom from atrial fibrillation was 51%. Patients with AF during follow-up on surface ECG didn't have episodes of sinus rhythm in their ambulatory monitoring. One patient implanted cardiac pacemaker due to persistent sinus bradycardia. Conclusion: Based on the results of this study, Cox Maze III ablation procedure is an effective and safe way for restoring sinus rhythm among patients who are candidate for open heart surgery, while no significant complication was seen among patients.
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Affiliation(s)
- Fariborz Akbarzadeh
- Department of Cardiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rezayat Parvizi
- Department of Cardiac Surgery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Naser Safaie
- Department of Cardiac Surgery, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Bita Hazhir-Karzar
- Students' Research Committee, Medical Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Babak Bagheri
- Department of Cardiology, Mazandaran University of Medical Sciences, Sari, Iran
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20
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Salehi R, Parvizi R, Pourafkari L, Nader ND. Large isolated hydatid cyst of the interventricular septum. Echo Res Pract 2014; 2:I5-I6. [PMID: 26693319 PMCID: PMC4676427 DOI: 10.1530/erp-14-0075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 12/19/2014] [Indexed: 12/04/2022] Open
Affiliation(s)
- Rezvaniyeh Salehi
- Cardiovascular Research Centre, Tabriz University of Medical Sciences, Madani Heart Hospital , Tabriz, 5166615573 , Iran
| | - Rezayat Parvizi
- Cardiovascular Research Centre, Tabriz University of Medical Sciences, Madani Heart Hospital , Tabriz, 5166615573 , Iran
| | - Leili Pourafkari
- Cardiovascular Research Centre, Tabriz University of Medical Sciences, Madani Heart Hospital , Tabriz, 5166615573 , Iran
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21
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Salehi R, Parvizi R, Pourafkari L. Thrombus in transit: traveling from the inferior vena cava to the left ventricle. Echo Res Pract 2014; 1:I7-I8. [PMID: 26693306 PMCID: PMC4676461 DOI: 10.1530/erp-14-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 10/02/2014] [Indexed: 11/09/2022] Open
Affiliation(s)
- Rezvanieh Salehi
- Cardiovascular Research Center, Tabriz Univesity of Medical Sciences , Tabriz , Iran
| | - Rezayat Parvizi
- Cardiovascular Research Center, Tabriz Univesity of Medical Sciences , Tabriz , Iran
| | - Leili Pourafkari
- Cardiovascular Research Center, Tabriz Univesity of Medical Sciences , Tabriz , Iran
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22
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Yaghoubi A, Rostamzadeh M, Pezeshkian M, Parvizi R, Imani S. Evaluation of Early and Intermediate Outcomes of Cryo-MazeProcedure for Atrial Fibrillation. J Cardiovasc Thorac Res 2013; 5:55-9. [PMID: 24251012 DOI: 10.5681/jcvtr.2013.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 06/03/2013] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in patients with mitral valve disease affecting 50% of patients undergoing mitral valve surgery, contributing to increased risks of systemic embolization, anticoagulant- related hemorrhage and mortality. The maze procedure is an effective way to treat AF. Over the last several years, cryoablation was substituted for atrial incision in many reports to simplify the maze procedure. However, few studies have been carried out to evaluate the results of cryoablation surgery. In the present study we evaluated the results of this procedure. METHODS In this cross sectional study, 47 AF patients were treated with Cryo-Maze surgery method. Rhythm assessment using electrocardiographic and echocardiographic survey was performed in all patients before surgery, during the patients' hospital stay, on discharge and after six months. RESULTS Survival rate of the studied patients at six months was 93.6%. Sinus rhythm restoration rate in Cryo-Maze patients was 72.1% on discharge and 76.7% six months after their operation. CONCLUSION The present study revealed that Cryo-Maze procedure is an effective and safe therapeutic modality in AF while normal sinus rhythm can be achieved in patients following this intervention.
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Affiliation(s)
- Alireza Yaghoubi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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23
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Parvizi R, Namdar H, Bilehjani E, Bayat A, Sheikhalizadeh MA. Simultaneous operation of hydatid cyst of the heart and liver: a case report. J Cardiovasc Thorac Res 2013; 5:127-8. [PMID: 24252990 DOI: 10.5681/jcvtr.2013.027] [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] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 09/04/2013] [Indexed: 12/28/2022] Open
Abstract
Primary echinococcosis of the heart is exceptionally uncommon and is reported 0.5% to 2% of all hydatid cyst sites in comparison with liver (70%) or lung (20%) involvement. Hydatid disease of the heart is caused by the cestode tapeworm echinococcosis granulosis or alveolaris. We present a 29-year-old female with hydatid disease of the liver and heart. She only complained of abdominal pain and palpitation. Echocardiography and multi-slice computed tomography (MSCT) showed a 120×101 mm cyst in the liver and 64 mm in the right ventricular free wall. Both cysts were excised within one procedure successfully.
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Affiliation(s)
- Rezayat Parvizi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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24
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Afrasiabirad A, Parvizi R, Pezeshkian M, Safaii N, Jodati A. OP-190 AORTIC VALVE REPAIR IN ACUTE DISSECTION OF THE ASCENDING AORTA. Int J Cardiol 2012. [DOI: 10.1016/s0167-5273(12)70115-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Pourafkari L, Parvizi R, Separham A, Ghaffari S. A coin in the heart. Heart Views 2012; 13:155. [PMID: 23437417 PMCID: PMC3573362 DOI: 10.4103/1995-705x.105738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Leili Pourafkari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Address for correspondence: Dr. Leili Pourafkari, Department of Cardiovascular Research, Tabriz University of Medical Sciences, Tabriz, Iran. E-mail:
| | - Rezayat Parvizi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Separham
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samad Ghaffari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Abstract
CONTEXT Congenital heart disease (CHD) patients bear a higher risk of scoliosis during their lifetime compared to their normal counterparts. On the other hand, operation on chest wall has been shown to increase the risk of scoliosis. However, the data are inconclusive. The present retrospective analysis is undertaken to determine the frequency of post-thoracotomy/sternotomy scoliosis in children with CHD. MATERIALS AND METHODS One hundred and eighty children with CHD who underwent thoracotomy/sternotomy and had a minimum followup of 3 years in a teaching center from 1997 to 2010 were recruited. After operation, all the patients were regularly examined for the development of scoliosis. 102 patients underwent thoracotomy and 78 sternotomy. Student's t test, Chi-square test, Fisher's exact test were used for statistical analyses. RESULTS Eighty-eight males and 92 females with a mean age of 9.95 ± 2.31 (range: 5-15) years were enrolled. The mean age at operation was 2.59 ± 1.66 (range: 0-9) years and the mean follow-up period was 7.36 ± 2.12 (range: 5-13) years. Scoliosis was confirmed in two patients (1.1%): 1 (1%) in the thoracotomy group (a 12-year-old female operated 2 years earlier with a spinal 22° convexity to the right and 78° kyphosis) and another (1.1%) in the sternotomy group (an 8-year-old female operated during her neonatal period with a spinal 23° convexity to the left). CONCLUSION Scoliosis is not a common finding among the operated children with CHD in our center.
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Affiliation(s)
- Hojjat Hosseinpour Feiz
- Department of Orthopedics, Tabriz University of Medical Sciences, Shohada Hospital, Tabriz, Iran
| | - Abbas Afrasiabi
- Department of Cardiac Surgery, Tabriz University of Medical Sciences, Madani Hospital, Tabriz, Iran
| | - Rezayat Parvizi
- Department of Cardiac Surgery, Tabriz University of Medical Sciences, Madani Hospital, Tabriz, Iran
| | - Ahad Safarpour
- Department of Orthopedics, Tabriz University of Medical Sciences, Shohada Hospital, Tabriz, Iran
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Miabi Z, Pourfathi H, Midia M, Midia R, Parvizi R. Comparison of CT angiography and digital subtraction angiography in the diagnosis of aortic coarctation. Pak J Biol Sci 2011; 14:74-7. [PMID: 21913502 DOI: 10.3923/pjbs.2011.74.77] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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
There are several methods for the diagnosis and evaluation of coarctation of the aorta. Digital Subtraction Angiography (DSA) is the standard detection method, though it entails complications and side-effects. The aim of the present study was to compare Computed Tomography (CT) angiography with DSA for diagnosing aortic coarctation. We performed a cross-sectional study of 15 patients (11 males and four females aged between two and 30 years) referred to Tabriz Shahid Madani Hospital and Imaging Center between August 2005 and February 2006 with suspected aortic coarctation. All patients were subjected to DSA and CT angiography for diagnosis of aortic coarctation. The mean age of the patients was 14.6 years; 11 were male (74.4%) and four (26.6%) were female. The DSA and CT angiography results were comparable in all patients in terms of diagnosis and the detection of complications, particularly cardiovascular complications. However, CT angiography was less time-consuming to perform than DSA (p < 0.0001). In conclusion, CT angiography, comparableto DSA, diagnosed coarctation of aorta in all the patients. However, CT angiography is a non-invasive, cost effective procedure that takes significantly less time to carry out than DSA. Therefore, CT angiography is recommended as an appropriate method for diagnosing the coarctation of aorta.
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Affiliation(s)
- Zinat Miabi
- Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran
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Farhoudi M, Mehrvar K, Afrasiabi A, Parvizi R, Khalili AA, Nasiri B, Hashemzadeh K, Ghabili K. Neurocognitive impairment after off-pump and on-pump coronary artery bypass graft surgery - an Iranian experience. Neuropsychiatr Dis Treat 2010; 6:775-8. [PMID: 21173884 PMCID: PMC2999523 DOI: 10.2147/ndt.s14348] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Coronary artery bypass graft (CABG) surgery is one of the most commonly performed surgical procedures worldwide, and it may be accompanied by postoperative neurocognitive impairment. Although this complication has been attributed to the use of cardiopulmonary bypass, it is still a matter of debate whether the switch from on-pump to off-pump technique affects the cognitive function. OBJECTIVE The aim of this study was to compare the impact of the on-pump and off-pump techniques on neurocognitive impairment in low-risk CABG surgery groups. METHODS In a descriptive and analytic study, 201 CABG patients with left-ventricular ejection fraction >30%, and without cardiac arrhythmia were enrolled. Before the elective operation, all patients underwent neurological examination and neurocognitive test, Mini-Mental State Examination (MMSE). Two months following the operation, both on- and off-pump, the patients were re-examined by MMSE to detect any neurocognitive impairment. RESULTS Out of 154 patients included in the study, 95 (61.6%) and 59 (38.3%) patients were in off-pump and on-pump groups, respectively. Mean age of the patients was 57.17 ± 9.82 years. A 2-month postoperative neurocognitive impairment was detected among 17 patients of on-pump group (28.8%) and in 28 cases of off-pump group (29.4%) (P = 0.54). The mean postoperative MMSE scores were not comparable between groups (25.01 ± 4.49 in off-pump group versus 23.73 ± 4.88 in on-pump group, P = 0.09). CONCLUSION The present study revealed that in low-risk patients undergoing CABG surgery, either the techniques of on-pump or off-pump did not differ regarding the neurocognitive outcome 2 months after the procedure.
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Abdulrahman RI, Parvizi R. Outcome of coronary artery bypass grafts: comparison between on pump and off pump. Acta Med Iran 2010; 48:158-163. [PMID: 21137651] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
The present study was undertaken to compare the in hospital results of coronary artery bypass graft (CABG) with (on pump) or without (off pump) cardiopulmonary bypass (CPB). Data were collected on all first-time isolated CABGs with saphenous vein and/or artery grafts at Shahid Madani Hospital in Tabriz-Iran, between 2006 and 2009. Age and clinical profile were marched between on pump and off pump group patients. Patients with concomitant cardiac operations or beating pump technique were excluded from the study. The study included 994 patients; CABG with CPB (ONCABG) was done in 578 (58%) and CABG without CPB (OPCABG) in 416 (42%). For pump and off pump group respectively, mortality rate was 2/3%, and 0.2%, the number of grafts was 2/92 +/- 0.82 and 2/12 +/- 0.73 and the use of intra aortic balloon-pump (IABP) was 1.5% and5.4%. Post operative ejection fraction (EF) was improved in off pump group (47.9 +/- 0.6) versus on pump group (44.53 +/- 1.5) and the latter group had more post operative atrial fibrillation, Stroke, acute renal failure, bleeding rate and blood products transfusion, prolonged intubation time but was not statistically significance. Meanwhile Hospitalization time and use of inotrops was less in comparison with former patients group. Off pump CABG was a safe method in our series. Patients with comparable risk profiles have similar prevalence's of selected complications after ONCABG and OPCABG, though some clinical and hemodynamic results are better with off pump technique.
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Affiliation(s)
- Rasoul Ibrahim Abdulrahman
- Department of Cardiac Surgery, Shahid Madani Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
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Rasoul-Amini S, Ghasemi Y, Morowvat MH, Ghoshoon MB, Raee MJ, Mosavi-Azam SB, Montazeri-Najafabady N, Nouri F, Parvizi R, Negintaji N, Khoubani S. Characterization of hydrocortisone bioconversion and 16S RNA gene in Synechococcus nidulans cultures. APPL BIOCHEM MICRO+ 2010. [DOI: 10.1134/s0003683810020110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Rasoul-Amini S, Ghasemi Y, Morowvat MH, Ghoshoon MB, Raee MJ, Mosavi-Azam SB, Montazeri-Najafabady N, Nouri F, Parvizi R, Negintaji N, Khoubani S. Characterization of hydrocortisone bioconversion and 16S RNA gene in Synechococcus nidulans cultures. Prikl Biokhim Mikrobiol 2010; 46:205-211. [PMID: 20391765] [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: 05/29/2023]
Abstract
A unicellular cyanobacterium, Synechococcus nidulans (Pringsheim) Komárek, was isolated from paddy-fields and applied in the biotransformation experiment of hydrocortisone (1). This strain has not been previously tested for steroid bioconversion. Fermentation was carried out in BG-11 medium supplemented with 0.05% substrate at 25 degrees C for 14 days of incubation. The obtained products were chromatographically purified followed by their characterization using spectroscopic methods. 11beta,17beta-dihydroxyandrost-4-en-3-one (2), 11beta-hydroxyandrost-4-en-3,17-dione (3), and androst-4-ene-3,17-dione (4) were the main bioproducts in the hydrocortisone bioconversion. The observed bioreaction characteristics were the side chain degradation of the substrate to prepare compounds (2) and (3) following the 11beta-dehydroxylation for accumulation of the compound (4). Time course study showed the accumulation of the product (2) from the second day of the fermentation and compounds (3) and (4) from the third day. All the metabolites reached their maximum concentration in seven days. Cyanobacterial 16S rRNA gene was also amplified by PCR. Sequences were amplified using the universal prokaryotic primers which amplify a approximately 400-bp region of the 16S rRNA gene. PCR products were sequenced to confirm their authenticity as 16S rRNA gene of cyanobacteria. The result of PCR blasted with other sequenced cyanobacteria in NCBI showed 99% identity to the 16S small subunit rRNA of seven Synechococcus species.
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Affiliation(s)
- S Rasoul-Amini
- Department of Pharmaceutical Biotechnology and Pharmaceutical Sciences Research Center, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz 71345-1583, Iran
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Azarfarin R, Pourafkari L, Parvizi R, Alizadehasl A, Mahmoodian R. Off-Pump Coronary Artery Bypass Surgery in Severe Left Ventricular Dysfunction. Asian Cardiovasc Thorac Ann 2010; 18:44-8. [DOI: 10.1177/0218492309354126] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Our aim was to examine hospital outcomes of coronary artery bypass surgery in patients with and without left ventricular dysfunction, with regard to the surgical technique (off- or on-pump). Between March 2007 and March 2008, 689 consecutive patients underwent isolated first-time coronary artery bypass; 127 had ejection fractions ≤30% (group 1) and 562 had ejection fractions >30% (group 2). Data of preoperative risk profiles and hospital outcomes were collected prospectively. Off-pump operations were performed in 49 (38.6%) patients in group 1 and 196 (34.9%) in group 2. The incidences of infectious, neurologic, and cardiac complications postoperatively were significantly higher in group 1. In multivariate analysis, preoperative ejection fraction ≤30% was found to be an independent risk factor for postoperative complications and hospital mortality. The subgroup of patients undergoing off-pump surgery in both groups had a significantly lower rate of total complications than those undergoing conventional on-pump operations, but no significant difference in mortality was observed between those undergoing off-pump or conventional surgery in either group. Off-pump surgery helped to limit the increased morbidity rate after coronary bypass in patients with ventricular dysfunction.
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Affiliation(s)
- Rasoul Azarfarin
- Cardiovascular Research Center Tabriz University of Medical Sciences Tabriz, Iran
| | - Leili Pourafkari
- Cardiovascular Research Center Tabriz University of Medical Sciences Tabriz, Iran
| | - Rezayat Parvizi
- Cardiovascular Research Center Tabriz University of Medical Sciences Tabriz, Iran
| | - Azin Alizadehasl
- Cardiovascular Research Center Tabriz University of Medical Sciences Tabriz, Iran
| | - Roghaiyeh Mahmoodian
- Cardiovascular Research Center Tabriz University of Medical Sciences Tabriz, Iran
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Ghotaslou R, Parvizi R, Safaei N, Yousefi S. A case of Aspergillus fumigatus mediastinitis after heart surgery in Madani Heart Center, Tabriz, Iran. ACTA ACUST UNITED AC 2008; 23:133-5. [PMID: 19039894 DOI: 10.1111/j.1751-7117.2008.00003.x] [Citation(s) in RCA: 5] [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: 11/30/2022]
Abstract
Reported here is the case of a 60-year-old male diabetic patient with mediastinitis caused by Aspergillus fumigatus following an open heart surgery that was successfully treated. A review of literature revealed that A. fumigatus as a cause of mediastinitis has been rarely described. Aspergillus infection should be considered in the differential diagnosis of mediastinitis after cardiac surgery, especially in a clinical setting of unexplained sepsis or nonhealing wound infection despite apparently adequate treatment.
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Affiliation(s)
- Reza Ghotaslou
- Department of Microbiology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
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Parvizi R, Maghamipour N, Safaei N, Hassanzadeh S. Survey of operative outcome for aortic dissection. Saudi Med J 2007; 28:752-4. [PMID: 17457445] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
OBJECTIVE To survey the results of operative outcome for aortic dissection. METHODS A retrospective study on 46 patients, admitted for operation in Shahid Madani Heart Hospital in Tabriz, Iran from 1994-2003. A questionnaire was used for collecting data. Statistical analysis was performed and was carried out through a descriptive statistical methods. RESULTS We included 30 males (65%) and 16 females (35%). Seven (15.2%) died in the operating room before surgery, while 39 patients (59% male and 41% female) underwent surgery. The mean age of patients was 48.9 +/- 2.3 years old. Pre-operative diagnosis was carried out by transesophageal echocardiography and angiography. All patients were operated in an emergency situation. In 42% of patients aortic valve replacement (AVR) with ascending aorta was replaced. In 24% only the ascending aorta was replaced, and in 10% the aortic valve was repaired with acute aortic dissection. In 10% of patients, the ascending aorta with aortic arch was replaced. Four patients (14%) had distal aortic dissection and replacement. Major complications were hemorrhage (31%) and respiratory failure (13.8%). A total of 20.7% died in hospital, and only 21 patients (45.5%) could be followed for 10 years. CONCLUSION Acute aortic dissection is a fatal disease. With early diagnosis and surgical intervention, we can save approximately 75% of patients with very good functional class and survival in the mid term.
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Affiliation(s)
- Rezayat Parvizi
- Department of Cardiothoracic Surgery, Cardiovascular Research Center of Tabriz University of Medical Sciences, Tabriz, Iran.
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Farhoudi M, Parvizi R, Bilehjani E, Tarzamni MK, Mehrvar K, Safaiyan A. Preoperative transcranial and carotid Doppler study in coronary artery bypass graft patients. Neurosciences (Riyadh) 2007; 12:42-45. [PMID: 21857617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To assess the correlation of postoperative neurologic complications with preoperative transcranial and carotid Doppler study findings of coronary artery bypass graft (CABG) patients. METHODS In a descriptive, analytic, follow up study we prospectively studied 201 patients undergoing elective and isolated CABG surgery during a 12 month period from October 2003 to September 2004 at Madani Hospital of Tabriz Medical Sciences University, Iran. Neurologic examination, intracranial cerebral arterial study using transcranial Doppler (TCD) and carotid duplex were performed preoperatively. Intraoperative and postoperative complications were followed up for one month. RESULTS Two hundred and one patients (158 male, 43 female) with a mean age of 57.29+/-9.67 were studied. Out of these, 131 patients had 3 coronary vessels disease, 64 had 2 vessels, 5 had one vessel, and one patient had diffuse coronary disease. A TCD was performed in 183 patients and disclosed abnormalities in 22 patients and was normal in 161 cases. The total number of involved arteries was 34. Among 154 carotid duplex studied patients, 102 had plaque, inducing <50% stenosis in 99, 50-74% stenosis in one, and 75-90% stenosis in 2 cases. Postoperative neurologic complication occurred as follows: 4 stroke, 7 delirium, and 3 amnesia. One of the operated patients died. Nine of 161 patients with normal TCD (5.6%) and 5 of 22 (22.7%) with intracranial cerebral arterial disease (ICAD) showed central nervous system (CNS) complications (p=0.015). There were significant correlations between number of involved cerebral arteries and post CABG CNS complications (p=0.0001), including stroke (p=0.007), and between diabetes mellitus history with these complications (p=0.012). CONCLUSION Our results suggest that lCAD is an independent risk factor for CNS complications after CABG surgery. Hence, we recommend pre-CABG evaluation of the cerebral arteries by TCD, for the risk assessment of CABG surgery.
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Affiliation(s)
- Mehdi Farhoudi
- Department of Neurology, Neurological Sciences Research Team, Imam Hospital, Tabriz University of Medical Sciences, Tabriz, Iran. Tel/Fax. +98 (411) 3342889. E-mail: /
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Parvizi R, Azarfarin R, Hassanzadeh S. Ultra-low dose aprotinin effects on reducing the need for blood transfusion in cardiac surgery. Saudi Med J 2007; 28:49-53. [PMID: 17206289] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
OBJECTIVE To assess the effects of ultra-low dose one million kallikrein inhibitor units (KIU) of aprotinin on bleeding and the need for transfusion after cardiac surgery. METHODS We carried out this randomized clinical trial on 162 cardiac surgery patients in Shahid Madani Hospital, Tabriz, Iran from April 2004 to December 2005. The patients were randomly divided into 2 groups of 81 individuals. In the aprotinin group, 0.5 million KIU infused before and 0.5 million KIU during cardiopulmonary bypass. In the placebo group, 100 ml normal saline was infused as above. The need to use fresh frozen plasma (FFP), packed red blood cells (PRBCs) transfusion during, after operation, the rate of chest tubes drainage at 6, 12 and 24 hours after surgery were measured in 2 groups. RESULTS Chest tubes drainage at 6 hours after surgery was 190 +/- 24 ml in the aprotinin group and 266 +/- 33 ml in the placebo group (p=0.066). The amount of bleeding at 12 and 24 hours was significantly different between 2 groups (p=0.048, p=0.009). The frequency of blood products transfusion in the aprotinin group was 68% and in the placebo group was 75% (p=0.02). The number of PRBCs and FFP units transfused were significantly lower in the aprotinin group (p=0.000, p=0.005). Total amount of blood and products transfusion in the aprotinin group was 2.56 +/- 0.27 units and in placebo group it was 4.37 +/- 0.27 units (p=0.0001). CONCLUSION Results indicate that the use of one million KIU of aprotinin in cardiac surgery is effective in reducing postoperative bleeding and transfusion requirements.
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Affiliation(s)
- Rezayat Parvizi
- Cardiovascular Research Center of Tabriz University of Medical Sciences, Tabriz, Iran.
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Parvizi R, Hashemzehi M, Salmasi SH, Safai N. Comparison of early results of limited thoracotomy versus complete sternotomy in atrial septal defect closure. Saudi Med J 2006; 27:742-5. [PMID: 16680279] [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: 05/09/2023] Open
Affiliation(s)
- Rezayat Parvizi
- Cardiovascular Research Center of Tabriz University of Medical Sciences, Tabriz, Iran.
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