Systemic Atherosclerosis Treated by Hybrid Surgical and Systemic Percutaneous Endovascular Management
Walid Hassan, MD, MACP, FACC, FSCAI, Amr Aljareh, MD, Mariam Hassan, Khaldoun Al Saadi, MD and Sahar Sharaf Eldin, MD
Article Type: Case Report | First Published: September 23, 2019
Atherosclerotic disease in one arterial site, raise the probability of having other sites affected by about 50% within the vascular axis. Hence once vascular pathology found in one site i.e. coronary artery disease (CAD), other sites i.e. Cerebral and peripheral circulation must be assessed thoroughly, especially in patients with multiple risk factors. Percutaneous intervention (PCI) is a conservative reasonable solution for high risk and inoperable cases; sometimes it supersedes the choice surg...
A Modified Advanced Cardiac Life Support Algorithm
Abdulhalim Jamal Kinsara
Article Type: PATIENT CARE | First Published: September 21, 2019
Advanced cardiac life support (ACLS) has been made with many algorithms. We are suggesting a simple combined one as a time frame expected to attend is minutes and maintaining coherent neurological status is crucial. In institutions with multiple nationalities, the way in which ACLS is taught might vary and the time frame expected to attend the important minutes in saving a life and maintaining coherent neurological status might been delayed....
A Rare Coronary Anomaly: Congenital Absence of the Left Circumflex Artery
Robert Tonks, MD, Rajiv Sharma, MD and Raj Baljepally, MD, FACC
Article Type: Case Report | First Published: August 26, 2019
Congenital anomalies of the coronary vasculature are usually asymptomatic and rare with an incidence of less than 1% and there are few cases reported of congenital absence of the left circumflex artery. It is important to recognize this anomaly and define the anatomy by left heart catheterization or coronary angiography by computerized tomography when considering percutaneous intervention or coronary artery bypass surgery on patients without a left circumflex artery. 71 yo male that recently mov...
Predictors of Heart Failure Caused by Volume Overload Using an Irrigation Catheter during Catheter Ablation for Atrial Fibrillation
Taeko Sato, RN, Issei Yoshimoto, MD, Naoya Oketani, MD, Hideki Okui, MD, Yasuhisa Iriki, MD, Hitoshi Ichiki, MD, Ryuichi Maenosono, PhD, Fuminori Namino, MT, Masaaki Miyata, MD and Mitsuru Ohishi, MD
Article Type: Original Article | First Published: August 14, 2019
Catheter ablation is an effective approach for managing patients with atrial fibrillation (AF). Currently, irrigation catheters are widely used in AF ablation. This causes volume overload during the procedure and occasionally causes heart failure after the procedure. Volume overload during catheter ablation caused heart failure not only in the patient with reduced ejection fraction but also who with preserved left ventricular ejection fraction. Heart failure with preserved left ventricular eject...
Angiographic Pattern of Coronary Artery Disease in Diabetic Patients Having Abnormal Ankle Brachial Index
Syed Haseeb Raza Naqvi, MBBS, FCPS, Han Naung Tun, MBBS, MD, Abdul Razzaq, MBBS, FCPS, Zubair Zaffar, MBBS, FCPS, Syed Nauman Ali, MBBS, FCPS, Haroon Babar, MBBS, FCPS and Tariq Abbas, MBBS, FCPS, FRCP
Article Type: Research Article | First Published: August 09, 2019
A total of 115 patients were included in the study. The mean age of patients was 62.40 years with standard deviation of 2.78 years. Majority of the patients in the study were male (68.7%). Mean ABI was of study participants was 1.2 with standard deviation of 0.58 while mean duration of disease was 3.2 years with standard deviation of 0.7 years. 97 of the study participants were hypertensive and 18 were smokers. A total of 28 patients (24.3%) did not have CAD as per angiography while the rest had...
The Impact of Transcatheter Aortıc Valve Implantatıon on Neutrophıl to Lymphocyte Ratıo: A Retrospective Study
Abdulmecit Afsin, MD, Veysi Kavalcı, MD, Zeynep Ulutas, MD, Hakan Kaya, MD, Erdal Akturk, Arif Suner and Necip Ermis
Article Type: Original Article | First Published: August 03, 2019
Transcatheter aortic valve implantation (TAVI) has become a novel therapeutic option for patients with severe aortic stenosis who have been considered inoperable or high risk for conventional surgical aortic valve replacement. The aim of this study was to determine the effect of TAVI on neutrophil to lymphocyte ratio (NLR). A total of 97 patients with severe aortic valve stenosis undergoing TAVI in our clinic were included in the study. The patients were divided into two groups based on valve t...
Left Main Coronary Artery Dissection during Breastfeeding Treated with CABG Complicated by Severe Ventricular Disfunction and Left Ventricular Thrombosis
Nicolo Sisti, MD, Giulia Elena Mandoli, MD, Antonio Pagliaro, MD, Giuseppe Guerrieri, MD, Carlotta Sciaccaluga, MD, Matteo Cameli, MD, PhD, Sergio Mondillo, MD and Serafina Valente, MD
Article Type: Case Report | First Published: July 18, 2019
Spontaneous coronary artery dissection (SCAD) should always be suspected in presence of chest pain during post-partum, since it is one of the possible causes. Strategies for the management of such disease and its complication are not still clearly encoded. A 40-years-old woman was referred with chest pain, started while breastfeeding, associated with an EKG pattern suggesting ischemia. After hospital admission, coronary angiography was performed showing a Type 1 left main coronary dissection. Gi...
Prevalence and Clinical Correlates of Spontaneous Echo Contrast in Patients on Oral Anticoagulation Undergoing Catheter Ablation for Atrial Fibrillation
Christian Grebmer, Carsten Lennerz, Amir Brkic, Patrick Blazek, Severin Weigand, Verena Semmler, Marc Kottmaier, Felix Bourier, Lena Friedrich, Elena Risse, Stephanie Brooks, Marie Kornmayer, Marta Telishevska, Tilko Reents, Christof Kolb, Gabriele Hessling and Isabel Deisenhofer
Article Type: Research Article | First Published: June 19, 2019
Spontaneous echo contrast (SEC) in the left atrial appendage (LAA) is associated with an increased risk of cerebral embolism in patients with atrial fibrillation (AF). Novel oral anticoagulants (NOACs) are increasingly prescribed as first-line therapy and have shown a comparable benefit-risk ratio compared to vitamin K antagonists (VKAs). The aim of this study was to investigate whether NOACs decrease the incidence of SEC compared to VKA. ...
Unroofed Coronary Sinus Syndrome Presenting with Early Pulmonary Hypertension
Maria E Franco-Fuenmayor, MD, Numra A Aleem, MD, Jorge D Salazar, MD, and Ashraf M Aly, MD
Article Type: Case Report | First Published: June 13, 2019
Isolated partial or complete absence of the coronary sinus roof hemodynamically behaves like an atrial septal defect and rarely causes pulmonary hypertension. We report a case of unroofed coronary sinus (URCS) presenting with post-operative cyanosis due to pulmonary hypertensive crisis following surgical repair of a ventricular septal defect at 6 months of age. He had progressively decreased stamina with gradual increase in pulmonary pressure requiring surgical closure of the URCS by 6 years of ...
Impact of Low-Dose Intracoronary Alteplase Infusion after Successful Primary Percutaneous Coronary Intervention
Ismail Mohamed Ibrahim, Ahmed S Eldamanhory, Mahmoud Abdelaziz and Abdelrashid Abdelaziz
Article Type: Research Article | First Published: June 05, 2019
In ST elevation myocardial infarction (STEMI), intracoronary thrombolysis after primary percutaneous coronary intervention (PPCI) was found to improve microvascular perfusion, yet without improvement in left ventricular (LV) remodeling. Our study aimed to find out possible effect on LV longitudinal function. 102 anterior STEMI patients eligible for PPCI were divided into: Alteplase group (53 patients; received intracoronary 0.3 mg/kg alteplase after PPCI) and control group (49 patients; treated ...
Left Ventricular Pacing in Patients with Mechanical Tricuspid Valve Replacement
Sara Khodor, Shreya Mishra, Dany Sayad and Anant Kharod
Article Type: Case Report | First Published: June 01, 2019
In patients with mechanical tricuspid valve replacement (TVR), management of atrioventricular conduction abnormalities can be challenging given inaccessibility of the right ventricle (RV) with an endocardial pacing lead. While implantation of an epicardial lead may serve as an alternative; it requires invasive surgical placement and is not an ideal option in patients with prior thoracotomy. The development of specialized leads have made lead implantation via coronary sinus (CS) an attractive alt...
Relationship between Hypovitaminosis D and Cardiac Abnormalities in Pre Dialysis Chronic Kidney Disease
Maria Carolina Neves, Luis Sette, Monica Becker, Lucila Valente and Brivaldo Markman Filho
Article Type: Research Article | First Published: June 01, 2019
The presence of structural and functional changes in the left ventricle (LV) are good predictors of cardiovascular events in patients with chronic kidney disease (CKD) and are associated with decreasing renal function. Studies in CKD patients on hemodialysis evidenced associations of serum 25-OH vitamin D (vit D) with myocardial function and structural changes. However, it is not known whether serum vit D is associated with Doppler echocardiogram (ECHO)-based cardiac changes in patients with CKD...
Hyperlipidemia Management in Proprotein Convertase Subtilisin- Kexin Type 9 (PCSK 9) Inhibitors Era
Abdulhalim Jamal Kinsara
Article Type: Original Article | First Published: June 01, 2019
Significant improvement in control of cardiovascular risk factors has been driven by performance measurement that focused on attainment of specific risk factor thresholds for blood glucose, lipids and blood pressure. Diet, statin and ezetimibe have reasonably controlled hyperlipidemia. However the discovery of proprotein convertase subtilisin-kexin type 9 inhibitors has given new hope of reaching the target lipid profile especially in the high-risk group and familial hypercholesterolemia. Here w...
Molecular Basis of Pulmonary Hypertension
Ambrin Farizah Babu
Article Type: Review Article | First Published: May 31, 2019
Pulmonary hypertension is a life threatening incurable disorder. The advances in physiology, genetics, and molecular biology have greatly improved our understanding of the cellular and molecular mechanisms underlying the disorder. In this review, the recent progresses in the understanding of molecular mechanism are presented. Many studies show that pulmonary hypertension is caused due to mitochondrial dysfunction, endothelin-1, prostacyclin and serotonin. These findings and their exploitation wi...
Current Endocarditis Prophylaxis Guidelines and Incidence of Infection
Article Type: Review Article | First Published: May 30, 2019
Infective endocarditis (IE) defined as an infection caused by bacteria that enter the bloodstream and settle in the endocardium, a heart valve or a blood vessel, has maintained a high prevalence, morbidity and mortality over the past few decades. The most obvious changes over time have been in terms of factors that lead to IE. For e.g. A larger elderly population, decrease in Rheumatic heart disease (RHD) cases, Increased use of prosthetic heart valves, increased intravenous drug abuse, and incr...