Objective: To evaluate the use of transesophogeal echocardiography (TEE) for percutaneous left atrial appendage (LAA) occlusion. Methods: LAA occlusion was performed in 20 atrial fibrillation (AF) patients with non-valvular lesions, including nine males and 11 females. TEE was used for the preoperative measurement of the maximal LAA orifice diameter and LAA depth and the guidance of atrial septum puncture. The release of the occluder during the occlusion procedure was also performed under TEE monitoring. Results: All 20 patients underwent successful occlusion of the LAA under the guidance of TEE. There were two (10.0%) cases with mild residual shunt after occlusion, among which only one (5.0%) patient still retained slight residual shunt at one month postoperative. All the other (95.0%) patients revealed no residual shunt. There was no difference between the maximal LAA orifice diameter (22.75 ± 4.85 mm vs. 22.15 ± 4.23) and LAA depth (36.60 ± 5.51 vs. 35.00 ± 4.76) derived from TEE and the digital subtraction angiography (DSA) measurement. Both the max orifice diameter and LAA depth measured by TEE were strongly correlated with that measured by DSA, with r = 0.75, P < 0.001 and r = 0.82, P < 0.001, respectively. Conclusions: TEE can accurately estimate the maximal LAA orifice diameter and LAA depth and provide an important reference for preoperative occluder size selection. It can also be used for intraoperative guidance and assessing results during the operation. TEE is of great importance for LAA occlusion.
目的:探讨经食管超声心动图(TEE)在经皮左心耳(LAA)闭塞中的应用。方法:对20例非瓣膜性房颤(AF)患者行LAA闭塞术，其中男9例，女11例。术前应用TEE测量LAA最大孔径和LAA深度，指导房间隔穿刺。在TEE监测下，在咬合过程中也进行了咬合器的释放。结果:20例患者均在TEE指导下成功闭塞LAA。术后2例(10.0%)患者存在轻度分流残留，其中1例(5.0%)患者术后1个月仍有轻微分流残留。其余95.0%的患者均未发现残留分流管。TEE与DSA测量LAA最大孔径(22.75±4.85 mm vs 22.15±4.23 mm)和LAA深度(36.60±5.51 vs 35.00±4.76)无差异。TEE测得的最大孔口直径和LAA深度与DSA测得的最大孔口直径和LAA深度均呈强相关，r = 0.75, P < 0.001, r = 0.82, P < 0.001。结论TEE能准确估计LAA最大孔径和LAA深度，为术前选择封堵器尺寸提供重要参考。也可用于术中指导和术中评估结果。TEE对LAA闭塞非常重要。
{"title":"Application of Transesophogeal Echocardiography in Percutaneous Left Atrial Appendage Occlusion","authors":"Yin Huang, Zi-qing Gao, Xiaobo Chen, Yong-quan Huang","doi":"10.13189/ijccd.2020.070201","DOIUrl":"https://doi.org/10.13189/ijccd.2020.070201","url":null,"abstract":"Objective: To evaluate the use of transesophogeal echocardiography (TEE) for percutaneous left atrial appendage (LAA) occlusion. Methods: LAA occlusion was performed in 20 atrial fibrillation (AF) patients with non-valvular lesions, including nine males and 11 females. TEE was used for the preoperative measurement of the maximal LAA orifice diameter and LAA depth and the guidance of atrial septum puncture. The release of the occluder during the occlusion procedure was also performed under TEE monitoring. Results: All 20 patients underwent successful occlusion of the LAA under the guidance of TEE. There were two (10.0%) cases with mild residual shunt after occlusion, among which only one (5.0%) patient still retained slight residual shunt at one month postoperative. All the other (95.0%) patients revealed no residual shunt. There was no difference between the maximal LAA orifice diameter (22.75 ± 4.85 mm vs. 22.15 ± 4.23) and LAA depth (36.60 ± 5.51 vs. 35.00 ± 4.76) derived from TEE and the digital subtraction angiography (DSA) measurement. Both the max orifice diameter and LAA depth measured by TEE were strongly correlated with that measured by DSA, with r = 0.75, P < 0.001 and r = 0.82, P < 0.001, respectively. Conclusions: TEE can accurately estimate the maximal LAA orifice diameter and LAA depth and provide an important reference for preoperative occluder size selection. It can also be used for intraoperative guidance and assessing results during the operation. TEE is of great importance for LAA occlusion.","PeriodicalId":269499,"journal":{"name":"International Journal of Cardiovascular and Cerebrovascular Disease","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114280845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-01DOI: 10.13189/ijccd.2020.070101
M. Reshma, P. Gouthami, P. Tasleem, B. Shailaja, J. Thipperudra
Drug related problems in cardio vascular disease patients may lead to morbidity, mortality and the decreased quality of life. The main aim of the study is to assess, identify and resolve drug related problems in patients with Cardiovascular Diseases. A total of 150 cardiac patients were enrolled into the study. In our study, out of 150 we got 71 DRPs like Drug-Drug interactions 33(46.4%), ADRs 14(20%), indication without Drug 6(8.4%), drug use without indication 8(11.2%), sub therapeutic dose 10(14%). The association between risk factors like alcohol abuse, smoking, diabetes, hypertension increased risk of CVD. The P value was statistically significant in males than in females. In this study, for individuals with drug related problems of cardiovascular diseases, males were found to be more when compared with females due to risk factors such as smoking, alcoholism, life style etc. the drug related problems were high in patients aged between 40-60 years because of their multiple co-morbid conditions. Polypharmacy was the main predisposing factor for drug related problems.
{"title":"Assessment of Drug Related Problems in Patients with Cardiovascular Diseases in Tertiary Care Hospital: A Clinical Pharmacist Intervention","authors":"M. Reshma, P. Gouthami, P. Tasleem, B. Shailaja, J. Thipperudra","doi":"10.13189/ijccd.2020.070101","DOIUrl":"https://doi.org/10.13189/ijccd.2020.070101","url":null,"abstract":"Drug related problems in cardio vascular disease patients may lead to morbidity, mortality and the decreased quality of life. The main aim of the study is to assess, identify and resolve drug related problems in patients with Cardiovascular Diseases. A total of 150 cardiac patients were enrolled into the study. In our study, out of 150 we got 71 DRPs like Drug-Drug interactions 33(46.4%), ADRs 14(20%), indication without Drug 6(8.4%), drug use without indication 8(11.2%), sub therapeutic dose 10(14%). The association between risk factors like alcohol abuse, smoking, diabetes, hypertension increased risk of CVD. The P value was statistically significant in males than in females. In this study, for individuals with drug related problems of cardiovascular diseases, males were found to be more when compared with females due to risk factors such as smoking, alcoholism, life style etc. the drug related problems were high in patients aged between 40-60 years because of their multiple co-morbid conditions. Polypharmacy was the main predisposing factor for drug related problems.","PeriodicalId":269499,"journal":{"name":"International Journal of Cardiovascular and Cerebrovascular Disease","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127683020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-07-01DOI: 10.13189/IJCCD.2014.020401
Henry H. Chen, T. Fritz, Preeti Banga, D. Wohns, S. Cohle, S. Banga
Nonbacterial thrombotic endocarditis (NBTE) is rare and undoubtedly an under-recognized cause of cryptogenic stroke. Its diagnosis relies on a high index of clinical suspicion, particularly in patients with previous malignancy. We present a case of a young woman, with three neurologic events occurring in rapid succession over three weeks, ultimately resulting in her death. The echo imaging findings here appear relatively benign compared to the catastrophic consequences, and speaks of the aggressive fibrin and platelet deposition that can embolize widely in this condition, confirmed on the postmortem examination. We discuss the details of NBTE aiming to increase awareness while assessing patients with undetermined systemic embolization.
{"title":"The Search for Cryptogenic Stroke, A Case of Marantic Endocarditis","authors":"Henry H. Chen, T. Fritz, Preeti Banga, D. Wohns, S. Cohle, S. Banga","doi":"10.13189/IJCCD.2014.020401","DOIUrl":"https://doi.org/10.13189/IJCCD.2014.020401","url":null,"abstract":"Nonbacterial thrombotic endocarditis (NBTE) is rare and undoubtedly an under-recognized cause of cryptogenic stroke. Its diagnosis relies on a high index of clinical suspicion, particularly in patients with previous malignancy. We present a case of a young woman, with three neurologic events occurring in rapid succession over three weeks, ultimately resulting in her death. The echo imaging findings here appear relatively benign compared to the catastrophic consequences, and speaks of the aggressive fibrin and platelet deposition that can embolize widely in this condition, confirmed on the postmortem examination. We discuss the details of NBTE aiming to increase awareness while assessing patients with undetermined systemic embolization.","PeriodicalId":269499,"journal":{"name":"International Journal of Cardiovascular and Cerebrovascular Disease","volume":"441 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115925862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-05-01DOI: 10.13189/IJCCD.2014.020302
A. O'Loughlin, S. Kazi, J. French, D. Richards, A. Denniss, A. Hennessy
Background: Coronary artery motion may contribute to the development of plaques that rupture and cause acute myocardial infarctions. This study evaluates whether a quantitative measure of the compression type of coronary artery motion obtained from analysis of coronary angiograms can predict the location of culprit lesions in patients who have subsequent myocardial infarction. Method: 28 patients were identified with coronary angiography performed on at least two occasions: related to primary or rescue percutaneous coronary intervention for a STEMI and coronary angiography before this that was available for review. These angiograms were used to determine a quantitative index of coronary artery motion (QCAM) (the ratio of the section lengths i.e. systolic length/diastolic length). The culprit section was subsequently identified and QCAM of this section was compared to non-culprit sections. Results: The two sample t-test comparing QCAM for the non-culprit and culprit sections was highly statistically significant with a p-value of 0.0004. The generalized linear mixed model with culprit section as the dependent variable and QCAM as the independent variable also showed a statistically significant result with a p-value of 0.026. Conclusion: QCAM is a predictor of the location of culprit lesions causing future ST segment elevation myocardial infarctions. Predicting the location of future culprit lesions using coronary angiography may allow targeted therapy to prevent myocardial infarctions.
{"title":"Quantitative Coronary Artery Motion Analysis Predicts the Location of Future ST Segment Elevation Myocardial Infarctions","authors":"A. O'Loughlin, S. Kazi, J. French, D. Richards, A. Denniss, A. Hennessy","doi":"10.13189/IJCCD.2014.020302","DOIUrl":"https://doi.org/10.13189/IJCCD.2014.020302","url":null,"abstract":"Background: Coronary artery motion may contribute to the development of plaques that rupture and cause acute myocardial infarctions. This study evaluates whether a quantitative measure of the compression type of coronary artery motion obtained from analysis of coronary angiograms can predict the location of culprit lesions in patients who have subsequent myocardial infarction. Method: 28 patients were identified with coronary angiography performed on at least two occasions: related to primary or rescue percutaneous coronary intervention for a STEMI and coronary angiography before this that was available for review. These angiograms were used to determine a quantitative index of coronary artery motion (QCAM) (the ratio of the section lengths i.e. systolic length/diastolic length). The culprit section was subsequently identified and QCAM of this section was compared to non-culprit sections. Results: The two sample t-test comparing QCAM for the non-culprit and culprit sections was highly statistically significant with a p-value of 0.0004. The generalized linear mixed model with culprit section as the dependent variable and QCAM as the independent variable also showed a statistically significant result with a p-value of 0.026. Conclusion: QCAM is a predictor of the location of culprit lesions causing future ST segment elevation myocardial infarctions. Predicting the location of future culprit lesions using coronary angiography may allow targeted therapy to prevent myocardial infarctions.","PeriodicalId":269499,"journal":{"name":"International Journal of Cardiovascular and Cerebrovascular Disease","volume":"1581 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127448039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-03-01DOI: 10.13189/IJCCD.2014.020202
T. Kitawaki, H. Oka, S. Usui, S. Hirohata, S. Kusachi
In this paper, we introduce a new estimation method for total creatine phosphokinase release based on a physiological model of the serum creatine phosphokinase (CPK) activity change that can be used to estimate the total CPK release accurately, as early as possible, without frequent blood sampling. The physiological model and a new calculation method were applied to the serum CPK activity change of patients who suffered acute myocardial infarction (AMI). According to the results, the physiological model showed good agreement with the serum CPK activity change and the estimated value of the total CPK release also agreed well with that calculated using the conventional technique with clinically acceptable accuracy.
{"title":"New Estimation Method of Total Creatine Phosphokinase Release in Early Stage in Acute Myocardial Infarction","authors":"T. Kitawaki, H. Oka, S. Usui, S. Hirohata, S. Kusachi","doi":"10.13189/IJCCD.2014.020202","DOIUrl":"https://doi.org/10.13189/IJCCD.2014.020202","url":null,"abstract":"In this paper, we introduce a new estimation method for total creatine phosphokinase release based on a physiological model of the serum creatine phosphokinase (CPK) activity change that can be used to estimate the total CPK release accurately, as early as possible, without frequent blood sampling. The physiological model and a new calculation method were applied to the serum CPK activity change of patients who suffered acute myocardial infarction (AMI). According to the results, the physiological model showed good agreement with the serum CPK activity change and the estimated value of the total CPK release also agreed well with that calculated using the conventional technique with clinically acceptable accuracy.","PeriodicalId":269499,"journal":{"name":"International Journal of Cardiovascular and Cerebrovascular Disease","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129463070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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