Pub Date : 2021-09-15DOI: 10.3329/cardio.v14i1.55379
Md. Abu Zahid, Mst Ferdousy Sultana, S. Ghafur, Hasanul Islam
Mycobacterium Endocarditis is a very rare case. A 5 years old boy presented us with the history of fever and breathlessness. CXR shows huge cardiomegaly, patient is anemic and temperature is raised. On echo revels vegetation on Tricuspid &Mitral valve ç huge pericardial effusion ç features of early tamponade. Pericardial fluid was drawn and the symptoms improved. Pericardial fluid colour was milky and exudative in nature. ADA for mycobacterium tuberculosis was positive. The patient was given anti tuberculosis drug & improved with time. Cardiovasc j 2021; 14(1): 76-78
{"title":"Mycobacterium Endocarditis- A Case Report","authors":"Md. Abu Zahid, Mst Ferdousy Sultana, S. Ghafur, Hasanul Islam","doi":"10.3329/cardio.v14i1.55379","DOIUrl":"https://doi.org/10.3329/cardio.v14i1.55379","url":null,"abstract":"Mycobacterium Endocarditis is a very rare case. A 5 years old boy presented us with the history of fever and breathlessness. CXR shows huge cardiomegaly, patient is anemic and temperature is raised. On echo revels vegetation on Tricuspid &Mitral valve ç huge pericardial effusion ç features of early tamponade. Pericardial fluid was drawn and the symptoms improved. Pericardial fluid colour was milky and exudative in nature. ADA for mycobacterium tuberculosis was positive. The patient was given anti tuberculosis drug & improved with time.\u0000Cardiovasc j 2021; 14(1): 76-78","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90142561","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 : 2021-09-15DOI: 10.3329/cardio.v14i1.55373
Nazmus Sabah, S. Ahmed, S. Khan, R. Hasan, Fidah Hossain, Manifa Naz Fatma
Background: Chronic Kidney Disease (CKD) is a major health issue all over the world. Patients with deteriorating renal function and end-stage renal disease require vascular access for hemodialysis. Studies suggest that Arterio-Venous fistula (AVF) constructed judiciously using autologous conduit give the best outcome in this regard. Objective of the study was to compare the outcomes of Radiocephalic and Brachiocephalic AVF in end stage renal disease (ESRD). Methods: It was a quasi-experimental study carried out at the Department of Vascular Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. The study was conducted from June 2019 to May 2020. Patients suffering from ESRD underwent AVF creation surgery for hemodialysis access. A total of 60 (Sixty) patients were included in this study. The patients were divided into two groups; Group I included 30 patients who underwent Radiocephalic AVF operation and Group II included 30 patients who had Brachiocephalic AVF operation. Results: In Group I, (Radiocephalic AVF) 60% were male and 40% were female. On the other hand, in Group II (Brachiocephalic AVF) 73.3% were male and 26.7% were female. Calculated volume flow (Q max) was significantly higher in Group II compared with Group I (769.11±101.54 ml/min vs 626.37±55.81) ml/min) with the difference being statistically significant (P=0.001). Maturation time was significantly less in Group II compared with Group I )37.78±1.93 vs 43.33±2.12 days) with the difference between the two group being statistically significant (P=0.001). Complication was more in Group I than Group II (16.7% vs 3.3%). Conclusion: The present study shows that Brachiocephalic AVF gives significantly better outcome in terms of shorter maturation time and less complications compared with Radio-Cephalic AVF. Color Doppler study is an essential tool for preoperative vessel evaluation which guides the selection of suitable AVF construction site. Cardiovasc j 2021; 14(1): 44-49
背景:慢性肾脏疾病(CKD)是世界范围内的主要健康问题。肾功能恶化和终末期肾病患者需要血管通路进行血液透析。研究表明，在这方面，明智地使用自体导管构建动静脉瘘(AVF)可以获得最佳效果。本研究的目的是比较放射性和头臂性AVF在终末期肾病(ESRD)中的预后。方法:准实验研究在达卡Bangabandhu Sheikh Mujib医科大学血管外科(BSMMU)进行。该研究于2019年6月至2020年5月进行。ESRD患者接受AVF创建手术以获得血液透析通路。本研究共纳入60例患者。患者分为两组;第一组30例行放射性头侧AVF，第二组30例行肱头侧AVF。结果:第一组(放射性头性AVF)男性占60%，女性占40%。II组(头臂AVF)男性占73.3%，女性占26.7%。计算容积流量(Q max) II组显著高于I组(769.11±101.54 ml/min vs 626.37±55.81)ml/min)，差异有统计学意义(P=0.001)。成熟时间(37.78±1.93 vs 43.33±2.12)明显少于成熟时间(P=0.001)。I组并发症发生率高于II组(16.7% vs 3.3%)。结论:与放射头侧AVF相比，头臂侧AVF在成熟时间短、并发症少等方面具有明显的优势。彩色多普勒研究是术前血管评估的重要工具，指导选择合适的AVF建设地点。心血管病杂志2021;14 (1): 44-49
{"title":"A Comparative Study between Radiocephalic and Brachiocephalic Arteriovenous Fistula in End Stage Renal Disease","authors":"Nazmus Sabah, S. Ahmed, S. Khan, R. Hasan, Fidah Hossain, Manifa Naz Fatma","doi":"10.3329/cardio.v14i1.55373","DOIUrl":"https://doi.org/10.3329/cardio.v14i1.55373","url":null,"abstract":"Background: Chronic Kidney Disease (CKD) is a major health issue all over the world. Patients with deteriorating renal function and end-stage renal disease require vascular access for hemodialysis. Studies suggest that Arterio-Venous fistula (AVF) constructed judiciously using autologous conduit give the best outcome in this regard. Objective of the study was to compare the outcomes of Radiocephalic and Brachiocephalic AVF in end stage renal disease (ESRD).\u0000Methods: It was a quasi-experimental study carried out at the Department of Vascular Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. The study was conducted from June 2019 to May 2020. Patients suffering from ESRD underwent AVF creation surgery for hemodialysis access. A total of 60 (Sixty) patients were included in this study. The patients were divided into two groups; Group I included 30 patients who underwent Radiocephalic AVF operation and Group II included 30 patients who had Brachiocephalic AVF operation.\u0000Results: In Group I, (Radiocephalic AVF) 60% were male and 40% were female. On the other hand, in Group II (Brachiocephalic AVF) 73.3% were male and 26.7% were female. Calculated volume flow (Q max) was significantly higher in Group II compared with Group I (769.11±101.54 ml/min vs 626.37±55.81) ml/min) with the difference being statistically significant (P=0.001). Maturation time was significantly less in Group II compared with Group I )37.78±1.93 vs 43.33±2.12 days) with the difference between the two group being statistically significant (P=0.001). Complication was more in Group I than Group II (16.7% vs 3.3%).\u0000Conclusion: The present study shows that Brachiocephalic AVF gives significantly better outcome in terms of shorter maturation time and less complications compared with Radio-Cephalic AVF. Color Doppler study is an essential tool for preoperative vessel evaluation which guides the selection of suitable AVF construction site.\u0000Cardiovasc j 2021; 14(1): 44-49","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"198 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73277846","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 : 2021-09-15DOI: 10.3329/cardio.v14i1.55381
S. Gupta, Jagadananda Roy, M. Hoque, Bhabesh C Mandol, P. Chanda
Double valve replacement is now-a-days a common procedure to treat diseased cardiac valves and the primary aim of prophylactic aortic replacement during concomitant valve replacement is to prevent dreadful complication like dissection, aortic rupture and even death. Although aortic surgeries are complex and have high morbidity and mortality rates, additional double valve procedure with coronary surgery can make it even worse. But for these patients, surgery remains the one and only treatment option for symptom relieve and prolongation of life. We herein present a case of severe aortic stenosis (AS) with severe aortic regurgitation (AR) with severe mitral regurgitation (MR) with coronary artery disease (CAD) and aortic aneurysm treated successfully by us at Square Hospitals; and to our best knowledge and according to the published articles, this is probably the first time, this type of combined cardiac procedure has been accomplished along with aortic surgery, in our country. We recommend that surgeons should perform bypass grafting along with aortic replacement and valve replacement surgery when indicated, without worrying that adding such a procedure will escalate post-operative adverse effect. Cardiovasc j 2021; 14(1): 82-87
{"title":"Case report of Double Valve Replacement with Coronary Artery Bypass Grafting with Supracoronary Ascending Aortic Replacement in a Single Patient - A Chimera","authors":"S. Gupta, Jagadananda Roy, M. Hoque, Bhabesh C Mandol, P. Chanda","doi":"10.3329/cardio.v14i1.55381","DOIUrl":"https://doi.org/10.3329/cardio.v14i1.55381","url":null,"abstract":"Double valve replacement is now-a-days a common procedure to treat diseased cardiac valves and the primary aim of prophylactic aortic replacement during concomitant valve replacement is to prevent dreadful complication like dissection, aortic rupture and even death. Although aortic surgeries are complex and have high morbidity and mortality rates, additional double valve procedure with coronary surgery can make it even worse. But for these patients, surgery remains the one and only treatment option for symptom relieve and prolongation of life. We herein present a case of severe aortic stenosis (AS) with severe aortic regurgitation (AR) with severe mitral regurgitation (MR) with coronary artery disease (CAD) and aortic aneurysm treated successfully by us at Square Hospitals; and to our best knowledge and according to the published articles, this is probably the first time, this type of combined cardiac procedure has been accomplished along with aortic surgery, in our country. We recommend that surgeons should perform bypass grafting along with aortic replacement and valve replacement surgery when indicated, without worrying that adding such a procedure will escalate post-operative adverse effect.\u0000Cardiovasc j 2021; 14(1): 82-87","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84398004","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 : 2021-09-15DOI: 10.3329/cardio.v14i1.55382
A. Bashar, H. Kabir, Mokhlesur M. Rahman, Md. Ahsanul Alam
Thoracic Endovascular Aortic Repair (TEVAR) is a state-of-the art endovascular intervention used to treat various thoracic aortic pathologies such as aneurysm, dissection and penetrating aortic ulcers (PAU). The procedure demands significant technical skill and involves considerable cost burden for the patients. The latter is the main reason why the procedure has not yet made it to the routine clinical practice in Bangladesh. We recently performed TEVAR for the successful treatment of an ominous-looking PAU in the descending thoracic aorta in a patient with renal failure. Cardiovasc j 2021; 14(1): 88-92
{"title":"Thoracic Endovascular Aortic Repair for Penetrating Aortic Ulcer in a Patient with Renal Failure: A Case Report","authors":"A. Bashar, H. Kabir, Mokhlesur M. Rahman, Md. Ahsanul Alam","doi":"10.3329/cardio.v14i1.55382","DOIUrl":"https://doi.org/10.3329/cardio.v14i1.55382","url":null,"abstract":"Thoracic Endovascular Aortic Repair (TEVAR) is a state-of-the art endovascular intervention used to treat various thoracic aortic pathologies such as aneurysm, dissection and penetrating aortic ulcers (PAU). The procedure demands significant technical skill and involves considerable cost burden for the patients. The latter is the main reason why the procedure has not yet made it to the routine clinical practice in Bangladesh. We recently performed TEVAR for the successful treatment of an ominous-looking PAU in the descending thoracic aorta in a patient with renal failure.\u0000Cardiovasc j 2021; 14(1): 88-92","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"111 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84009120","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 : 2021-09-15DOI: 10.3329/cardio.v14i1.55374
F. Jahan, Md Shahed Kamal Bhuya, Muhammed Shahed Anwar Bhuya, Jamal Uddin Gaji, Rumana Nushrat, Zulfikar Ali, N. Sultana
Background: The novel corona virus (COVID 19) pandemic is a major global health threat of the twenty-first century. Clinical presentation, rapid identification of causes and isolation are vital for containments of rapidly spreading disease. The objective of the study was to report early findings on demographic profile, clinical presentation of the confirmed COVID 19 patients with their clinical outcome. Methods: This observational study was conducted in Microbiology Department of National Institute of Cardiovascular Diseases (NICVD) for the period of October 01, 2020 to November 30, 2020. Total 300 positive COVID 19 patients were included and interviewed. Informed written consent was ensured before participation. After collection, Data were analyzed to show the characteristics of COVID 19 cases and their clinical outcome after treatment. Results: Among the 300 cases 228 (76%) patients were male and 72 (24%) patients were female. Average age of the patients was 39 years. The most commonly observed symptoms were fever (70%), followed by cough (55%), breathlessness (42%), dysgeusia (38%), anosmia (25%). Respiratory symptom was the dominant feature of clinical presentation. The most prevalent affected age groups were 114 (38%) patients in 41-50 years age, 102 (34%) patients in 31- 40 years age. Among the total cases 255 (85%) patients were Urban residents and 234 (78%) had contact history. Among 300 patients 102 (34%) patients had co-morbidities and presence of co-morbidities (p<0.01) were significantly associated with mortality. The death rate was 2%. Conclusion: Typical presentations of COVID-19 were fever, cough, breathlessness, dysgeusia and anosmia. Requirement of ICU was 6% and overall mortality was 2% which was associated with comorbidities. Cardiovasc j 2021; 14(1): 50-54
{"title":"Socio-demographic and Clinical Profile of Bangladeshi COVID 19 Patients with their Clinical Outcome in National Institute of Cardiovascular Diseases, Dhaka","authors":"F. Jahan, Md Shahed Kamal Bhuya, Muhammed Shahed Anwar Bhuya, Jamal Uddin Gaji, Rumana Nushrat, Zulfikar Ali, N. Sultana","doi":"10.3329/cardio.v14i1.55374","DOIUrl":"https://doi.org/10.3329/cardio.v14i1.55374","url":null,"abstract":"Background: The novel corona virus (COVID 19) pandemic is a major global health threat of the twenty-first century. Clinical presentation, rapid identification of causes and isolation are vital for containments of rapidly spreading disease. The objective of the study was to report early findings on demographic profile, clinical presentation of the confirmed COVID 19 patients with their clinical outcome.\u0000Methods: This observational study was conducted in Microbiology Department of National Institute of Cardiovascular Diseases (NICVD) for the period of October 01, 2020 to November 30, 2020. Total 300 positive COVID 19 patients were included and interviewed. Informed written consent was ensured before participation. After collection, Data were analyzed to show the characteristics of COVID 19 cases and their clinical outcome after treatment.\u0000Results: Among the 300 cases 228 (76%) patients were male and 72 (24%) patients were female. Average age of the patients was 39 years. The most commonly observed symptoms were fever (70%), followed by cough (55%), breathlessness (42%), dysgeusia (38%), anosmia (25%). Respiratory symptom was the dominant feature of clinical presentation. The most prevalent affected age groups were 114 (38%) patients in 41-50 years age, 102 (34%) patients in 31- 40 years age. Among the total cases 255 (85%) patients were Urban residents and 234 (78%) had contact history. Among 300 patients 102 (34%) patients had co-morbidities and presence of co-morbidities (p<0.01) were significantly associated with mortality. The death rate was 2%.\u0000Conclusion: Typical presentations of COVID-19 were fever, cough, breathlessness, dysgeusia and anosmia. Requirement of ICU was 6% and overall mortality was 2% which was associated with comorbidities.\u0000Cardiovasc j 2021; 14(1): 50-54","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"243 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76555879","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 : 2021-09-15DOI: 10.3329/cardio.v14i1.55372
M. Rokonujjaman, Naveen Sk, S. Islam, N. Ghafoor, Syed Tanvir Ahmad, A. Shoeb, Atiqur Rahman, I. Khalilullah, S. Islam, Nowshin Siraj, S. Roy, P. Saha
Background: Atrial Septal Defects (ASD) can be closed surgically using conventional midline sternotomy or minimal invasive technique. This study was done to evaluate the outcome and safety of the minimal invasive cardiac surgical (MICS) approach using right vertical infra axillary incision (RVAI) for the repair of ASD. Methods: We performed a prospective observational cross-sectional analysis on 50 patients who were diagnosed as ASD of various types and not amenable to device closure. Their surgery was done RVAI using central cardiopulmonary bypass. Outcome of the study was evaluated using the following variables: length of the incision, satisfaction of patients, mortality, infection of surgical site, blood transfusion, duration of total operation, intensive care unit (ICU) stay, mechanical ventilation, hospital stay and aortic occlusion. Operations were done between December 2013 to December 2020. All the recruited patients were treated through RVAI as per patient’s choice. Results: Mean age was 11.4± 6.4 years. 18(36%) were male and 32(64%) were female. Body weight ranged from 10 to 65 kg. Mean length of incision was 6.2±0.8 cm. Mean aortic occlusion time was 42±14 min. ASD closed directly, using autologous treated pericardial patch or dacron patch. Mean total operation time was 4.08±0.6 hours and mean mechanical ventilation time was 8.3±5 hours. Average ICU stay was 35.6±6 hours and total hospital stay was 7.2±0.9 days. There was no significant blood loss. Only 10 patients required intravenous (IV) analgesics in the post-operative period. One patient required re-exploration, one conversion to median sternotomy and one suffered from superficial skin infection. There were no operative or late mortalities. Patient satisfaction was excellent. Conclusions: MICS technique using RVAI for surgical repair of ASD revealed a safe procedure and could be performed with excellent cosmetic and clinical outcomes. It provided a good alternative to the standard median sternotomy. Cardiovasc j 2021; 14(1): 37-43
{"title":"Experience of Minimal Invasive Cardiac Surgery for repair of Atrial Septal Defects- A Single Center Study","authors":"M. Rokonujjaman, Naveen Sk, S. Islam, N. Ghafoor, Syed Tanvir Ahmad, A. Shoeb, Atiqur Rahman, I. Khalilullah, S. Islam, Nowshin Siraj, S. Roy, P. Saha","doi":"10.3329/cardio.v14i1.55372","DOIUrl":"https://doi.org/10.3329/cardio.v14i1.55372","url":null,"abstract":"Background: Atrial Septal Defects (ASD) can be closed surgically using conventional midline sternotomy or minimal invasive technique. This study was done to evaluate the outcome and safety of the minimal invasive cardiac surgical (MICS) approach using right vertical infra axillary incision (RVAI) for the repair of ASD.\u0000Methods: We performed a prospective observational cross-sectional analysis on 50 patients who were diagnosed as ASD of various types and not amenable to device closure. Their surgery was done RVAI using central cardiopulmonary bypass. Outcome of the study was evaluated using the following variables: length of the incision, satisfaction of patients, mortality, infection of surgical site, blood transfusion, duration of total operation, intensive care unit (ICU) stay, mechanical ventilation, hospital stay and aortic occlusion. Operations were done between December 2013 to December 2020. All the recruited patients were treated through RVAI as per patient’s choice.\u0000Results: Mean age was 11.4± 6.4 years. 18(36%) were male and 32(64%) were female. Body weight ranged from 10 to 65 kg. Mean length of incision was 6.2±0.8 cm. Mean aortic occlusion time was 42±14 min. ASD closed directly, using autologous treated pericardial patch or dacron patch. Mean total operation time was 4.08±0.6 hours and mean mechanical ventilation time was 8.3±5 hours. Average ICU stay was 35.6±6 hours and total hospital stay was 7.2±0.9 days. There was no significant blood loss. Only 10 patients required intravenous (IV) analgesics in the post-operative period. One patient required re-exploration, one conversion to median sternotomy and one suffered from superficial skin infection. There were no operative or late mortalities. Patient satisfaction was excellent.\u0000Conclusions: MICS technique using RVAI for surgical repair of ASD revealed a safe procedure and could be performed with excellent cosmetic and clinical outcomes. It provided a good alternative to the standard median sternotomy.\u0000Cardiovasc j 2021; 14(1): 37-43","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78271811","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 : 2021-09-15DOI: 10.3329/cardio.v14i1.55371
Rubaiya Reza Tumpa, Al Masum Ziaul Haque, Md. Kamrul Hasan
Background: In patients undergoing surgery for mitral valve replacement (MVR) for valvular heart disease, pulmonary artery hypertension (PAH) has been considered a major risk factor. In this prospective study, we have studied the early hemodynamic changes and post-operative outcomes of MVR among patients with mild to severe PAH in Bangladesh perspective. Methods: Total 60 patients who underwent mitral valve replacement for predominantly mitral regurgitation (MR) and mixed lesion with mitral stenosis (MS) having pulmonary arterial hypertension ranging from mild to severe pulmonary artery pressure (PAP) were studied prospectively for immediate postoperative haemodynamic and outcome. The mean age of the patients was 36.23±9.18 years. Total 13 (21.66%) patients had mitral regurgitation and 47 (78.33%) had mixed lesion with mitral stenosis. Patients were divided into two groups based on preoperative pulmonary artery pressures. Group A patients with mild to moderate pulmonary hypertension (PASP 40-59 mm of Hg) and Group B patients with severe pulmonary hypertension (PASPe” 60 mm of Hg). Results: After mitral valve replacement, pulmonary arterial systolic pressure (PASP) decreased significantly in Group A to near normal levels (PASP41.25±7.25). In Group B also the PASP decreased insignificantly (PASP 61.85±9.12) but significant residual PAH remained. Operative mortality was nil (0%) in Group A and 6.7% in Group B. Conclusions: Mitral valve replacement is safe and effective at the presence of PAH as long as the PASP is below or equal to 60 mm of Hg. With PASP >60 mm of Hg, MVR carries a high risk of mortality and the patients continues to have severe PAH in the postoperative period. Cardiovasc j 2021; 14(1): 30-36
背景:在接受二尖瓣置换术(MVR)治疗瓣膜性心脏病的患者中，肺动脉高压(PAH)被认为是一个主要的危险因素。在这项前瞻性研究中，我们研究了孟加拉国轻度至重度PAH患者MVR的早期血流动力学变化和术后结局。方法:对60例以二尖瓣返流(MR)为主、混合性病变合并二尖瓣狭窄(MS)合并肺动脉高压(轻度至重度肺动脉压(PAP))的患者行二尖瓣置换术进行前瞻性研究，观察术后立即血流动力学和预后。患者平均年龄36.23±9.18岁。二尖瓣返流13例(21.66%)，合并二尖瓣狭窄47例(78.33%)。根据术前肺动脉压将患者分为两组。A组为轻中度肺动脉高压(PASP 40-59 mm Hg)， B组为重度肺动脉高压(PASP 60 mm Hg)。结果:二尖瓣置换术后，A组肺动脉收缩压(PASP)明显下降至接近正常水平(pas41.25±7.25)。B组PASP值(61.85±9.12)明显降低，但仍有明显的PAH残留。结论:在PAH存在时，只要PASP小于等于60 mm Hg，二尖瓣置换术是安全有效的。当PASP >60 mm Hg时，MVR具有较高的死亡风险，患者术后仍有严重的PAH。心血管病杂志2021;14 (1): 30-36
{"title":"In Hospital Outcome of Mitral Valve Replacement with Severe Pulmonary Hypertension","authors":"Rubaiya Reza Tumpa, Al Masum Ziaul Haque, Md. Kamrul Hasan","doi":"10.3329/cardio.v14i1.55371","DOIUrl":"https://doi.org/10.3329/cardio.v14i1.55371","url":null,"abstract":"Background: In patients undergoing surgery for mitral valve replacement (MVR) for valvular heart disease, pulmonary artery hypertension (PAH) has been considered a major risk factor. In this prospective study, we have studied the early hemodynamic changes and post-operative outcomes of MVR among patients with mild to severe PAH in Bangladesh perspective.\u0000Methods: Total 60 patients who underwent mitral valve replacement for predominantly mitral regurgitation (MR) and mixed lesion with mitral stenosis (MS) having pulmonary arterial hypertension ranging from mild to severe pulmonary artery pressure (PAP) were studied prospectively for immediate postoperative haemodynamic and outcome. The mean age of the patients was 36.23±9.18 years. Total 13 (21.66%) patients had mitral regurgitation and 47 (78.33%) had mixed lesion with mitral stenosis. Patients were divided into two groups based on preoperative pulmonary artery pressures. Group A patients with mild to moderate pulmonary hypertension (PASP 40-59 mm of Hg) and Group B patients with severe pulmonary hypertension (PASPe” 60 mm of Hg).\u0000Results: After mitral valve replacement, pulmonary arterial systolic pressure (PASP) decreased significantly in Group A to near normal levels (PASP41.25±7.25). In Group B also the PASP decreased insignificantly (PASP 61.85±9.12) but significant residual PAH remained. Operative mortality was nil (0%) in Group A and 6.7% in Group B.\u0000Conclusions: Mitral valve replacement is safe and effective at the presence of PAH as long as the PASP is below or equal to 60 mm of Hg. With PASP >60 mm of Hg, MVR carries a high risk of mortality and the patients continues to have severe PAH in the postoperative period.\u0000Cardiovasc j 2021; 14(1): 30-36","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88974414","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 : 2021-09-15DOI: 10.3329/cardio.v14i1.55370
Md Mahfuzur Rahman, F. Ahmed, S. Sharmin, T. Hyder, Saifuddin Nehal
Background: Coronary artery disease (CAD) is the single largest cause of death in the developed countries and is one of the leading causes of disease burden in developing countries. The prevalence of dyslipidemia and conventional risk factors profile at the time of admission in patients with Acute Coronary Syndrome (ACS) is not well described in our context. The aim of this study was to investigate the prevalence of dyslipidemia and conventional risk factors profiles of patients with ACS in a tertiary care center of Bangladesh. Methods: This descriptive cross-sectional study included 96 admitted patients of ACS [30 cases of Unstable Angina, 25 cases of Non ST segment Elevation Myocardial Infarction and 41 cases of ST segment Elevation Myocardial Infarction] from the Department of Cardiology, Abdul Malek Ukil Medical College Hospital, Noakhali, Bangladesh from January 2019 to June 2019. Fasting serum lipid profile was obtained within 24 hours of hospitalization and demographic and other cardiovascular risk factors were documented. Results: The mean age of the subjects were 57.7±14.4 years with majority (71.9%) being male. The most frequent reported risk factor was smoking, present in 55.2% of patients, followed by hypertension (47.9%), diabetes (37.5%), dyslipidemia (27.1%) and family history of CAD (15.6%). Based on Body Mass index 50% patients were obese (≥25kg/m2) and 69.8% had central obesity based on waist circumference. The lipid profile analysis revealed that 99% of patients had some type of dyslipidemia, and the most frequent was high level of triglyceride and low levels of high-density lipoprotein cholesterol (68.8% of cases in each). Conclusion: Dyslipidemia is a significant risk factor in patients with ACS and high TG and low HDL-C were more prevalent. Careful attention to its management may help to reduce further events. Cardiovasc j 2021; 14(1): 24-29
背景:冠状动脉疾病(CAD)是发达国家最大的单一死亡原因，也是发展中国家疾病负担的主要原因之一。在我们的研究中，急性冠脉综合征(ACS)患者入院时血脂异常的患病率和常规危险因素并没有得到很好的描述。本研究的目的是调查孟加拉国三级保健中心ACS患者的血脂异常患病率和常规危险因素概况。方法:本描述性横断面研究纳入2019年1月至2019年6月在孟加拉国Noakhali Abdul Malek Ukil医学院医院心内科住院的96例ACS患者[30例不稳定型心绞痛，25例非ST段抬高型心肌梗死，41例ST段抬高型心肌梗死]。在住院24小时内获得空腹血脂，并记录人口统计学和其他心血管危险因素。结果:患者平均年龄57.7±14.4岁，男性居多(71.9%)。最常见的危险因素是吸烟，占55.2%，其次是高血压(47.9%)、糖尿病(37.5%)、血脂异常(27.1%)和CAD家族史(15.6%)。根据体重指数，50%的患者为肥胖(≥25kg/m2)，根据腰围，69.8%的患者为中心性肥胖。脂质分析显示，99%的患者有某种类型的血脂异常，最常见的是高水平的甘油三酯和低水平的高密度脂蛋白胆固醇(每种病例的68.8%)。结论:血脂异常是ACS患者的重要危险因素，高TG和低HDL-C更为普遍。对其管理的仔细关注可能有助于减少进一步的事件。心血管病杂志2021;14 (1): 24-29
{"title":"Dyslipidemia and Conventional Risk Factors in Patients with Acute Coronary Syndrome Admitted in a CCU of a Tertiary Care Hospital of Bangladesh","authors":"Md Mahfuzur Rahman, F. Ahmed, S. Sharmin, T. Hyder, Saifuddin Nehal","doi":"10.3329/cardio.v14i1.55370","DOIUrl":"https://doi.org/10.3329/cardio.v14i1.55370","url":null,"abstract":"Background: Coronary artery disease (CAD) is the single largest cause of death in the developed countries and is one of the leading causes of disease burden in developing countries. The prevalence of dyslipidemia and conventional risk factors profile at the time of admission in patients with Acute Coronary Syndrome (ACS) is not well described in our context. The aim of this study was to investigate the prevalence of dyslipidemia and conventional risk factors profiles of patients with ACS in a tertiary care center of Bangladesh.\u0000Methods: This descriptive cross-sectional study included 96 admitted patients of ACS [30 cases of Unstable Angina, 25 cases of Non ST segment Elevation Myocardial Infarction and 41 cases of ST segment Elevation Myocardial Infarction] from the Department of Cardiology, Abdul Malek Ukil Medical College Hospital, Noakhali, Bangladesh from January 2019 to June 2019. Fasting serum lipid profile was obtained within 24 hours of hospitalization and demographic and other cardiovascular risk factors were documented.\u0000Results: The mean age of the subjects were 57.7±14.4 years with majority (71.9%) being male. The most frequent reported risk factor was smoking, present in 55.2% of patients, followed by hypertension (47.9%), diabetes (37.5%), dyslipidemia (27.1%) and family history of CAD (15.6%). Based on Body Mass index 50% patients were obese (≥25kg/m2) and 69.8% had central obesity based on waist circumference. The lipid profile analysis revealed that 99% of patients had some type of dyslipidemia, and the most frequent was high level of triglyceride and low levels of high-density lipoprotein cholesterol (68.8% of cases in each).\u0000Conclusion: Dyslipidemia is a significant risk factor in patients with ACS and high TG and low HDL-C were more prevalent. Careful attention to its management may help to reduce further events.\u0000Cardiovasc j 2021; 14(1): 24-29","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"98 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90438831","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 : 2021-08-08DOI: 10.22541/au.162838895.52054678/v1
A. Islam, A. Majumder, Shovan Rahman, K. Ananya, T. Ahmad, B. Dutta
Background: The predominant cause of giant left atrium (GLA) is rheumatic mitral valvular disease. GLA is commonly defined echocardiographically by measuring the left atrial diameter (LAD). In the context of changing epidemiology of rheumatic heart disease (RHD) globally, and introduction of left atrial volume index (LAVI), the aetiology of GLA and utility of LAVI for defining GLA may be necessary. Methods: The prospective observational study was carried out at a dedicated tertiary care cardiac centre of a developing country to know the aetiology and clinical pattern of GLA over 8 years. GLA was defined echocardiographically as a left atrium (LA) having a diameter ≥80 mm in the left parasternal long-axis view. Follow-up was made over the telephone. Results: Thirty cases of GLA were diagnosed over 8 years from 2013 to 2021. Twenty two were due to rheumatic heart disease (RHD), 7 due to MVP, and 1 due to flail anterior mitral leaflet. Mean LAD was 92.13 ± 16.72 mm, and the mean LAVI was 288.77 ± 134.40 ml/m2. LA thrombus was present in 5 patients, 6 had spontaneous echo contrast (SEC) in LA, 2 had both LA thrombus and SEC. Mean follow-up was 0.99 ± 1.06 years. Out of 15 patients, 5 died, while 10 were alive. Mean survival was 1.8 ± 1.17 years, ranging from less than 1 year to 4 years. Conclusion: RHD continues to be the predominant cause of GLA; however, MVP is also important. The cut-off value of LAVI for defining GLA needs further study.
{"title":"Aetiology and Clinical Profile of Giant Left Atrium -- An Observational Study.","authors":"A. Islam, A. Majumder, Shovan Rahman, K. Ananya, T. Ahmad, B. Dutta","doi":"10.22541/au.162838895.52054678/v1","DOIUrl":"https://doi.org/10.22541/au.162838895.52054678/v1","url":null,"abstract":"Background: The predominant cause of giant left atrium (GLA) is\u0000rheumatic mitral valvular disease. GLA is commonly defined\u0000echocardiographically by measuring the left atrial diameter (LAD). In\u0000the context of changing epidemiology of rheumatic heart disease (RHD)\u0000globally, and introduction of left atrial volume index (LAVI), the\u0000aetiology of GLA and utility of LAVI for defining GLA may be necessary.\u0000Methods: The prospective observational study was carried out at a\u0000dedicated tertiary care cardiac centre of a developing country to know\u0000the aetiology and clinical pattern of GLA over 8 years. GLA was defined\u0000echocardiographically as a left atrium (LA) having a diameter ≥80 mm in\u0000the left parasternal long-axis view. Follow-up was made over the\u0000telephone. Results: Thirty cases of GLA were diagnosed over 8 years from\u00002013 to 2021. Twenty two were due to rheumatic heart disease (RHD), 7\u0000due to MVP, and 1 due to flail anterior mitral leaflet. Mean LAD was\u000092.13 ± 16.72 mm, and the mean LAVI was 288.77 ± 134.40 ml/m2. LA\u0000thrombus was present in 5 patients, 6 had spontaneous echo contrast\u0000(SEC) in LA, 2 had both LA thrombus and SEC. Mean follow-up was 0.99 ±\u00001.06 years. Out of 15 patients, 5 died, while 10 were alive. Mean\u0000survival was 1.8 ± 1.17 years, ranging from less than 1 year to 4 years.\u0000Conclusion: RHD continues to be the predominant cause of GLA; however,\u0000MVP is also important. The cut-off value of LAVI for defining GLA needs\u0000further study.","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80061777","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 : 2020-12-07DOI: 10.3329/cardio.v13i1.50562
Z. Islam, Sakila Israt Jahan, S. Moinuddin, Khondokar Shamim Shahriar Ziban Rushel, S. Islam, F. Islam, K. Hasan
Background: Our objective was to analyze the outcome of patients of Down’s syndrome with congenital heart diseases undergoing cardiac surgery. Methods: This was a retrospective study conducted between January 2013 and June 2019. 49 consecutive patients with Down’s syndrome with congenital heart disease admitted in pediatric cardiac surgery unit at National Institute of Cardiovascular Diseases (NICVD). Patients were followed up postoperatively for in-hospital outcome. Results: Among 49 patients the heart lesion ranked in incidence as follows- VSD 24(48.97%), AV canal defect 12(24.48%), TOF 6(12.24%), PDA 6(12.24%) and ASD 1(2.04%). Pulmonary hypertension was found in 63.25% patients. Moderate pulmonary hypertension was most common, found in 18(38.66%) patients. Severe and mild pulmonary hypertension was found in 10(32.38%) and 3(9.67%) patients respectively. All the patients had undergone surgical correction. The postoperative period was complicated in 44.89% of patients. The most frequent complication was pulmonary infection 20.40%, Wound infection 6.12% and low output syndrome 6.12% were the next. One patient had postoperative heart block, needed permanent pace maker implantation. In-hospital mortality was 12.24%. Conclusion: Patients with Down’s syndrome with congenital heart disease undergoing surgical correction had an acceptable postoperative morbidities and mortality. Cardiovasc. j. 2020; 13(1): 35-39
{"title":"Down’s Syndrome with Congenital Heart Disease: Our Surgical Experience","authors":"Z. Islam, Sakila Israt Jahan, S. Moinuddin, Khondokar Shamim Shahriar Ziban Rushel, S. Islam, F. Islam, K. Hasan","doi":"10.3329/cardio.v13i1.50562","DOIUrl":"https://doi.org/10.3329/cardio.v13i1.50562","url":null,"abstract":"Background: Our objective was to analyze the outcome of patients of Down’s syndrome with congenital heart diseases undergoing cardiac surgery. \u0000Methods: This was a retrospective study conducted between January 2013 and June 2019. 49 consecutive patients with Down’s syndrome with congenital heart disease admitted in pediatric cardiac surgery unit at National Institute of Cardiovascular Diseases (NICVD). Patients were followed up postoperatively for in-hospital outcome. \u0000Results: Among 49 patients the heart lesion ranked in incidence as follows- VSD 24(48.97%), AV canal defect 12(24.48%), TOF 6(12.24%), PDA 6(12.24%) and ASD 1(2.04%). Pulmonary hypertension was found in 63.25% patients. Moderate pulmonary hypertension was most common, found in 18(38.66%) patients. Severe and mild pulmonary hypertension was found in 10(32.38%) and 3(9.67%) patients respectively. All the patients had undergone surgical correction. The postoperative period was complicated in 44.89% of patients. The most frequent complication was pulmonary infection 20.40%, Wound infection 6.12% and low output syndrome 6.12% were the next. One patient had postoperative heart block, needed permanent pace maker implantation. In-hospital mortality was 12.24%. \u0000Conclusion: Patients with Down’s syndrome with congenital heart disease undergoing surgical correction had an acceptable postoperative morbidities and mortality. \u0000Cardiovasc. j. 2020; 13(1): 35-39","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"87 1","pages":"35-39"},"PeriodicalIF":0.0,"publicationDate":"2020-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84275135","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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