Pub Date : 2020-12-07DOI: 10.3329/cardio.v13i1.50564
I. J. Shimu, Muhammad Badrul Alam, A. Islam, Khondoker Asaduzzaman, Amiruzzaman Khan, M. M. E. Khoda
Background: Like elsewhere, there is an ongoing paradigm shift of route of vascular access for percutaneous coronary intervention (PCI) from trans-femoral to trans-radial in Bangladesh. However, the efficacy, safety and cost effectiveness of TRI in Bangladesh have not been studied adequately. The present study was carried out to find the safety and efficacy of trans-radial PCI in a tertiary level hospital of Bangladesh. Methods: The prospective observational study was conducted in the Department of Cardiology, Sir Salimullah Medical College & Mitford Hospital (SSMC & MH), Dhaka over a period of 1 year from January to December 2016. A total of 90 subjects were included in the study. Of them, 45 patients had PCI through trans-femoral approach (group 1) and 45 through trans-radial approach (group 2). Results: The baseline characteristics were comparable except the gender distribution. Vascular access failure was more commonly encountered in trans-radial than in trans-femoral route (p = 0.0002). Angiographic success was comparable between the groups. Though not statistically significant, overall complications and per-procedural and post-procedural complications were more commonly encountered in trans-femoral than in trans-radial approach. In-stent thrombosis, arrhythmia and fever were insignificantly more common in trans-radial access whereas, puncture related complications, bleeding and death were more common in trans-femoral than the counterpart. Conclusion: Compared to trans-femoral PCI, trans-radial PCI has reasonable safety and efficacy. However, patients should be selected for TR-PCI more carefully to avoid vascular access failure. (Cardiovasc. j. 2020; 13(1): 46-51)
{"title":"Safety and Efficacy of Trans-Radial Percutaneous Coronary Intervention – Experience in a Tertiary Level Hospital of Bangladesh","authors":"I. J. Shimu, Muhammad Badrul Alam, A. Islam, Khondoker Asaduzzaman, Amiruzzaman Khan, M. M. E. Khoda","doi":"10.3329/cardio.v13i1.50564","DOIUrl":"https://doi.org/10.3329/cardio.v13i1.50564","url":null,"abstract":"Background: Like elsewhere, there is an ongoing paradigm shift of route of vascular access for percutaneous coronary intervention (PCI) from trans-femoral to trans-radial in Bangladesh. However, the efficacy, safety and cost effectiveness of TRI in Bangladesh have not been studied adequately. The present study was carried out to find the safety and efficacy of trans-radial PCI in a tertiary level hospital of Bangladesh. Methods: The prospective observational study was conducted in the Department of Cardiology, Sir Salimullah Medical College & Mitford Hospital (SSMC & MH), Dhaka over a period of 1 year from January to December 2016. A total of 90 subjects were included in the study. Of them, 45 patients had PCI through trans-femoral approach (group 1) and 45 through trans-radial approach (group 2). Results: The baseline characteristics were comparable except the gender distribution. Vascular access failure was more commonly encountered in trans-radial than in trans-femoral route (p = 0.0002). Angiographic success was comparable between the groups. Though not statistically significant, overall complications and per-procedural and post-procedural complications were more commonly encountered in trans-femoral than in trans-radial approach. In-stent thrombosis, arrhythmia and fever were insignificantly more common in trans-radial access whereas, puncture related complications, bleeding and death were more common in trans-femoral than the counterpart. Conclusion: Compared to trans-femoral PCI, trans-radial PCI has reasonable safety and efficacy. However, patients should be selected for TR-PCI more carefully to avoid vascular access failure. (Cardiovasc. j. 2020; 13(1): 46-51)","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"23 1","pages":"46-51"},"PeriodicalIF":0.0,"publicationDate":"2020-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78834962","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.v13i1.50559
A. Haque, N. Ahmed, Mi Zulkarnine, S. Ahmed
Background: Cardiopulmonary bypass is associated with increased incidence of hyperglycemia. Many studies have shown that diabetes is associated with increased morbidity and mortality in coronary artery bypass (CABG) surgery. We reviewed the outcome of on-pump versus off pump CABG in diabetic patients. Methods- 80 Adult diabetic patients undergoing isolated CABG both on-pump and OPCAB were divided into 2 groups – 40 patients in each group. To evaluate both preoperative, perioperative and postoperative out come and to compare their in hospital outcome mortality and morbidity. Results: Diabetic patients undergoing coronary artery bypass grafting without cardiopulmonary bypass had fewer complications, including neurological dysfunction (7.5% vs. 10.0%, p=0.1), and reduced incidence of prolonged ventilation (7.5% vs. 12.5%, p = 0.709), atrial fibrillation (15.0% vs. 20.0%, p = 0.002), and renal dysfunction (10.0% vs. 17.5%, p=0.556). In postoperative period, 70% patients in OPCAB group did not experience any cardiac events whereas 30% patients developed myocardial infarction, 5% had cardiac arrest and 7.5% had low output syndrome. . In on pump group 65% patients had no cardiac events whereas 35% patients developed one or more cardiac events. Of them 20% patients developed atrial fibrillation, 2.5% developed myocardial infarction, 2.5% develop cardiac arrest and 10% had low output syndrome. 2.5% patient developed both atrial fibrillation and low output. Conclusion: Diabetic patients undergoing CABG without cardiopulmonary bypass compared with those having coronary artery bypass grafting with cardiopulmonary bypass had higher mean predicted mortality and morbidity. Cardiovasc. j. 2020; 13(1): 12-18
背景:体外循环与高血糖发生率增高有关。许多研究表明，糖尿病与冠状动脉搭桥(CABG)手术的发病率和死亡率增加有关。我们回顾了有泵与无泵CABG治疗糖尿病患者的结果。方法:80例成人糖尿病患者行单泵和OPCAB CABG，随机分为两组，每组40例。评估术前、围手术期和术后的预后，并比较其住院结果死亡率和发病率。结果:行冠状动脉旁路移植术的糖尿病患者并发症较少，包括神经功能障碍(7.5% vs. 10.0%， p=0.1)，延长通气(7.5% vs. 12.5%， p= 0.709)，房颤(15.0% vs. 20.0%， p= 0.002)和肾功能障碍(10.0% vs. 17.5%， p=0.556)的发生率降低。术后，OPCAB组70%的患者未发生任何心脏事件，30%的患者发生心肌梗死，5%的患者发生心脏骤停，7.5%的患者发生低输出综合征。在一个泵组中，65%的患者没有心脏事件，而35%的患者出现了一种或多种心脏事件。其中20%的患者发生心房颤动，2.5%的患者发生心肌梗死，2.5%的患者发生心脏骤停，10%的患者发生低输出综合征。2.5%的患者同时出现房颤和低输出量。结论:与行冠状动脉旁路移植术合并体外循环的糖尿病患者相比，行冠状动脉旁路移植术合并体外循环的糖尿病患者平均预测死亡率和发病率更高。Cardiovasc。j。2020;13 (1): 12 - 18
{"title":"Evaluation of Mortality and Morbidity in Offpump Coronary Artery Bypass Grafting Versus Coronary Artery Bypass Grafting with Cardiopulmonary Bypass in Diabetic Patient Study at NICVD.","authors":"A. Haque, N. Ahmed, Mi Zulkarnine, S. Ahmed","doi":"10.3329/cardio.v13i1.50559","DOIUrl":"https://doi.org/10.3329/cardio.v13i1.50559","url":null,"abstract":"Background: Cardiopulmonary bypass is associated with increased incidence of hyperglycemia. Many studies have shown that diabetes is associated with increased morbidity and mortality in coronary artery bypass (CABG) surgery. We reviewed the outcome of on-pump versus off pump CABG in diabetic patients. \u0000Methods- 80 Adult diabetic patients undergoing isolated CABG both on-pump and OPCAB were divided into 2 groups – 40 patients in each group. To evaluate both preoperative, perioperative and postoperative out come and to compare their in hospital outcome mortality and morbidity. \u0000Results: Diabetic patients undergoing coronary artery bypass grafting without cardiopulmonary bypass had fewer complications, including neurological dysfunction (7.5% vs. 10.0%, p=0.1), and reduced incidence of prolonged ventilation (7.5% vs. 12.5%, p = 0.709), atrial fibrillation (15.0% vs. 20.0%, p = 0.002), and renal dysfunction (10.0% vs. 17.5%, p=0.556). In postoperative period, 70% patients in OPCAB group did not experience any cardiac events whereas 30% patients developed myocardial infarction, 5% had cardiac arrest and 7.5% had low output syndrome. . In on pump group 65% patients had no cardiac events whereas 35% patients developed one or more cardiac events. Of them 20% patients developed atrial fibrillation, 2.5% developed myocardial infarction, 2.5% develop cardiac arrest and 10% had low output syndrome. 2.5% patient developed both atrial fibrillation and low output. \u0000Conclusion: Diabetic patients undergoing CABG without cardiopulmonary bypass compared with those having coronary artery bypass grafting with cardiopulmonary bypass had higher mean predicted mortality and morbidity. \u0000Cardiovasc. j. 2020; 13(1): 12-18","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"105 5","pages":"12-18"},"PeriodicalIF":0.0,"publicationDate":"2020-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91407980","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.v13i1.50570
Naharuma Aive Hyder Chowdhury, T. Haq, M. Sharifuzzaman
Certain congenital heart defects require the creation of an unrestrictive atrial septal defect (ASD) secundum to achieve adequate atrial mixing to improve systemic oxygen saturation by placing septal stent. We reported a case of 7-month-old child who was presented with shock like state with marked desaturation. He was diagnosed as a case of mixed total anomalous pulmonary venous return with restricted closing ASD secundum. We performed atrial septal stenting as a palliative procedure for saving the life. Creation or enlargement of ASD in infants using nonconventional transcatheter techniques is feasible, safe, and effective when usual technique fails or not suitable. After the procedure systemic saturation improved and patient became hemodynamically stable and there after rerouting of pulmonary veins to left atrium with ASD closure and removal of stent done by open heart surgery and send him home safely. Cardiovasc. j. 2020; 13(1): 86-91
{"title":"Atrial Septal Stenting - A Lifesaving Procedure: First Case Report from Bangladesh","authors":"Naharuma Aive Hyder Chowdhury, T. Haq, M. Sharifuzzaman","doi":"10.3329/cardio.v13i1.50570","DOIUrl":"https://doi.org/10.3329/cardio.v13i1.50570","url":null,"abstract":"Certain congenital heart defects require the creation of an unrestrictive atrial septal defect (ASD) secundum to achieve adequate atrial mixing to improve systemic oxygen saturation by placing septal stent. We reported a case of 7-month-old child who was presented with shock like state with marked desaturation. He was diagnosed as a case of mixed total anomalous pulmonary venous return with restricted closing ASD secundum. We performed atrial septal stenting as a palliative procedure for saving the life. Creation or enlargement of ASD in infants using nonconventional transcatheter techniques is feasible, safe, and effective when usual technique fails or not suitable. After the procedure systemic saturation improved and patient became hemodynamically stable and there after rerouting of pulmonary veins to left atrium with ASD closure and removal of stent done by open heart surgery and send him home safely. \u0000Cardiovasc. j. 2020; 13(1): 86-91","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"54 1","pages":"86-91"},"PeriodicalIF":0.0,"publicationDate":"2020-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82266192","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.v13i1.50560
M. Siddiqui, Mizanur Rahman, B. Ahmed, Abdul Latif Molla, Iftekhar Uddin, Belal Hossain, P. Karmaker, M. Ahsan
Background: In-hospital length of stay (LOS) is an important metric for assessing the quality of care and planning capacity within a hospital. Percutaneous Coronary Interventions (PCI) merit short LOS following an uncomplicated procedure. Various factors have been studied that may influence LOS. The relationship between BMI and LOS after PCI has not been thoroughly investigated, especially in Bangladesh. Methods: This cross-sectional observational study was conducted at National Institute of Cardiovascular Diseases, on total 100 patients who underwent PCI with two equally divided groups on the basis of BMI of Asian ethnicity: Group I (BMI < 23 kg/m2) and Group II (BMI e” 23.0 kg/m2). In-hospital outcomes and LOS were observed and recorded after PCI. Results: The mean BMI of study population was 23.9 ± 1.9 kg/m2. The sum of occurrence of adverse in-hospital outcomes was 14.0%. Complications were significantly (p < 0.01) higher in Group I than Group II. Among all adverse in-hospital outcomes, only acute left ventricular failure was found to be statistically significant between groups (p < 0.01). The difference of mean LOS after PCI was higher in Group-I which was statistically significant (p < 0.01). Diabetes mellitus and dyslipidemia were found to be the independent predictors for developing adverse in-hospital outcome (OR= 1.68 and 1.46; 95% CI = 1.25 – 2.24 and 1.16 – 1.83; p = 0.018 and 0.040, respectively). BMI was inversely associated with adverse in-hospital outcome after PCI (OR = 0.95; 95% CI = 0.91 – 0.98; p = 0.007). Conclusion: BMI is inversely associated with adverse in-hospital outcome after PCI. The underweight people are likely to experience longer LOS following PCI. Cardiovasc. j. 2020; 13(1): 19-26
{"title":"Impact of Body Mass Index on In-Hospital Length of Stay after Percutaneous Coronary Interventions","authors":"M. Siddiqui, Mizanur Rahman, B. Ahmed, Abdul Latif Molla, Iftekhar Uddin, Belal Hossain, P. Karmaker, M. Ahsan","doi":"10.3329/cardio.v13i1.50560","DOIUrl":"https://doi.org/10.3329/cardio.v13i1.50560","url":null,"abstract":"Background: In-hospital length of stay (LOS) is an important metric for assessing the quality of care and planning capacity within a hospital. Percutaneous Coronary Interventions (PCI) merit short LOS following an uncomplicated procedure. Various factors have been studied that may influence LOS. The relationship between BMI and LOS after PCI has not been thoroughly investigated, especially in Bangladesh. \u0000Methods: This cross-sectional observational study was conducted at National Institute of Cardiovascular Diseases, on total 100 patients who underwent PCI with two equally divided groups on the basis of BMI of Asian ethnicity: Group I (BMI < 23 kg/m2) and Group II (BMI e” 23.0 kg/m2). In-hospital outcomes and LOS were observed and recorded after PCI. \u0000Results: The mean BMI of study population was 23.9 ± 1.9 kg/m2. The sum of occurrence of adverse in-hospital outcomes was 14.0%. Complications were significantly (p < 0.01) higher in Group I than Group II. Among all adverse in-hospital outcomes, only acute left ventricular failure was found to be statistically significant between groups (p < 0.01). The difference of mean LOS after PCI was higher in Group-I which was statistically significant (p < 0.01). Diabetes mellitus and dyslipidemia were found to be the independent predictors for developing adverse in-hospital outcome (OR= 1.68 and 1.46; 95% CI = 1.25 – 2.24 and 1.16 – 1.83; p = 0.018 and 0.040, respectively). BMI was inversely associated with adverse in-hospital outcome after PCI (OR = 0.95; 95% CI = 0.91 – 0.98; p = 0.007). \u0000Conclusion: BMI is inversely associated with adverse in-hospital outcome after PCI. The underweight people are likely to experience longer LOS following PCI. \u0000Cardiovasc. j. 2020; 13(1): 19-26","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"1 1","pages":"19-26"},"PeriodicalIF":0.0,"publicationDate":"2020-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91330230","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.v13i1.50557
S.R. Khan
Abstract not available Cardiovasc. j. 2020; 13(1): 5-6
摘要:心血管。j。2020;13 (1): 5 - 6
{"title":"Reminiscences of Prof. SR Khan on Prof. Abu Zafar","authors":"S.R. Khan","doi":"10.3329/cardio.v13i1.50557","DOIUrl":"https://doi.org/10.3329/cardio.v13i1.50557","url":null,"abstract":"Abstract not available \u0000Cardiovasc. j. 2020; 13(1): 5-6","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"8 1","pages":"5-6"},"PeriodicalIF":0.0,"publicationDate":"2020-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73549895","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.v13i1.50567
N. Fatema, Nure Ishrat Nazme, Md Ashfaque Ahemmed Khan, A. Amin, Atm Asadullah Kaisar Sujan
From last two decades, coronaviruses have led to three major outbreaks that started from 2002 with SARS-CoV, then MERS-CoV in 2012 and currently SARS-CoV-2 (COVID-19). There is limited data regarding the demographics and clinical features of SARS-CoV-2 infection in children. This information is especially important as pneumonia is the single leading cause of death in children worldwide. This Systematic Review aims to elucidate a better understanding of the epidemiologic, clinical and diagnostic findings, treatment and prevention options as well as global impact of COVID- 19 on the pediatric population with a focus on status in Bangladesh. Cardiovasc. j. 2020; 13(1): 62-74
{"title":"Covid-19 Pandemic: A Focused Review on Paediatric Patients","authors":"N. Fatema, Nure Ishrat Nazme, Md Ashfaque Ahemmed Khan, A. Amin, Atm Asadullah Kaisar Sujan","doi":"10.3329/cardio.v13i1.50567","DOIUrl":"https://doi.org/10.3329/cardio.v13i1.50567","url":null,"abstract":"From last two decades, coronaviruses have led to three major outbreaks that started from 2002 with SARS-CoV, then MERS-CoV in 2012 and currently SARS-CoV-2 (COVID-19). There is limited data regarding the demographics and clinical features of SARS-CoV-2 infection in children. This information is especially important as pneumonia is the single leading cause of death in children worldwide. This Systematic Review aims to elucidate a better understanding of the epidemiologic, clinical and diagnostic findings, treatment and prevention options as well as global impact of COVID- 19 on the pediatric population with a focus on status in Bangladesh. \u0000Cardiovasc. j. 2020; 13(1): 62-74","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"10 1","pages":"62-74"},"PeriodicalIF":0.0,"publicationDate":"2020-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79643803","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.v13i1.50569
N. Begum, Ferdousur Rahman Sarkar, A. Khan, Mohammad Nazmul Islam Bhuiyan
Pulmonary atresia (PA) with intact ventricular septum is a rare, heterogeneous congenital heart defect with varying degrees of right ventricular and tricuspid valve hypoplasia and wide spectrum clinical features. Initial treatment at presentation is to establish systemic to pulmonary shunt or ductus stenting. The treatment options i.e. biventricular, one and half ventricular or one ventricular repair are often dictated by the degree of development of the tricuspid valve and right ventricle. X, 11 years old teenage girl got admitted to Combined Military Hospital (CMH) Dhaka at 5 months of age with severe cyanosis, respiratory distress, acidosis and shock. After immediate stabilization and work up, she was diagnosed as pulmonary atresia with intact ventricular septum, flapped atrial septal defect (ASD) and a small patent ductus arteriosus (PDA). On urgent basis, stenting of PDA done with 3.5 X 11 mm coronary stent at cardiac catheterization laboratory. Her SPO2 stepped up to 90 % from base line SPO2 from 50% following procedure. At 15 months of age she underwent intracardiac repair with short trans annular patch and ASD left open as a vent for RV. On follow up her ASD was getting larger and became desaturated and symptomatic. She was followed up for the right ventricular (RV) and tricuspid valve growth and ASD shunt. As her RV was developing nicely during follow up and achieved TV z score –1, ASD device closure was done with 18 mm Amplatzer ASD device at 5 years of age. She is now asymptomatic and thriving well. Cardiovasc. j. 2020; 13(1): 81-85
肺动脉闭锁合并完整室间隔是一种罕见的异质先天性心脏缺损，表现为不同程度的右心室和三尖瓣发育不全，临床特征广泛。最初的治疗是建立全身到肺分流或导管支架置入。治疗的选择，即双心室，一个和半心室或一个心室修复通常是由三尖瓣和右心室的发展程度决定的。11岁的少女X在5个月大时因严重的紫绀、呼吸窘迫、酸中毒和休克被送入达卡联合军事医院。在立即稳定和工作后，她被诊断为肺闭锁，室间隔完整，扑动性房间隔缺损(ASD)和小动脉导管未闭(PDA)。紧急情况下，在心导管实验室用3.5 X 11mm冠状动脉支架置入PDA。她的SPO2从手术后的50%基线SPO2上升到90%。15个月大时，她接受了心内修复术，使用短环补片和ASD作为RV的通风口。在随访中，她的ASD越来越大，变得不饱和，有症状。她随访右心室(RV)和三尖瓣生长和ASD分流。由于她的右心室在随访期间发育良好，TV z评分为-1，因此在5岁时使用18mm Amplatzer ASD装置闭合ASD装置。她现在无症状，健康状况良好。Cardiovasc。j。2020;13 (1): 81 - 85
{"title":"Successful multiple Percutaneous Interventions and Biventricular Surgical Repair in a Child with Pulmonary Atresia with Intact Ventricular Septum— A Case Report","authors":"N. Begum, Ferdousur Rahman Sarkar, A. Khan, Mohammad Nazmul Islam Bhuiyan","doi":"10.3329/cardio.v13i1.50569","DOIUrl":"https://doi.org/10.3329/cardio.v13i1.50569","url":null,"abstract":"Pulmonary atresia (PA) with intact ventricular septum is a rare, heterogeneous congenital heart defect with varying degrees of right ventricular and tricuspid valve hypoplasia and wide spectrum clinical features. Initial treatment at presentation is to establish systemic to pulmonary shunt or ductus stenting. The treatment options i.e. biventricular, one and half ventricular or one ventricular repair are often dictated by the degree of development of the tricuspid valve and right ventricle. X, 11 years old teenage girl got admitted to Combined Military Hospital (CMH) Dhaka at 5 months of age with severe cyanosis, respiratory distress, acidosis and shock. After immediate stabilization and work up, she was diagnosed as pulmonary atresia with intact ventricular septum, flapped atrial septal defect (ASD) and a small patent ductus arteriosus (PDA). On urgent basis, stenting of PDA done with 3.5 X 11 mm coronary stent at cardiac catheterization laboratory. Her SPO2 stepped up to 90 % from base line SPO2 from 50% following procedure. At 15 months of age she underwent intracardiac repair with short trans annular patch and ASD left open as a vent for RV. On follow up her ASD was getting larger and became desaturated and symptomatic. She was followed up for the right ventricular (RV) and tricuspid valve growth and ASD shunt. As her RV was developing nicely during follow up and achieved TV z score –1, ASD device closure was done with 18 mm Amplatzer ASD device at 5 years of age. She is now asymptomatic and thriving well. \u0000Cardiovasc. j. 2020; 13(1): 81-85","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"9 1","pages":"81-85"},"PeriodicalIF":0.0,"publicationDate":"2020-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84790070","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 : 2020-12-03DOI: 10.3329/cardio.v13i2.52964
Avishek Sarker Dhruba, Md. Kamrul Hasan, Md Azizul Islam Khan
Background: Among the various options of treatment of ischemic heart disease coronary artery bypass grafting (CABG) remains one of the standard modes of revascularization. Coronary artery bypass grafting can be done with or without using cardiopulmonary bypass (CPB). This study was to compare postoperative early (up to 1 month) outcome of intact versus open pleura after off pump coronary artery bypass grafting (OPCAB). Methods: In this study, sixty patients aged 18-70 years admitted in Department of Cardiac Surgery, NICVD who underwent OPCAB were selected for the study sample and divided into two groups. Groups I (n=30) consist of the patients who underwent OPCAB with pleurotomy and Group II (n=30) consists of patients who underwent OPCAB with intact pleura. Outcome of patients including Forced expiratory volume in first second (FEV1) & Forced vital capacity were evaluated. Results: Patients having OPCAB with intact pleura showed lower incidence of atelectasis and pleural Effusion in 2nd postoperative & 5th postoperative day (p<0.05). Lower amount of chest tube drainage and transfusion requirement were observed in group II patients than Group I (530.00 ± 28.97 vs. 485.96±38.62; p<0.05 and 611.23±99.22 vs. 577.93±135.38, p>0.05, respectively). Moreover, higher duration of ventilation were noted in group I (7.50 ± 2.22 vs. 6.30±2.32, p<0.05). Beside these, total duration of ICU stay & hospital stay were significantly higher in patients OPCAB with open pleura (p<0.05). Conclusion: Keeping the pleura intact during OPCAB is significantly associated with low rate of atelectasis and pleural effusion. Clinically, it decreases postoperative amount of blood loss and significantly lowers ICU stay, mechanical ventilation time and hospital stay. Therefore, it can be concluded that intact pleura during OPCAB improves postoperative pulmonary outcomes. Cardiovasc. j. 2021; 13(2): 112-119
{"title":"Effect of Intact Pleura on Early Outcome after Off-Pump Coronary Artery Bypass Grafting","authors":"Avishek Sarker Dhruba, Md. Kamrul Hasan, Md Azizul Islam Khan","doi":"10.3329/cardio.v13i2.52964","DOIUrl":"https://doi.org/10.3329/cardio.v13i2.52964","url":null,"abstract":"Background: Among the various options of treatment of ischemic heart disease coronary artery bypass grafting (CABG) remains one of the standard modes of revascularization. Coronary artery bypass grafting can be done with or without using cardiopulmonary bypass (CPB). This study was to compare postoperative early (up to 1 month) outcome of intact versus open pleura after off pump coronary artery bypass grafting (OPCAB). \u0000Methods: In this study, sixty patients aged 18-70 years admitted in Department of Cardiac Surgery, NICVD who underwent OPCAB were selected for the study sample and divided into two groups. Groups I (n=30) consist of the patients who underwent OPCAB with pleurotomy and Group II (n=30) consists of patients who underwent OPCAB with intact pleura. Outcome of patients including Forced expiratory volume in first second (FEV1) & Forced vital capacity were evaluated. \u0000Results: Patients having OPCAB with intact pleura showed lower incidence of atelectasis and pleural Effusion in 2nd postoperative & 5th postoperative day (p<0.05). Lower amount of chest tube drainage and transfusion requirement were observed in group II patients than Group I (530.00 ± 28.97 vs. 485.96±38.62; p<0.05 and 611.23±99.22 vs. 577.93±135.38, p>0.05, respectively). Moreover, higher duration of ventilation were noted in group I (7.50 ± 2.22 vs. 6.30±2.32, p<0.05). Beside these, total duration of ICU stay & hospital stay were significantly higher in patients OPCAB with open pleura (p<0.05). \u0000Conclusion: Keeping the pleura intact during OPCAB is significantly associated with low rate of atelectasis and pleural effusion. Clinically, it decreases postoperative amount of blood loss and significantly lowers ICU stay, mechanical ventilation time and hospital stay. Therefore, it can be concluded that intact pleura during OPCAB improves postoperative pulmonary outcomes. \u0000Cardiovasc. j. 2021; 13(2): 112-119","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87807658","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 : 2020-07-12DOI: 10.3329/cardio.v12i2.48158
N. Hosain
Abstract not available Cardiovasc. j. 2020; 12(2): 154-157
摘要:心血管。j。2020;12 (2): 154 - 157
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