Early outcome of surgical treatment of 20 cases of postinfartion ventricular septal rupture by extended sandwich patch technique via right ventricle approach

Objective: Different techniques have been described to repair post myocardial infarction ventricular septal rupture (VSR), each method may result in residual shunting, bleeding, and post-operative mortality. The aim of this report is to describe early results of extended sandwich technique through right ventricle in 20 consecutive patients. Patients and Methods: A retrospective, cross-sectional and descriptive study on 20 patients underwent surgery for myocardial infarction VSR by extended sandwich technique through right ventricle from 12/2018 to 3/2021 in Hanoi Heart Hospital. Result: 20 consecutive patients (10 women and 10 men) with postinfarction ventricular septal rupture (mean age 72 years, range 48-84) underwent surgical repair for by extended sandwich technique performed through right ventricle from December 2018 to August 2021 in our institute. Reconstruction of the septum was performed by two patches according to the method described by Asai et al. The mean aortic clamp time was 101. The mean extracorporeal circulation time was 143 min. Postoperative intensive care unit (ICU) stay averaged 4 days (range, 1-10 days). There was 30% hospital mortality. 10% postoperative residual shunting was detected, and no patient needed reoperation for bleeding. Conclusion: This method of extended sandwich technique through right ventricle was safe, simple, and it could be performed in acute phase of myocardial infarction.

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Early Results after Aortic Valve Replacement Using Last Generation Bioprosthetic Aortic Valve

The Heart Surgery Forum ◽

10.1532/hsf.4189 ◽

2021 ◽

Vol 24 (6) ◽

pp. E598-E962

Author(s):

Dritan Useini ◽

Markus Schlömicher ◽

Peter Haldenwang ◽

Hamid Naraghi ◽

Vadim Moustafine ◽

...

Keyword(s):

Myocardial Infarction ◽

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Pacemaker Implantation ◽

Paravalvular Leakage ◽

Concomitant Surgery ◽

Early Results ◽

The Mean ◽

Few Data

Introduction: Few data are available about the newest generation surgical bioprosthesis. We aimed to evaluate early clinical and hemodynamic outcomes after using the INSPIRIS RESILIA aortic valve (Edwards Lifesciences, Irvine, California, USA). Methods: Between July 2018 and April 2021, 80 patients underwent aortic valve replacement receiving the INSPIRIS RESILIA aortic valve at our institution. Primary outcomes were the composite of early mortality, stroke, and myocardial infarction. Secondary outcomes were hemodynamic performances of the valve, paravalvular leakage, and new pacemaker implantation. Results: The mean age of the study population was 60.6 ± 8.3 years. The mean Society of Thoracic Surgery-Predicted Risk of Mortality score was 2.9 ± 1.7%. In 43.7% of the patients, concomitant surgery was performed. The in-hospital mortality, all-stroke, and myocardial infarction rates were 2.5%, 1.2%, and 1.2%, respectively. No valve was explanted and no redo was performed. The mean postoperative trans-prosthetic gradient at discharge was 10.2 ± 4.1 mm Hg. There was no need for new pacemaker implantation. We registered only two cases with minimal (trace) paravalvular leakage. Conclusion: The use of the INSPIRIS RESILIA aortic valve in a young, low-risk population is safe and associated with very good early clinical and hemodynamic outcomes.

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STUDY OF PANEL OF DIAGNOSTIC CARDIAC MARKERS FOR ACUTE MYOCARDIAL INFARCTION

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2019.v12i3.29560 ◽

2019 ◽

pp. 181-184

Author(s):

ANOOP KUMAR ◽

PREETI SHARMA ◽

PRADEEP KUMAR ◽

ASHOK KUMAR

Keyword(s):

Myocardial Infarction ◽

Troponin T ◽

Cross Sectional Study ◽

Mean Value ◽

Cardiac Markers ◽

Negative Group ◽

Cross Sectional ◽

Positive Group ◽

Reactive Protein ◽

The Mean

Objectives: The aim of this study is to estimate the level of creatine kinase-myocardial band (CK-MB), C-reactive protein (CRP), and lactate dehydrogenase (LDH) biomarker in myocardial infarction (MI) (troponin T-positive) and compare with normal healthy individuals (Troponin-T [TnT] negative). Methods: A cross-sectional study on 172 patients involving 100 patients with nondiabetic MI and 72 apparently healthy controls with no history of diabetes and/or MI was done from December 2017 to May 2018. The diagnosis of MI was established with electrocardiogram findings and TnT estimation. Blood samples were gathered and processed for the estimation of CK-MB, LDH, and CRP. Results: The mean age of the cases was 62.15±7.75 years and in the controls was 61.49±8.35 years (p=0.592). The mean value of CK-MB, LDH, and CRP in the TnT positive group was 111.94±29.59 IU/L, 564.43±110.99 IU/L, and 15.69±4.04 mg/L, whereas in the TnT negative group was 16.36±3.77 IU/L, 223.68±36.23 IU/L, and 6.08±2.02 mg/L, respectively (p<0.0001). CK-MB was deranged in 100% of TnT positive group, and in only 2.78% in TnT negative group (p<0.0001). LDH was deranged in 100% TnT positive group, and in 16.67% in TnT negative group (p<0.0001). CRP was deranged in 4% TnT positive group, and in 0% in TnT negative group (p=0.141). Conclusion: This study indicated that CK-MB and LDH are sensitive cardiac markers for the diagnosis of MI.

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Survey of the Impact of Myocardial Infarction on Patients’ Quality of Life: A Single-Centre Cross-Sectional Study

Evidence Based Health Policy Management and Economics ◽

10.18502/jebhpme.v4i4.4889 ◽

2020 ◽

Author(s):

Habib Jalilian ◽

Ali Imani ◽

Habibeh Mir ◽

Elnaz Javanshir ◽

Mehdi Mamene ◽

...

Keyword(s):

Quality Of Life ◽

Myocardial Infarction ◽

Heart Attack ◽

Cross Sectional Study ◽

P Value ◽

Sectional Study ◽

Cross Sectional ◽

The Mean ◽

The Impact

Background: A heart attack is one of the most common cardiovascular diseases, affecting different dimensions of the patients’ quality of life due to the disease’s disabling and limiting nature. Therefore, this study aimed to examine the impact of myocardial infarction on patients’ quality of life referring to the Shahid Madani Medical & Training Hospital, in East Azerbaijan Province in 2017, in Iran. Methods: This was a cross-sectional study. A total of 220 patients with a heart attack were selected in this study. Sampling was conducted using the systematic random method. Data were collected using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Descriptive statistics (frequency, mean) and statistical analyses (Mann-Whitney test, Spearman correlation, and Generalized Linear Models Regression) were performed at a significance level of P-value < 0.05 using SPSS22. Results: In this study, the mean score of the total effect of a heart attack on the patients’ quality of life was 30.09 ± 17.73. The mean score of the effect of a heart attack on the patient’s quality of life in the physical, emotional, and general subscales was 34.85 ± 24.24, 26.63 ± 27.73, and 27.51 ± 17.83, respectively. There was a statistically significant association between education status (P-value = 0.006), income status (P- value = 0.000), and the mean score of the effect of a heart attack on the patient’s quality of life; also a positive and significant correlation was found between age (CC = 0.135, P-value = 0.046), the number of hospitalization (CC = 0.187, P-value = 0.006) and the mean score of the effect of a heart attack on the patient’s quality of life. Conclusion: A heart attack has a considerable impact on the patients’ quality of life, particularly on the physical dimension. Hence, health professionals should pay more attention to these vulnerable groups and offer rehabilitation services suitable to these groups to reduce the impact of the disease.

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Relationship of Sense of Coherence to Other Psychosocial Indices

European Journal of Psychological Assessment ◽

10.1027/1015-5759.20.4.227 ◽

2004 ◽

Vol 20 (4) ◽

pp. 227-236 ◽

Cited By ~ 19

Author(s):

Sara Holmberg ◽

Anders Thelin ◽

Eva-Lena Stiernström

Keyword(s):

Social Support ◽

Psychosocial Factors ◽

Sense Of Coherence ◽

Living Conditions ◽

Strong Negative Correlation ◽

Cross Sectional ◽

Positive Correlation ◽

Work Related ◽

Job Demand ◽

The Mean

Summary: The concept of “sense of coherence” (SOC) has been widely recognized since it was first introduced by Antonovsky. The originality and usefulness of the SOC scale and its relation to other psychosocial measures has been the subject of lively debate. The aim of this paper was to test for associations between SOC and work-related psychosocial factors (mainly the Job Demand-Control model), general living conditions, education, and social network factors. Cross-sectional data from a population-based sample of 1782 rural males from nine counties in Sweden were analyzed with a multiple regression technique. The subjects were occupationally active at inclusion and the mean age was 50 years (range 40-60). SOC was assessed with the original 29-item questionnaire. Psychosocial variables and lifestyle factors were assessed using questionnaires and structured interviews. The mean SOC among the subjects was 152.3 (standard deviation, 19.4). A strong negative correlation was found between SOC and job demand, whereas a positive correlation with job control was demonstrated. A positive correlation with general living conditions and with social support was also found. However, there was no correlation to education and occupation. Thus, SOC was shown to be strongly correlated to work-related psychosocial factors and social support, but independent of sociodemographic factors.

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Influence of Acute Myocardial Infarction and rt-PA Therapy on Circulating Fibrinogen

Thrombosis and Haemostasis ◽

10.1055/s-0038-1651605 ◽

1993 ◽

Vol 69 (04) ◽

pp. 321-327 ◽

Cited By ~ 3

Author(s):

E Seifried ◽

M Oethinger ◽

P Tanswell ◽

E Hoegee-de Nobel ◽

W Nieuwenhuizen

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Thrombolytic Agent ◽

Degradation Products ◽

Maximum Plasma ◽

Normal Range ◽

Fibrinogen Degradation Products ◽

Fibrin Degradation Products ◽

Rebound Phenomenon ◽

The Mean

SummaryIn 12 patients treated with 100 mg rt-PA/3 h for acute myocardial infarction (AMI), serial fibrinogen levels were measured with the Clauss clotting rate assay (“functional fibrinogen”) and with a new enzyme immunoassay for immunologically intact fibrinogen (“intact fibrinogen”). Levels of functional and “intact fibrinogen” were strikingly different: functional levels were higher at baseline; showed a more pronounced breakdown during rt-PA therapy; and a rebound phenomenon which was not seen for “intact fibrinogen”. The ratio of functional to “intact fibrinogen” was calculated for each individual patient and each time point. The mean ratio (n = 12) was 1.6 at baseline, 1.0 at 90 min, and increased markedly between 8 and 24 h to a maximum of 2.1 (p <0.01), indicating that functionality of circulating fibrinogen changes during AMI and subsequent thrombolytic therapy. The increased ratio of functional to “intact fibrinogen” seems to reflect a more functional fibrinogen at baseline and following rt-PA infusion. This is in keeping with data that the relative amount of fast clotting “intact HMW fibrinogen” of total fibrinogen is increased in initial phase of AMI. The data suggest that about 20% of HMW fibrinogen are converted to partly degraded fibrinogen during rt-PA infusion. The rebound phenomenon exhibited by functional fibrinogen may result from newly synthesized fibrinogen with a high proportion of HMW fibrinogen with its known higher degree of phosphorylation. Fibrinogen- and fibrin degradation products were within normal range at baseline. Upon infusion of the thrombolytic agent, maximum median levels of 5.88 μg/ml and 5.28 μg/ml, respectively, were measured at 90 min. Maximum plasma fibrinogen degradation products represented only 4% of lost “intact fibrinogen”, but they correlatedstrongly and linearly with the extent of “intact fibrinogen” degradation (r = 0.82, p <0.01). In contrast, no correlation was seen between breakdown of “intact fibrinogen” and corresponding levels of fibrin degradation products. We conclude from our data that the ratio of functional to immunologically “intact fibrinogen” may serve as an important index for functionality of fibrinogen and select patients at high risk for early reocclusion. Only a small proportion of degraded functional and “intact fibrinogen”, respectively, is recovered as fibrinogen degradation products. There seems to be a strong correlation between the degree of elevation of fibrinogen degradation products and the intensity of the systemic lytic state, i.e. fibrinogen degradation.

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The Quantitation of Platelet Aggregation Induced by Four Compounds: A Study in Relation to Myocardial Infarction

Thrombosis and Haemostasis ◽

10.1055/s-0038-1655660 ◽

1966 ◽

Vol 16 (03/04) ◽

pp. 752-767 ◽

Cited By ~ 23

Author(s):

J. R O’Brien ◽

F. C Path ◽

Joan B. Heywood ◽

J. A Heady

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Platelet Aggregation ◽

Platelet Rich Plasma ◽

Myocardial Infarct ◽

Control Groups ◽

The Mean ◽

Platelet Shape

SummaryMethods for measuring and comparing day to day differences in the response of platelet aggregation in platelet-rich plasma to added ADP, 5-H.T., adrenaline and collagen are reported. Platelet aggregation induced by ADP, 5-H.T. and adrenaline was studied in patients with acute myocardial infarction and in others 3 months to 5 years after an infarct; some were receiving anti-coagulants and others not: these three groups were compared with three control groups. The mean platelet shape was rounder and the response to ADP and to 5-H.T. and one parameter of the response to adrenaline was significantly greater in all groups of patients with myocardial infarct taken together than in the controls. The platelet-rich plasma from patients with recent infarction were most responsive to ADP and 5-H.T. immediately after the infarct. Anti-coagulants had no effect on these tests. However, there was wide variation within the individuals and much overlap between groups, and these tests can only reliably distinguish between groups and not between individuals. The significance of these findings is discussed.

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Age related volume of cadaver-prostates in Bangladesh

Ibrahim Medical College Journal ◽

10.3329/imcj.v4i2.6501 ◽

1970 ◽

Vol 4 (2) ◽

pp. 74-77

Author(s):

Rukshana Ahmed ◽

Shamim Ara

Keyword(s):

Prostate Gland ◽

Age Groups ◽

Clinical Settings ◽

Cross Sectional ◽

Medical College ◽

Age Related ◽

Group A ◽

Key Words Prostate ◽

The Mean ◽

Group B

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77

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Brief Overview and Experience of Visual Evoked Potential of First 67 cases at Referral Neuroscience Hospital in Bangladesh

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v6i2.50744 ◽

2020 ◽

Vol 6 (2) ◽

pp. 74-77

Author(s):

Mohammad Enayet Hussain ◽

Bithi Debnath ◽

AFM Al Masum Khan ◽

Md Ferdous Mian ◽

Md Nahidul Islam ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optic Neuritis ◽

Clinical Diagnosis ◽

Optic Neuropathy ◽

Cross Sectional Study ◽

P Value ◽

Pattern Reversal ◽

Cross Sectional ◽

The Mean ◽

Visual Evoked

Background: The visual evoked potentials (VEP) is a valuable tool to document occult lesions of the central visual channels especially within the optic nerve. Objectives: The purpose of the present study was to observe the findings of first few cases of VEP done in the neurophysiology department of the National Institute of Neurosciences (NINS), Dhaka, Bangladesh. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2017 to March 2020. All patients referred to the Neurophysiology Department of NINS for VEP were included. Pattern reversal VEPs were done using standard protocol set by International Federation of Clinical Neurophysiology (IFCN). Results: The mean age of the study population was 30.70 (±12.11) years (6-68 years) with 31 (46.3%) male and 36 (53.7%) female patients. The mean duration of illness was 8.71 (±1.78) months (3 days- 120 months). Most common presenting symptom was blurring of vision (37.3%) and dimness of vision (32.8%). Patterned VEP revealed mixed type (both demyelinating and axonal) of abnormality in most cases [29(43.35)]. The most common clinical diagnosis was multiple sclerosis (29.85%) and optic neuropathy (26.87%). In the clinically suspected cases of multiple sclerosis, optic neuropathy and optic neuritis most of the cases of VEP were abnormal and the p value is 0.04 in optic neuropathy and optic neuritis. Conclusion: The commonest presentation of the patients in this series were blurring of vision and dimness of vision. The most common clinical diagnosis for which VEP was asked for, was optic neuritis and multiple sclerosis. Most abnormalities were of mixed pattern (demyelinating and axonal). Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 74-77

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Sonographic Assessment of Amniotic Fluid Volume using Single Deepest Pocket (SDP) among Igbo Women with Uncomplicated Singleton Pregnancies.

10.33798/ajmas2019/00265. ◽

2019 ◽

Vol 2 (1) ◽

pp. 1-18

Author(s):

Chijioke Okeudo ◽

B.U. Ezem

Keyword(s):

Amniotic Fluid ◽

Gestational Age ◽

Cross Sectional Study ◽

Fluid Volume ◽

Singleton Pregnancy ◽

Cross Sectional ◽

South Eastern ◽

Amniotic Fluid Volume ◽

The Mean ◽

Singleton Pregnancies

Background: The amniotic fluid is fundamental for proper fetal development and growth. Ultrasound visualization of the amniotic fluid permits both subjective and objective estimates of the amniotic fluid. Objective: The objective of this study was to determine the reference values of normal single deepest pocket (SDP) – upper and lower limits, mean SDP and variation of the SDP with gestational age among Igbo women of South-Eastern Nigeria extraction carrying uncomplicated singleton pregnancy. Methodology: This was a prospective cross sectional study involving 400 women carrying uncomplicated singleton pregnancies and who were sure of the date of the first day of their last menstrual period. The single deepest pocket / maximum vertical pool were determined once at presentation at the hospital.. The study was conducted from January 1st to December 31st 2015. The second author carried out all the scanning. The SDP was obtained. Results: The womens’ mean and median ages were the same at 28 years. The gestational age range of the pregnancies was 14-41 weeks. The mean SDP was 5.8cm, while the 5th and 95th percentiles were 3.3cm and 8.5cm respectively. There was no difference in the mean SDP in both term and preterm. There was irregular but continuous rise of mean SDP to a peak of 6.8cm at gestational age of 39 weeks. In conclusion, the participants had a mean SDP of 5.8cm. There was also a positive correlation between SDP and Gestational age. We therefore recommend a longitudinal study to assess perinatal outcome and abnormal amniotic fluid volume among Igbo women of South-Eastern Nigeria. Key words: Single Deepest Pocket, Uncomplicated Singleton Pregnancy, Igbo Women.

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Outcomes of the Extracardiac Fontan Procedure Using Cardiopulmonary Bypass: Early Results

The Heart Surgery Forum ◽

10.1532/hsf98.2014327 ◽

2014 ◽

Vol 17 (3) ◽

pp. 173 ◽

Cited By ~ 1

Author(s):

Murat Ugurlucan ◽

Eylem Yayla Tuncer ◽

Fusun Guzelmeric ◽

Eylul Kafali ◽

Omer Ali Sayin ◽

...

Keyword(s):

Cardiopulmonary Bypass ◽

Fontan Procedure ◽

Fontan Operation ◽

Arterial Oxygen Saturation ◽

Vena Cava ◽

Arterial Oxygen ◽

Shunt Operation ◽

Early Results ◽

The Mean ◽

Extracardiac Fontan

Background: Although the avoidance of cardiopulmonary bypass during the Fontan procedure has potential advantages, using cardiopulmonary bypass during this procedure has no adverse effects in terms of morbidity and mortality rates. In this study, we assessed the postoperative outcomes of our first 9 patients who have undergone extracardiac Fontan operation by the same surgeon using cardiopulmonary bypass.Methods: Between September 2011 and April 2013, 9 consecutive patients (3 males and 6 females) underwent extra-cardiac Fontan operation. All operations were performed under cardiopulmonary bypass at normothermia by the same surgeon. The age of patients ranged between 4 and 17 (9.8 ± 4.2) years. Previous operations performed on these patients were modified Blalock-Taussig shunt procedure in 2 patients, bidirectional cavopulmonary shunt operation in 6 patients, and pulmonary arterial banding in 1 patient. Except 2 patients who required intracardiac intervention, cross-clamping was not applied. In all patients, the extracardiac Fontan procedure was carried out by interposing an appropriately sized tube graft between the infe-rior vena cava and right pulmonary artery.Results: The mean intraoperative Fontan pressure and transpulmonary gradient were 12.3 ± 2.5 and 6.9 ± 2.2 mm Hg, respectively. Intraoperative fenestration was not required. There was no mortality and 7 patients were discharged with-out complications. Complications included persistent pleural effusion in 1 patient and a transient neurological event in 1 patient. All patients were weaned off mechanical ventila-tion within 24 hours. The mean arterial oxygen saturation increased from 76.1% ± 5.3% to 93.5% ± 2.2%. All patients were in sinus rhythm postoperatively. Five patients required blood and blood-product transfusions. The mean intensive care unit and hospital stay periods were 2.9 ± 1.7 and 8.2 ± 1.9 days, respectively.Conclusions: The extracardiac Fontan operation per-formed using cardiopulmonary bypass provides satisfactory results in short-term follow-up and is associated with favor-able postoperative hemodynamics and morbidity rates.

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