Effect of acute ischemia on QT dispersion.
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Angioplasty, Balloon, Coronary↗
Biomedical subjects
F Ozmen
Publications and source records attributed to F Ozmen.
Is there any association between dissection after successful percutaneous transluminal coronary angioplasty and late restenosis? An angiographic study.
Restenosis continues to be the most important limitation of percutaneous transluminal coronary angioplasty (PTCA). Many clinical, angiographic, and procedural variables are thought to be related to the development of restenosis. This study was aimed at investigating the effects of no dissection, minor dissections, and major dissections on the long-term outcome of lesions after successful PTCA. The study group comprised 91 patients with 100 lesions who underwent successful PTCA and in whom follow-up coronary angiography was performed at 8.8 +/- 7.2 (two to twenty-three) months after dilation. Dissections were classified according to the National Heart, Lung, and Blood Institute criteria. Restenosis was defined as more than 50% stenosis at follow-up angiography. Restenosis rates were found to be 22% in the no-dissection group (10 restenoses in 46 patients), 27% in the minor dissection group (11 restenoses in 40 patients), and 36% in the major dissection group (5 restenoses in 14 patients). The authors applied corrected Yates Chi-square test and no difference was observed in the restenosis rate between the group without any dissections and that with minor dissections (P > 0.05). However, a statistically significant difference was observed in the restenosis rate between the major dissection group and the other two groups (P < 0.05). The authors conclude that the occurrence of major dissections after successful PTCA may adversely affect the long-term outcome and may increase the restenosis rate.
Angioplasty, Balloon, Coronary↗
Does increased lipoprotein (a) impair the effectiveness of thrombolysis with streptokinase?
Although lipoprotein (a) [Lp(a)] has been shown to interfere with thrombolysis in vitro, its effects on thrombolytic therapy in patients with acute myocardial infarction (MI) are not clear. The authors evaluated 32 male patients ages thirty-five to seventy-five (mean fifty-two +/- ten) with the diagnosis of acute MI who underwent thrombolytic therapy with 1,500,000 units of intravenous streptokinase. All patients underwent coronary angiography within seven days of the infarction from which the thrombolysis in myocardial infarction (TIMI) flow grades of the infarct-related artery, coronary scores, and ejection fraction were determined. Anterior MI was found in 19 patients (59.4%), inferior MI in 12 (37.5%), and posterolateral MI in 1 patient (3.1%). They found that 6 patients (18.8%) had TIMI flow 0 to 1, and 26 patients (81.2%) had TIMI flow grade 2 or 3. The Lp(a) levels ranged from 0.1 to 60 mg/dL with a mean of 8.6 +/- 17 mg/dL. Eight (25%) of the patients had Lp(a) levels above 30 mg/dL. The TIMI flow rates were not found to be lower in patients with high Lp(a) levels (P > 0.05), and there was no significant correlation between the TIMI flow rates and the Lp(a) levels (r = 0.28). There was a good correlation between coronary scores and Lp(a) levels (r = 0.87). They conclude that although there is a good correlation between the extent of coronary atherosclerosis and Lp(a) levels, Lp(a) is not a strong predictor of the outcome of thrombolytic therapy.
Adult↗
Mitral valve surgery in the presence of pulmonary hypertension.
Mitral valve surgery was performed in 59 patients with severe pulmonary hypertension (average systolic pulmonary artery pressure 77.1 +/- 18.6 mmHg; range 50-115 mmHg) between 1983 and 1990. Thirty-eight patients had been subjected to mitral valve replacement, 16 patients both mitral and aortic valve replacement, and 5 patients had open mitral commissurotomy, with an operative (30 day) mortality of 5.0%. These 3 deaths happened during the early postoperative period. Survivors were followed up for a period ranging from 6 months to 7 years with a mean of 36 months. Four late deaths (7.1%) occurred in patients with valve replacement. Actuarial survival was 93 +/- 3% at 5 years, and 90.7 +/- 4.4% at 7 years. Right ventricular catheterization was performed on 14 patients a mean of 38 months following operation. Systolic pulmonary artery pressure had decreased from a mean of 77.1 +/- 18.6 to 39.7 +/- 14.0 mmHg (p less than 0.001) and 90% of the survivors were in New York Heart Association Class 1 or II compared to 23.7% preoperatively. The clinical and hemodynamic findings in this series suggest that severe pulmonary hypertension is not a contraindication, and pulmonary hypertension decreases significantly after mitral valve surgery.
Adolescent↗
Pregnancy and its complications after cardiac valve replacement.
The outcome of 64 pregnancies in 40 women who conceived after cardiac valve replacement were reviewed. Fetal wastage was 53.2% (25/47) in coumarin administered pregnancies, 36.4% (4/11) using heparin and 16.7% (1/6) without anticoagulants. Two fetal malformations were noted in coumarin administered pregnancies. There were two maternal deaths. Maternal morbidity due to antenatal bleeding, atrial fibrillation, thromboembolic episodes and cardiac failure were found to be 20.0% (8/40), 17.5% (7/40), 10.0% (4/40) and 10.0% (4/40), respectively.
Abnormalities, Drug-Induced↗
Supravalvular and valvular aortic stenosis in homozygous familial hypercholesterolemia.
Premature atherosclerosis with a particular predilection to the coronary arteries is a well-known complication of homozygous familial hypercholesterolemia. However, well documented involvement of the aortic root and valve with aortic stenosis has not been recognized frequently antemortem. Clinical, echocardiographic, hemodynamic and angiographic features of a case with valvular and supravalvular aortic stenosis secondary to homozygous familial hypercholesterolemia are described. Surgical relief of the left ventricular outflow obstruction was not attempted because of the patient's refusal.
Adult↗