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Biomedical subjects

H Sadeghi

Publications and source records attributed to H Sadeghi.

At least 109 records · Page 6Linked to original sources
PubMed1982

Improvement of left ventricular function after percutaneous transluminal coronary angioplasty.

Cardiac function and left ventricular dynamics were measured in seven consecutive patients 1 day before and 6 months after percutaneous transluminal balloon angioplasty of subtotal proximal stenosis of the left anterior descending coronary artery. Before angioplasty all patients had obvious left ventricular dysfunction during exercise and to a smaller degree during isoproterenol infusion; the condition of all patients was greatly improved 6 months after angioplasty. After angioplasty, left ventricular end-diastolic pressure was normal at rest and decreased from a mean (+/- standard error of the mean) of 33.8 +/- 1.6 to 19.2 +/- 0.5 mm Hg on exercise. Left ventricular ejection fraction, measured by a gated blood pooling technique with technetium-99m, improved on exercise from 46 +/- 5.0 percent to 69 +/- 1.0 percent. Cardiac output and stroke volume index increased significantly with exercise after angioplasty. The peak negative rate of pressure reduction in the left ventricle (dP/dt/min), an index of left ventricular relaxation, was highly abnormal on exercise before (2,307 +/- 260 mm Hg/s) and increased to the normal range (3,154 +/- 200 mm Hg/s) after angioplasty. The improvement in left ventricular function after transluminal angioplasty in these cases of proximal left anterior descending coronary arterial stenosis is extremely encouraging.

Adult↗
PubMed1982

Iatrogenic myocardial infarction. A possible complication of mitral valve surgery related to anatomical variation of the circumflex coronary artery.

Following mitral valve replacement, a 43-year-old male presented electrocardiographic signs of myocardial ischemia-injury in the postero-inferior wall, and subsequently died. The post mortem examination revealed a subendocardial myocardial infarction in the postero-inferior wall. The myocardial infarction was related to the accidental ligation of the circumflex coronary artery by one of the sutures fixing the prosthetic valve. Technically, this surgical accident can be explained by the anomalous origin and course of the circumflex coronary artery found in this patient at the time of the post mortem examination. Anatomical variations of the coronary arteries and their surgical implications are discussed. This iatrogenic complication could have been avoided by performing a preoperative coronary angiography, which was not done in the reported case for medical reasons.

Adult↗
PubMed1981

[Severity of stabilized angina pectoris and indication for coronary bypass-implications for prognosis].

The prognosis in patients with mild or moderate angina pectoris (class I or I-II) and significant coronary artery lesions (70% or more luminal diameter reduction) is controversial. Since 1967 these cases have not been operated upon in our Division. To assess the justice of this approach, 61 mildly symptomatic, non-operated patients (group I) were compared with 65 markedly symptomatic (class II to IV) patients in whom coronary artery bypass procedures were indicated but not performed (group II). These patients either had refused surgery or the lesions were considered unsuited to revascularization. Although 44 patients in group I had 70% or more stenosis of one or more coronary arteries, the 8-year mortality rate in group I was 17% compared with 40% in group II. For patients with single vessel disease (32 patients in group I, 35 patients in group II) the 8-year mortality was 9.4% in group I and 34% in group II; the difference is significant. This retrospective study suggests that mild and moderate angina pectoris (class I or I-II with or without medical treatment) is associated with a rather favourable prognosis (one single death during the first four years in group I). It may be concluded that an aggressive approach can be delayed until further symptoms develop despite adequate medical therapy.

Angina Pectoris↗
PubMed1978

[Surgical treatment of associated coronary disease and heart valve disease].

25 patients underwent combined surgery for coronary artery and valvular heart disease. Although patients suffering from associated coronary artery and valvular lesions represent a high operative risk group, the combined surgical procedure is clearly justified by the functional improvement of the patients. Selective coronaro-angiography should be carried out in the assessment of patients over 40 years of age with valvular disease, since not all patients present angina in spite of diseased coronary arteries. Three hospital deaths (13.5%) indicate the gravity of the procedure, but the absence of intra- or postoperative myocardial infarction and the comparatively rapid recovery of the patients with relatively few complications are very encouraging.

Adult↗
PubMed1975

[Proceedings: Results of the surgical treatment of valvulopathies and ischemic heart disease in patients older than 65 years].

53 patients aged from 65 to 76 years underwent surgery for valvulopathies (23 patients), atherosclerotic heart disease (24 patients) or both diseases combined (6 patients). All these cases were in NYHA fonctional classes III and IV except for one patient in class II. Hospital mortality after surgical treatment of these cardiopathies was 3.8% (2 deaths). The late mortality of 19% (10 deaths), though high, was of non-cardiac origin in 7 of these patients. The clinical and hemodynamic findings in the two patients who died in the postoperative period were compared with those in the others. These two patients were more severely ill and had a greater degree of cardiomegaly than the average patient in the surviving group. The satisfactory clinical improvement in these elderly cardiac patients suggests that surgery can be recommended at least up to 75 years of age if there are no obvious contraindications. Life expectancy of 13-16 years for patients aged 65 and 8-9 years for patients aged 75 is a further reason for advocating surgical intervention.

Aged↗
PubMed1975

[Surgery of aortic valvulopathies].

75 patients were operated for isolated aortic congenital or acquired valvulopathies (46 men, 25 women and 4 children). 8 patients were reoperated because of functional defects of the artificial valve or paravalvular dehiscence. 3 children from 3 to 10 years of age underwent aortic valvular commissurotomy. The other patients had aortic valve replacement by an artificial valve. Two types of valves were used. In the beginning, we employed the Starr-Edwards valves, models 1200, 2300, 2310 and 2320. Since July 1971, we are using the Björk-Shiley valve. Less pressure gradient across the valve and less hemolysis with Björk-Shiley valve are two important factors in favoring its use. Our hospital mortality has been 5.3% and late mortality also 5.3%. Clinical improvement is observed among 80% of patients in follow-up controls.

Adolescent↗