Biomedical subjects

S S Chatterjee

Publications and source records attributed to S S Chatterjee.

114 records · Page 7Linked to original sources

PubMedDate not supplied

Long term follow-up of percutaneous transluminal renal angioplasty with special reference to aorto-arteritis.

Percutaneous transluminal renal angioplasty (PTRA) was attempted in 96 patients of renovascular hypertension (RVHT) admitted during the period 1986 to 1992. The patients' age ranged from 14-70 (mean: 38.7 +/- 18.8) years. There were 42 (43.8%) males and 54 (56.2%) females. The cause of renal artery stenosis (RAS) was aorto-arteritis in 44 (45.8%), atherosclerosis in 28 (29.2%) and fibromuscular dysplasia in 24 (25%). Bilateral RAS was found in 16 (16.7%). PTRA was angiographically successful in 92 (95.8%) patients. The mean pressure gradient decreased from 82.6 +/- 8.2 to 11.2 +/- 3.6 mm Hg in aorto-arteritis, 75.2 +/- 13.2 to 9.6 +/- 6.4 mm Hg in atherosclerosis and from 86.4 +/- 10.6 to 13.2 +/- 8.2 mm Hg in fibromuscular dysplasia respectively. The patients were followed up for 43.2 +/- 24.1 (range: 6-77) months. Remission or satisfactory lowering of blood pressure was achieved in 80 (86.9%) patients. Clinical success rate (remission or satisfactory lowering of BP) at the end of follow-up period was 75.3 percent. Randomly selected repeat angiography was done in 45 out of 92 (49.1%) patients at the end of 24 months of follow-up. Restenosis was detected in 12 (26.7%) patients and was commonest in the atherosclerotic group (42.8%), followed by fibromuscular dysplasia (14.3%) and least common in aorto-arteritis (11.8%). Repeat angioplasty was done successfully in 10 (83.3%) patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMedDate not supplied

Evaluation of coronary artery disease by dipyridamole echocardiography test.

Role of oral dipyridamole echocardiography test (DET) was evaluated in 50 patients with effort angina. All patients underwent coronary angiography, the day after oral DET. The echo studies were performed at rest and 65 +/- 15 minutes after 300 mg of oral dipyridamole. Segmental wall motion was analysed in a 16 segment model and a wall motion score index (WMSI) was generated for the entire left ventricle both at rest and following the drug. WMSI was significantly higher after oral dipyridamole, (p < 0.001) compared to resting condition with increased sensitivity (86% vs 74%). When results of DET were compared with coronary angiography, the correlation of WMSI was statistically significant in three vessel disease (p < 0.001), two vessel disease (p < 0.001) as well as for left anterior descending lesions (p < 0.001). However, it was insignificant for single vessel disease, viz, right coronary artery and circumflex artery. Thus we conclude that oral DET is a safe, inexpensive, sensitive and non-exercise dependent method for demonstrating myocardial ischaemia with high diagnostic accuracy.

Coronary Angiography↗

PubMedDate not supplied

Left main coronary artery compression by dilated main pulmonary artery in atrial septal defect.

Left main coronary artery compression by dilated pulmonary artery in patients with atrial septal defect has previously been reported, but not well characterized. Accordingly, we review retrospectively data of patients with atrial septal defect in whom selective coronary angiograms were done. 41 patients (26 females), aged 47.3 +/- 7.4 years were studied. The pulmonary artery mean pressure was 22.7 +/- 8.3 mm Hg and all patients had left to right shunt ratio of 2:1 or more (mean ratio: 3.9 +/- 1.7). Two patients (4.8%) had left coronary ostial stenosis. There were no clinical or haemodynamic parameters to differentiate the patients with or without these changes. Two patients (4.8%) had coexistent atherosclerotic coronary artery disease. In conclusion, left main coronary trunk compression rarely occurs in patients with atrial septal defect. This information may be relevant in evaluating patients with atrial septal defect.

Adult↗

PubMedDate not supplied

Intravenous thrombolytic therapy in unstable angina.

One hundred consecutive age and sex-matched patients of 3 different subsets of unstable angina (recent onset angina -65, crescendo angina -20, post-infarct angina-15) were randomized 1:1 after coronary angiography to receive I.V., either 1.5 x 10(6) units of streptokinase (SK) in 200 ml of normal saline or 200 ml of normal saline alone (control) in 1 hour. Repeat angiography was done in those patients having intra-coronary thrombi (37.3%) during the initial angiography. Both groups received optimal doses of heparin followed by warfarin, aspirin and other standard drugs and were followed up for 6 months. Anginal pain subsided significantly in the SK group-41 (82%) vs 25 (50%) (P < 0.005), especially in patients with recent onset angina (92.5% vs 60%, P < 0.005). Incidence of acute myocardial infarction (AMI) was much less in the SKgp (4(8%) vs 17 (34%) (p < 0.05). Four cases of fatal MI and four cases of sudden cardiac death (SCD) occurred in the control group against none in the SKgp. Requirements of mechanical revascularization was significantly less (P < 0.05) in the SK gp. Angiographic evidence of partial or complete clot lysis was noted in 90% of SK gp. vs 4.8% of control (P < 0.01). Echocardiographically assessed LV function improved significantly with SK-therapy in recent onset (P < 0.05) and crescendo angina (P < 0.001) subsets--however, the improvements in post infarct angina subset were not statistically significant. The beneficial outcome with SK therapy was observed in patients irrespective of angiographic evidence of thrombi.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMedDate not supplied

Low-dose amiodarone in severe chronic heart failure.

Sudden cardiac death is a common cause of mortality in patients with congestive heart failure. Asymptomatic ventricular arrhythmia has been attributed as the cause for increased overall mortality in such patients. We conducted a prospective randomised single-blind placebo-controlled trial with low-dose amiodarone to assess its efficacy in reducing mortality in severe congestive heart failure and its effect on exercise tolerance, left ventricular systolic function and ventricular ectopic activity. Patients were randomised to receive amiodarone (n = 36) 400 mg/day orally for one month followed by a maintenance dose of 200 mg/day, or to a standard treatment (n = 40) according to intention-to-treat principle. There were 10 cardiac deaths in the amiodarone-treated group and 16 in the control group. Significant improvement was noted in exercise time in the treadmill test (modified Bruce Protocol) among patients in the amiodarone-treated group while no such statistical difference was detectable in the placebo group. Side-effects in the amiodarone group included asymptomatic rise in hepatic enzymes (three-fold) in 6 percent and proarrhythmia in 3 percent of patients. Nausea was reported in one patient and rash in one. Though low-dose amiodarone proved to be an effective antiarrhythmic agent, it failed to live up to the expectation of improving sudden cardiac death in patients with severe chronic heart failure and asymptomatic ventricular ectopy.

Amiodarone↗

PubMedDate not supplied

Follow-up results of balloon angioplasty for native coarctation of aorta.

Balloon angioplasty of native discrete (< 1 cm) coarctation of thoracic aorta was performed in 29 patients [aged 13 to 31 years (mean 21.5 +/- 5.8 years), 22 males and 7 females], from March 1993 to December 1995. The patients were followed up for two years. After angioplasty, peak systolic arterial pressure (PSAP) decreased from 173.5 +/- 18.1 mm Hg to 122.5 +/- 9.9 mm Hg (p < 0.001), peak systolic pressure gradient (PSG) decreased by 90.9 percent from 86.2 +/- 15.77 to 7.77 +/- 3.8 mm Hg (p < 0.001) and the coarcted segment diameter increased about three times from 3.7 +/- 1.6 to 10.9 +/- 3.3 mm (p < 0.001). PSG decreased to < 10 mm Hg in 27 patients (93%) whereas in the other two patients PSG was 17 and 13 mm Hg. Restenosis appeared in 2 patients (6.8%); aneurysm in one patient (3.4%) which remained static even after 1.3 years of follow-up; mild dissection in 3 patients (10.3%); temporary femoral artery occlusion in 2 (6.8%) patients who recovered with heparin injection. Though hypertension disappeared after balloon dilatation in all patients, it reappeared in 3 patients (10.3%) within 7 days and in 10 patients (34.5%) within 6 months. In conclusion, balloon angioplasty of CoA is a good alternative to surgical correction.

Adolescent↗