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Biomedical subjects

S Sharma

Publications and source records attributed to S Sharma.

At least 1,585 records · Page 88Linked to original sources
PubMedDate not supplied

Clinical experience with low profile fixed wire balloon catheter system for percutaneous transluminal coronary angioplasty.

Clinical records of the first 45 consecutive patients (66 lesions) in whom the Probe TM a balloon on the wire, was used for percutaneous transluminal coronary angioplasty have been reviewed. The aim of this analysis was to establish the efficacy and safety of this device. Majority of the lesions taken up were considered severe and difficult to cross. The probe was the 1st catheter used in 51 lesions (77%) and in 15 lesions (23%) it was used after other balloon catheters. In 88% (58/66) of lesions treated the Probe reduced the stenosis to less than 50% of the luminal diameter. Of the 45 patients treated 39 (87%) had a successful result. Of the 19 patients with multiple lesions 74% (14/19) had complete revascularisation and in 16% (3/29) had the most significant vessel dilated. Two patients (3%) required urgent coronary artery bypass surgery for acute occlusions. There was no hospital death. Of 50 probe devices used 5 (10%) malfunctioned: the balloon ruptured (at 5 Bars pressure) in 2 instances, balloon twisted causing "Volvulous" in 1 and balloon failed to deflate in 2 cases. The probe has significant advantages over other balloon systems for treating severe coronary lesions because of its low profile. It is however a delicate catheter system and prone to malfunction if not handled with care. Our results show that it is an excellent system for opening difficult and tight coronary lesions.

Adult↗
PubMedDate not supplied

Our experience with percutaneous transluminal coronary angioplasty--two years follow-up study.

The results of 130 consecutive percutaneous transluminal coronary angioplasty (PTCA) procedures carried out in 112 patients between November, 1986 and October, 1988 are reported. The follow-up period ranged from 1 month to 24 months. Eighty-four patients (75%) had single vessel disease, and 28 (25%) had multivessel disease. Two-vessel dilatation was done in 23 patients. The primary success rate was 92%. In successful cases, the diameter of stenosis was changed on an average from an initial 85% to 23%. Acute occlusion of the vessel occurred on 9 occasions (6.8%). Emergency coronary bypass surgery (CABG) was done in 3 (2.7%), 2 patients (1.8%) were subjected to immediate re-dilatation. One patient who underwent CABG died (case fatality 0.8%). Occlusion of the dilated vessels did not occur after the patients were discharged from hospital. Follow-up data revealed that long-term clinical success (class I status) was seen in 78 patients who had a successful primary dilatation. Of the 25 patients who were studied by a repeat coronary arteriography, 7 had developed restenosis. Five of these patients have been successfully redilated. It is concluded that PTCA is an effective and safe method of treatment in selected patients with coronary artery disease in our setting.

Adult↗
PubMedDate not supplied

Efficacy of pre-operative levo-phase pulmonary angiograms in detecting left atrial thrombi.

We have studied the efficacy of levo-phase pulmonary angiograms in detecting thrombosis of the left atrium or its appendage in 33 patients with rheumatic mitral stenosis who subsequently underwent open-heart surgery. Left atrial thrombi had been suspected in all these patients due to the presence of atrial fibrillation and/or history of systemic embolization. The angiographic criteria for the presence of thrombus included mobile or persistent fixed filling defects of constant size in the contrast shadow of the left atrium or its appendage, partial or complete non-visualization of the left atrial appendage, irregular outline of the left atrium or its appendage and an atrial chamber which appeared smaller than the atrial shadow. 19 patients showed one or more angiographic features of thrombosis. All the patients subsequently underwent open-heart surgery for mitral valve disease, and thrombi were found in 17 patients. The angiogram was false positive in three patients, and false negative in one patient. The angiographic diagnosis of left atrial thrombosis by levo-phase pulmonary angiography has a sensitivity of 94%, specificity of 81.3%, and predictive value of 84.2%. Non-visualization of left atrial appendage as the only feature of thrombus formation was seen in five patients, and thrombi were subsequently formed at surgery in four patients (80%). Levo-phase pulmonary angiograms are safe and reasonably accurate for preoperatively detection of left atrial thrombi, and should be performed in all the patients of mitral stenosis if left atrial thrombi are clinically suspected.

Adolescent↗