Ultra Long Stent in an Aberrant Right Coronary Artery.

The prevalence of anomalous origin of right coronary artery from the left sinus is about 0.92%. A percutaneous coronary intervention (PCI) in such a vessel is challenging especially when maneuvering long stents.

Percutaneous Coronary Interventions in Chronic Total Occlusion - Profile, Technique and Outcome - The Malabar Experience.

Introduction: Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) remains a challenge. The reasons being that these procedures may be lengthy and complex, with elevated radiation exposure, increased contrast load, lower procedural success rate, and a higher risk of complication when compared with non-CTO elective PCI.Clarifying the long-term clinical outcomes of CTO-PCI is very important to justify potential investments in training and technology.

Balloon embedded bifurcation stenting with single stent for side branch protection - Preliminary results from an Indian population.

Background: Intervention for bifurcation lesions is associated with increased risk of adverse events and includes acute side branch (SB) occlusion during main branch (MB) stenting. This acute occlusion of side branch can often be catastrophic for the patient. We here in describe our experience in Indian population with a technique which can be incorporated into bifurcation stenting to reduce or almost eliminate the incidence of side branch occlusion.

Balloon embedded stenting: A novel technique for percutaneous coronary intervention of bifurcation lesions, experience in Indian population.

Background: Bifurcation lesions account for 15-20% of interventions carried out in a catheterization laboratory. Several techniques have been described for treating bifurcation lesions of which culotte and T-stenting and protrusion(TAP) are commonly used. Both these techniques involve recrossing the struts of primary stent, failing which the flow in second branch which can be impaired and lead to catastrophic events.

Prevalence and prognostic significance of left ventricular myocardial late gadolinium enhancement in severe aortic stenosis.

Background: Myocardial fibrosis occurs in aortic stenosis (AS) as part of the hypertrophic response. It can be detected by LGE, which is associated with an adverse prognosis in the form of increased mortality and morbidity.

Objectives: To assess the prevalence of LGE patterns using cardiac magnetic resonance (CMR) in severe AS patients and to study its prognostic significance.

Percutaneous closure of a giant pulmonary arteriovenous malformation using multiple devices.

Percutaneous device closure is an established method to treat pulmonary arteriovenous malformation (PAVM). This report describes the case of a 23-year-old man with hereditary hemorrhagic telangiectasia (HHT) presenting with dyspnea and hypoxia. The patient was found to have a giant left-sided PAVM.

24h and 30 day outcome of Perclose Proglide suture mediated vascular closure device: An Indian experience.

Introduction: Advantages of vascular closure device over manual compression include patient comfort, early mobilisation and discharge, avoidance of interruption of anticoagulation, avoidance of local compression and its sequelae and less time constraint on staff. No published Indian data exist regarding Perclose Proglide suture mediated vascular closure device (SMC).

Aim: To study the 24h and 30 day outcome of Perclose Proglide SMC retrospectively.

Transradial retrograde percutaneous transluminal angioplasty with stenting of long segment occlusion of subclavian artery.

We report a case of retrograde percutaneous transluminal angioplasty with stenting to chronically occluded upper limb vessels in a young female with Takayasu arteritis. A self-expanding stent (Supera peripheral stent system - Abbott Vascular, Santa Clara, CA, USA) was tracked retrogradely via ipsilateral radial access and the procedure was successful with good results. To our knowledge this is the first report of a Supera stent being tracked retrogradely through the radial artery.

Safety and efficacy of percutaneous balloon mitral valvotomy in severe mitral stenosis with moderate mitral regurgitation - A prospective study.

Background: Percutaneous balloon mitral valvotomy (PBMV) is generally considered as a contraindication in patients with mitral stenosis (MS) associated with moderate to severe mitral regurgitation (MR). We sought to compare the safety and efficacy of PBMV in patients with severe MS and with moderate MR with those with less than moderate or no MR.

Materials And Methods: Symptomatic patients of MS with mitral valve area ≤1.

Maternal and fetal outcomes in pregnant women undergoing balloon mitral valvotomy for rheumatic mitral stenosis.

Background: Rheumatic mitral stenosis constitutes a major cause of acquired heart disease complicating pregnancy in India. In the present study, we have studied the fetal and maternal outcomes of women undergoing balloon mitral valvotomy during pregnancy.

Methods And Results: 49 pregnant ladies were included in this study in whom balloon mitral valvotomy was performed.

A comparative study of ivabradine and atenolol in patients with moderate mitral stenosis in sinus rhythm.

Background: Beta-blockers are frequently used in patients with mitral stenosis to control the heart rate and alleviate exercise-related symptoms. The objective of our study was to examine whether ivabradine was superior to atenolol for achieving higher exercise capacity in patients with moderate mitral stenosis in sinus rhythm. We also evaluated their effects on left ventricular myocardial performance index (MPI).

Correlation of pulmonary capillary wedge pressure with left atrial pressure in patients with mitral stenosis undergoing balloon valvotomy.

Aims: We sought to evaluate the correlation between PCWP and LAP and to compare transmitral gradients obtained with LAP and PCWP in MS, before and after balloon mitral valvotomy (BMV).

Methods: Consecutive patients with MS for BMV were included in this prospective cohort study. Simultaneous PCWP and LAP were recorded followed by simultaneous left atrium-left ventricular (LA-LV) and pulmonary capillary wedge pressure-left ventricular (PCWP-LV) gradients before and after BMV.

Echocardiographic assessment of right ventricular function in inferior wall myocardial infarction and angiographic correlation to proximal right coronary artery stenosis.

Background: Presence of right ventricular (RV) infarction imposes a higher risk of adverse events in inferior wall myocardial infarction (IWMI). In this study, we attempted to correlate various indices of RV function assessed by echocardiography with presence of a proximal right coronary artery (RCA) stenosis in patients with first episode of acute IWMI.

Methods: In a prospective study, patients with first episode of acute IWMI underwent echocardiographic assessment within 24 h of symptom onset and indices of RV function viz.

Coronary sinus filling time: a novel method to assess microcirculatory function in patients with angina and normal coronaries.

Objective: Dysfunction of the coronary microcirculation is considered as one of the factors responsible for symptoms and abnormal stress tests in patients with angina and normal coronaries (syndrome X). We sought to evaluate the usefulness of coronary sinus filling time (CSFT) to assess coronary microcirculation in this group of patients.

Methods: We compared the CSFT of patients having definite angina or atypical angina with positive treadmill electrocardiography test (angina group), with that of patients undergoing coronary angiogram (CAG) prior to balloon mitral valvuloplasty (control group).