Cardiology Commons^™

Dilemma In The Diagnosis Of Mediastinal Adenopathy In The South Asian Population-Role Of Ct Guided Biopsy, Mediastinoscopy And Video-Assisted Thoracoscopy (Vats), Marium Muzaffar, Hashim M Hanif, Saulat H. Fatimi

Section of Cardiothoracic Surgery

The diagnosis of mediastinal adenopathy is a dilemma amongst treating physicians especially in South Asia. This is because although tuberculosis is endemic in this region, many a times lymphoma and sarcoidosis cannot be excluded. Often patients are being treated with medications without a confirmed diagnosis. The Video-assisted thoracoscopy (VATS) has revolutionized the way mediastinal adenopathy is diagnosed and managed in this part of the world.

Sequential Segmental Analysis., Robert H. Anderson, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Pulmonary Vein Isolation Using A High Density Mesh Ablator Catheter: Incorporation Of Three-Dimensional Navigation And Mappin, Jiun Tuan, Jeilan Mohamed, Faizel Osman, Suman Kundu, Rajkumar Mantravadi, Peter J. Stafford, G. André Ng

Internal Medicine, East Africa

Background: We evaluated the use of a novel High Density Mesh Ablator (HDMA) catheter in combination with three-dimensional navigation for the treatment of paroxysmal atrial fibrillation.

Methods: The HDMA catheter was used to carry out pulmonary vein isolation in a consecutive series of patients. Three-dimensional geometry of the left atrial-pulmonary vein (LA-PV) junctions were first created with the HDMA catheter. Ostial, proximal and distal sites within the pulmonary veins were tagged with catheter shadows on the created geometry to allow for re-interrogation of these exact sites after ablation.

Results: The HDMA catheter was successfully used to create three dimensional geometry …

Outcome And Factors Associated With Hospital Mortality In Patients With Impaired Left Ventricular Function Undergoing Coronary Artery Bypass Grafting: Where Do We Stand?, Mubashir Zareen Khan, S Perveen, Ja Ansari, Sa Sami, S Furnaz, Saulat H. Fatimi

Section of Cardiothoracic Surgery

Objective: Impaired ventricular function is a known risk factor for mortality after coronary artery bypass grafting however increasingly more patients with impaired ventricular function are referred for surgery. Currently no large data is available from Pakistan regarding this aspect of coronary surgery. Our objectives were to find out the hospital mortality and mid term functional improvement in patients with impaired ventricular function undergoing coronary artery by pass grafting and identify the risk factors for mortality.
Methodology: Retrospective analysis of preoperative, operative and postoperative variables of patients with impaired ventricular function who were operated for isolated first time coronary artery …

Rationale And Design Of A Trial Of Angiotensin-Converting Enzyme Inhibition In Infants With Single Ventricle., Daphne T. Hsu, Seema Mital, Chitra Ravishankar, Renee Margossian, Jennifer S. Li, Lynn A. Sleeper, Richard V. Williams, Jami C. Levine, Brian W. Mccrindle, Andrew M. Atz, Darlene Servedio, Lynn Mahony, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Angiotensin converting enzyme (ACE) inhibitors are known to improve clinical outcome and ventricular function in adults with heart failure. Infants with single-ventricle physiology show abnormalities in ventricular function as well as poor growth. The ability of an ACE inhibitor to preserve ventricular function and improve growth in these infants is unknown.

METHODS: The Pediatric Heart Network designed a randomized, double-blind trial to compare outcomes in infants with single-ventricle physiology receiving enalapril or placebo. Neonates < or =45 days old were eligible. The primary outcome is weight-for-age Z-score at 14 months of age. Secondary outcomes include other measures of somatic growth, laboratory and functional measures of heart failure, developmental indices, measures of ventricular size and function, and the relationship of the renin-angiotensin-aldosterone system genotype to the response to enalapril. The incidence and spectrum of adverse events will also be compared between treatment groups.

RESULTS: A total of 1,245 neonates were screened and 533 (43%) were eligible. The consent rate was 43%; 230 subjects were enrolled. Parental reluctance to …

Training New Mothers In Infant Cardiopulmonary Resuscitation (Cpr), Gavin C. Barr Jr. Md, Marna R. Greenberg Do, Mph, Facep, Valerie Rupp Rn, Bsn, Charles C. Worrilow Md, Katie Fredericks, Anne Marie Crown, John Reed Rrt

Department of Emergency Medicine

No abstract provided.

Letter By Jeilan Et Al Regarding Article, "Longitudinal Strain Delay Index By Speckle Tracking Imaging: A New Marker Of Response To Cardiac Resynchronization Therapy"., Jeilan Mohamed, Jiun H. Tuan, G. Andre' Ng

Internal Medicine, East Africa

We read with interest the recent article by Lim et al.1 This article demonstrated a strong correlation between a novel longitudinal strain delay index and left ventricular end-systolic volume reduction in both ischemic and nonischemic patients.

The principle outlined by the authors is that an increased longitudinal strain delay index requires both dyssynchrony (defined in their article as a discrepancy between the time of end-systolic contraction and the time to peak strain) and residual contractility. Their concept elegantly considers the problem of cardiac resynchronization therapy (CRT) nonresponse in heart failure patients who have myocardial segments with delayed contraction due …

A Three-Year-Old Boy With X-Linked Adrenoleukodystrophy And Congenital Pulmonary Adenomatoid Malformation: A Case Report, Ibrahim Abdulhamid, Sermin Saadeh, Nedim Cakan

Wayne State University Associated BioMed Central Scholarship

Abstract

Introduction

X-linked adrenoleukodystrophy leads to demyelination of the nervous system, adrenal insufficiency, and accumulation of long-chain fatty acids. Most young patients with X-linked adrenoleukodystrophy develop seizures and progressive neurologic deficits, and die within the first two decades of life. Congenital or acquired disorders of the respiratory system have not been previously described in patients with X-linked adrenoleukodystrophy.

Case presentation

A 3-year-old Arabic boy from Yemen presented with discoloration of the mucous membranes and nail beds, which were considered cyanoses due to methemoglobinemia. He also had shortness of breath, fatigue, emesis and dehydration episodes for which he was admitted to …

The Value Of Implantable Cardioverter-Defibrillators In Managing Atrial Fibrillation, Daniel Frisch

Division of Cardiology Faculty Papers

Atrial fibrillation (AF) is associated with an increased risk of mortality as well as significant morbidity including bothersome symptoms, exacerbation of heart failure, and thromboembolic events. Explanations for the mortality risk are variable, but the majority opinion favors AF as a marker of reduced health status, especially cardiovascular health.

Maturation Of The Human Fetal Startle Response: Evidence For Sex-Specific Maturation Of The Human Fetus, Claudia Buss, Elyssia Poggi Davis, Quetzal A. Class, Matt Gierczak, Carol Pattillo, Laura M. Glynn, Curt A. Sandman

Psychology Faculty Articles and Research

Despite the evidence for early fetal experience exerting programming influences on later neurological development and health risk, very few prospective studies of human fetal behavior have been reported. In a prospective longitudinal study, fetal nervous system maturation was serially assessed by monitoring fetal heart rate (FHR) responses to vibroacoustic stimulation (VAS) in 191 maternal/fetal dyads. Responses were not detected at 26 weeks gestational age (GA). Sex-specific, age-characteristic changes in the FHR response to VAS were observed by 31 weeks' GA. Males showed larger responses and continued to exhibit maturational changes until 37 weeks'GA, females however, presented with a mature FHR …