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Biomedical subjects

E Perin

Publications and source records attributed to E Perin.

7 recordsLinked to original sources
PubMed2001

Excimer laser revascularisation: current indications, applications and techniques.

The ultraviolet pulsed excimer laser (308 nm wavelength) is currently the only laser approved by the FDA for percutaneous intervention in patients with ischemic coronary artery disease. The clinical presentation of the treated patients varies from stable and unstable angina to acute myocardial infarction. Potential advantages of excimer laser revascularisation in acute coronary syndromes and in ischaemic obstructive peripheral vascular disease include concomitant plaque debulking and thrombus removal; absence of systemic lytic state; shortened thrombus clearing time and facilitation of adjunct balloon angioplasty and stenting. Improved understanding of laser-tissue interactions and positive clinical outcomes through the use of safe lasing techniques have led to expansion of indications/applications for laser angioplasty. These include stent restenosis, complex lesions and thrombotic stenoses, bifurcation lesions, balloon failure, total occlusions, focal saphenous vein graft lesions and peripheral arterial obstructions. The excimer laser can be effectively utilised in patients with depressed left ventricular ejection fraction and does not require implantation of a temporary pacemaker as no-reflow phenomenon and severe arrhythmias are rarely encountered. Careful case selection, proper utilisation of equipment and incorporation of efficient lasing techniques play a crucial role in effective and safe cardiovascular laser applications.

Angioplasty, Laser↗
PubMed1992

Anomalous coronary arteries: angiographic findings in 80 patients.

Among 13010 adults who underwent coronary arteriography, 80 (0.61%) patients had a total of 83 anomalous coronary arteries. Thirty-three (41%) of the patients were of Hispanic origin, while out of the entire population studied 30% were Hispanic. The right coronary artery was the most common anomalous vessel. It was identified in 50 (62%) patients, arising in 35 from the left aortic sinus, in 14 from the posterior sinus, and in 1 from the left coronary artery. An anomalous circumflex artery was recognized in 22 (27%) patients. Nine (11%) patients presented an anomalous left anterior descending artery, 1 patient an anomalous left main coronary artery, and another an anomalous septal perforator artery. Twenty-three (29%) patients had concomitant congenital heart abnormalities, most commonly. bicuspid aortic valve and mitral valve prolapse. In each of 5 patients with complex congenital heart disease the course of the anomalous vessel could have interfered with a surgical procedure. In 4 cases anomalous coronary arteries were associated with either anomalous systemic venous circulation or anomalous cardiac veins. In 5 (6%) patients only, the anomalous coronary artery was solely responsible for a clinical event. Coronary atherosclerosis of the anomalous arteries was found in 28% of the patients, while the overall incidence of the disease in this series was 65%. Thus, anomalous coronary arteries are associated with a high incidence of congenital heart diseases, but do not appear to be associated with an increased risk for development of coronary atherosclerosis. The angiographic recognition of these vessels is important in patients who undergo coronary angioplasty or cardiac surgery. Variations in the frequency of congenital coronary anomalies as reported herein may be attributed to a genetic background.

Abnormalities, Multiple↗
PubMed1991

Rate-related left bundle branch block as a cause of non-ischemic chest pain.

A case is presented of rate-dependent left bundle branch block associated with chest pain in a patient with angiographically normal coronary arteries. Lactate extraction showed no evidence of myocardial ischemia. It appears that in this case, chest pain was associated with sudden ventricular asynergy rather than myocardial ischemia.

Bundle-Branch Block↗
PubMed1991

Coronary sinus mapping through a persistent left superior vena cava in Wolff-Parkinson-White syndrome.

Persistent left superior vena cava is not an uncommon finding in patients undergoing evaluation for preexcitation syndromes. In such patients, this anatomical configuration might be used advantageously for mapping and ablation of a left-sided accessory pathway during electrophysiologic studies. We successfully used this mapping approach in a 16-year-old boy undergoing evaluation for Wolff-Parkinson-White syndrome. The patient was found to have a persistent left superior vena cava confluent with the coronary sinus. During electrophysiologic studies, mapping of the left-sided accessory pathway was facilitated by retrograde entry into the coronary sinus through the persistent left superior vena cava. Mapping was also performed in the conventional manner, yielding identical results and thus validating this new technique.

Journal Article↗
PubMed1989

Young adult survivors of sudden cardiac arrest: analysis of invasive evaluation of 22 subjects.

Twenty-two young adult (mean age 27.8 +/- 5.3 years) survivors of sudden cardiac arrest underwent invasive cardiac assessment. Initial evaluation by cardiac catheterization, coronary angiography, and hemodynamic studies identified two groups of young survivors. The first consisted of 13 (60%) subjects who had definable structural cardiac or lung disease accountable for a cardiac arrest event. Dilated cardiomyopathy dominated this group. Mitral valve prolapse, hypertrophic cardiomyopathy, left ventricular hypertrophy, anomalous origin of the right coronary artery, and tetralogy of Fallot were also encountered. The second group included nine subjects (40%) with normal cardiac structure and normal hemodynamic parameters. Electrophysiologic testing demonstrated in three of these patients the presence of Wolff-Parkinson-White syndrome. The electrophysiologic studies had a higher yield in reproduction of life-threatening arrhythmias among the subjects in the second group as opposed to the first group. The observation that 10 subjects (45%) from both groups had preceding symptoms varying from palpitations and chest pain to syncope and recurrent cardiac arrest events, is in contradiction to previous findings in the literature and raises a question of appropriate evaluation of young adults with cardiac symptoms.

Adult↗