PubMed Health⌕ Search

Biomedical subjects

F K Nakhjavan

Publications and source records attributed to F K Nakhjavan.

At least 19 recordsLinked to original sources
PubMed1994

Directional coronary atherectomy can be successfully performed in the elderly.

The influence of age on the clinical and angiographic outcome of directional coronary atherectomy is evaluated. Results demonstrate that DCA can be performed successfully in the vast majority (78.7-90%) of patients in all age groups. However, there is a non-statistical trend toward decreased success rates in the elderly (P > .05). Major ischemic complications and groin complications tend to be more common in the elderly (P > .05). Blood transfusions are required significantly more often in the elderly (P < .05). Directional coronary atherectomy is a useful method of coronary artery revascularization in all age groups, including the elderly.

Aged↗
PubMed1994

Directional coronary atherectomy in women compared with men.

The influence of gender on the procedural outcome of directional coronary atherectomy (DCA) is controversial. This study of 373 consecutive patients (418 lesions) undergoing DCA demonstrates that the procedural success rate of DCA is significantly lower in women compared with men (72.7 vs. 82.9%, p = 0.011). Women have significantly smaller coronary arteries than men (2.5 mm vs. 2.7 mm, p = 0.028) and were older than men (66 vs. 61 years, p = 0.0001). Multivariate analysis identifies small coronary vessel size rather than female gender per se as an independent predictor of poor procedural outcome. Procedural success rates in women with coronary vessel size > or = 2.5 mm is significantly higher (92.2%) than in women with coronary vessel size < 2.5 mm (73.1%), and parallels that in men with vessel size > or = 2.5 mm (89.3%). Inability to engage the ostium of the coronary artery adequately with the guiding catheter and to cross the lesion with the atherectomy device is significantly more common in women compared with men. Major ischemic complication rates are similar in women and men (8.5 vs. 8.7%). Groin complications are significantly more common in women compared with men (13.5 vs. 2.9%). We conclude that procedural success rates in women may be improved by careful patient selection, with particular attention to small vessel size. DCA is best performed in vessels > 2.5 mm in diameter.

Aged↗
PubMed1990

Exit block: a new technique for difficult side branch angioplasty.

Angioplasty of a stenosis at the origin of a diagonal branch was initially unsuccessful because of the straight course of the anterior descending artery and a sharp bend at the diagonal branch. Therefore, in a second attempt, the anterior descending artery was blocked by inflating a balloon distal to the diagonal branch, thereby facilitating the passage of guidewire and balloon into the diagonal branch.

Angina Pectoris↗
PubMed1988

Use of angioplasty guidewire for technically difficult angiography.

A new technique for negotiating severe vessel tortuosity or stenosis is described whereby a PTCA guidewire is initially used to cross the tortuosity or stenosed area. After introduction of a long-tipped Sones catheter over the PTCA wire and past the stenosis, the latter is exchanged for the usual 0.035-in guidewire. The Sones catheter is then removed and angiography proceeds as usual.

Angiography↗
PubMed1987

Noninvasive evaluation of mid-left ventricular obstruction by two-dimensional and Doppler echocardiography and color flow Doppler echocardiography.

Three patients with midventricular obstruction resulting from three different pathophysiologic mechanisms and differing anatomic bases for the development of obstruction are presented. In the first patient, a membrane-like structure appeared to cause some fixed obstruction, but a superimposed dynamic component to the obstruction was also evident. Papillary muscle hypertrophy with approximation of the papillary muscles during systole was the mechanism in the second patient. In the third patient, apical infarction with hyperdynamic contraction of the mid- and basal portions of the myocardium appeared to be the pathophysiologic mechanism. Color flow Doppler echocardiography was particularly useful in localizing the site of obstruction and allowed further evaluations by pulsed and continuous-wave Doppler techniques to precisely determine pressure gradients.

Blood Pressure↗
PubMed1987

High risk percutaneous transluminal coronary angioplasty in the treatment of severe coronary artery disease.

We report on 27 "high risk" patients out of 171 consecutive patients undergoing percutaneous transluminal coronary angioplasty from June 1984 to August 1985. The ages ranged from 31-80 years (mean 62.7 +/- 10) years. High risk percutaneous transluminal coronary angioplasty was defined as: salvage cases (3 patients) where the patients presented in cardiogenic shock or the vessels were not bypassable; multivessel coronary artery disease (22 patients) where a large area of jeopardized myocardium was dependent on the angioplasty vessel(s); left ventricular dysfunction (7 patients) as defined by two of the three criteria: left ventricular end-diastolic volume index greater than 100 ml/m2; ejection fraction less than 30%; and left ventricular end-diastolic pressure greater than 20 mm Hg. The initial success rate in the high risk patients was 85.2%. Emergency coronary artery bypass surgery in these patients was 7.4%. There was one death in the high risk group, as one of the salvage cases died 24 hours after successful percutaneous transluminal coronary angioplasty due to severe underlying myocardial disease. In conclusion percutaneous transluminal coronary angioplasty can be successfully performed in high risk patients with a low complication rate and should be considered as an alternative to coronary artery bypass graft surgery in selected high risk patients.

Adult↗
PubMed1986

"Crossing balloons:" a new technique for complex angioplasty.

A new technique is described for complex percutaneous transluminal coronary angioplasty of a lesion at the bifurcation of the obtuse marginal branch of the left coronary artery, just distal to a venous bypass graft insertion. Two separate angioplasty guide wire and catheter systems were used and the coronary artery side branch was protected in a "crossing" manner.

Adult↗
PubMed1984

Ergonovine provocative testing: description of a "double catheter technique".

Since coronary arteries should be immediately accessible during ergonovine provocative testing (EPT), a double catheter technique is described. Using the catheter sheath technique from the right and left femoral arteries, right and left Judkins' catheters are introduced into each femoral artery. Selective coronary cineangiography during EPT is thus rapidly performed without the delay of exchanging catheters. Should coronary arterial spasm occur during the test, nitroglycerin can be administered into the coronary artery without delay.

Cardiac Catheterization↗
PubMed1983

Iatrogenic postoperative left ventricular outflow tract obstruction.

A 56-year-old female, who underwent aortocoronary bypass graft for occlusion of anterior descending artery is reported, who postoperatively developed a harsh systolic murmur, mitral regurgitation, and intraventricular systolic pressure gradient suggestive of hypertrophic subaortic stenosis. The above findings were due to the administration of dobutamine hydrochloride for hypotension in association with afterload reduction (intra-aortic balloon pumping) and disappeared almost immediately after left ventriculography (volume load).

Aortic Stenosis, Subvalvular↗