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Hee-Hwa Ho

Publications and source records attributed to Hee-Hwa Ho.

6 recordsLinked to original sources
PubMed2006

Modified crush technique with double kissing balloon inflation (sleeve technique): a novel technique for coronary bifurcation lesions.

We report a modified crush technique with double kissing balloon inflation (the sleeve technique) in an attempt to increase the success rate of final kissing balloon inflation, which has been shown to improve the angiographic outcomes of side branch in bifurcation lesions. A stent was advanced across the side branch with protrusion of 3-5 mm of proximal stent segment into the main vessel. At the same time, a size-matched balloon with length long enough to cover the bifurcation as well as the protruding stent segment was placed in the main vessel. The side-branch stent is deployed first, the wire and stent balloon are removed. This is followed by balloon inflation in main vessel at high pressure to crush the protruding stent segment against vessel wall. The side branch is then rewired, two balloons are advanced to the main vessel and side branch, and the bifurcation is kissed with balloons the first time. The side branch is now like a new sleeve. The balloon and wire of the side branch are removed. Another stent was positioned and then deployed in the main vessel. The side branch is rewired the second time, two balloons are advanced to the main vessel and side branch again, followed by final (second) kissing balloon inflation of the bifurcation. The sleeve technique has been employed in six consecutive patients with 100% success rate of final kissing balloon inflation. There was no major adverse cardiac events or stent thrombosis encountered within 30 days of percutaneous coronary intervention.

Aged↗
PubMed2006

Export aspiration catheter-enhanced FilterWire delivery: an innovative strategy for treatment of saphenous vein graft disease.

We report a series of 4 cases of percutaneous saphenous vein graft intervention on thrombus-containing occlusive lesions. After passing a 0.014-inch flexible coronary wire, primary thrombosuction was performed using an Export aspiration catheter (EAC). After removing the premounted delivery sheath, a 300-cm long FilterWire EZ was loaded into the aspiration lumen of the EAC. The EAC-FilterWire assembly was then advanced across the lesion. The filter sac was deployed after withdrawing the EAC. The coronary wire was removed, and angioplasty and stenting were performed in the usual manner over the FilterWire. Filter no-reflow developed in 2 cases, which was promptly reversed by repeated manual thrombosuction using the EAC. Finally, normal coronary blood flow was restored after filter retrieval. Visible thrombi or debris were detectable in 2 patients. This interventional strategy increases the efficiency of FilterWire delivery and also gives both active and passive embolic protection without causing any adverse clinical events. It may play a positive role in saphenous vein graft intervention and primary angioplasty in the future.

Aged↗
PubMed2005

Anomalous origin of right coronary artery from the left coronary sinus: incidence, characteristics, and a systematic approach for rapid diagnosis.

Twenty-three patients were found to have anomalous origin of right coronary artery from the left coronary sinus (LCS) from January 2000 to October 2003. The mean age was 58.6+/-14.3 years with male predominance (56.5%). Cardiovascular risk factors were found in 18 (78.3%) patients while coronary artery disease was seen in 13 (56.5%) patients. Among the coronary artery disease patients, the left anterior descending artery was the most commonly involved, followed by the right coronary artery and the left circumflex artery. Right coronary artery dominance was seen in 19 (82.6%) patients. The anomalous right coronary artery originates within the left coronary sinus in 17 (73.9%) patients while from the left aortic wall above the sinus in 6 (26.1%) patients only. Congenital heart disease and acquired valvular heart disease were the most common associated conditions. The author will share his experience and suggest a four-step approach of early recognition and selection of the anomalous right coronary artery ostium. Using the suggested strategy, most of the anomalous right coronary artery could be opacified with a left amplatz 1 catheter. Aortogram was needed only in 47.8% of cases.

Aged↗
PubMed2004

Clinical characteristics of and long-term outcome in Chinese patients with hypertrophic cardiomyopathy.

BACKGROUND: Data on the phenotypical pattern and natural history of hypertrophic cardiomyopathy in Chinese patients are very limited. The purpose of this study was to describe the clinical characteristics of and long-term outcome in Chinese patients with hypertrophic cardiomyopathy. METHODS: We evaluated 118 Chinese patients (62 male) who were diagnosed with hypertrophic cardiomyopathy at Queen Mary Hospital from 1973 to 2002. Diagnosis was based on the demonstration of left ventricular hypertrophy (wall thickness > or =15 mm during diastole), either in a specific region or with diffuse distribution, using echocardiography or magnetic resonance imaging. Clinical predictors of major cardiovascular events related to hypertrophic cardiomyopathy (cardiovascular death, potentially fatal cardiac arrhythmia, and refractory heart failure requiring cardiac transplantation or percutaneous alcohol septal ablation) were evaluated with univariate and multivariate Cox proportional hazards regression models. RESULTS: The mean (+/- SD) age at presentation was 54 +/- 18 years. During a mean follow-up of 5.8 +/- 4.3 years (range, 1 to 29 years) from presentation, major cardiovascular events related to hypertrophic cardiomyopathy occurred in 19 patients (16%), including 9 deaths. Annual cardiovascular mortality was 1.6%. Fifty-five patients (47%) had one or more cardiovascular complications related to hypertrophic cardiomyopathy, of which atrial fibrillation was the most common (35%, n = 41). The most common type of hypertrophic cardiomyopathy was the apical variant (41%, n = 49). In multivariate analysis, female sex was the only independent predictor of major cardiovascular events related to hypertrophic cardiomyopathy (hazard ratio = 5.86; 95% confidence interval: 1.77 to 7.21; P = 0.007). CONCLUSION: Hypertrophic cardiomyopathy in Chinese patients is characterized by late onset of presentation, a high incidence of the apical form of the condition, and adverse clinical outcome in female patients, which suggest a different phenotypical pattern than in white patients.

Adult↗
PubMed2004

Anomalous origin of the right coronary artery from the left coronary sinus is associated with early development of coronary artery disease.

BACKGROUND: Anomalous origin of the right coronary artery (RCA) from the left coronary sinus can cause sudden cardiac death. Whether this unique anatomical defect also predisposes to early development of coronary artery disease (CAD) remains uncertain. METHODS: Demography, cardiovascular risk factor profiles and coronary angiograms were reviewed in 1,532 consecutive patients over the past 3 years. RESULTS: Thirteen patients (0.8%) had anomalous RCA from the left coronary sinus, while the rest had normal origin from the right coronary sinus. CAD was found in 9/13 anomalous RCA patients (group A) and in 795/1,519 patients with normal RCA origin (group B). There were no differences in the distributions of age, sex or cardiovascular risk factors between the two groups. The distribution of critical lesions among the 3 major coronary arteries showed no significant differences either. However, among the patients with RCA involvement, the anomalous RCA group was significantly younger (54.8 +/- 4.8 years versus 64.9 +/- 10.1 years; p = 0.022). CONCLUSION: The anomalous RCA from left coronary sinus is associated with early development of CAD. The affected patients are 10 years younger.

Aorta↗