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Biomedical subjects

J Gourassas

Publications and source records attributed to J Gourassas.

12 recordsLinked to original sources

Model-based morphological segmentation and labeling of coronary angiograms.

A method for extraction and labeling of the coronary arterial tree (CAT) using minimal user supervision in single-view angiograms is proposed. The CAT structural description (skeleton and borders) is produced, along with quantitative information for the artery dimensions and assignment of coded labels, based on a given coronary artery model represented by a graph. The stages of the method are: 1) CAT tracking and detection; 2) artery skeleton and border estimation; 3) feature graph creation; and iv) artery labeling by graph matching. The approximate CAT centerline and borders are extracted by recursive tracking based on circular template analysis. The accurate skeleton and borders of each CAT segment are computed, based on morphological homotopy modification and watershed transform. The approximate centerline and borders are used for constructing the artery segment enclosing area (ASEA), where the defined skeleton and border curves are considered as markers. Using the marked ASEA, an artery gradient image is constructed where all the ASEA pixels (except the skeleton ones) are assigned the gradient magnitude of the original image. The artery gradient image markers are imposed as its unique regional minima by the homotopy modification method, the watershed transform is used for extracting the artery segment borders, and the feature graph is updated. Finally, given the created feature graph and the known model graph, a graph matching algorithm assigns the appropriate labels to the extracted CAT using weighted maximal cliques on the association graph corresponding to the two given graphs. Experimental results using clinical digitized coronary angiograms are presented.

Algorithms↗

Coronary artery skeleton detection based on topographic features.

A new approach to the problem of detecting the skeletons of coronary arteries in coronary angiograms is proposed. The digitized grayscale coronary angiograms are regarded as noisy sampling of the underlying continuous surface. After the application of Gaussian filtering to reduce noise, the topographic features of the smoothed image are detected based on first and second order image derivatives. Then, the candidate arteries skeleton points are detected based on the observation that arteries are smooth elongated objects having approximately a Gaussian smoothed semi-elliptical profile. Experimental results on real digitized coronary angiograms are presented.

Algorithms↗

Stenting the distal anastomotic site of the left internal mammary artery graft: a case report.

The major problem associated with the long-term patency of the internal mammary artery graft is the early occurrence of stenosis usually at its distal anastomotic site; its management by balloon angioplasty has been associated with a high success rate. We report the case of an unsuccessful balloon angioplasty of an anastomotic stenosis of a left internal mammary artery graft that was successfully managed by stenting with one-half of a Palmaz-Schatz stent.

Angina, Unstable↗

Use of half of the Palmaz-Schatz stent in a stent-related dissection.

The placement of a Palmaz-Schatz stent may be associated with the development of a dissection and this may increase the danger of coronary thrombosis. In this case report we describe the use of half of the Palmaz-Schatz stent to cover such a dissection. The use of the half stent, by reducing the amount of metal and stent overlapping, may reduce the incidence of thrombosis and restenosis.

Aortic Dissection↗

Quantitative ECG changes and patency of infarct-related arteries after intravenous streptokinase.

Thirty-three patients with acute inferior myocardial infarction (MI), who were treated with intravenous streptokinase, were studied by serial 12-lead ECGs for 48 hours to determine the relationship between early changes in the sum of elevations above the baseline 40 ms after the end of the QRS complex in leads II, III and AFV (SumST), the sum of amplitude of R waves in leads II, III and AVF, the sum of the Q waves in leads II, III and AVF, the sum of ST-segment depression in leads V1-V4 as measured from the baseline to 80 ms after the J point (SumST (V1-V4] and the patency of the infarct-related artery at angiography after MI. Patients with patent arteries had a faster rate of decline in the SumST during the first 2.5 hours; reached the steady state earlier; had a more pronounced decrease in the SumST at 1.25 hours; a larger percentage drop in SumR at 4.5 hours and a more pronounced SumST (V1-V4) early on but resolution times similar to that of patients with closed arteries. Several ECG indices may indicate reperfusion of the infarct-related artery in patients with inferior MI.

Angiography↗

Intravenous streptokinase in acute myocardial infarction.

The safety and efficacy of streptokinase (STK) (Kabikinase; Keatings) in restoring vessel patency in 70 patients with acute myocardial infarction are reported. Return of vessel patency occurred more frequently (76%) in patients receiving STK than in patients in a control group (12%) (P = 0.001). The main complication was bleeding, which invariably resulted from invasive procedures. Dangerous dysrhythmias were uncommon and no fatalities were caused by STK administration. It is recommended that thrombolytic therapy be started as early as possible in patients with acute myocardial infarction, who can then be referred to centres equipped for coronary angiography for further management. Unnecessary invasive procedures should be avoided.

Adult↗

Echophonocardiographic estimation of pulmonary capillary pressure in acute myocardial infarction.

Non-invasive estimation of pulmonary capillary wedge (PCW) pressure by an echophonocardiographic technique is reported. The ratio of time interval from the Q-wave to the C-point (echocardiogram) (Q-C) and from aortic closing (A2) to the E-point (A2-E) correlated well with the measured PCW pressure (r = 0.89; P = 0.001). When these two intervals were subtracted (A2-E)-(Q-C) the correlation was r = -0.90 (P = 0.001).

Echocardiography↗

Double valve replacement in a patient with osteogenesis imperfecta.

Successful mitral and aortic valve replacement in a patient with osteogenesis imperfecta (OI) is reported. The potential complications of valvular dehiscence and bleeding in patients with this connective tissue disorder is discussed with a short review of the reported experience of valvular surgery in patients with OI.

Adult↗

Torsade de pointes induced by sotalol and hypokalaemia.

The problem of a sotalol-induced ventricular arrhythmia (torsade de pointes) is presented and the contributory role of hypokalaemia is emphasized. It is concluded that sotalol may not be a suitable beta-blocker to use with a diuretic.

Drug Combinations↗