Biomedical subjects

K Suleiman

Publications and source records attributed to K Suleiman.

3 recordsLinked to original sources

PubMed1997

The effect of training on the interpretation of 99Tcm-sestamibi myocardial perfusion SPET in patients with suspected coronary artery disease.

The aim of this study was to examine the effect of a period of concentrated training in nuclear cardiology on the accuracy of reporting 99Tcm-sestamibi (99Tcm-MIBI) single photon emission tomographic (SPET) images. Two visiting cardiologists, with no previous experience in nuclear cardiology, were asked to report blindly 60 99Tcm-MIBI SPET scans after 2 weeks of training in nuclear cardiology. One (observer 2) reported the same scans blindly after 2 months of further training. The results were compared with the assessment made by two experienced nuclear cardiologists and by using kappa statistics. Kappa values for the overall interpretation of the scan (normal or abnormal), segmental analysis (normal, ischaemic, fixed or mixed) and the three arterial territories were 0.7, 0.58 and 0.67 respectively. Following 2 months of further intensive training of observer 2, the kappa values were 0.857, 0.78 and 0.91 respectively. The difference between the two readings of observer 2 was significantly different for the segmental analysis (P < 0.001) and arterial territories (P = 0.006) but it did not reach statistical significance for the overall interpretation (P = 0.7). Thus, cardiologists without previous interpretation skills in nuclear cardiology required about 2 months of intensive training to achieve good accuracy in the interpretation of 99Tcm-MIBI SPET images. Accordingly, these techniques can be established in centres other than tertiary sites.

Adrenergic beta-Agonists↗

PubMed1996

[Balloon mitral valvuloplasty].

Since March 1990 we performed 100 balloon mitral valvuloplasties (BMV) in 82 females and 18 males (mean age 37 +/- 1 years; range 16 - 81) Initially we used the single shaft, dual or triple balloon system, while during the past 3 years we have been using the Inoue balloon system with step-wise inflation, monitoring with trans-thoracic echo (TTE) for immediate evaluation of mitral valve area (MVA) and/or severity of mitral regurgitation (MR), with 93% technical success. Hemodynamic data before and immediately after the procedure are in table below: [table: see text] C.O. cardiac output, DGR diastolic gradient, LAP left atrial pressure, MVA mitral valve area; all differences significant, p < 0.05. Acute complications included cardiac tamponade in 4/100; severe, acute MR in 2/100; only 5 were referred for urgent surgery. Neither cardiac tamponade nor severe MR were noted in the past 3 years. There was no periprocedural mortality in the past 5 years. Of 93 patients followed for 27 +/- 6 months (range 0-60), 90 (96%) were in NYHA classes I and II, 5 had late MVR, 2 underwent repeated BMV, and there was 1 death 16 months after the procedure. Immediate hemodynamic improvement followed BMV in most patients with pliable mitral stenosis. The Inoue system, with step-wise inflation and monitoring by TTE, proved to be a safe procedure. Symptomatic improvement continues during more than 4 years of follow-up.

Adolescent↗

PubMed1995

[Transseptal left heart catheterization: a new application of an old invasive technique].

In this evolving era of balloon mitral valvotomy (BMV), radiofrequency ablation (RF) of left-sided bypass tracts via catheter, and hemodynamic evaluation of aortic mechanical prostheses, there has been renewed interest in transseptal left heart catheterization (TSLHC). In the 3 years 1990-1994, 122 consecutive patients were referred for TSLHC to our institute (which lacks thoracic surgical facilities). 12 patients were excluded; 10 with a LA mass proven by transesophageal echocardiography (TEE), 1 with a vascularized thrombus in the circumflex coronary system and 1 with congenital interruption of the inferior vena cava with azygous continuity. In the remaining 110 cases TSLHC was performed for interventions in 90 cases (82%) of BMV, and for left-sided catheter radiofrequency (RF) ablation in 3 (3%). For diagnostic purposes it was performed in 17 (15%) cases for hemodynamic evaluation of mechanical aortic valve prostheses. Using the Brockenbrough needle, the adult Mullins sheath system (MSS) and single plane fluoroscopy, 100% technical success was achieved. Needle puncture was not needed in 30 (27%) due to direct crossing with the MSS through a stretched foramen ovale. In 2 we had to perform SVC dye injection for better interatrial septum localization. There were no complications when TSLHC was only used for diagnostic procedures. 1 patient had perforation of the LA due to right lower pulmonary vein laceration following septal dilatation. Following stabilization by immediate pericardiocentesis, the patient was transferred for open heart surgery. There were no great vessel perforations, systemic embolization or periprocedural deaths. TSLHC can be performed quite safely with single-plane fluoroscopy without an onsight surgical team, as with an experienced staff this procedure has very low morbidity and mortality.

Cardiac Catheterization↗