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Probal Ghosh

Publications and source records attributed to Probal Ghosh.

5 recordsLinked to original sources
PubMed2006

Mid-term results of the 'hybrid maze': a combination of bipolar radiofrequency and cryoablation for surgical treatment of atrial fibrillation.

BACKGROUND AND AIM OF THE STUDY: Although the use of new sources of energy for the ablation of atrial fibrillation (AF) has simplified the procedure, concerns have been expressed with regard to the safety and efficacy of the various devices. Herein are described the results of a technique using a combination of bipolar radiofrequency (RF) and cryoablation. METHODS: Between February 2004 and August 2005, the combined procedure was used on 60 patients, 32 of whom (54%) had persistent AF, and 28 (46%) permanent AF. Lesions set similar to the Maze III procedure were used, with the addition of a right atrial isthmus lesion in the area of the coronary sinus and without right atrial appendage amputation and septal lesion. RESULTS: There were no operative complications and no death or major morbidity. The mean duration of the ablation procedure was 30 min (range: 27-36 min) for biatrial procedures, and 16 min (range: 15-19 min) for left atrial procedures. Forty-two patients (70%) were discharged in sinus rhythm. On completion of follow up, 48 patients (80%) were in sinus rhythm. Among 45 patients treated with cryoablation rather than monopolar RF, 89% were in sinus rhythm at the mean follow up of nine months. The predictor for recurrent post-procedural AF was preoperative permanent AF for more than 10 years' duration (p = 0.039), while that for postoperative atypical flutter was use of the monopolar RF ablator rather than the cryoablator (p = 0.001). CONCLUSION: The use of a bipolar RF device with the cryoprobe is an appealing combination which enables the Maze III lesion set to be completed in a straightforward, safe, and efficient manner.

Adult↗
PubMed2004

Changing trends in valve surgery in Europe: 1991-2000.

BACKGROUND AND AIM OF THE STUDY: This study sought to elaborate the changing trends in valve surgery in Europe during the 1990s. METHODS: The databases of different national surgical societies, registries and governments and international organizations were consulted and the data obtained were analyzed. RESULTS: The population of Europe (excluding Russia, CIS and Turkey) increased by 2.29%, from 509.67 million in 1991 to 519.15 million in 2000. During this period, the volume of cardiac surgery increased in Europe by 101% to 413,520 operations (797 per 10(6) population). The volume of valve surgery increased by 63% to 85,076 (164 per 10(6) population). The largest volumes of valve surgery were performed in Germany, France, UK, Italy and Spain. The increase in valve surgery volume was maximum in the Baltic states (+287%) and least in Scandinavia (+30%). Valve surgery volume per center per year changed from 139 in 1991 to 140 in 2000. The increase in overall valve surgery volume was sustained by an increase in subsets of octogenarian patients, valve surgery combined with coronary artery surgery, and increased productivity of the emerging economies of countries such as the Czech Republic, Hungary and Poland. Valve surgery as a proportion of cardiac surgery in Europe changed from 25.95% in 1991 to 21% in 2000. In 2000, valve surgery with combined procedures constituted 6.7% of total cardiac surgical volume, but 32% of valve surgical output in Europe. Mechanical valves have continued to dominate and were used in 77% of cases in 2000. Increased use of bioprostheses in the elderly subset among affluent economies was balanced by an increased use of mechanical prostheses in younger patients in emerging facilities in the East and South. The capital-intensive innovations (viz. robotic valve surgery, minimally invasive valve surgery, bioengineered valves) found niches only in some West European centers. Catheter-based procedures did not fulfil their promise. Balloon aortic valve dilatation investigations decreased drastically by the end of the decade, and balloon mitral dilatations number. Conservative aortic valve surgery is not yet practiced widely across Europe, while mitral repair has become widely accepted in clinical parlance. CONCLUSION: Despite the greater political and economic integration of Europe, the pattern of valve surgery continues to remain extremely diverse within the continent.

Aged↗
PubMed2003

Does gender affect outcome of cardiac surgery in octogenarians?

The long-term results of cardiac surgery in 212 consecutive octogenarians (116 men, 96 women) were reviewed retrospectively. Preoperative functional status, Euroscore, and the incidences of hypertension and chronic obstructive pulmonary disease were similar in both sexes. Women had more diabetes mellitus (45% versus 25%; p < 0.05) but less renal dysfunction (16% versus 29%; p < 0.05). Men required emergency procedures more frequently (p < 0.05). Women underwent complete revascularization more often and had more arterial grafts. Hospital mortality was similar (11.5% in women versus 12.9% in men), but women had more complications (76% versus 64%), longer convalescence (24.3 versus 18.5 days), fewer psychiatric disorders (14% versus 23%) and less heart block (9% versus 19%). Men had a slightly better outcome in terms of functional class and Euroqol score during follow-up of up to 114 months. Median survival was longer in women (3.15 versus 2.96 years) but 1-, 3-, and 5-year survival rates and late deaths were similar. Outcomes appear to be equitable for both sexes among octogenarians.

Age Factors↗