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Biomedical subjects

Rajesh Vijayvergiya

Publications and source records attributed to Rajesh Vijayvergiya.

13 recordsLinked to original sources

Concomitant congenital, atherosclerotic coronary and peripheral artery disease: managed with percutaneous interventions.

Coexistence of both congenital and atherosclerotic coronary heart disease is rare. We report a 52-year-old man who had severe valvular pulmonic stenosis and significant atherosclerotic disease involving coronary, subclavian and renal arteries. This combination of congenital heart disease and atherosclerotic arterial disease is probably the first report in published English literature. He underwent successful staged percutaneous interventions, which included balloon pulmonic valvuloplasty and angioplasty and stenting of right renal, left subclavian and right coronary arteries. On follow-up at 8 months, a check angiogram revealed patent stents and insignificant gradient across pulmonic valve.

Angioplasty, Balloon↗

Sex ratio in India.

Explore the source record for details and available documents.

Cross-Sectional Studies↗

A randomized, placebo-controlled, double-blind, crossover study to evaluate the efficacy of oral sildenafil therapy in severe pulmonary artery hypertension.

BACKGROUND: Severe pulmonary artery hypertension (PAH) is a disorder with limited treatment options. Recently, several newer drugs have recently been introduced to treat PAH. Sildenafil is one which has shown promise in several uncontrolled studies, but controlled trials have been few. In this randomized placebo-controlled study, we evaluated the efficacy of oral sildenafil in idiopathic PAH and PAH caused by Eisenmenger syndrome. METHODS: This was a randomized, double-blind, placebo-controlled crossover study. Twenty patients, 10 of each of idiopathic PAH and Eisenmenger syndrome, were randomized to receive placebo or sildenafil in a double-blind manner for 6 weeks and, after a washout period of 2 weeks, were crossed over. The primary end point of efficacy was the improvement in distance covered in 6-minute walk test. Secondary end points were reduction in pulmonary artery pressure as measured by Doppler echocardiography after 6 weeks of treatment, improvement in clinical condition, New York Heart Association (NYHA) class, and exercise duration and metabolic equivalents (Mets) achieved on modified Bruce exercise protocol. RESULTS: There was significant improvement in primary and secondary end points. The primary end point of distance covered in 6-minute walk test improved from 262 +/- 99 to 358.9 +/- 96.5 m (P < .0001) after treatment with sildenafil. Pulmonary artery pressure, the secondary end point, improved from the baseline of 98.8 +/- 20.5 to 78.3 +/- 15.3 mm Hg (P < .0001), NYHA class improved from 2.65 +/- 0.59 to 1.55 +/- 0.51 (P < .0001), exercise duration from 6.4 +/- 3.1 to 10.2 +/- 2.05 minutes (P < .0001), and Mets achieved from 3.32 +/- 1.57 to 6.04 +/- 1.87 (P < .0001) after treatment with sildenafil. There was no significant fall in blood pressure with placebo and sildenafil, and no serious side effects of drug were observed in the study. CONCLUSIONS: Sildenafil significantly improved the symptomatic status, exercise capacity, NYHA class, and hemodynamic parameters of patients with severe PAH and can be safely used as a primary or adjunctive treatment of the same.

3',5'-Cyclic-GMP Phosphodiesterases↗

Buddy wire technique: a simple technique for treating calcified lesion during percutaneous coronary intervention: a case report.

The buddy wire technique, i.e., using an additional 0.014 inch coronary guidewire along with the one being used to advance balloons, stents or other devices help to accomplish otherwise challenging procedures during percutaneous coronary intervention (PCI). It improves the balloon or stent support and also provides the guiding catheter stability. It is a simple, quick, easily available and deliverable method for complex lesions during PCI. We report technical aspects of a case of a mid-left anterior descending (LAD) calcified lesion in which a buddy wire facilitated the procedural success of PCI.

Angioplasty, Balloon, Coronary↗

Anomalous left anterior descending, absent circumflex and unusual dominant course of right coronary artery: a case report--R1.

A 40-years-old female presented with atypical chest pain. Selective coronary angiography revealed separate osteal origin of anomalous left anterior descending (LAD) and normal origin of right coronary artery (RCA) from right anterior coronary sinus. LAD had a septal course. Left circumflex (LCx) was absent. RCA, a dominant vessel, continued beyond the crux, along the entire length of atrioventricular groove as circumflex artery. There was no myocardial ischemia on stress thallium. As per our knowledge, this type of combination of anatomical variation of coronary circulation has not been described in the literature.

Adult↗

Gunshot injury of the heart: an unusual cause of acute myocardial infarction.

A 30-year-old man had multiple pellet injuries after being shot. An asymptomatic, acute, inferior-wall myocardial infarction was detected on an electrocardiogram at the time of a pre-anesthetic evaluation for eye surgery. A computed tomographic scan of the chest confirmed the presence of an intracardiac foreign body. Coronary angiography showed occlusion of the distal right coronary artery by a pellet. The patient was managed conservatively with aspirin and metoprolol. In conclusion, a single coronary lesion, the absence of other cardiac complications, and a favorable outcome with conservative medical treatment after a gunshot injury contribute to the rarity of this case of myocardial infarction.

Adrenergic beta-Antagonists↗

Endovascular management of isolated axillary artery aneurysm--a case report.

The purpose of this paper is to report a case of axillary artery aneurysm, successfully treated by percutaneous transfemoral self-expandable polytetrafluoroethylene (PTFE) covered Wallgraft stent. A 20-year-old man presented with sudden-onset, severe aching pain of left upper limb that occurred while doing isometric exercise. He had feeble left brachial and radial pulses. Angiography revealed a 21 x 14 mm left axillary artery aneurysm with a 15 mm neck. There was an organized clot in the midpart of the left brachial artery. The aneurysm was successfully closed with a self-expandable 10 x 30 mm Wallgraft endoprosthesis PTFE graft stent, via the right femoral route. A check angiogram at 6 weeks of follow-up showed a patent stent with no endovascular leak. At 1 year of follow-up, the patient was asymptomatic with normal upper limbs pulsations. Axillary artery aneurysm may be treated with a stent graft, which is an effective, rapid, and definite treatment and is an acceptable alternative to standard open surgical repair.

Adult↗

Acquired atrioventricular block in a patient with sinus node disease on single-chamber atrial pacing.

Single-chamber atrial pacing is the most physiological and yet economical modality of treatment in patients with symptomatic sinus node disease with normal atrioventricular conduction. However, because of the possibility of future development of a high-degree atrioventricular block and atrial fibrillation, most patients are implanted either dual- or single-chamber right ventricular pacemakers. We report a patient with symptomatic sinus node disease on single-chamber atrial pacing for the past 7 years who developed a progressive increase in the PR interval and ultimately presented with symptomatic high-degree atrioventricular block requiring pacemaker upgradation. The pacemaker was upgraded to the single-chamber ventricular mode with one additional ventricular lead introduced from the same side percutaneously.

Atrial Fibrillation↗