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Biomedical subjects

S Fighali

Publications and source records attributed to S Fighali.

12 recordsLinked to original sources
PubMed1997

Permanent pacing for asystole of the donor heart after heterotopic heart transplantation.

A 41-year-old woman presented with shortness of breath and decreased exercise tolerance 1 year after heterotopic heart transplantation. She was found to have an ejection fraction of less than 20% for the native heart and severely depressed left ventricular systolic function of the donor heart. A left ventriculogram of the donor heart showed no systolic contractility. A permanent pacemaker was implanted into the right ventricle of the donor heart. One year after pacemaker insertion, systolic function of the donor heart had returned to normal.

Adult↗
PubMed1989

Percutaneous transluminal coronary angioplasty after cardiac transplantation.

This report describes the 1st use of percutaneous transluminal coronary angioplasty in a posttransplant patient at the Texas Heart Institute. The patient, a 44-year-old man, experienced 3 episodes of moderate allograft rejection, hypercholesterolemia, transient severe hyperglycemia, and transient severe renal insufficiency in the posttransplant period. His cholesterol levels became elevated immediately and remained between 200 and 250 mg/dL, despite treatment with gemfibrozil. He had increasing lower-extremity claudication that was treated with bilateral femoral-popliteal bypass grafting. At 5-year follow-up, a discrete 75% stenosis was found in the right coronary artery. He was treated successfully with percutaneous transluminal coronary angioplasty on 20 February 1989 and was able to return to work thereafter.

Journal Article↗
PubMed1987

Progression of hypertrophic cardiomyopathy into a hypokinetic left ventricle: higher incidence in patients with midventricular obstruction.

The development of segmental or generalized left ventricular hypokinesia is an unusual occurrence in patients with hypertrophic cardiomyopathy. To determine the incidence and possible pathophysiologic mechanisms responsible for this process, the serial clinical and laboratory data of 62 patients with the diagnosis of hypertrophic cardiomyopathy were analyzed. During a mean follow-up period of 8 years (range 2 to 21), 5 patients (Group A) developed left ventricular hypokinesia, whereas the remaining 57 patients (Group B) continued to exhibit the clinical and laboratory findings of hypertrophic cardiomyopathy. Three patients developed a dilated left ventricle with generalized hypokinesia; two other patients had segmental left ventricular wall motion abnormalities. None of these five patients who developed left ventricular hypokinesia had fixed coronary artery disease. The mean age, sex, mean duration of follow-up, presence of coronary myocardial bridges and angina pectoris, and an interventricular gradient were all similar in Groups A and B. Midventricular obliteration was seen in 4 (80%) of the 5 patients in Group A and in 4 (7%) of the 57 patients in Group B (p less than 0.001). Findings from this study reveal that segmental or generalized left ventricular hypokinesia can develop in patients with hypertrophic cardiomyopathy in the absence of fixed coronary artery disease. Such hypokinesia can occur after an acute myocardial infarction or it can develop gradually without clinical or electrocardiographic evidence of infarction. Patients with the mid-ventricular obliteration variant of hypertrophic cardiomyopathy are at a higher risk of developing segmental or diffuse left ventricular hypokinesia.

Adolescent↗
PubMed1985

Safety of outpatient cardiac catheterization.

In this study, we compared the procedure-related complications of inpatient and outpatient cardiac catheterization when performed at the same institution by the same group of cardiologists. The majority of the studies were done using a brachial arterial cutdown approach. The mean age, sex, cardiac diagnosis, mean left ventricular ejection fraction, and the distribution of coronary arterial lesions were similar in both groups. There were relatively more patients in the New York Heart Association's class 4 in the inpatient group (p less than 0.01). In the outpatient group (676 patients), there were no major complications, and the rate of minor complications was 1 percent. In the inpatient group (1,106 patients), the rate of major complications was 0.4 percent and of minor complications 1.4 percent. The rates of major, minor, and total complications were statistically similar between the two groups. In the outpatient group the presence of left main coronary arterial disease, triple-vessel coronary disease, a left ventricular ejection fraction less than 30 percent, or a history of a recent myocardial infarction did not alter rates of complications. The hospital-related cost of the procedure on an outpatient basis was 26 percent less than on an inpatient basis. Our findings indicate that outpatient cardiac catheterization, using a brachial cutdown approach, is safe even in a higher risk subgroup of patients and provides significant financial savings.

Adolescent↗
PubMed1984

Septal myomectomy and mitral valve replacement for idiopathic hypertrophic subaortic stenosis: short- and long-term follow-up.

The long-term results of septal myotomy-myomectomy or mitral valve replacement, or both, were assessed in 36 patients with idiopathic hypertrophic subaortic stenosis who were followed up for 5 to 67 months (mean 48) postoperatively. The mean left ventricular outflow tract gradient at rest decreased postoperatively in all three patient groups. It decreased from 60 mm Hg (range 17 to 160) preoperatively to 3 mm Hg (range 0 to 20) postoperatively (p less than 0.001) in the 13 patients who underwent mitral valve replacement alone, from 69 mm Hg (range 18 to 140) to 35 mm Hg (range 20 to 50) (p less than 0.05) in the 12 patients who underwent myotomy-myomectomy alone and from 89 mm Hg (range 60 to 165) to 3.8 mm Hg (range 0 to 27) (p less than 0.001) in the 11 patients who underwent myomectomy plus mitral valve replacement. The reduction in gradient was more impressive after mitral valve replacement with or without septal myotomy-myomectomy than after septal myotomy-myomectomy alone. There was a marked reduction in symptoms after all three surgical procedures that was long-lasting and independent of the type of operation performed. There was no operative mortality. Postoperative annual mortality rate was 1.6%. Patients with severe congestive heart failure, significantly elevated left ventricular end-diastolic pressure and atrial fibrillation have a less favorable long-term postoperative prognosis. Septal myotomy-myomectomy is recommended as the procedure of choice for the majority of patients with idiopathic hypertrophic subaortic stenosis who require surgery, because it can alleviate symptoms without subjecting patients to the complications of a valve prosthesis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

Predictive value of angiotensin II antagonists in renovascular hypertension.

An angiotensin II antagonist, sarcosine-1, threonine-8 angiotensin II ( [Sar1, Thr8] A II), was infused preoperatively in 14 patients with renal artery stenosis. Postoperative graft patency was documented by renal flow scan in 13 patients. One of these required antihypertensive therapy immediately after surgery, while the other 12 had a significant BP reduction in the first postoperative week (141 +/- 3.7 to 110 +/- 1.6 mm Hg). With longer follow-up, six patients remained normotensive (group 1), while the other six had "residual hypertension" (group 2). There was no significant difference between the two groups as regards age, preoperative BP level, plasma renin activity, blood volume, or response to [Sar1, Thr8] A II. In contrast, clinical signs were most helpful in predicting response to surgery. "Cured" patients had shorter duration of hypertension (less than one year) than patients with residual hypertension, and less impairment of renal excretory function; three patients in group 2 but none in group 1 had a history of malignant hypertension. The decision to operate remains a multifactorial evaluation and cannot be based on results of any single test alone.

Adult↗
PubMed1983

Congestive cardiomyopathy presumably secondary to oxacillin.

A patient developed congestive cardiomyopathy after a long-term course of oxacillin. When the drug was discontinued, cardiac function returned to normal. The summary of clinical findings strongly suggested a cause-and-effect relationship between the intake of oxacillin and the deterioration in myocardial contractility.

Journal Article↗
PubMedDate not supplied

Early experience with balloon angioplasty of internal iliac arteries for vasculogenic impotence.

Five patients with vasculogenic impotence underwent balloon angioplasty of internal iliac and/or internal pudendal artery obstructions in an attempt to increase the blood pressure in the dorsalis penis artery and thus improve erectile function. Four patients had bilateral obstructions, and one patient had unilateral iliopudendal arterial disease. Balloon angioplasty was used to dilate bilateral lesions in three patients and unilateral lesions in two patients. Four of the five patients had improvement in erectile function for 2 to 18 months (mean, 12 months) after angioplasty. We conclude that balloon angioplasty is an adequate, expeditious, and relatively inexpensive method for treating subtotal obstruction of the internal iliac and/or internal pudendal arteries in patients with vasculogenic impotence.

Angioplasty, Balloon↗