PubMed Health⌕ Search

Biomedical subjects

V Dev

Publications and source records attributed to V Dev.

At least 37 records · Page 2Linked to original sources
PubMed1993

Percutaneous balloon mitral valvuloplasty: analysis of echocardiographic and other variables related to outcome.

To determine whether mitral valve (MV) morphology influences the result of balloon mitral valvuloplasty (BMV) for mitral stenosis, two-dimensional echocardiography was performed before BMV in 53 patients and in 25 normal controls. The two-dimensional echocardiographic features of MV leaflets: thickness, length and motion, diastolic MV excursion, chordal length, MV annular diameter (MVAnD), subvalvular distance ratio (SDR), and effective balloon dilating area (EBDA) and diameter (EBDD) were then correlated to the immediate post-BMV mitral valve area (MVA). For the total patient population, post-BMV MVA increased from 0.76 +/- 0.24 to 1.91 +/- 0.59 cm2 (p < 0.0001) and mean diastolic transmitral gradient decreased from 20.1 +/- 6.15 to 5.8 +/- 3.29 mm (p < 0.0001). The patients were divided into two groups on the basis of post-BMV MVA. Group I had post-BMV MVA < 2.0 cm2 and group II had post-BMV MVA > or = 2.0 cm2. A statistically significant difference was noted in SDR (0.33 +/- 0.057 vs 0.45 +/- 0.042, p < 0.0001); mid-MV anulus to tip of papillary muscle (PM) distance (20.0 +/- 3.8 vs 27.9 +/- 4.54 mm, p < 0.0001); chordal length (4.3 +/- 3.6 vs 9.8 +/- 3.9 mm, p < 0.0001); diastolic MV excursion (15.5 +/- 2.6 vs 18.2 +/- 4.2 mm, p < 0.01); leaflet mobility (p < 0.05); and EBDA (4.4 +/- 0.6 vs 4.9 +/- 0.5 cm2, p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Echocardiographic diagnosis of aneurysm of the sinus of Valsalva.

Echocardiographic and Doppler data of 62 patients with ASOV are presented. Catheterization and angiography were performed in 38 cases and surgery in 25 of the 38. The origin of these aneurysms was the RCS in 56 cases, NCS in 5, and LCS in 1 case. Seven had unruptured aneurysms, 6 rising from RCS dissected into the ventricular septum, producing heart block in 4, AR in 5, mitral regurgitation in 1; 1 aneurysm rising from the LCS was asymptomatic. In other cases (n = 55) the aneurysm had ruptured into one of the cardiac chambers. Thirty-two of the 50 RCS aneurysms ruptured into the RVOT, 13 into the RV cavity, 2 into the RA, and 3 into the LV. Of the 5 NCS aneurysms, (3 ruptured into the RA, 1 into the RV, and 1 into both the RA and RV. Associated VSD was identified in 16 (25.8%) of 62 cases. All of these patients had RCS aneurysms that ruptured into the RVOT. Echocardiography missed VSD in three cases that at surgery were found to have VSD. AR was found in 34 of 62 cases. Echocardiography picked up discrete subaortic stenosis in two cases but missed subvalvar PS in 2 of the 3 cases. A detailed echocardiographic study (two-dimensional, Doppler, and color flow imaging) is accurate in the diagnosis of ASOV, in the identification of its site of origin and rupture, and in the evaluation of the associated defects; in the vast majority of cases, it can totally supplant the need for angiography.

Adolescent↗
PubMed1993

Echocardiographic diagnosis of total anomalous pulmonary venous connection.

Over a 7-year period, 110 of 35,000 echocardiographic cases were diagnosed to have total anomalous pulmonary venous connection (TAPVC). Ages ranged from 7 days to 38 years (male 62, female, 48). In 60 cases the diagnosis was confirmed by angiography (n = 47) and/or surgery (n = 50). In 13 cases angiography was not performed; surgery was performed on the basis of echocardiographic diagnosis. Diagnosis of TAPVC was correctly made in all of the 60 confirmed cases. Drainage sites were correctly identified by echocardiography in 58 (96.7%) of these 60 cases. Of the five cases of mixed TAPVC, the second drainage site was missed by echocardiography in two cases. Of the 110 cases the drainage sites were as follows: supracardiac 70, cardiac 30, infracardiac 5, and mixed variety 5. Seventeen cases had Doppler echocardiographic evidence of obstruction along the course of the anomalous vein. The continuous wave Doppler signal for tricuspid regurgitation was present in 14 of 47 catheterized patients, and catheterization-measured peak pulmonary artery systolic pressure correlated well with that derived by Doppler study (r = 0.96, p = 0.001). Additionally, 17 patients had other cardiac anomalies that were correctly diagnosed by echocardiography. Combined two-dimensional and Doppler echocardiography is accurate in the diagnosis of TAPVC, identification of the site of drainage, presence of obstruction, and assessment of pulmonary arterial hypertension and other associated anomalies.

Adolescent↗
PubMed1993

Concurrent percutaneous balloon valvotomy for combined rheumatic tricuspid and aortic stenosis.

Concurrent percutaneous balloon valvotomy of aortic and tricuspid valve was successfully performed in a 20-year-old male with severe rheumatic aortic and tricuspid stenosis. Balloon valvotomy was done using a 18-mm single balloon for aortic and 20 + 20-mm double balloon for the tricuspid valve. Immediately after valvotomy the peak transaortic systolic gradient decreased from 120 to 32 mmHg and the aortic valve area increased from 0.27 to 1.1 cm2, the mean and end-diastolic trans-tricuspid gradient decreased from 14 and 18 to 1.5 and 2 mmHg, respectively, the tricuspid valve area increased from 0.8 to 3.6 cm2 and the cardiac-index increased from 2 to 2.9 l/mt/m2. At 1 year of follow-up the clinical (NYHA class 1) and hemodynamic improvement was maintained.

Adult↗
PubMed1993

Anopheline fauna and malaria incidence in Changlang District (Arunachal Pradesh).

Data on malaria incidence and prevalence as well as on abundance of anopheline species collected in Jairampur, Arunachal Pradesh, show that P. falciparum contributed 27.59% of the total positive cases, most of these being recorded during July to September. Of the twelve anopheline species recorded, Anopheles maculatus was the most predominant comprising 54.32% of the total collection. Other common species were An. peditaeniatus, An. philippinensis and An. kochi in order of decreasing proportion. An. dirus, the known vector, was collected in the whole-night human bait catches (indoor) but in low numbers. An. philippinensis is implicated as another potential vector, and changes in anopheline/vector fauna are attributed to ecological succession.

Animals↗
PubMed1992

Balloon angioplasty for complete obstruction of inferior vena cava: needle puncture followed by balloon dilatation.

We report herein 2 cases with complete obstruction of the suprahepatic portion of the inferior vena cava successfully treated by balloon angioplasty after crossing the obstructing segment with the stiff end of the guidewire in 1 case and the Brockenbrough's trans-septal needle in the other. The gradients across the obstruction fell from 13 and 20 mm Hg to 3 and 4 mm Hg, respectively. Angioplasty resulted in dramatic clinical hemodynamic and angiographic improvement.

Adult↗
PubMed1992

Fish oil supplements for prevention of restenosis after coronary angioplasty.

We have evaluated the effect of fish oil supplementation in the prevention of restenosis after percutaneous transluminal coronary angioplasty by a randomised trial conducted in 107 patients. The treatment group (n = 58, 96 significant coronary narrowings) received 10 capsules of fish oil (1.8 g eicosapentaenoic acid, 1.2 g docosahexaenoic acid) besides aspirin and calcium blockers, beginning 4.3 (SD 2.9) days before coronary angioplasty. The conventional medical treatment group (n = 49, 81 significant coronary narrowings) received only aspirin and calcium blockers. Enrollment required the presence of angina pectoris and successful dilatation of all significant coronary narrowings. All patients were followed-up for at least 6 months. Restenosis was identified by symptoms and exercise testing and confirmed by angiography. The incidence of angiographic restenosis was 32% in the fish oil group and 27% in the conventional treatment group. Biochemical investigations showed a greater decrease in serum triglyceride levels in fish oil group as compared to the conventional treatment group. There was no significant difference in the cholesterol levels over the treatment period. Administration of fish oil in a dose of 3 g per day did not reduce the incidence of early restenosis after coronary angioplasty.

Angioplasty, Balloon, Coronary↗
PubMed1992

Immunosuppressive therapy in inflammatory myocarditis: long-term follow-up.

Sixteen patients (12 male and 4 female, age 2-46 years) with endomyocardial biopsy-proven myocarditis were prospectively evaluated with immunosuppressive therapy including azathioprine and prednisolone in addition to other standard measures. Patients were either in NYHA class IV (n = 12) or class III (n = 4). Twelve patients showed improvement and the remaining 4 continued to deteriorate: 2 died at 1 and 2 months after therapy and the other 2 were lost to follow-up after 4-6 weeks of therapy. Three of the 12 patients who showed significant improvement, after sudden omission of therapy (at 8 weeks, 6 and 8 months) worsened and died. One patient who showed significant improvement died suddenly after 9 months of therapy while playing football. The remaining patients have shown significant clinical and haemodynamic improvement with normalization of myocardial morphology. Serial haemodynamic studies revealed a significant fall in cardiothoracic ratio (before: 62.3 +/- 4.7%; 3 months: 55.1 +/- 3.1%, P less than 0.0001; 6-12 months: 50.6 +/- 1.5%, P less than 0.0001), mean pulmonary artery pressure (before: 34.3 +/- 13.05 mm; 3 months: 20.4 +/- 8.71 mm, P less than 0.01; 6-12 months: 20.0 +/- 2.75 mm, P less than 0.01) and mean pulmonary artery wedge pressure (before: 26.0 +/- 9.07 mm; 3 months 14.0 +/- 5.63 mm, P less than 0.001; 6-12 months: 13.2 +/- 4.57 mm, P less than 0.001). The left ventricular ejection fraction improved from 24.3 +/- 8.36% to 35.8 +/- 9.72% (P less than 0.001) at 3 months and 49.8 +/- 18.2% (P less than 0.0001) at 6-12 months of therapy. Two patients have been subsequently lost to follow-up whereas the remaining 6 patients are on follow-up for 1-4 years after therapy and are doing fine. Our uncontrolled observations suggest that immunosuppressive therapy may be useful in patients with inflammatory myocarditis.

Adolescent↗
PubMed1992

Aortic dissection following transluminal angioplasty of the thoracic aorta in nonspecific aortoarteritis.

We performed transluminal angioplasty for an eccentric, calcific stenosis of the thoracic aorta in a patient with nonspecific aortoarteritis and encountered an iatrogenic aortic dissection. Follow-up by intravenous digital subtraction angiography at 12 hours and at one week showed no change in the picture. He is asymptomatic at 6 months except for residual hypertension. Eccentric, localized thoracic stenosis may constitute an unfavourable angiographic morphology for angioplasty.

Adult↗
PubMed1992

Comparison of immediate hemodynamic response to closed mitral commissurotomy, single-balloon, and double-balloon mitral valvuloplasty in rheumatic mitral stenosis.

The hemodynamic response to closed mitral commissurotomy, single-balloon, and double-balloon mitral valvuloplasty was compared using 20 patients in each group. All patients had symptomatic rheumatic mitral stenosis with a mitral valve area < 1 cm2, without any left atrial clot, mitral valve calcification, or mitral regurgitation. There was a significant improvement in hemodynamics following intervention in all three groups. The mean pulmonary artery pressure decreased from 49.1 +/- 17.5 to 28.6 +/- 8.3 mm Hg (p < 0.001), 48.8 +/- 12.3 to 34.0 +/- 13.9 mm Hg (p < 0.001), and 46.7 +/- 18.0 to 26.3 +/- 13.7 mm Hg (p < 0.001) in the closed mitral commissurotomy, single-balloon, and double-balloon mitral valvuloplasty groups, respectively. The mitral valve area increased from 0.62 +/- 0.27 to 1.5 +/- 0.5 cm2 (p < 0.001), 0.68 +/- 0.24 to 1.5 +/- 0.4 cm2 (p < 0.001), and 0.68 +/- 0.25 to 1.9 +/- 0.8 cm2 (p < 0.001) in the closed mitral commissurotomy, single-balloon, and double-balloon mitral valvuloplasty groups, respectively. The increase in the mitral valve area was maximum in the group with double-balloon mitral valvuloplasty. In the closed mitral commissurotomy group there was a significant rise in left ventricular end-diastolic pressure, from 6.8 +/- 3.9 to 9.3 +/- 3.1 mm Hg (p < 0.001), but this remained unchanged in the single-balloon and double-balloon mitral valvuloplasty groups. Our study shows that single-balloon and double-balloon mitral valvuloplasty are comparable to closed mitral commissurotomy in the immediate hemodynamic response, with a larger valve area in the double-balloon mitral valvuloplasty group.

Adolescent↗
PubMed1992

Arrhythmias and conduction defects in patients with mitral valve prolapse: a study based on ambulatory monitoring and electrophysiologic studies.

Twenty consecutive symptomatic patients of mitral valve prolapse (MVP) and 20 normal age, sex and symptom matched controls were studied. Ambulatory monitoring studies revealed the presence of atrial premature beats (APC) in 16 subjects in each group. Isolated ventricular premature beats (VPC) were observed in 12 patients with MVP and 15 subjects in control group (p = ns). Complex VPCs (Lown IVa, IVb) were recorded in 4 patients of MVP vs 3 controls (p = ns). There was no correlation between the occurrence of arrhythmias with the degree of MVP or the degree of mitral regurgitation. Likewise, MVP patients with prolonged QTc interval did not show higher incidence of spontaneous arrhythmias when compared to those with normal QTc interval. Nineteen patients underwent electrophysiological studies. Two patients showed evidence of abnormal sinus node function. Both these patients in addition had AV nodal abnormalities, manifested by prolonged AH interval. Programmed stimulation studies induced AV nodal tachycardia in one and non-sustained ventricular tachycardia in two (polymorphic in one and monomorphic in the other). Ambulatory monitoring in both these patients did not show any evidence of complex VPCs or VT, indicating poor correlation between inducibility and presence of spontaneous complex VPCs. Patients with MVP do not have a higher prevalence of spontaneous atrial or ventricular arrhythmias when compared to matched normal controls with similar symptomatology. The presence of mitral regurgitation, severity of MVP and associated prolonged QTc interval is not associated with higher prevalence of arrhythmias. The correlation between spontaneous and inducible arrhythmias is poor.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Idiotypic cross-reactivity of immunoglobulins expressed in Waldenström's macroglobulinemia, chronic lymphocytic leukemia, and mantle zone lymphocytes of secondary B-cell follicles.

Monoclonal antibodies (MoAbs) specific for autoantibody-associated cross-reactive idiotypes (CRIs) of Waldenström's IgM react frequently with the surface Ig (slg) expressed by leukemia cells of patients with chronic lymphocytic leukemia (CLL). Evaluation of the molecular basis for this cross-reactivity indicates that such CRIs are encoded by conserved antibody variable region genes (V genes) that have undergone little or no somatic hypermutation. We find that such anti-CRI MoAbs stain a subpopulation of cells within the mantle zones surrounding the germinal centers of normal human tonsil. In contrast, MoAbs specific for variable region subgroup determinants react with cells in both the mantle zones and germinal centers of secondary B-cell follicles. To test whether mantle zone B cells not reactive with existing anti-CRI MoAbs may express slg bearing as-yet-unrecognized CRIs present on Igs produced by neoplastic cells of some patients with Waldenström's macroglobulinemia or CLL, we immunized mice with purified Waldenström's IgM that have been characterized for their variable region subgroups using subgroup-specific antisera raised against synthetic peptides. The supernatants of hybridomas generated from the splenocytes of immunized mice were screened for their ability to stain a subpopulation of mantle zone lymphocytes in human tonsil. With this approach, two new anti-CRI MoAbs were identified, designated OAK1 and VOH3. OAK1 binds to a CRI present on a subset of kappa light chains of the VK1 subgroup. VOH3 recognizes a CRI determinant(s) present on a subset of antibody heavy chains of the VH3 subgroup. Flow cytometric analyses demonstrated that OAK1 specifically binds leukemia cells from 5 to 20 patients (25%) with kappa light chain expressing CLL. In addition, VOH3 reacted with the leukemia cells from 1 of 17 (6%) patients tested. The success of these methods demonstrates that the variable regions of the Igs produced by mantle zone B cells share idiotypic determinants with Igs expressed in B-cell CLL (B-CLL) and Waldenström's macroglobulinemia.

Antibodies, Monoclonal↗
PubMed1991

Percutaneous balloon mitral valvuloplasty in rheumatic mitral stenosis: an experience of 50 patients in India.

We attempted percutaneous balloon mitral valvuloplasty in 50 patients (27 female and 23 male, age 10-38 years) with rheumatic mitral stenosis. The procedure could be completed in 40 patients. The failures were caused by problems related to transseptal puncture in eight cases and inability to cross the mitral valve in two cases. Immediately after valvuloplasty there was a remarkable reduction in the mean pulmonary artery pressure, left atrial mean pressure, mean diastolic gradient across the mitral valve, and the calculated pulmonary vascular resistance. The calculated mitral valve area increased and the cardiac index increased marginally. Inadequate results with a post valvuloplasty mitral valve area of 0.9 cm2 were seen in only one patient. Repeat hemodynamic evaluation in 25 patients within two weeks of valvuloplasty showed persistent benefit in all except one patient, who showed partial restenosis. Follow-up cardiac catheterization at 3-6 months in 13 patients showed evidence of restenosis (mitral valve area less than 1.0 cm2 and mean diastolic gradient of greater than 10 mmHg) in one patient, while all others maintained hemodynamic benefit. Repeat hemodynamic evaluation at 9-18 months after valvuloplasty in eight patients showed evidence of restenosis in an additional two cases. The patients in our series are young (28 patients less than 20 years), small body surface area (1.35-0.2 m2), and have high left atrial and pulmonary arterial pressures.

Adolescent↗
PubMed1991

Echocardiographic determinants of outcome after percutaneous transluminal balloon dilatation of discrete subaortic stenosis.

Eleven patients (seven females and four males; age 4 to 24 years) with discrete subaortic stenosis (DSS) diagnosed on echocardiography were subjected to balloon dilatation. The site of the obstruction was 1 to 8 mm below the aortic valve. On the basis of echocardiographic appearance, the patients could be divided into three groups. Group I patients had a uniformly thin (1 to 3 mm) obstructing "membrane" (n = 7). Group II patients had a thin obstructing "membrane" present at the tip of a thick bulge from the interventricular septum (n = 2) (intermediate form). Group III patients had an obstruction caused by a thick ridge of tissue (6 to 8 mm thick, n = 2). Maximum inflatable diameter of the balloon used was less than or equal to the aortic valve anulus. After balloon dilatation in group I, the gradients across the obstruction fell from 86.6 +/- 16.9 mm Hg to 24.0 +/- 13.1 mm Hg. Relief of obstruction persisted on follow-up of 3 to 24 months (gradient 28.8 +/- 15.7 mm Hg). In group II patients gradients fell from 116 and 40 mm Hg to 58 and 20 mm Hg, respectively immediately after balloon dilatation. On follow-up of 6 and 9 months the gradients have increased to 76 and 32 mm Hg, respectively. In group III the gradients fell from 64 and 70 mm Hg to 15 and 16 mm Hg, respectively, immediately after balloon dilatation, which increased to 58 and 60 mm Hg, respectively, within 24 hours and persisted around that level at 3 months' follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Unusual electrocardiographic response during pulmonary balloon valvoplasty.

An 18-year-old girl with severe valvar pulmonary stenosis was subjected to balloon valvoplasty. During each inflation of the balloon, we observed transient electrocardiographic disappearance of 'R' waves in the monitoring lead. The possible explanations for this observation include sudden severe right ventricular strain and ischemia.

Adolescent↗