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V Dev

Publications and source records attributed to V Dev.

101 records · Page 6Linked to original sources

Echocardiographic assessment of the size of aortic and pulmonary valve annulus before balloon valvoplasty.

Two dimensional echocardiographic measurements of the size of aortic and pulmonary valve annulus were made in 60 patients before balloon valvoplasty and compared to the angiographic measurements. Aortic valve annulus was measured in 34 patients (26 with valvar aortic stenosis and 8 with discrete subaortic stenosis) in the parasternal long axis or apical 5-chamber views. The pulmonary valve annulus was measured in 26 patients with valvar pulmonary stenosis (PS) in the parasternal short axis view of the right ventricular outflow view. The visualization of the annulus was good in all except 2 patients with valvar PS. Angiographic measurements of the aortic and pulmonary valve annulus were made in aortic root and right ventricular angiograms respectively, taken in both right and left anterior oblique views. There was an excellent correlation between the measurements of the annulus size by the two techniques (r value for pulmonary valve 0.91; for aortic valve 0.96; over all 0.94). Echocardiography can accurately measure valve annulus size and help in choosing balloon dilatation catheter of appropriate size before the valvoplasty procedure.

Adolescent

Clinical experience with low profile fixed wire balloon catheter system for percutaneous transluminal coronary angioplasty.

Clinical records of the first 45 consecutive patients (66 lesions) in whom the Probe TM a balloon on the wire, was used for percutaneous transluminal coronary angioplasty have been reviewed. The aim of this analysis was to establish the efficacy and safety of this device. Majority of the lesions taken up were considered severe and difficult to cross. The probe was the 1st catheter used in 51 lesions (77%) and in 15 lesions (23%) it was used after other balloon catheters. In 88% (58/66) of lesions treated the Probe reduced the stenosis to less than 50% of the luminal diameter. Of the 45 patients treated 39 (87%) had a successful result. Of the 19 patients with multiple lesions 74% (14/19) had complete revascularisation and in 16% (3/29) had the most significant vessel dilated. Two patients (3%) required urgent coronary artery bypass surgery for acute occlusions. There was no hospital death. Of 50 probe devices used 5 (10%) malfunctioned: the balloon ruptured (at 5 Bars pressure) in 2 instances, balloon twisted causing "Volvulous" in 1 and balloon failed to deflate in 2 cases. The probe has significant advantages over other balloon systems for treating severe coronary lesions because of its low profile. It is however a delicate catheter system and prone to malfunction if not handled with care. Our results show that it is an excellent system for opening difficult and tight coronary lesions.

Adult

A follow up study of major intimal dissections treated with perfusion balloon catheter.

Major intimal dissections during coronary angioplasty are an important cause of early morbidity and mortality. In the recent past various non-surgical modalities to manage such dissections have been developed. The choice of therapy among these needs knowledge not only of immediate success but also of long term results. Data on long term follow up of patients managed with prolonged balloon inflations using a perfusion balloon catheter is limited. We herein report our experience of twenty seven consecutive patients managed by prolonged dilatations using Stack perfusion balloon catheter. All the patients had a long dissection with luminal compromise, 6 (22%) had in addition an acute complete occlusion, and in 4 (15%) there was a thrombus. Only 6 (22%) needed an emergency CABG, with the remaining having an event free hospital stay. At follow up after 6-26 months, 7/21 (33%) had severe symptoms and 5 of them underwent coronary arteriography with four having a repeat successful dilatation. The findings of this study suggest that the perfusion balloon catheter is a useful modality for management of major dissections with a restenosis rate similar to that of primary PTCA. Randomised controlled trials are required to assess its efficacy vis a vis the newer therapeutic options like stents, lasers and atherectomy.

Angioplasty, Balloon, Coronary

Gastric outlet obstruction secondary to post cholecystectomy biloma: case report and review of the literature.

BACKGROUND: Postcholecystectomy bilomas are relatively uncommon with a reported incidence of about 2.5%, and most often present with right upper quadrant pain and fever within seven days of the operation. There are a number of approaches to the treatment of this uncommon lesion. CASE REPORT: The authors report a case of a cholecystectomy performed in a 35-year-old female which resulted in a biloma, presenting 11 days postoperatively with gastric outlet obstruction. The literature is reviewed to suggest the optimal management and treatment plans for this complication. RESULTS: This patient was successfully managed with radiologic intervention for the treatment of a biloma and resulting gastric outlet obstruction after open cholecystectomy. CONCLUSION: Although uncommon, bilomas may present in an unusual manner such as with gastric outlet obstruction. As with early bilomas, they may be treated successfully with interventional radiologic techniques.

Adult