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Mahadevappa M.,JSS Medical College | Hegde M.,Dr Br Ambedkar Medical College | Math R.,Sri Jayadeva Institute of Cardiovascular science and Research Institute
Journal of Clinical and Diagnostic Research | Year: 2016

Introduction: The normative data of coronary artery size among Indians are sparse. It is often essential to know the coronary dimensions especially during interventions such as stenting to choose the appropriate size of the stent and to decide the very need for stenting. In current practice it is the luminal angiography which is most widely employed to assess the coronary artery size. However, luminal angiography is not very accurate in estimating the epicardial coronary artery size as it does not take into account the mural thickness of the arterial wall. Hence it is prudent to assess coronary artery size by other methods such as Computed Tomography (CT) coronary angiography, quantitative coronary angiogram, Magnetic Resonanace (MR) angiogram, etc. In this study we chose computed tomography as it demonstrates mural thickness along with lumen of the vessels and hence measures the diameter more accurately. Aim: To establish normative data for diameters of the proximal coronary artery segments during life by using MDCT in a cohort of individuals without any structural heart disease. Materials and Methods: Between October 2012 and April 2013, 168 consecutive patients who did not have any structural heart disease underwent CT coronary angiography for evaluation of Coronary Artery Disease (CAD) with atypical symptoms with low pretest probability. Patients who were found to have no coronary artery disease on CT-CAG were recruited in this study. The baseline clinical status and demographic data were obtained from the hospital records. Results: In our study we found that the mean indexed diameter to BSA among females for LMCA 2.32±0.12mm, LAD 1.95±0.15mm, LCX 1.73±0.20mm and RCA 1.84±0.22mm. For males the values were LMCA 2.33±0.13mm, LAD 1.94±0.16mm, LCX 1.74±0.21mm, and RCA 1.79±0.20mm. These values are comparable to other studies. Conclusion: We attempted to establish normative data for normal proximal coronary artery dimensions among South Indian population. Coronary artery dimensions in Indians (in-dexed to BSA) for proximal major epicardial coronary arteries are similar to that reported in the West. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved.

Borde D.,P. D. Hinduja National Hospital | Gandhe U.,P. D. Hinduja National Hospital | Hargave N.,P. D. Hinduja National Hospital | Pandey K.,P. D. Hinduja National Hospital | And 2 more authors.
Annals of Cardiac Anaesthesia | Year: 2014

Aims and Objectives: Postoperative atrial fibrillation (POAF) is the most common arrhythmia after coronary artery bypass grafting (CABG) surgery. The identification of patients at risk for POAF would be helpful to guide prophylactic therapy. Presently, there is no simple preoperative scoring system available to predict patients at higher risk of POAF. In a retrospective observational study, we evaluated the usefulness of CHA2 DS 2 -VASc score to predict POAF after CABG. Materials and Methods: After obtaining approval from Institutional Review Board, 729 patients undergoing CABG on cardiopulmonary bypass (CPB) were enrolled. Patients were followed in the postoperative period for POAF. A multiple regression analysis was run to predict POAF from various variables. The area under the receiver operating characteristic (ROC) curve was calculated to test discriminatory power of CHA2 DS2 -VASc score to predict POAF. Results: POAF occurred in 95 (13%) patients. The patients with POAF had higher CHA2 DS2 -VASc scores than those without POAF (4.09 ± 0.90 vs. 2.31 ± 1.21; P < 0.001). The POAF rates after cardiac surgery increased with increasing CHA2 DS2 -VASc scores. The odds ratio for predicting POAF was highest with higher CHA2 DS2 -VASc scores (3.68). When ROC curve was calculated for the CHA2 DS2 -VASc scores, area of 0.87 was obtained, which was statistically significant (P < 0.0001). Conclusions: The CHA2 DS2 -VASc score was found useful in predicting POAF after CABG. This scoring system is simple and convenient to use in the preoperative period to alert the clinician about higher probability of POAF after CABG surgery.

Jagadeeshan N.,Sri Jayadeva Institute of Cardiovascular science and Research Institute | Jayaprakash S.,Sri Jayadeva Institute of Cardiovascular science and Research Institute | Ramegowda R.T.,Sri Jayadeva Institute of Cardiovascular science and Research Institute | Manjunath C.N.,Professor and Director of Sri Jayadeva Institute of Cardiovascular science and Research Institute | Lavanya V.,Sri Jayadeva Institute of Cardiovascular science and Research Institute
Indian Heart Journal | Year: 2016

Corynebacterium striatum (C. striatum) is a ubiquitous saprophyte with a potential to cause bacteremia. We report the first case of C. striatum endocarditis in a patient with congenital lymphedema and rheumatic heart disease. © 2015 Cardiological Society of India.

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