Un Mehta Institute Of Cardiology And Research Center

Ahmadābād, India

Un Mehta Institute Of Cardiology And Research Center

Ahmadābād, India

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Sharma K.H.,Un Mehta Institute Of Cardiology And Research Center | Kamath N.A.,Bj Medical College
Indian Journal of Pharmacology | Year: 2014

Objective: To estimate and compare the cost-effectiveness and safety of nebivolol with sustained-release metoprolol in reducing blood pressure by 1 mm of Hg per day in hypertensive patients.Materials and Methods: This was a prospective, randomized, open label, observational analysis of cost-effectiveness, in a questionnaire-based fashion to compare the cost of nebivolol (2.5 mg, 5 mg, 10 mg) and sustained released metoprolol succinate (25 mg, 50 mg, 100 mg) in hypertensive patients using either of the two drugs. A total of 60 newly detected drug naïve hypertensive patients were considered for the comparison, of which 30 patients were prescribed nebivolol and the other 30 were prescribed metoprolol succinate as per the recommended dosage. Based on the data, statistical analysis was carried out using GraphPad Prism 5 and MS Excel Spreadsheet 2007.Result: The cost of reducing 1 mm of Hg blood pressure per day with nebivolol was 0.60, 0.70, and 1.06 INR, whereas that of metoprolol succinate was 0.93, 1.18, and 1.25 INR at their respective equivalent doses, hence significantly lower with the nebivolol group as compared to the metoprolol group (P < 0.05).Conclusion: This pharmacoeconomic analysis shows that nebivolol is more cost-effective as compared to metoprolol when the cost per reduction in blood pressure per day is considered. This may affect the patients economically during their long-term use of these molecules for the treatment of hypertension.


Abhyankar A.D.,Shri Bdm Mahavir Heart Institute | Prajapati J.,Un Mehta Institute Of Cardiology And Research Center | Reddy S.,Sunshine Hospitals | Reddy S.,Malla Reddy Narayana Hrudayalaya Hospital
Minerva Cardioangiologica | Year: 2013

Aim. The aim of this study was to evaluate the strut apposition and neointimal coverage of Supralimus-Core stent struts at 4 months after implantation using optical coherence tomography (OCT). Methods. The Supralimus-Core OCT study is a retrospective, single-center study evaluating strut apposition and neointimal coverage with OCT at 4 months after stent implantation. A total of 12 patients, who had 15 stents implanted were included in the study. The OCT was obtained using a C7-XR FD-OCT (frequency-domain OCT) intravascular imaging system. Strut apposition, neointimal hyperplasia (NIH) thickness and stent coverage on each stent strut were evaluated. Results. A total of 2870 struts and 1950 frames were analyzed from 15 stents. Average stent length was 29.3 mm. Average reference vessel diameter was 2.64 mm. Among 12 patients, 3 (25.0%) patients were with diabetes, 4 (26.7%) type B2 and 10 (66.7%) type C lesions. The apposed and covered struts were 2787 (97.11%), whereas malapposed and covered struts were 3 (0.10%), apposed and uncovered 49 (1.71%) and malapposed and uncovered 31 (1.08%). Mean NIH thickness was 155.1±55.2 μm. Conclusion. The present study suggests that Supralimus-Core stent has a favorable vascular healing pattern at 4 months after stent implantation in terms of stent-strut coverage and strut apposition. This information indicates that the Supralimus-Core stent is a promising solution for decreasing late stent restenosis and preventing stent thrombosis.


Prajapati J.,Un Mehta Institute Of Cardiology And Research Center | Jain S.,Un Mehta Institute Of Cardiology And Research Center | Virpariya K.,Un Mehta Institute Of Cardiology And Research Center | Rawal J.,Un Mehta Institute Of Cardiology And Research Center | And 4 more authors.
Journal of Association of Physicians of India | Year: 2014

Objectives: In this study we aimed to analyse the frequency of atherosclerotic risk factors with focus to novel risk factors for coronary artery disease and angiographic profile in young (≤ 40 years) acute coronary syndrome (ACS) patient with healthy controls in Gujarat, India. Methods: Between January 2008 and December 2012, 109 consecutive young patients aged ≤ 40 years old, diagnosed to have ACS were included in the study. All ACS patients underwent diagnostic coronary angiography. An equivalent age and sex matched population without coronary disease with similar risk factors without tobacco considered a control group. All angiographic patients were evaluated for conventional risk factors for coronary artery disease like diabetes mellitus, hypertension, smoking, obesity as well as novel atherogenic risk factors like high sensitivity C-reactive protein (Hs-CRP), Lipoprotein(a) [LP(a)], homocysteine, apolipoprotein A1 (ApoA1) and B (ApoB). Result: In a study group, out of 109 young patients, 90 (82.6%) patients were presented to our hospital as ST-segment elevation myocardial infarction (STEMI), 10 (9.2%) presented as known non- ST-elevation myocardial infarction (NSTEMI) and 9 (8.3%) presented as unstable angina (UA). Serum cholesterol, triglycerides, LDL, LP(a) and lipid tetrad index were significantly higher in the study group whereas the HDL levels significantly lower as compared to the control group. Conclusion: A quite common risk factors of premature CAD are smoking, high Hs-CRP, high LP(a), hyperhomocysteinaemia and positive family history in the young ACS. Most common presentation of ACS in young was STEMI. On angiography, single vessel involvement was the most common finding. © JAPI.


PubMed | Un Mehta Institute Of Cardiology And Research Center and University of Lucknow
Type: Case Reports | Journal: Echocardiography (Mount Kisco, N.Y.) | Year: 2016

Double-chambered right ventricle (DCRV) is a rare congenital anomaly in which the right ventricle is divided into two compartments with varying pressures due to an anomalous muscle bundle. Here, we describe a case of an adolescent male with DCRV with associated ventricular septal defect and subaortic membrane. Two-dimensional and three-dimensional transthoracic echocardiography with color flow clearly outlined all the three cardiac anomalies as well as their relationship with each other. The diagnosis was confirmed by cardiac catheterization. The patient underwent successful surgical resection of the anomalous muscle bundle along with repair of the associated anomalies.


Garg R.,Un Mehta Institute Of Cardiology And Research Center | Thakkar B.,Un Mehta Institute Of Cardiology And Research Center | Oswal N.,Un Mehta Institute Of Cardiology And Research Center
Cardiology in the Young | Year: 2013

The neuro-cutaneous syndrome tuberous sclerosis is commonly associated with rhabdomyomas in various organs including the heart. We are reporting a rare case of a 7-month old male child with congenitally corrected transposition of the great arteries associated with tuberous sclerosis and cardiac rhabdomyomas. To our knowledge, this rare association has not been reported so far. © Cambridge University Press, 2013.


Mishra A.,Un Mehta Institute Of Cardiology And Research Center | Shah M.,Un Mehta Institute Of Cardiology And Research Center | Sharma P.,Un Mehta Institute Of Cardiology And Research Center | Kothari J.,Un Mehta Institute Of Cardiology And Research Center | Malhotra A.,Un Mehta Institute Of Cardiology And Research Center
Medical Journal Armed Forces India | Year: 2014

Background: Cardiac myxomas are the most common benign intracardiac tumors. We studied the clinical presentation of cardiac myxomas, their morbidity, mortality and recurrence rate following surgery at our institution over a period of four years. Methods: During August 2008 to November 2012, a total of 12023 cardiac surgeries were performed. Amongst these, 50 patients (12 males, 38 females) underwent complete removal of primary or recurrent intracardiac myxomas. Complete tumor excision with a cuff of interatrial septum followed copious saline irrigation of the cardiac chambers was performed in each case. Results: Forty six patients survived the surgery of which 43 are being followed up at regular intervals for development of recurrence. Myxomas constituted 0.41% of the total cardiac surgeries at our institute. Most of them were noted in the fourth decade. The commonest location was left atrium (74%) followed by right atrium (22%). Only one patient had a myxoma in the right ventricle. Forty six patients (92%) survived the surgery. Conclusion: Cardiac myxoma excision account for a very small percentage of cardiac procedures. Immediate surgical treatment is indicated in all patients. Cardiac myxomas can be excised with a low rate of mortality and morbidity. © 2013, Armed Forces Medical Services (AFMS). All rights reserved.


PubMed | Un Mehta Institute Of Cardiology And Research Center
Type: Case Reports | Journal: Cardiology in the young | Year: 2014

The neuro-cutaneous syndrome tuberous sclerosis is commonly associated with rhabdomyomas in various organs including the heart. We are reporting a rare case of a 7-month old male child with congenitally corrected transposition of the great arteries associated with tuberous sclerosis and cardiac rhabdomyomas. To our knowledge, this rare association has not been reported so far.


PubMed | Mehta Institute of Cardiology and Research Center and Un Mehta Institute Of Cardiology And Research Center
Type: Journal Article | Journal: Brazilian journal of cardiovascular surgery | Year: 2016

Transposition of the great arteries is a common congenital heart disease. Arterial switch is the gold standard operation for this complex heart disease. Arterial switch operation in the presence of intramural coronary artery is surgically the most demanding even for the most experienced hands. We are presenting our experience with a modified technique for intramural coronary arteries in arterial switch operation.This prospective study involves 450 patients undergoing arterial switch operation at our institute from April 2006 to December 2013 (7.6 years). Eighteen patients underwent arterial switch operation with intramural coronary artery. The coronary patterns and technique used are detailed in the text.The overall mortality found in the subgroup of 18 patients having intramural coronary artery was 16% (n=3). Our first patient had an accidental injury to the left coronary artery and died in the operating room. A seven-day old newborn died from intractable ventricular arrhythmia fifteen hours after surgery. Another patient who had multiple ventricular septal defects with type B arch interruption died from residual apical ventricular septal defect and sepsis on the eleventh postoperative day. The remainder of the patients are doing well, showing a median follow-up duration of 1235.34815.26 days (range 369 - 2730).Transposition of the great arteries with intramural coronary artery is demanding in a subset of patients undergoing arterial switch operation. We believe our technique of coronary button dissection in the presence of intramural coronary arteries using coronary shunt is simple and can be a good addition to the surgeons armamentarium.


PubMed | Un Mehta Institute Of Cardiology And Research Center
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2015

Although numerous risk factors have been established to predict the development of acute coronary syndrome (ACS), the risk factor profile may be different between the younger and older individuals.To analyse the frequency and pattern of atherogenic risk factors and angiographic profiles in age-stratified Gujarati patients with ACS.ACS patients undergoing coronary angiography at U.N. Mehta Institute of Cardiology and Research, Gujarat, India between January 2008 and December 2012 were classified in to two age groups with 40y as cut-off. Patients were assessed for conventional risk factors (diabetes mellitus, dyslipidaemia, hypertension, smoking, obesity), novel risk factors (high sensitivity C-reactive protein, lipoprotein (a), homocysteine), and angiographic profiles.The statistical difference between two age groups was determined by Students t-test for continuous variables and Chi-square or Fishers exact test for categorical variables.A total of 200 patients, 100 patients 40 y of age and 100 patients >40 y of age, were evaluated. Older patients had higher frequency of hypertension (32 vs. 16%, p=0.008), while family history of coronary artery disease was more common among younger patients (19 vs. 9%, p=0.041). The incidence of diabetes, dyslipidaemia, smoking and tobacco chewing did not vary significantly between the two groups. Total cholesterol and low-density lipoprotein cholesterol levels were significantly higher in the younger group (p<0.05). Lipoprotein (a), homocysteine and high-sensitivity C reactive protein levels were comparable between two age groups. Multi-vessel coronary artery disease was more common among older group. The most commonly affected coronary artery was the left anterior descending artery among younger patients (44%) and the left circumflex artery among older patients (38.1%).Young patients with ACS had different atherosclerotic risk profile and less extensive coronary artery disease as compared to older counterparts. Emphasis should be given on diagnosis and management of major modifiable risk factors.


PubMed | Un Mehta Institute Of Cardiology And Research Center
Type: Case Reports | Journal: Journal of cardiac surgery | Year: 2013

We present the surgical management of an adult patient with circumflex aortic arch (CAA). We performed a ventral aorta repair with transposition of the left subclavian artery (LSCA) and resection of the arch. The usefulness of sternotomy and cardiopulmonary bypass in the management of these patients is described.

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