Search

Your search keyword '"Gerula, Christine"' showing total 36 results
Start Over Author "Gerula, Christine"
36 results on '"Gerula, Christine"'

34. The functional SYNTAX score - a huge step forward or research in motion?

Author

Dehnee A, Gerula C, Mazza V, Maher J, Dhruvakumar S, and Kaluski E

Subjects
Angioplasty, Balloon, Coronary mortality, Cohort Studies, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease mortality, Female, Humans, Male, Myocardial Revascularization methods, Myocardial Revascularization mortality, Predictive Value of Tests, Radiography, Research, Risk Assessment, Sensitivity and Specificity, Severity of Illness Index, Societies, Medical, Survival Analysis, Angioplasty, Balloon, Coronary methods, Coronary Artery Disease therapy, Fractional Flow Reserve, Myocardial
Abstract

In a recent manuscript in the Journal of the American College of Cardiology, the newly introduced "functional SYNTAX score" (FSS) was found to be a better tool to assess the extent and severity of coronary artery disease than the SYNTAX score (SS) and has reclassified 1/3 of the studied cohort into lower-risk categories. Besides being more invasive, costly, and time consuming, FSS still suffers from inherent deficiencies of its own. Like SS, FSS does not incorporate clinical risk predictors and consequently is a suboptimal tool for predicting PCI risk. FSS is not supported by a wealth of contemporary outcome data in a wide range of patient and lesions subsets. Key unanswered questions are whether PCI of hemodynamically significant lesions (FFR <0.80) is superior to optimal medical therapy (OMT) and whether complete revascularization yields considerably better outcomes than partial revascularization. Since partial revascularization is still an option, operational FSS (taking into account only the FSS of lesions subject to PCI) combined with a clinical risk score will probably better predict the procedural risk of the planned PCI.

Published
2012

35. Intra-aortic balloon pump prior to noncardiac surgery: a forgotten remedy?

Author

Schmidt R, Kasper M, Gerula C, Klapholz M, Haider B, and Kaluski E

Subjects
Aged, 80 and over, Female, Hip Joint surgery, Humans, Hypertension, Portal surgery, Middle Aged, Prosthesis Failure, Reoperation, Treatment Outcome, Arthroplasty, Replacement, Hip adverse effects, Heart Failure etiology, Heart Failure prevention & control, Intra-Aortic Balloon Pumping methods, Portasystemic Shunt, Transjugular Intrahepatic adverse effects, Preoperative Care methods
Abstract

High-risk cardiac patients, especially those with severe coronary artery disease, are prone to ischemic, arrhythmic and heart failure complications during urgent or emergent noncardiac surgery. The American and European guidelines endorse selective revascularization by either coronary artery bypass grafting or percutaneous coronary intervention in symptomatic ischemic patients prior to major elective surgery. However, conventional revascularization may not be suitable for certain patients requiring emergent or urgent surgery. Reported are two representative cases in which severely ischemic patients were bridged uneventfully through moderate-risk surgery by using prophylactic intra-aortic balloon pump (IABP). Prophylactic IABP should be considered for the support of ischemic patients who are severely symptomatic or hemodynamically unstable undergoing moderate-high risk surgery, who are not suitable for preoperative revascularization. This therapeutic option should be acknowledged in the relevant guidelines.

Published
2011

36. Right coronary artery anatomical variants: where and how?

Author

Solanki P, Gerula C, Randhawa P, Benz M, Maher J, Haider B, Klapholz M, Palmaro J, Alfano D, and Kaluski E

Subjects
Algorithms, Coronary Angiography, Coronary Sinus diagnostic imaging, Coronary Vessels diagnostic imaging, Echocardiography, Transesophageal, Humans, Magnetic Resonance Imaging, Prevalence, Retrospective Studies, Tomography, X-Ray Computed, Choristoma diagnostic imaging, Choristoma epidemiology, Coronary Sinus abnormalities, Coronary Vessel Anomalies diagnostic imaging, Coronary Vessel Anomalies epidemiology, Coronary Vessels anatomy & histology
Abstract

Background: Ectopic origin of the right coronary artery (RCA) occurs in approximately 1.0% of studied populations. We investigated the prevalence and location of ectopic RCAs among patients undergoing coronary angiography (CA) and assessed its effects on resource utilization., Methods: Cases of ectopic RCAs were prospectively collected over 21 months among patients undergoing cardiac catheterization at a University Hospital. "Ectopic RCA" was defined as a RCA originating outside the posterior two-thirds of the right coronary sinus., Results: The study population included 2,120 patients, of which 23 (1.1%) had ectopic RCAs. Of these, 15 (65%) originated from the anterior third of the right sinus, while 8 (35%) originated from the anterior half of the left sinus. Mean procedure and fluoroscopy times were 60 +/- 33 and 15 +/- 12 minutes (min) for the former, and 78 +/- 35 and 31 +/- 20 min for the latter, while mean contrast volume for CA was 112 +/- 62 ml and 192 +/- 85 ml, respectively. 26% required a second CA or a second intervention to image the RCA., Conclusion: Ectopic RCAs pose a clinical problem, consuming time and resources. The search for an ectopic RCA should have < 90 degree boundaries limited to the anterior third of the right sinus and anterior half of the left sinus.

Published
2010

Catalog

Books, media, physical & digital resources
See catalog results