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6. Primary percutaneous coronary intervention in patients with acute myocardial infarction.

Author

Safi M, Moghadam HR, Sadeghi R, Saadat H, Namazi MH, Vakili H, Hassantash SA, and Motamedi MR

Abstract

Background: Primary percutaneous coronary intervention (primary PCI) is the method of choice in establishing reperfusion in acute myocardial infarction (AMI) patients. The aim of this study was to determine the success rate of primary PCI in a university medical center in Iran with a view to promoting it as a first-line therapy in patients with AMI, especially in centers with established catheterization labs across the country. Methods: All cases of AMI admitted between September 2001 and September 2005 underwent primary PCI. The achieved thrombolysis in myocardial infarction (TIMI) flow was recorded, and the patients were followed during the hospital admission for major adverse cardiac events (MACE). Results: A total of 180 patients, consisting of 36 females and 144 males, with a mean age of 56±2.1 years were included in the study. The target vessel was the left anterior descending artery in 66.1%, right coronary artery in 27.2%, and left circumflex artery in 6.7% of the cases. The respective rate of anatomical and procedural success was 94.4% and 90%. The rates of mortality, coronary artery bypass grafting (CABG), and reinfarction were 6.7%, 1.1%, and 2.2%, respectively. Most patients were discharged with no complications in less than a week. Anatomical success in patients <65 years old was 95% versus 92.5% for those >=65 years of age. Procedural success in patients <65 years of age was 93.6% versus 77.5% for those >=65 years old (P<0.05). No significant relation was detected between the success rate and sex, target vessel, or major coronary artery disease risk factors. More patients in the mortality group had a longer door-to-balloon (DTB) time compared to the surviving group (P<0.05). Conclusion: In light of the results of this study, primary PCI may also be practiced as the therapy of choice for AMI patients in centers with established equipment in our region with acceptable rates of MACE and complications. Better procedural success rates are achieved in younger patients and in those with a shorter DTB time. [ABSTRACT FROM AUTHOR]

Published
2009

8. Poster session 4

Author

Parisi, V, Ferro, G, Bevilacqua, A, Caruso, A, Grimaldi, G, Rengo, G, Leosco, D, Ferrara, N, Yan, B P Y, Lai, KH, Chan, MYT, Lam, DYY, Fong, KNY, Chau, C, Fok, MHL, Kam, K, Tam, GM, Lee, PW, Takeuchi, H, Angelis, A, Aggeli, K, Ioakeimidis, N, Felekos, I, Abdelrasoul, M, Aznaouridis, K, Rokas, K, Vlachopoulos, C, Tousoulis, D, Cano Carrizal, R, Casanova Rodriguez, C, Prieto Moriche, E, Iglesias Del Valle, D, Cadenas Chamorro, R, De Juan Baguda, J, Martin-Penato Molina, A, Paredes Gonzalez, B, Garcia Garcia, A, Plaza Perez, I, Caiani, EG, Arbeille, P, Massabuau, P, Colombo, F, Ferri, G, Kasswat, C, Medvedofsky, D, Lang, RM, Vaida, P, Kuznetsov, VA, Yaroslavskaya, EI, Krinochkin, DV, Pushkarev, GS, Gorbatenko, EA, Bruno, RM, Bianchini, E, Di Lascio, N, Stea, F, Ujka, K, Marabotti, A, D’angelo, GS, Ghiadoni, L, Pratali, L, Zemedkun, M, Wang, Z, Asch, FM, Niki, K, Sugawara, M, Yauchi, S, Inoue, K, Yagawa, M, Takamisawa, I, Umemura, J, Yoshikawa, T, Sumiyoshi, T, Tomoike, H, Christov, G, Saundankar, J, Perdreau, E, Mukasa, T, Shah, V, Klein, N, Brogan, P, Marek, J, Batalli, A, Ibrahimi, P, Ahmeti, A, Haliti, E, Bytyci, I, Poniku, A, Henein, MY, Bajraktari, G, Luo, XX, Fang, F, Gan, SF, Ma, Z, Yu, CM, Gonella, A, Conte, E, Morena, L, Riva, L, Civelli, D, Losardo, L, Canepari, ME, Castellino, C, Grasso, M, Margaria, F, Massoure, P L, Camus, O, Gabaudan, C, Desmots, F, Fourcade, L, Jacquier, A, Divchev, D, Weippert, M, Schmidt, P, Gettel, H, Neugebauer, A, Behrens, K, Braumann, K-M, Wolfarth, B, Nienaber, CA, Rodriguez Gonzalez, E, Monivas Palomero, V, Mingo Santos, S, Restrepo Cordoba, MA, Goirigolzarri Artaza, J, Gomez Bueno, M, Garcia Izquierdo, E, Serrano Fiz, S, Gonzalez Roman, A, Segovia Cubero, J, Pila-On, SASTRA, Atmadikoesoemah, C, Soesanto, A, Andriantoro, H, Kowallick, J T, Morton, G, Lamata, P, Jogiya, R, Kutty, S, Lotz, J, Hasenfuss, G, Nagel, E, Chiribiri, A, Schuster, A, Jung, IH, Moon, JG, Byun, YS, Kim, TH, Park, SH, Seo, HS, Wellnhofer, E, Kriatselis, C, Gerds-Li, JH, Kropf, M, Pieske, B, Graefe, M, Eldeep, M, Marghany, K, Mokarrab, M, Albaz, M, Marcos-Alberca Moreno, P, Perez-Isla, L, Palacios, J, Gomez De Diego, JJ, De Agustin, JA, Luaces, M, Mahia, P, Arrazola, J, Garcia-Fernandez, MA, Macaya, C, Attenhofer Jost, C H, Mueller, P, Naegeli, B, Levis, P, Amann, FW, Seifert, B, Maurer, D, Bertel, O, Caspar, T, Samet, H, Jesel, L, Petit-Eisenmann, H, Trinh, A, Talha, S, Morel, O, Ohlmann, P, Leao, S, Cordeiro, F, Magalhaes, P, Moz, M, Trigo, J, Mateus, P, Fontes, P, Moreira, I, Sharif, D, Matanis, W, Sharif-Rasslan, A, Sharif, Y, Rosenschein, U, Faustino, M, Bravo Baptista, S, Freitas, A, Bicho Augusto, J, Leal, P, Nedio, M, Antunes, C, Farto E Abreu, P, Gil, V, Morais, C, Nguyen, VT, Cimadevilla, C, Arangalage, D, Dehoux, M, Dreyfus, J, Codogno, I, Duval, X, Huart, V, Vahanian, A, Messika-Zeitoun, D, Cakmak, HA, Aslan, S, Erturk, M, Ornek, V, Tosu, AR, Kalkan, AK, Ozturk, D, Tasbulak, O, Avci, Y, Gul, M, Cioffi, G, Mazzone, C, Di Nora, C, Barbati, G, Ognibene, F, Nistri, S, Tarantini, L, Pulignano, G, Di Lenarda, A, Faggiano, P, Nishimura, S, Izumi, C, Amano, M, Miyake, M, Tamura, T, Kondo, H, Kaitani, K, Nakagawa, Y, Rosa, I, Ancona, F, Stella, S, Marini, C, Spartera, M, Barletta, M, Pavon, AG, Margonato, A, Agricola, E, Arangalage, D, Nguyen, V, Robert, T, Melissopoulou, M, Mathieu, T, Codogno, I, Cimadevilla, C, Dehoux, M, Vahanian, A, Messika-Zeitoun, D, Rahman, MT, Zito, C, Longobardo, L, Cusma Piccione, M, Zucco, M, D'angelo, M, Rivetti, L, Carerj, ML, Boretti, I, Calabro, MP, Carerj, S, Lozano Granero, VC, Rodriguez Munoz, D, Carbonell San Roman, A, Moya Mur, JL, Hinojar, R, Gonzalez, A, Casas, E, Jimenez Nacher, JJ, Fernandez-Golfin, C, Zamorano Gomez, JL, Gripari, P, Tamborini, G, Muratori, M, Ghulam Ali, S, Fusini, L, Alamanni, F, Pepi, M, Keramida, K, Bellamy, M, Dawson, D, Nihoyannopoulos, P, Solowjowa, N, Musayeva, L, Hrytsyna, Y, Knosalla, CH, Falk, V, Muraru, D, Maddalozzo, A, Jenei, C, Dequal, D, Veronesi, F, Aruta, P, Romeo, G, Iliceto, S, Badano, L, Gursoy, MO, Kalcik, M, Ozkan, M, Astarcioglu, MA, Gokdeniz, T, Yesin, M, Karakoyun, S, Gunduz, S, Tuncer, MA, Koksal, C, Cresti, A, Chiavarelli, M, Guerrini, F, D'aiello, N, Albano, A, De Sensi, F, Picchi, A, Cesareo, F, Severi, S, Braga, M, Nascimento, H, Flores, L, Ribeiro, V, Melao, F, Dias, P, Maciel, MJ, Bettencourt, P, Ferreiro Quero, C, Delgado Ortega, M, Puentes Chiachio, M, Mesa Rubio, M D, Ruiz Ortiz, M, Duran Jimenez, E, Sanchez Fernandez, J, Morenate Navio, C, Pan, M, Suarez De Lezo, J, Jansen, R, Agostoni, P, Stella, PR, Nijhoff, F, Ramjankhan, FZ, Suyker, WJ, Chamuleau, SAJ, Scislo, P, Huczek, Z, Kochman, J, Rymuza, B, Kochanowski, J, Scisbisz, A, Piatkowski, R, Opolski, G, Ray, R, Knott, K, Smith, D, Rodriguez, A, Finocchiaro, G, Sharma, R, Veiga, C, Calvo Iglesias, F, Paredes-Galan, E, Pazos, Pablo, Romo, Andres Iniguez, Ageing, Disease, Cardiovascular, Krejci, J, Hude, P, Ozabalova, E, Zampachova, V, Mlejnek, D, Sochorova, D, Spinarova, L, Wess, G, Klueser, L, Holler, PJ, Simak, J, Kuechenhoff, H, Vago, H, Czimbalmos, CS, Toth, A, Csecs, I, Kecskes, K, Suhai, F, Kiss, O, Simor, T, Becker, D, Merkely, B, Hinojar, R, Fernandez-Golfin, C, Portugal, JC, Esteban, A, Megias, A, Ruiz Leria, S, Rincon, LM, Jimenez-Nacher, JJ, Zamorano, JL, Dejgaard, LA, Haland, T, Lie, OH, Massey, R, Edvardsen, T, Haugaa, KH, Pavlyukova, EN, Evtushenko, VA, Smushlyaev, KA, Karpov, RS, Zaroui, A, Asmi, MONIA, Ben Said, RYM, Zidi, WIEM, Wali, SANA, Feki, M, Mourali, MS, Kaabachi, NEZIHZ, Mechmeche, RACHID, Labarre, Q, Garcia, R, Degand, B, Christiaens, L, Coisne, D, Csecs, I, Czimbalmos, CS, Toth, A, Suhai, F I, Pozsonyi, Z, Becker, D, Simor, T, Merkely, B, Vago, H, Maceira Gonzalez, A M, Tuset, L, Ripoll, C, Cosin-Sales, J, Igual, B, Salazar, J, Belloch, V, Coisne, D, Viera, F, Labarre, Q, Garcia, R, Degand, B, Christiaens, L, Rodriguez Gonzalez, E, Monivas Palomero, V, Mingo Santos, S, Restrepo Cordoba, MA, Goirigolzarri Artaza, J, Gomez Bueno, M, Serrano Fiz, S, Gonzalez Roman, A, Garcia Izquierdo Jaen, E, Segovia Cubero, J, Rojek, A, Chrostowska, M, Dudziak, M, Narkiewicz, K, Grapsa, J, Tan, TC, Dawson, D, Nihoyannopoulos, P, Methia, N, Cioffi, G, Viapiana, O, Ognibeni, F, Dalbeni, A, Gatti, D, Di Nora, C, Mazzone, C, Faganello, G, Di Lenarda, A, Rossini, M, Styczynski, G, Milewska, A, Marczewska, M, Sobieraj, P, Sobczynska, M, Dabrowski, M, Kuch-Wocial, A, Szmigielski, C A, Czimbalmos, C, Vago, H, Csecs, I, Toth, A, Suhai, F I, Kiss, O, Sydo, N, Becker, D, Simor, T, Merkely, B, Konopka, M, Burkhard-Jagodzinska, K, Krol, W, Jakubiak, A, Aniol-Strzyzewska, K, Sitkowski, D, Dluzniewski, M, Braksator, W, Sturmberger, T, Eder, V, Ebner, C, Winter, S, Martinek, M, Puererfellner, H, Aichinger, J, Sormani, P, Rusconi, C, Zancanella, M, Peritore, A, De Chiara, B, Spano’, F, Vallerio, P, Cairoli, R, Giannattasio, C, Moreo, A, Siliste, RN, Chitroceanu, A, Ianula, R, Spataru, D, Isacoff, D, Rodrigues, AC, Monaco, C, Guimaraes, L, Cordovil, R, Piveta, R, Franca, L, Fischer, CH, Vieira, M, Lira, E, Morhy, S, Antonielli, E, Pizzuti, A, Dogliani, S, Mabritto, B, Bassignana, A, Pancaldo, D, Doronzo, B, Evdoridis, C, Papasaikas, D, Sergi, E, Papadimitriou, D, Tolios, P, Papagiannis, G, Tzamou, V, Trikas, A, Scali, MC, Bombardini, T, Picano, E, Scali, MC, Bombardini, T, Salvadori, S, Costantino, MF, Picano, E, Scali, MC, Bombardini, T, Salvadori, S, Picano, E, Generati, G, Bandera, F, Pellegrino, M, Labate, V, Carbone, F, Alfonzetti, E, Guazzi, M, Rivetti, L, Cusma Piccione, M, Zito, C, D'angelo, M, Manganaro, R, Pizzino, F, Terrizzi, A, Quattrocchi, S, Ioppolo, A, Carerj, S, Giga, V, Boskovic, N, Stepanovic, J, Beleslin, B, Nedeljkovic, I, Dobric, M, Djordjevic-Dikic, A, Popovic, D, Petrovic, I, Banovic, M, Lasica, R, Pesic, V, Plecas - Solarovic, B, Vidojevic, D, Djordjevic, T, Orovic, M, Vujisic - Tesic, B, Bordonaro, V, Buccheri, S, Bottari, VE, Romano, C, Atanasio, FA, Tamburino, C, Monte, I P, Korchi, F, Kassongo, A, Meimoun, P, De Zuttere, D, Lardoux, HERVE, Zoppellaro, G, Venneri, L, Khattar, RS, Li, W, Senior, R, Casanova Rodriguez, C, Cano Carrizal, R, Cadenas Chamorro, R, Iglesias Del Valle, D, Prieto Moriche, E, Garcia Garcia, A, Martin Penato Molina, A, De Juan Baguda, J, Paredes Gonzalez, B, Plaza Perez, I, Sreekumar, P, Manjunath, CN, Ravindranath, KS, Dhanalakshmi, CD, Ranjbar, S, Karvandi, M, Ranjbar, F, Ghaffaripour Jahromi, M, Hassantash, SA, Foroughi, M, Maurea, N, Coppola, C, Piscopo, G, Galletta, F, Maurea, C, Esposito, E, Barbieri, A, Riccio, G, De Laurentiis, M, De Lorenzo, C, Strachinaru, M, De Jong, N, Geleijnse, ML, Van Dalen, BM, Vos, HJ, Keramida, K, Kouris, N, Dawson, D, Olympios, CD, Nihoyannopoulos, P, Rodriguez Munoz, D, Carbonell San Roman, A, Lozano Granero, C, Moya Mur, JL, Fernandez-Golfin, C, Moreno Planas, J, Casas Rojo, E, Fernandez Santos, S, Hernandez-Madrid, A, Zamorano Gomez, JL, D'auria, F, Leone, R, Itri, F, Del Negro, G, Colombino, M, Masiello, P, Longobardi, A, Rosapepe, F, Iesu, S, Di Benedetto, G, Capotosto, L, D'orazio, S, Ashurov, R, Continanza, G, Mangieri, E, Terzano, C, Vitarelli, A, Seo, J, Cho, IJ, Chang, HJ, Hong, GR, Ha, JW, Chung, NS, Shim, CY, Bianco, F, Cicchitti, V, Radico, F, Conti, M, Bucciarelli, V, Marchetti, M, Tonti, G, De Caterina, R, Di Girolamo, E, Gallina, S, Plokhova, EV, Akasheva, D, Tkacheva, O, Strazhesko, I, Dudinskaya, E, Pokshubina, I, Pykhtina, V, Kruglikova, A, Brailova, N, Boytsov, S, Weng, K-P, Lin, CC, Wahba Hassanein, M, Ashour, Z A, Bakhoum, S W G, Abdel Wahab, A M A, Hussein, EKHLAS, Saad, ZIZI, Malik, RAUOOF, Almasswary, ADEL, Elrawy, M, Lo Iudice, F, Lembo, M, Muscariello, R, Carlomagno, F, Pivonello, R, Colao, A, Trimarco, B, Galderisi, M, Purwowiyoto, S L, Santoso, A, Soesanto, A M, Indonesia), PERKI (Perhimpunan Dokter Spesialis Kardiovaskular, Segura De La Cal, T, Moya Mur, JL, Garcia Martin, A, Carbonell, S, Fraile Sanz, C, Rincon, LM, Rodriguez Munoz, DA, Jimenez Nacher, JJ, Fernandez-Golfin, C, Zamorano, JL, Ongun, A, Habibova, U, Gerede, DM, Dincer, I, Kilickap, M, Erol, C, Nouhravesh, N, Andersen, HU, Jensen, JS, Rossing, P, Jensen, MT, Gasior, Z, Dabek, J, Balys, M, Glogowska-Rygus, J, and Pysz, P

Abstract

Purpose: Epicardial adipose tissue (EAT) thickness, measured by echocardiography, is associated to the presence of coronary artery disease (CAD) and severe aortic stenosis (AS). EAT thickness is commonly referred as the diameter of the echo-free space between the right ventricular wall and the visceral layer of the pericardium in parasternal long axis view, using the aortic annulus as an anatomic landmark (EAT-1). We aimed to demonstrate that the direct measurement of the adipose tissue thickness visualized in the space between the ascending aorta and the right ventricle (EAT-2) might be considered an alternative method. Methods: We measured EAT-1 and EAT-2 in 130 pts with severe cardiac disease referred for cardiac surgery: 53 pts with isolated AS, 49 pts with severe CAD, and 28 pts with both severe AS and CAD (AS+CAD); and in 50 control subjects matched for age, sex and BMI. The two measurements were obtained at end-systole in 3 cardiac cycles (figure). Results. Both EAT-1 and EAT-2 measurements had an excellent reproducibility. With respect to controls pts had significantly increased EAT-1 (2,4 ± 0,5mm vs 6 ± 2mm; p<0,05) and EAT-2 (3 ± 1,2mm vs 12 ± 3mm; p<0,05). EAT-1 and EAT-2 were not statistically different in controls. EAT-2 was significantly higher than EAT-1 in CAD, AS, and AS+CAD pts (p<0,05). Interestingly, EAT-2, but not EAT-1, was significantly increased in AS+CAD pts with respect to EAT-2 of pts with isolated AS and isolated CAD. Conclusions: Our data demonstrate that EAT-2, as well as EAT-1, is a valuable method to measure EAT thickness. Further, EAT-2 seems to better recognize EAT increase, in pts with AS+CAD. Comprehensively, EAT-2 is greater than EAT-1. The larger space between ascending aorta and right ventricle, allowing EAT expansion, could justify our observation.

Published
2015
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9. Poster session 6: Saturday 6 December 2014, 08:30-12:30 * Location: Poster area

Author

Goirigolzarri Artaza, J, Gallego Delgado, M, Jaimes Castellanos, CP, Cavero Gibanel, MA, Pastrana Ledesma, MA, Alonso Pulpon, LA, Gonzalez Mirelis, J, Al Ansi, R Z, Sokolovic, S, Cerin, G, Szychta, W, Popa, B A, Botezatu, D, Benea, D, Manganiello, S, Corlan, A, Jabour, A, Igual Munoz, B, Osaca Asensi, JOA, Andres La Huerta, AALH, Maceira Gonzalez, AMG, Estornell Erill, JEE, Cano Perez, OCP, Sancho-Tello, MJSTDC, Alonso Fernandez, PAF, Sepulveda Sanchez, PSS, Montero Argudo, AMA, Palombo, C, Morizzo, C, Baluci, M, Kozakova, M, Panajotu, A, Karady, J, Szeplaki, G, Horvath, T, Tarnoki, DL, Jermendy, AL, Geller, L, Merkely, B, Maurovich-Horvat, P, Group, MTA-SE "Lendület" Cardiovascular Imaging Research, Moustafa, S, Mookadam, F, Youssef, M, Zuhairy, H, Connelly, M, Prieur, T, Alvarez, N, Ashikhmin, Y, Drapkina, O, Boutsikou, M, Demerouti, E, Leontiadis, E, Petrou, E, Karatasakis, G, Kozakova, M, Morizzo, C, Bianchi, V, Marchi, B, Federico, G, Palombo, C, Chatzistamatiou, E, Moustakas, G, Memo, G, Konstantinidis, D, Mpampatzeva Vagena, I, Manakos, K, Traxanas, K, Vergi, N, Feretou, A, Kallikazaros, I, Goto, M, Uejima, T, Itatani, K, Pedrizzetti, G, Mada, RO, Daraban, AM, Duchenne, J, Voigt, JU, Chiu, D Y Y, Green, D, Johnstone, L, Sinha, S, Kalra, PA, Abidin, N, Group, Salford Vascular Research, Sikora-Frac, M, Zaborska, B, Maciejewski, P, Bednarz, B, Budaj, A, Nemes, A, Sasi, V, Gavaller, H, Kalapos, A, Domsik, P, Katona, A, Szucsborus, T, Ungi, T, Forster, T, Ungi, I, Pluchinotta, FR, Arcidiacono, C, Saracino, A, Carminati, M, Bussadori, C, Dahlslett, T, Karlsen, S, Grenne, B, Sjoli, B, Bendz, B, Skulstad, H, Smiseth, OA, Edvardsen, T, Brunvand, H, Vereckei, A, Szelenyi, ZS, Szenasi, G, Santoro, C, Galderisi, M, Niglio, T, Santoro, M, Stabile, E, Rapacciuolo, A, Spinelli, L, De Simone, G, Esposito, G, Trimarco, B, Hubert, S, Jacquier, A, Fromonot, J, Resseguier, C, Tessier, A, Guieu, R, Renard, S, Haentjiens, J, Lavoute, C, Habib, G, Menting, M E, Koopman, LP, Mcghie, JS, Rebel, B, Gnanam, D, Helbing, WA, Van Den Bosch, AE, Roos-Hesselink, JW, Shiino, K, Yamada, A, Sugimoto, K, Takada, K, Takakuwa, Y, Miyagi, M, Iwase, M, Ozaki, Y, Placido, R, Ramalho, A, Nobre E Menezes, M, Cortez-Dias, N, Goncalves, S, Guimaraes, T, Robalo Martins, S, Francisco, AR, Almeida, AG, Nunes Diogo, A, Hayashi, T, Itatani, K, Inuzuka, R, Shindo, T, Hirata, Y, Shimizu, N, Miyaji, K, Henri, C, Dulgheru, R, Magne, J, Kou, S, Davin, L, Nchimi, A, Oury, C, Pierard, L, Lancellotti, P, Kovalyova, O, Honchar, O, Tengku, WINDA, Ketaren, ANDRE, Mingo Santos, S, Monivas Palomero, V, Restrepo Cordoba, A, Rodriguez Gonzalez, E, Goirigolzarri Artaza, J, Sayago Silva, I, Garcia Lunar, I, Mitroi, C, Cavero Gibanel, M, Segovia Cubero, J, Ryu, SK, Park, JY, Kim, SH, Choi, JW, Goh, CW, Byun, YS, Choi, JH, Westholm, C, Johnson, J, Jernberg, T, Winter, R, Rio, P, Moura Branco, L, Galrinho, A, Pinto Teixeira, P, Viveiros Monteiro, A, Portugal, G, Pereira-Da-Silva, T, Afonso Nogueira, M, Abreu, J, Cruz Ferreira, R, Mazzone, A, Botto, N, Paradossi, U, Chabane, A, Francini, M, Cerone, E, Baroni, M, Maffei, S, Berti, S, Tatu-Chitoiu, G P, Deleanu, D, Macarie, C, Chioncel, O, Dorobantu, M, Udroiu, C, Calmac, L, Diaconeasa, A, Vintila, V, Vinereanu, D, investigators, RO-STEMI, Ghattas, A, Shantsila, E, Griffiths, H, Lip, GY, Galli, E, Guirette, Y, Daudin, M, Auffret, V, Mabo, P, Donal, E, Fabiani, I, Conte, L, Scatena, C, Barletta, V, Pratali, S, De Martino, A, Bortolotti, U, Naccarato, AG, Di Bello, V, Falanga, G, Alati, E, Di Giannuario, G, Zito, C, Cusma' Piccione, M, Carerj, S, Oreto, G, Dattilo, G, Alfieri, O, La Canna, G, Generati, G, Bandera, F, Pellegrino, M, Alfonzetti, E, Labate, V, Guazzi, M, Cho, EJ, Park, S-J, Lim, HJ, Yoon, HR, Chang, S-A, Lee, S-C, Park, SW, Cengiz, B, Sahin, S T, Yurdakul, S, Kahraman, S, Bozkurt, A, Aytekin, S, Borges, I P, Peixoto, ECS, Peixoto, RTS, Peixoto, RTS, Marcolla, VF, Venkateshvaran, A, Sola, S, Dash, P K, Thapa, P, Manouras, A, Winter, R, Brodin, LA, Govind, S C, Mizariene, V, Verseckaite, R, Bieseviciene, M, Karaliute, R, Jonkaitiene, R, Vaskelyte, J, Arzanauskiene, R, Janenaite, J, Jurkevicius, R, Rosner, S, Orban, M, Nadjiri, J, Lesevic, H, Hadamitzky, M, Sonne, C, Manganaro, R, Carerj, S, Cusma-Piccione, MC, Caprino, A, Boretti, I, Todaro, MC, Falanga, G, Oreto, L, D'angelo, MC, Zito, C, Le Tourneau, T, Cueff, C, Richardson, M, Hossein-Foucher, C, Fayad, G, Roussel, JC, Trochu, JN, Vincentelli, A, Obase, K, Weinert, L, Lang, R, Cavalli, G, Muraru, D, Miglioranza, MH, Addetia, K, Veronesi, F, Cucchini, U, Mihaila, S, Tadic, M, Lang, RM, Badano, L, Polizzi, V, Pino, PG, Luzi, G, Bellavia, D, Fiorilli, R, Chialastri, C, Madeo, A, Malouf, J, Buffa, V, Musumeci, F, Gripari, P, Tamborini, G, Bottari, V, Maffessanti, F, Carminati, C, Muratori, M, Vignati, C, Bartorelli, A, Alamanni, F, Pepi, M, Polymeros, S, Dimopoulos, A, Spargias, K, Karatasakis, G, Athanasopoulos, G, Pavlides, G, Dagres, N, Vavouranakis, E, Stefanadis, C, Cokkinos, DV, Pradel, S, Mohty, D, Magne, J, Darodes, N, Lavergne, D, Damy, T, Beaufort, C, Aboyans, V, Jaccard, A, Mzoughi, K, Zairi, I, Jabeur, M, Ben Moussa, F, Ben Chaabene, A, Kamoun, S, Mrabet, K, Fennira, S, Zargouni, A, Kraiem, S, Jovanova, S, Arnaudova-Dezjulovic, F, Correia, C E, Cruz, I, Marques, N, Fernandes, M, Bento, D, Moreira, D, Lopes, L, Azevedo, O, GROUP, SUNSHINE, Keramida, K, Kouris, N, Kostopoulos, V, Psarrou, G, Giannaris, V, Olympios, CD, Marketou, M, Parthenakis, F, Kalyva, N, Pontikoglou, CH, Maragkoudakis, S, Zacharis, E, Patrianakos, A, Roufas, K, Papadaki, H, Vardas, P, Dominguez Rodriguez, F, Monivas Palomero, V, Mingo Santos, S, Arribas Rivero, B, Cuenca Parra, S, Zegri Reiriz, I, Vazquez Lopez-Ibor, J, Garcia-Pavia, P, Szulik, M, Streb, W, Wozniak, A, Lenarczyk, R, Sliwinska, A, Kalarus, Z, Kukulski, T, Nemes, A, Domsik, P, Kalapos, A, Forster, T, Serra, W, Lumetti, FL, Mozzani, FM, Del Sante, GDS, Ariani, AA, Corros, C, Colunga, S, Garcia-Campos, A, Diaz, E, Martin, M, Rodriguez-Suarez, ML, Leon, V, Fidalgo, A, Moris, C, De La Hera, JM, Kylmala, M M, Rosengard-Barlund, M, Groop, P H, Lommi, J, Bruin De- Bon, HACM, Bilt Van Der, IA, Wilde, AA, Brink Van Den, RBA, Teske, AJ, Rinkel, GJ, Bouma, BJ, Teixeira, R, Monteiro, R, Garcia, J, Silva, A, Graca, M, Baptista, R, Ribeiro, M, Cardim, N, Goncalves, L, Duszanska, A, Skoczylas, I, Kukulski, T, Polonski, L, Kalarus, Z, Choi, J-H, Park, JS, Ahn, JH, Lee, JW, Ryu, SK, Ahn, J, Kim, DH, Lee, HO, Przewlocka-Kosmala, M, Mlynarczyk, J, Rojek, A, Mysiak, A, Kosmala, W, Pellissier, A, Larochelle, E, Krsticevic, L, Baron, E, Le, V, Roy, A, Deragon, A, Cote, M, Garcia, D, Tournoux, F, Yiangou, K, Azina, C, Yiangou, A, Zitti, M, Ioannides, M, Ricci, F, Dipace, G, Aquilani, R, Radico, F, Cicchitti, V, Bianco, F, Miniero, E, Petrini, F, De Caterina, R, Gallina, S, Jardim Prista Monteiro, R, Teixeira, R, Garcia, J, Baptista, R, Ribeiro, M, Cardim, N, Goncalves, L, Chung, H, Kim, JY, Joung, B, Uhm, JS, Pak, HN, Lee, MH, Lee, KY, Ragab, AM, Abdelwahab, AMIR, Yazeed, YASER, El Naggar, WAEL, Spahiu, K, Spahiu, E, Doko, A, Liesting, C, Brugts, JJ, Kofflard, MJM, Kitzen, JJEM, Boersma, E, Levin, M-D, Coppola, C, Piscopo, G, Rea, D, Maurea, C, Caronna, A, Capasso, I, Maurea, N, Azevedo, O, Tadeu, I, Lourenco, M, Portugues, J, Pereira, V, Lourenco, A, Nesukay, E, Kovalenko, V, Cherniuk, S, Danylenko, O, Muhammedov, MB, Ahmedova, DM, Hojakuliyev, BG, Atayeva, D, Nemes, A, Domsik, P, Kalapos, A, Lengyel, C, Varkonyi, TT, Orosz, A, Forster, T, Castro, M, Abecasis, J, Dores, H, Madeira, S, Horta, E, Ribeiras, R, Canada, M, Andrade, MJ, Mendes, M, Morosin, M, Piazza, R, Leonelli, V, Leiballi, E, Pecoraro, R, Cinello, M, Dell' Angela, L, Cassin, M, Sinagra, G, Nicolosi, GL, Wierzbowska-Drabik, K, Hamala, P, Kasprzak, JD, O'driscoll, J, Rossato, C, Gargallo-Fernandez, P, Araco, M, Sharma, S, Sharma, R, Jakus, N, Baricevic, Z, Ljubas Macek, J, Skoric, B, Skorak, I, Velagic, V, Separovic Hanzevacki, J, Milicic, D, Cikes, M, Deljanin Ilic, M, Ilic, S, Kocic, G, Pavlovic, R, Stoickov, V, Ilic, V, Nikolic, LJ, Generati, G, Bandera, F, Pellegrino, M, Alfonzetti, E, Labate, V, Guazzi, M, Labate, V, Bandera, F, Generati, G, Pellegrino, M, Donghi, V, Alfonzetti, E, Guazzi, M, Zakarkaite, D, Kramena, R, Aidietiene, S, Janusauskas, V, Rucinskas, K, Samalavicius, R, Norkiene, I, Speciali, G, Aidietis, A, Kemaloglu Oz, T, Ozpamuk Karadeniz, F, Akyuz, S, Unal Dayi, S, Esen Zencirci, A, Atasoy, I, Osken, A, Eren, M, Fazendas, P R, Caldeira, D, Stuart, B, Cruz, I, Rocha Lopes, L, Almeida, A R, Sousa, P, Joao, I, Cotrim, C, Pereira, H, Fazendas, P R, Caldeira, D, Stuart, B, Cruz, I, Rocha Lopes, L, Almeida, A R, Joao, I, Cotrim, C, Pereira, H, Sinem Cakal, SC, Elif Eroglu, EE, Baydar, O, Beytullah Cakal, BC, Mehmet Vefik Yazicioglu, MVY, Mustafa Bulut, MB, Cihan Dundar, CD, Kursat Tigen, KT, Birol Ozkan, BO, Ali Metin Esen, A, Yagasaki, H, Kawasaki, M, Tanaka, R, Minatoguchi, S, Houle, H, Warita, S, Ono, K, Noda, T, Watanabe, S, Minatoguchi, S, Cho, E J, Park, S J, Lim, H J, Chang, S A, Lee, S C, Park, S W, Cho, E J, Park, S J, Lim, H J, Chang, S A, Lee, S C, Park, S W, Mornos, C, Cozma, D, Ionac, A, Mornos, A, Popescu, I, Ionescu, G, Pescariu, S, Melzer, L, Faeh-Gunz, A, Seifert, B, Attenhofer Jost, C H, Storve, S, Haugen, BO, Dalen, H, Grue, JF, Samstad, S, Torp, H, Ferrarotti, L, Maggi, E, Piccinino, C, Sola, D, Pastore, F, Marino, PN, Ranjbar, S, Karvandi, M, Hassantash, SA, Karvandi, M, Ranjbar, S, Tierens, S, Remory, I, Bala, G, Gillis, K, Hernot, S, Droogmans, S, Cosyns, B, Lahoutte, T, Tran, N, Poelaert, J, Al-Mallah, M, Alsaileek, A, Nour, K, Celeng, CS, Horvath, T, Kolossvary, M, Karolyi, M, Panajotu, A, Kitslaar, P, Merkely, B, Maurovich Horvat, P, Group, MTA-SE "Lendület" Cardiovascular Imaging Research, Aguiar Rosa, S, Ramos, R, Marques, H, Portugal, G, Pereira Da Silva, T, Rio, P, Afonso Nogueira, M, Viveiros Monteiro, A, Figueiredo, L, and Cruz Ferreira, R

Abstract

Introduction: The increase of left auricular volume (LAV) is a robust cardiovascular event predictor. Despite that echochardiography is more often used, cardiac MRI is considered more accurate. Our objetives are to validate "fast" LAV measures by MRI vs the considered gold standard (GS) and to compare Echo and MRI in a wide spectrum of patients. Methods: In a non-selected popullation with MRI study previously realized, we measured LAV by biplane method (BPMR) and by area-length in 4 chamber view (ALMR) and compared them with biplane (BPe) and discs method (MDDe) in 4 chamber view in echo. To validate MRI measurements, we measured LAV in short axis slices (Simpson Method, SM) in a group of patients and considered it the GS. Results: 186 patients were included (mean age 51 ± 17 age; 123 male; 14 in AF) with clinical indication of cardiac MRI (Philips 1,5 T). In 24 patients SM was calculated. 29% of cardiac MRI were considered normal. Mean underlying pathologies were myocardiopathy (27%), Ischemic myocardiopathy (17%), myopericarditis (10%), prior to AF ablation (4%), valvular disease (6%) and miscellaneous (7%). Excellent correlation was obtained between "fast" MRI measurements and SM in MRI (SM vs BPMR interclass correlation coefficient ICC=0.965 and SM vs ALMR, ICC=0.958; P<0.05) with low interobserver variability (ICC=0.983 for SM; ICC=0.949 for BPMR; ICC=0.931 for ALMR). "Fast" measurements by MRI showed stadistical correlation between them (CCI=0.910) (Figure). Correlation between Echo and MRI measures was only moderate. (BPRM vs BPe CCI=0,469 mean difference -30 ml; ALMR vs MDDe ICC=0,456 mean difference -24 mL). Conclusions: ‘fast’ LAV measures by MRI are comparable with the MRI GS and also between them. Echo values seem to underestimate compared to MRI, so its use may not be suitable.

Published
2014
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10. Author's reply: To PMID 23171851.

Author

Bikdeli B, Hassantash SA, and Kalantarian S

Subjects
Female, Humans, Male, Atherosclerosis pathology, Coronary Artery Bypass, Plaque, Atherosclerotic pathology, Postoperative Complications pathology, Saphenous Vein pathology
Published
2013
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11. Histopathologic insight into saphenous vein bypass graft disease.

Author

Bikdeli B, Hassantash SA, Pourabdollah M, Kalantarian S, Sadeghian M, Afshar H, Sabeti S, Marzban M, Ahmadi H, and Mohammadi F

Subjects
Female, Humans, Male, Middle Aged, Prospective Studies, Reoperation, Saphenous Vein transplantation, Transplants, Atherosclerosis pathology, Coronary Artery Bypass, Plaque, Atherosclerotic pathology, Postoperative Complications pathology, Saphenous Vein pathology
Abstract

Objectives: Vein graft disease is a major drawback of coronary artery bypass grafting. However, histopathologic studies of old human aortocoronary grafts are scarce., Methods: We screened patients undergoing redo coronary artery bypass grafting at three university hospitals and selected those with at least one excisable old vein graft. Native non-grafted saphenous veins were also obtained as controls. Clinical and angiographic data were separately documented., Results: We evaluated 117 segments from 29 veins. All but 4 old graft segments showed degrees of luminal narrowing and fibrointimal proliferation. Moreover, 61 segments demonstrated atherosclerotic plaques. Such plaques were typically concentric and, compared with other segments, more frequently represented necrosis, calcification and giant cells (p < 0.001 for all comparisons) and had a higher inflammatory cell count, predominantly of lymphocytic origin. Native saphenous veins frequently showed fibrosis, but no calcification or active inflammation. Angiographic findings showed moderate correlation with the histological degree of luminal stenosis (Spearman's ρ = 0.564, p < 0.001)., Conclusions: Human vein graft atherosclerosis and arterial atherosclerosis share many features; however, we found lymphocytes to be the dominant inflammatory cells within plaques. Conventional angiography underestimated the atherosclerosis burden in vein grafts. Improved understanding of disease pathophysiology could lead to the development of novel interventions that reduce costly and suboptimal repeat revascularizations., (Copyright © 2012 S. Karger AG, Basel.)

Published
2012
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13. Prolonged QT interval and coronary artery bypass mortality due to heart failure.

Author

Foroughi M, Karkhaneh Yousefi Z, Majidi Tehrani M, Noori Foroutaghe A, Ghanavati A, and Hassantash SA

Subjects
Aged, Arrhythmias, Cardiac complications, Arrhythmias, Cardiac diagnosis, Arrhythmias, Cardiac physiopathology, Cardiac Output, Low etiology, Cardiac Output, Low physiopathology, Coronary Artery Bypass adverse effects, Coronary Artery Disease complications, Coronary Artery Disease physiopathology, Electrocardiography, Female, Heart Failure etiology, Heart Failure physiopathology, Humans, Logistic Models, Male, Middle Aged, Predictive Value of Tests, Retrospective Studies, Risk Assessment, Risk Factors, Arrhythmias, Cardiac mortality, Cardiac Output, Low mortality, Coronary Artery Bypass mortality, Coronary Artery Disease mortality, Coronary Artery Disease surgery, Heart Conduction System physiopathology, Heart Failure mortality
Abstract

QT-interval prolongation has been shown to predict mortality in coronary artery disease and heart failure. To assess the prognostic value of QT interval for death due to low cardiac output after coronary artery bypass grafting, the QT interval was measured in 3 consecutive beats on the preoperative electrocardiogram (leads II and V(4)) in 30 patients who died perioperatively due to heart failure and a control group of 168 randomly matched hospital survivors during the same 3-year period. Mean corrected QT interval was significantly longer in the patients who died compared to the control group (480.7 +/- 96.2 vs. 425.4 +/- 21 ms). Among the variables evaluated, QT prolongation was the only independent predictor of perioperative death. In patients admitted for coronary artery bypass grafting, QT interval measurement is a simple clinical tool that may identify patients with a greater probability of a troublesome operative course.

Published
2009
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14. Unusual ethiologies of severe acute mitral regurgitation not requiring surgery.

Author

Foroughi M, Hassantash SA, Saadat H, and Ghanavaty A

Subjects
Adrenergic beta-Antagonists therapeutic use, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Drug Therapy, Combination, Emergencies, Female, Humans, Middle Aged, Stress, Psychological complications, Mitral Valve Insufficiency etiology, Takotsubo Cardiomyopathy complications
Published
2008
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16. Pathophysiology of aortocoronary saphenous vein bypass graft disease.

Author

Hassantash SA, Bikdeli B, Kalantarian S, Sadeghian M, and Afshar H

Subjects
Graft Occlusion, Vascular pathology, Humans, Saphenous Vein transplantation, Coronary Artery Bypass methods, Coronary Disease surgery, Graft Occlusion, Vascular physiopathology, Saphenous Vein pathology
Abstract

Aortocoronary saphenous vein bypass grafting relieves anginal pain in patients with coronary artery disease. However, its effectiveness is limited due to graft failure; the 10-year patency rate is 50%-60%. Early, 1-year and late graft failure may be due to thrombosis, fibrointimal hyperplasia and atherosclerosis, respectively. There is general agreement that vein graft atherosclerosis differs from arterial lesions in terms of temporal and histological changes. Vein graft atherosclerosis is more rapid, with diffuse concentric changes and a less noticeable fibrous cap, making venous plaques more vulnerable to rupture and subsequent thrombus formation. Despite progress in understanding the pathophysiology, some aspects of vein graft atherosclerosis need to be clarified. This review focuses on the pathophysiologic aspects of this widespread, costly and disabling disease, with emphasis on late graft occlusion and distinctions between arterial and venous atherosclerosis in terms of histology, pathophysiology and risk factors.

Published
2008
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18. Pharmacological prevention of the deleterious effects of cardiopulmonary bypass.

Author

Hassantash SA, Omrani GR, Givtaj N, and Afrakhteh M

Subjects
Anti-Inflammatory Agents, Non-Steroidal pharmacology, Blood Coagulation drug effects, C-Reactive Protein metabolism, Coagulants pharmacology, Complement C3 metabolism, Complement C4 metabolism, Double-Blind Method, Female, Humans, Immunoglobulins metabolism, Indomethacin pharmacology, Inflammation etiology, Inflammation metabolism, Ketoconazole pharmacology, Male, Middle Aged, Postoperative Hemorrhage blood, Postoperative Hemorrhage etiology, Postoperative Hemorrhage surgery, Prospective Studies, Reoperation, Respiration, Artificial, Time Factors, Treatment Outcome, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Cardiac Surgical Procedures, Cardiopulmonary Bypass adverse effects, Coagulants therapeutic use, Indomethacin therapeutic use, Inflammation prevention & control, Ketoconazole therapeutic use, Postoperative Hemorrhage prevention & control
Abstract

Indomethacin is a known immune modulator that inhibits cyclooxygenase. Studies indicate that ketoconazole, a selective lipoxygenase and thromboxane A(2) synthetase inhibitor, can prevent activation of the inflammatory cascade by inhibition of proinflammatory mediators. This study was designed to determine if ketoconazole or indomethacin could reduce the adverse effects of extracorporeal circulation. As a double-blind prospective study, 76 patients were randomized into 3 groups according to preoperative medication: indomethacin, ketoconazole, and placebo groups, with 25, 26, and 25 patients, respectively. Four types of parameters were evaluated preoperatively and up to 24 hr after cardiac surgery in all patients: inflammatory (complement C3 and C4, C-reactive protein, immunoglobulins); hematologic; coagulation; and physiologic (blood loss, fluid and blood components received, weight gain, and duration of ventilation). Statistical analyses showed similar patient profiles in each group. Complement C4 decreased in all groups postoperatively, but significantly less in the indomethacin group ( p < 0.01). Ketoconazole reduced postoperative bleeding ( p < 0.0001) as well as the incidence of re-operation for bleeding ( p = 0.05). It was concluded that indomethacin decreases complement (specifically C4) consumption during cardiopulmonary bypass, and ketoconazole may reduce postoperative bleeding by limiting coagulation abnormalities in cardiac surgery patients.

Published
2007
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19. Associated coronary anomalies in 135 Iranian patients with tetralogy of Fallot.

Author

Hekmat M, Rafieyian S, Foroughi M, Majidi Tehrani MM, Beheshti Monfared M, and Hassantash SA

Subjects
Adolescent, Adult, Aortic Arch Syndromes complications, Aortic Arch Syndromes surgery, Cardiac Surgical Procedures, Child, Child, Preschool, Coronary Vessel Anomalies epidemiology, Coronary Vessel Anomalies surgery, Ductus Arteriosus, Patent complications, Ductus Arteriosus, Patent surgery, Female, Humans, Incidence, Infant, Iran epidemiology, Male, Retrospective Studies, Superior Vena Cava Syndrome complications, Superior Vena Cava Syndrome surgery, Tetralogy of Fallot epidemiology, Tetralogy of Fallot surgery, Ventricular Outflow Obstruction complications, Ventricular Outflow Obstruction surgery, Coronary Vessel Anomalies complications, Tetralogy of Fallot complications
Abstract

Coronary artery anomalies are common among patients with tetralogy of Fallot. One hundred and thirty-five patients (80 males and 55 females) with tetralogy of Fallot who underwent repair between 1995 and 2002 were studied to determine the incidence of coronary anomalies in Iranian patients. Eight (5.9%) patients (4 males and 4 females) had a surgically relevant coronary artery anomaly: single coronary ostium in 5, origin of the left anterior descending artery from the right coronary artery in 2, and origin of the right coronary artery from the left coronary artery in 1. The surgical technique in 3 of these patients was repair of the ventricular septal defect with a transverse incision on the right ventricle, without damage to the coronary arteries. In another patient, an allograft aortic valve cylinder was inserted. In the other 4 patients with a single coronary ostium, placement of a limited transannular patch was adequate. Consideration of these anomalies during primary repair could decrease the risk of operation in such patients. However, it seems that the presence of anomalous coronary arteries does not affect incremental risk after surgical repair.

Published
2005
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20. Cardiac surgery in an Iranian teaching hospital: outcome and risk factors.

Author

Hassantash SA, Mirpoor K, and Afrakhteh M

Subjects
Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Cardiopulmonary Bypass, Cardiovascular Diseases complications, Cardiovascular Diseases mortality, Cardiovascular Diseases surgery, Female, Hospitals, Teaching, Humans, Iran, Male, Middle Aged, Outcome and Process Assessment, Health Care, Prospective Studies, Risk Factors, Sex Factors, Cardiac Surgical Procedures adverse effects, Cardiac Surgical Procedures mortality
Abstract

Cardiac surgery in Iran has been associated with different facilities, equipment and patient populations in comparison to countries from which most of the academic papers used for identification of risk factors related to outcome and subsequent establishment of risk stratification models originate from. During a 15-month period all patients admitted for adult cardiac surgery using cardiopulmonary bypass (CBP) in a university affiliated teaching hospital were enrolled in a prospective study. Appropriate statistical tests were used to analyze data for mortality and morbidity. There were 730 adults (63% male, 37% female), with age ranged from 16 to 82 (mean, 51.4 +/- 14.4). A mortality rate of 5.3% and morbidity of 14.8% (major + minor) were observed in the whole group. Factors correlated with mortality were: age (p = 0.019), emergency surgery (p < 0.0001), redo cardiac surgery (p = 0.01), left ventricular (LV) aneurysm (p < 0.001), presence of catastrophic states (p < 0.001), low ejection fraction (p = 0.04), history of hypertension (p = 0.05), the individual surgeon (p < 0.0001), and CPB duration (p < 0.0001). Factors affecting morbidity included: female gender (p = 0.04), age (p = 0.03), emergency surgery (p = 0.001), redo surgery (p = 0.008), and catastrophic states (p < 0.001). The mortality in our study group may be compared with reports presented in the literature. Factors such as age, emergency surgery, redo cardiac surgery, and catastrophic states are statistically related to both mortality and morbidity.

Published
2004
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21. Causalgia: a meta-analysis of the literature.

Author

Hassantash SA, Afrakhteh M, and Maier RV

Subjects
Causalgia diagnosis, Causalgia etiology, Causalgia surgery, Humans, Peripheral Nerves surgery, Causalgia epidemiology, Peripheral Nerves physiopathology, Sympathectomy methods, Warfare, Wounds and Injuries complications
Abstract

Background: Causalgia is not familiar to most physicians whose training and experience are limited to civilian practice., Hypothesis: Through a thorough review of the literature, we attempted to determine the boundaries of causalgia and separate it from other sympathetically related disorders., Data Sources: Database search for English-language articles in MEDLINE and Index Medicus up to the year 2000 as both keyword and subject under causalgia., Study Selection: References that described any new cases referred to as "causalgia" by their authors were included in a meta-analysis., Data Synthesis: One hundred ten articles contained a total of 1528 cases of causalgia. High-velocity missiles caused at least 77% of the injuries. In 72% and 90% of the cases reported, the time from injury to onset of pain was within 1 week and 1 month, respectively. Median nerve alone or in combination with other nerves (56%) and sciatic trunk injury (60%) were the most common nerves involved. In 92%, the nerve injury was incomplete. The most prominent clinical manifestations included burning pain in 86%, increased sweating in 73%, relief with application of cold in 62%, warmth in 50%, paresthesias in 96%, absence of anesthesia in 81%, and sensitivity to stimuli in 98%. Response to sympathetic blocks was observed in 88%. Finally, a total of 94% of the patients undergoing sympathectomy were cured., Conclusions: Cases of causalgia are easy to recognize and treat, with excellent results. Causalgia always follows a somatic nerve injury, usually partial, and is associated with near-constant, very severe pain distal to the injury in the extremity, varied in nature but characteristically with a predominantly burning quality. An effective anesthetic block of the appropriate part of the sympathetic chain frequently immediately relieves the pain. Most cases are cured by surgical sympathectomy.

Published
2003
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22. The clinical significance of flow cytometry crossmatching in heart transplantation.

Author

Aziz S, Hassantash SA, Nelson K, Levy W, Kruse A, Reichenbach D, Himes V, Fishbein D, and Allen MD

Subjects
Female, Flow Cytometry, Graft Rejection immunology, Graft Rejection mortality, Heart Transplantation mortality, Histocompatibility Testing, Humans, Immunosuppression Therapy, Male, Retrospective Studies, Heart Transplantation immunology
Abstract

Background: Flow cytometry crossmatching is more sensitive than cytotoxic methods in identifying preformed antibodies to donor alloantigens. However, the significance of a positive flow crossmatch remains unknown for a recipient of a heart transplant who has a negative anti-human globulin crossmatch., Methods: Flow crossmatching was performed retrospectively for 92 recipients of a primary cardiac allograft who underwent transplantation with a negative AHG crossmatch., Results: Forty-six patients were flow crossmatch-positive for alloantibody: 20 were positive on both T and B lymphocytes, 12 were positive only on B lymphocytes, and 13 were positive only on T lymphocytes. Eleven had autoantibody invalidating the flow crossmatch with donor cells. Thirty-six patients had negative flow crossmatch. A significantly higher incidence of graft dysfunction with vascular rejection by 6 months was found for patients who had a positive flow crossmatch on B lymphocytes. This group also had an increased incidence of mortality within this same period. Patients who were flow crossmatch-positive on T and B lymphocytes were more likely to experience greater than two episodes of treated cellular rejection within the first 6 months. Flow crossmatch-positive patients stayed longer in the hospital in comparison to the other two groups, although the increases were not statistically significant. There were no differences between groups with regard to time to first rejection, absence of rejection episodes, episodes of decreased cardiac index (<2.3 L/m2), depressed left and right ventricular ejection fraction, or development of transplant atherosclerosis., Conclusion: A positive flow crossmatch identified a subset of patients who are predisposed to development of vascular rejection or are more likely to have frequent cellular rejection.

Published
1998

23. Abdominal wall biloma: an unusual complication of laparoscopic cholecystectomy.

Author

Festekjian JH, Hassantash SA, and Taylor EW

Subjects
Abdominal Pain diagnosis, Abdominal Pain etiology, Adult, Bile, Biliary Tract Diseases diagnosis, Cholelithiasis surgery, Female, Humans, Bile Ducts injuries, Biliary Tract Diseases etiology, Cholecystectomy, Laparoscopic adverse effects
Published
1997

24. Is hypothermia in the victim of major trauma protective or harmful? A randomized, prospective study.

Author

Gentilello LM, Jurkovich GJ, Stark MS, Hassantash SA, and O'Keefe GE

Subjects
Female, Humans, Injury Severity Score, Male, Middle Aged, Prospective Studies, Survival Analysis, Time Factors, Treatment Outcome, Wounds and Injuries mortality, Cardiopulmonary Resuscitation methods, Hypothermia, Induced adverse effects, Hypothermia, Induced mortality, Wounds and Injuries therapy
Abstract

Objective: The purpose of this randomized, prospective clinical trial was to determine whether hypothermia during resuscitation is protective or harmful to critically injured trauma patients., Summary Background Data: Hypothermia has both protective and harmful clinical effects. Retrospective studies show higher mortality in patients with hypothermia; however, hypothermia is more common in more severely injured patients, which makes it difficult to determine whether hypothermia contributes to mortality independently of injury severity. There are no randomized, prospective treatment studies to assess hypothermia's impact as an independent variable., Methods: Fifty-seven hypothermic (T < or = 34.5 C), critically injured patients requiring a pulmonary artery catheter were randomized to a rapid rewarming protocol using continuous arteriovenous rewarming (CAVR) or to a standard rewarming (SR) control group. The primary outcome of interest was first 24-hour blood product and fluid resuscitation requirements. Other comparative analyses included coagulation assays, hemodynamic and oxygen transport measurements, length of stay, and mortality., Results: The two groups were well matched for demographic and injury severity characteristics. CAVR rewarmed significantly faster than did SR (p < 0.01), producing two groups with different amounts of hypothermia exposure. The patients who underwent CAVR required less fluid during resuscitation to the same hemodynamic goals (24,702 mL vs. 32,540 mL, p = 0.05) and were significantly more likely to rewarm (p = 0.002). Only 2 (7%) of 29 patients who underwent CAVR failed to warm to 36 C and both died, whereas 12 (43%) of 28 patients who underwent SR failed to reach 36 C, and all 12 died. Patients who underwent CAVR had significantly less early mortality (p = 0.047)., Conclusion: Hypothermia increases fluid requirements and independently increases acute mortality after major trauma.

Published
1997
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25. Surgical treatment of myasthenia gravis in two major Middle East teaching hospitals: factors influencing outcome.

Author

Hassantash SA, Ashbaugh DG, Verrier ED, and Maier RV

Subjects
Adolescent, Adult, Child, Child, Preschool, Female, Humans, Infant, Iran, Male, Middle Aged, Myasthenia Gravis complications, Prospective Studies, Thymoma complications, Thymus Neoplasms complications, Time Factors, Treatment Outcome, Myasthenia Gravis surgery, Thymectomy
Abstract

Background: The results of thymectomy on patients with generalised myasthenia gravis have been widely reported. However, there is no information on whether the experience of western countries can be generalised to the population of the Middle East. The purpose of this study was to evaluate the safety and efficacy of thymectomy in patients with myasthenia gravis in a Middle East patient population and to identify clinical and histopathological factors associated with improved long term outcome of surgery., Methods: In a prospective study, sixty three patients (aged 1.5-51 years) were treated in two university teaching hospitals between 1984 and 1991 and followed up for a mean of four years. Close communication was established with neurologists to obtain early referral. Radical anterior mediastinal dissection through a median sternotomy was performed in all patients. The response was evaluated by modified Osserman's classification., Results: Eighteen patients achieved complete remission and a further 39 improved, producing an overall response rate of 90.5%. Patients with milder disease (stage II) had a higher response rate (97%) than those with more advanced disease (78%). Patients operated on with less than three years of symptoms had a better outcome (94%) than those with longer duration of preoperative symptoms, especially in non-thymomatous patients. Age and sex had no effect on the outcome. There was no effect on response rate if patients had hyperplastic or non-specific thymic histological findings, but patients with thymoma fared worse., Conclusions: These results are comparable with reports from the western world and represent the first prospective study from the Middle East. Thymectomy is indicated for all patients suffering from generalised myasthenia gravis soon after the diagnosis is made, regardless of age, stage, thymic pathology, and preoperative clinical status.

Published
1996
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26. Traumatic visceral artery aneurysm: presentation as massive hemorrhage from perforation into an adjacent hollow viscus.

Author

Hassantash SA, Mock C, and Maier RV

Subjects
Adolescent, Adult, Hemorrhage etiology, Humans, Lung Diseases etiology, Male, Renal Artery injuries, Retrospective Studies, Rupture, Aneurysm etiology, Gastrointestinal Hemorrhage etiology, Wounds, Penetrating complications
Abstract

Background: While diagnosis of extremity pseudoaneurysm is usually straightforward, pseudoaneurysms arising from visceral arteries may be occult. Perforation of a visceral artery pseudoaneurysm into an adjacent hollow viscus with subsequent hemorrhage has been rarely reported., Objective and Design: To retrospectively evaluate the cause, clinical presentation, and outcome of patients with bleeding traumatic visceral artery aneurysms., Materials and Methods: Records of nine patients with visceral hemorrhage due to posttraumatic arterial aneurysms., Results: All had penetrating torso trauma 2 to 52 (mean, 12.3) weeks before presentation to our facility and had undergone 1 to 5 (mean, 2.2) prior operations. They had 2 to 15 episodes of hemorrhage into the gastrointestinal (seven cases), respiratory (one case), and urinary (one case) tracts. All underwent emergent surgery with ligation of the involved artery and resection of the corresponding portion of viscus. Evidence of prior attempts at hemostasis with multiple heavy ligatures was evident in all cases. All patients recovered without further complications., Conclusions: Traumatic visceral artery aneurysms are usually due to penetrating trauma. They present as episodes of massive bleeding through one of the hollow viscera, and may stop bleeding without direct intervention only to occur again. Prompt operative therapy is usually necessary.

Published
1995
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27. The impact of hypothermia on dilutional coagulopathy.

Author

Gubler KD, Gentilello LM, Hassantash SA, and Maier RV

Subjects
Adolescent, Adult, Aged, Blood Coagulation Tests, Critical Illness, Female, Hemodilution, Humans, Male, Middle Aged, Prospective Studies, Temperature, Blood Coagulation physiology, Blood Coagulation Disorders physiopathology, Hypothermia physiopathology
Abstract

Unlabelled: The control of hemorrhage in hypothermic patients with platelet and clotting factor depletion is often impossible. Determining the cause of coagulopathic bleeding (CB) will enable physicians to appropriately focus on rewarming, clotting factor repletion, or both., Objective: To determine the contribution of hypothermia in producing CB and ascertain if simultaneous hypothermia and dilutional coagulopathy (DC) interact synergistically., Method: Prothrombin time, partial thromboplastin time, and platelet function were determined at assay temperatures of 29 degrees to 37 degrees C on normal and critically ill, noncoagulopathic (NC) individuals. Dilutional coagulopathy was created using buffered saline and the assays repeated., Results: Hypothermic assay at < or = 35 degrees C significantly prolonged coagulation times. The effect of hypothermia on NC and DC samples was not different., Conclusion: Assays performed at 37 degrees C underestimate coagulopathy in hypothermic patients. The effect of hypothermia on NC and DC is not different, indicating the lack of a synergistic effect. Normalization of clotting requires both rewarming and clotting factor repletion.

Published
1994
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