20 results on '"Preet Randhawa"'
Search Results
2. Acute myocardial infraction and pulmonary embolism in a same patient with COVID -19: a rare association
- Author
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Preet Randhawa, Parminder P. Singh, Nirmal Guragai, Parminder Kaur, Balraj Singh, and Jasjit S. Walia
- Subjects
coronavirus disease-2019 ,acute pulmonary embolism ,thromboembolism ,acute myocardial infarction ,Internal medicine ,RC31-1245 - Abstract
Coronavirus disease-2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 is associated with a hypercoagulable state leading to increased incidence of thromboembolism. However, it is exceedingly rare to see presence of both arterial and venous thromboembolism simultaneously. Herein, we report an unusual presentation of a 39-year-old male with recently diagnosed COVID -19 who initially had acute myocardial infarction secondary to thrombotic occlusion of right coronary artery followed by acute pulmonary embolism. Health care providers should be aware of this uncommon yet possible co-existence of two life-threatening manifestations in order to prevent fatal consequences.
- Published
- 2021
- Full Text
- View/download PDF
3. Spontaneous coronary artery dissection associated with incidental finding of left ventricular thrombus
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Melvin Santana, Nirmal Guragai, Biren Patel, Rahul Vasudev, Preet Randhawa, Meherwan Joshi, Habib Mirette, and Fayez Shamoon
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spontaneous coronary artery dissection ,left ventricular thrombus ,myocardial infarction ,Internal medicine ,RC31-1245 - Abstract
Spontaneous Coronary Artery Dissection (SCAD) is one of the nonatherosclerotic causes of Acute Coronary Syndrome. It’s extremely rare for SCAD to present in an asymptomatic male, with incidental finding of Left Ventricular (LV) thrombus on echocardiogram. This report presents the case of a 36-year-old male with such an atypical presentation of Spontaneous Coronary Artery Dissection with Left Ventricular apical thrombus as a complication. The patient received successful medical management, with excellent clinical outcomes. This case highlights the importance of an early recognition and treatment strategy for both conditions using medical therapy.
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- 2021
- Full Text
- View/download PDF
4. Gadolinium-based coronary angiography in a patient with prior known anaphylaxis to iodine-based dye
- Author
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Nirmal Guragai, Sherif Roman, Rahul Vasudev, Upamanyu Rampal, Preet Randhawa, Fayez Shamoon, Hartaj Virk, Mahesh Bikkina, JW Moses, and Apurva Motivala
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angiography ,complication ,gadolinium use ,iodine contrast allergy ,pci complication ,percutaneous coronary intervention ,stenting ,ventricular fibrillation ,Internal medicine ,RC31-1245 - Abstract
Gadodiamide is a gadolinium-based chemical element that is considered safe and well tolerated in patients without renal dysfunction and is therefore routinely used as a contrast agent in magnetic resonance imaging. Although radio-opaque, it is not frequently used for coronary angiography due to its less than optimal image quality and prohibitive cost. Our center’s previous experience was less than satisfactory but the addition of a power injection system yielded good quality diagnostic images. We report a case of 63 years old male with a known history of severe, life-threatening anaphylactic reaction to previous iodinated dye presenting with persistent angina despite optimal medical therapy. Coronary and bypass graft angiography was performed using 24 cc of undiluted Gadodiamide (OMNISCAN) with a power injector (ACIST®) without any incidents or premedication with an interpretable angiogram.
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- 2021
- Full Text
- View/download PDF
5. A Case of STEMI Masquerading Brugada Syndrome: Emphasizing the Importance of Clinical Decision Making in Emergencies
- Author
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Nirmal Guragai MD, Rahul Vasudev MD, Dhaval Shah MD, Balraj Singh MD, Parminder Kaur MD, Ashen Fernando MD, Fayez Shamoon MD, Raja Pullatt MD, Meherwan Joshi MD, and Preet Randhawa MD
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Medicine (General) ,R5-920 ,Pathology ,RB1-214 - Abstract
Brugada syndrome is a rare arrhythmogenic syndrome that is associated with an increased risk of ventricular fibrillation and sudden cardiac death. Electrocardiographic findings include patterns similar to a right bundle branch block (RBBB) and persistent ST-segment elevation in precordial leads (V1 and V2). There are numerous reports of Brugada syndrome mimicking ST-segment elevation myocardial infraction (STEMI); however, we describe a case of 47-year-old male who presented with STEMI mimics Brugada syndrome with preexisting RBBB. The patient developed polymorphic ventricular tachycardia generating into ventricular fibrillation right before catheterization making the diagnosis more challenging. The patient, eventually, was found to have obstructive coronary artery disease and no evidence of abnormal sodium channelopathy on further testing. This case highlights the importance of meticulous history taking and appropriate diagnostic test in establishing proper diagnosis of STEMI in a patient with preexisting RBBB, which can mimic Brugada syndrome.
- Published
- 2021
- Full Text
- View/download PDF
6. Gadolinium-based coronary angiography in a patient with prior known anaphylaxis to iodine-based dye
- Author
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Sherif Roman, Upamanyu Rampal, Nirmal Guragai, Mahesh Bikkina, Apurva Motivala, Hartaj Virk, Jeffrey W. Moses, Fayez Shamoon, Preet Randhawa, and Rahul Vasudev
- Subjects
medicine.medical_specialty ,PCI complication ,medicine.medical_treatment ,Gadolinium ,stenting ,chemistry.chemical_element ,Case Report ,complication ,030204 cardiovascular system & hematology ,Iodine ,gadolinium use ,03 medical and health sciences ,0302 clinical medicine ,iodine contrast allergy ,Internal Medicine ,medicine ,030212 general & internal medicine ,medicine.diagnostic_test ,business.industry ,Gadodiamide ,percutaneous coronary intervention ,Angiography ,Percutaneous coronary intervention ,ventricular fibrillation ,medicine.disease ,RC31-1245 ,chemistry ,Iodine contrast allergy ,Radiology ,Complication ,business ,Anaphylaxis ,medicine.drug - Abstract
Gadodiamide is a gadolinium-based chemical element that is considered safe and well tolerated in patients without renal dysfunction and is therefore routinely used as a contrast agent in magnetic resonance imaging. Although radio-opaque, it is not frequently used for coronary angiography due to its less than optimal image quality and prohibitive cost. Our center’s previous experience was less than satisfactory but the addition of a power injection system yielded good quality diagnostic images. We report a case of 63 years old male with a known history of severe, life-threatening anaphylactic reaction to previous iodinated dye presenting with persistent angina despite optimal medical therapy. Coronary and bypass graft angiography was performed using 24 cc of undiluted Gadodiamide (OMNISCAN) with a power injector (ACIST®) without any incidents or premedication with an interpretable angiogram.
- Published
- 2021
7. A Case of STEMI Masquerading Brugada Syndrome: Emphasizing the Importance of Clinical Decision Making in Emergencies
- Author
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Ashen Fernando, Balraj Singh, Preet Randhawa, Parminder Kaur, Fayez Shamoon, Dhaval Shah, Rahul Vasudev, Meherwan Joshi, Raja Pullatt, and Nirmal Guragai
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Male ,medicine.medical_specialty ,Medicine (General) ,Epidemiology ,Bundle-Branch Block ,Clinical Decision-Making ,Case Report ,030204 cardiovascular system & hematology ,Sudden cardiac death ,Electrocardiography ,03 medical and health sciences ,0302 clinical medicine ,R5-920 ,ST-elevation myocardial infraction ,Clinical decision making ,Internal medicine ,medicine ,Pathology ,Humans ,RB1-214 ,030212 general & internal medicine ,cardiovascular diseases ,Safety, Risk, Reliability and Quality ,Brugada Syndrome ,Brugada syndrome ,business.industry ,Brugada ,Middle Aged ,Right bundle branch block ,ventricular fibrillation ,medicine.disease ,right bundle branch block ,Electrocardiographic Finding ,Increased risk ,Ventricular fibrillation ,Cardiology ,ST Elevation Myocardial Infarction ,Emergencies ,business ,Safety Research - Abstract
Brugada syndrome is a rare arrhythmogenic syndrome that is associated with an increased risk of ventricular fibrillation and sudden cardiac death. Electrocardiographic findings include patterns similar to a right bundle branch block (RBBB) and persistent ST-segment elevation in precordial leads (V1 and V2). There are numerous reports of Brugada syndrome mimicking ST-segment elevation myocardial infraction (STEMI); however, we describe a case of 47-year-old male who presented with STEMI mimics Brugada syndrome with preexisting RBBB. The patient developed polymorphic ventricular tachycardia generating into ventricular fibrillation right before catheterization making the diagnosis more challenging. The patient, eventually, was found to have obstructive coronary artery disease and no evidence of abnormal sodium channelopathy on further testing. This case highlights the importance of meticulous history taking and appropriate diagnostic test in establishing proper diagnosis of STEMI in a patient with preexisting RBBB, which can mimic Brugada syndrome.
- Published
- 2021
8. Rare Association of Non-Bacterial Thrombotic Endocarditis, Myocardial Infarction, and Acute Limb Ischemia Secondary to Rheumatoid Arthritis: Comprehensive Case Series With Literature Review
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Preet Randhawa, Raul Angel Garcia, Nirmal Guragai, Mirette Habib, and Rahul Vasudev
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Aortic valve ,medicine.medical_specialty ,Acute coronary syndrome ,medicine.medical_treatment ,Cardiology ,Infectious Disease ,030204 cardiovascular system & hematology ,Malignancy ,Chest pain ,non-st elevation myocardial infraction ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Internal medicine ,medicine ,Endocarditis ,Myocardial infarction ,Embolization ,non-bacterial thrombotic endocarditis ,business.industry ,General Engineering ,medicine.disease ,medicine.anatomical_structure ,Rheumatoid arthritis ,rheumatoid arthriitis ,limb ischemia ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Most cases of non-bacterial thrombotic endocarditis (NBTE) tend to be related to malignancy or rheumatologic and autoimmune disorders like systemic lupus erythematosus. Rheumatoid arthritis (RA) itself has been associated with increased atherosclerosis, coronary artery plaque formation, and endothelial damage. However, it is rare to see NBTE in RA, simultaneously presenting with the acute coronary syndrome and acute limb ischemia due to distant embolization. Here we present a case of a 46-year-old female presenting with chest pain and right leg numbness, found to have ST-elevation myocardial infarction (STEMI) and occlusion of a peripheral artery due to embolization of vegetation present in the aortic valve. We also provide an extensive literature review of the relationship between NBTE and MI. One must be extra vigilant in managing these patients, especially if the size of vegetation is large as it has a tendency to embolize causing devastating complications.
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- 2021
9. A Rare Case of Myocarditis Mimicking ST-Elevation Myocardial Infarction
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Rahul Vasudev, Nirmal Guragai, Raja Pullatt, Ashen Fernando, and Preet Randhawa
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medicine.medical_specialty ,Viral Myocarditis ,Myocarditis ,st-elevation myocardial infarction ,medicine.medical_treatment ,Cardiology ,030204 cardiovascular system & hematology ,Chest pain ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Palpitations ,Internal Medicine ,Myocardial infarction ,cardiovascular diseases ,Cardiac catheterization ,Ejection fraction ,business.industry ,General Engineering ,Dilated cardiomyopathy ,medicine.disease ,dilated cardiomyopathy ,viral myocarditis ,medicine.symptom ,myocarditis ,business ,030217 neurology & neurosurgery - Abstract
Myocarditis is caused by acute injury and inflammation of cardiac myocytes and is most commonly caused by a viral infection. Myocarditis remains a rare diagnosis and manifests with a wide spectrum of non-specific symptoms that include chest pain, dyspnea, and palpitations associated with electrocardiographic abnormalities that resemble that of ST-elevation myocardial infarction (STEMI). Therefore, clinical diagnosis is often challenging and is often misdiagnosed. We present a case of a 22-year-old male who presented with left-sided non-radiating chest pain associated with shortness of breath, elevated troponin of 3.2 ng/ml (
- Published
- 2020
10. RARE CASE OF CONSTRICTIVE PERICARDITIS DUE TO METASTATIC PERICARDIAL MALIGNANCY WITHOUT RECURRENCE TO PRIMARY MALIGNANT SITE
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Bhavik N. Patel, Abanoub Rushdy, Muhammad Atif Masood Noori, Fayez Shamoon, Meherwan Joshi, Preet Randhawa, and Biren Patel
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Constrictive pericarditis ,medicine.medical_specialty ,business.industry ,Rare case ,medicine ,Radiology ,Cardiology and Cardiovascular Medicine ,Malignancy ,medicine.disease ,business - Published
- 2021
11. Anteriorly displaced right coronary artery in acute myocardial infarction: what should every cardiologist know
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Bunyad Haider, Christine Gerula, Edo Kaluski, Monica Sanchez-Ross, Pallavi Solanki, Muhamed Saric, Preet Randhawa, and Marc Klapholz
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Coronary angiography ,medicine.medical_specialty ,Delayed Diagnosis ,Coronary Vessel Anomalies ,medicine.medical_treatment ,Myocardial Infarction ,Coronary Angiography ,Cocaine-Related Disorders ,Electrocardiography ,Predictive Value of Tests ,Internal medicine ,medicine.artery ,Occlusion ,Fibrinolysis ,Humans ,Medicine ,Thrombolytic Therapy ,Myocardial infarction ,Atrioventricular Block ,Sinus (anatomy) ,Adult patients ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Echocardiography, Doppler, Color ,medicine.anatomical_structure ,Right coronary artery ,Cardiology ,Female ,Radiology ,Hypotension ,Cardiology and Cardiovascular Medicine ,business ,Atrioventricular block ,Algorithms ,Echocardiography, Transesophageal - Abstract
Anteriorly displaced right coronary artery (RCA) and anomalous origin RCAs occur in ≈1% and 0.1% of adult patients, respectively, and are the leading cause of incomplete coronary angiography and prolonged procedure times. We present a case in which anteriorly displaced RCA occlusion resulted in an acute inferior–posterior–right ventricular myocardial infarction complicated by complete atrioventricular block and hypotension. Failure to image the RCA resulted in considerable delay in reperfusion time with fibrinolysis. The authors discuss the most frequent anatomic locations of ectopic RCAs and suggest an algorithm to be employed when an ectopic RCA cannot be imaged with conventional diagnostic catheters. Contrary to popular belief, the search for an ectopic RCA has b90° boundaries limited to the anterior third of the right sinus and anterior half of the left sinus. © 2011 Elsevier Inc. All rights reserved.
- Published
- 2011
12. Optimizing primary PCI beyond 'door to intervention time'—are we there yet?
- Author
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James Maher, Christine Gerula, Diane Alfano, Preet Randhawa, Edo Kaluski, Marc Klapholz, Bunyad Haider, Gerard Oghlakian, Jack Palmaro, Steve Tsai, and Muhamed Saric
- Subjects
Male ,Emergency Medical Services ,medicine.medical_specialty ,Time Factors ,Cost-Benefit Analysis ,medicine.medical_treatment ,Myocardial Infarction ,Platelet Glycoprotein GPIIb-IIIa Complex ,Unnecessary Procedures ,Coronary Angiography ,Revascularization ,Health Services Accessibility ,Decision Support Techniques ,Electrocardiography ,Angioplasty ,medicine ,Humans ,Registries ,Angioplasty, Balloon, Coronary ,Hospital Costs ,Aged ,Retrospective Studies ,New Jersey ,business.industry ,Patient Selection ,Medical record ,Stent ,Percutaneous coronary intervention ,Drug-Eluting Stents ,Retrospective cohort study ,General Medicine ,Middle Aged ,Surgery ,Outcome and Process Assessment, Health Care ,Transportation of Patients ,Treatment Outcome ,Emergency medicine ,Conventional PCI ,Female ,Myocardial infarction diagnosis ,Cardiology and Cardiovascular Medicine ,business ,Platelet Aggregation Inhibitors - Abstract
Aim To assess the effects of shortened door-to-intervention (DTI) time on appropriate clinical decisions regarding the four most critical and costly decisions during primary percutaneous coronary intervention (PCI): cath-lab activation (CLA), use of glycoprotein IIb/IIIa inhibitors (GPI), use of PCI, and deployment of drug-eluting stent (DES). Background STEMI PCI patients are frequently subject to decision making based on abbreviated medical encounter and limited medical information. Methods Clinical data were prospectively collected in a STEMI registry over 19 months. Retrospective chart reviews were conducted to determine the level of appropriateness of the above-mentioned decisions. Results Between June 2006 and December 2007, 200 EKGs with suspected STEMI were transmitted; 88 (44%) resulted in CLA. Compared to prior year, DTI times decreased from 145.7 to 69.9 min ( P =.00001). DTI was longer during nights and weekends (87.5 vs. 51.8 min, P =.001) and the initial 6 months of the registry (86.8 vs. 66.8 min, P =.07). Nineteen (21.6%) of the patients undergoing angiography did not require revascularization, 56 (63.6%) received GPIs, and 65 patients (73.8%) underwent at least one vessel PCI, and at least one DES was used in 39 patients (60% of PCI cohort). When assessed for appropriateness, CLA was appropriate in 81.8% of the time and rendered borderline or inappropriate in 5.7% and 12.5%, respectively. GPI use was appropriate in 66% of the patients but seemed borderline or inappropriate in 28.5% and 5.4%, respectively. PCI was appropriate in 90% of the lesions treated, and borderline or inappropriate in 7.1% and 2.9%, respectively. DES use was viewed appropriate in 38.4%, and borderline or inappropriate in 51% and 10.2% of the DES deployments, respectively. Conclusions (1) In view of expedited care, certain information required for decision-making process is either not available or ignored during primary PCI. (2) Appropriate use of resources in primary PCI needs to be better defined. (3) Measures of extracting patients' previous medical records and imaging studies along with in-lab immediate blood work and echocardiography and establishing new "time-out" protocols for STEMI patients may improve resource utilization and patient care and outcome.
- Published
- 2010
13. Length of Hospital Stay After Percutaneous Coronary Interventions
- Author
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Pat Jones, Edo Kaluski, Deborah Dolny-Korasick, Diane Alfano, Karen Romano, Jack Palmaro, Preet Randhawa, and Marc Klapholz
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Male ,medicine.medical_specialty ,Time Factors ,Quality management ,Percutaneous ,medicine.medical_treatment ,Perioperative Care ,Hospitals, University ,Hospitals, Urban ,Patient satisfaction ,Cost Savings ,Angioplasty ,Outcome Assessment, Health Care ,Humans ,Medicine ,Nurse Practitioners ,Angioplasty, Balloon, Coronary ,Hospital Costs ,Early discharge ,Advanced and Specialized Nursing ,New Jersey ,business.industry ,Health services research ,Percutaneous coronary intervention ,Length of Stay ,Middle Aged ,Patient Discharge ,Nursing Evaluation Research ,Patient Satisfaction ,Emergency medicine ,Conventional PCI ,Feasibility Studies ,Female ,Health Services Research ,Cardiology and Cardiovascular Medicine ,business ,Case Management ,Program Evaluation ,Total Quality Management - Abstract
Introduction and aim Post-percutaneous coronary intervention (PCI) length of hospital stay (LOHS) is one of the key modifiers of hospital cost and quality assessment. Commencing 2000, the cardiovascular services at our institution engaged in a continuous quality improvement program to reduce post-PCI LOHS. Methods All PCI patients were screened for potential early discharge. An expedited discharge protocol was applied to all suitable patients. Length of hospital stay and other outcomes were monitored daily. Data were compiled and reported monthly and quarterly by an independent chart review and data analysis team. Results Over the study period, PCI volume increased 4-fold. Annually, 61.8% to 78.4% of the patients were rendered suitable for abbreviated LOHS. Timely discharge of suitable candidates gradually improved from 77.6% (n = 116) discharged within 48 hours in 2000 to 95% (n = 480) discharged within 30 hours in 2006. Conclusion With the appropriate continuous quality improvement program, 30-hour post-PCI discharge is feasible in more than 95% of suitable cases.
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- 2008
14. Right coronary artery anatomical variants: where and how?
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Pallavi, Solanki, Christine, Gerula, Preet, Randhawa, Michael, Benz, James, Maher, Bunyad, Haider, Marc, Klapholz, Jack, Palmaro, Diane, Alfano, and Edo, Kaluski
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Coronary Vessel Anomalies ,Coronary Sinus ,Prevalence ,Humans ,Choristoma ,Coronary Angiography ,Tomography, X-Ray Computed ,Coronary Vessels ,Magnetic Resonance Imaging ,Algorithms ,Echocardiography, Transesophageal ,Retrospective Studies - Abstract
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.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.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.Ectopic RCAs pose a clinical problem, consuming time and resources. The search for an ectopic RCA should have90 degree boundaries limited to the anterior third of the right sinus and anterior half of the left sinus.
- Published
- 2010
15. Massive coronary perforation and shock: From appropriate labeling to appropriate calls
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Edo Kaluski, Preet Randhawa, Marc Klapholz, Bunyad Haider, and Christine Gerula
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medicine.medical_specialty ,medicine.medical_treatment ,Perforation (oil well) ,Shock, Cardiogenic ,Balloon ,Cardiac tamponade ,Angioplasty ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Angioplasty, Balloon, Coronary ,Aged, 80 and over ,business.industry ,Cardiogenic shock ,Percutaneous coronary intervention ,Stent ,Balloon Occlusion ,medicine.disease ,Combined Modality Therapy ,Coronary Vessels ,Surgery ,Treatment Outcome ,Shock (circulatory) ,Emergency Medicine ,Drainage ,Female ,Stents ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Coronary perforation is a rare, unpredictable and dreaded complication of percutaneous coronary Intervention. With Ellis Grade 3 perforations the only effective treatment includes temporary balloon occlusion of the perforated coronary artery and placement of JOSTENT GraftMaster stent to cover the perforation. The authors describe coronary perforation during proximal right coronary artery (RCA) stenting, resulting in immediate cardiogenic shock. The patient was treated with temporary balloon occlusion of the RCA, reversal of anti-coagulation, sealing of the perforation with a GraftMaster stent, inotropes, intra-aortic balloon counterpulsation (IABC) and surgical drainage the pericardial space. The authors describe the rational of their therapeutic strategy. The methodology and pitfalls of GraftMaster deployment, in patients with massive coronary perforation are discussed. This report also emphasizes, that as opposed to manufactures instructions and all previous manuscripts, GraftMaster can be easily deployed via conventional 6F guiding catheters with internal diameter 0.070 inch (1.8 mm).
- Published
- 2009
16. Funneling: enhancing results of small-vessel stenting
- Author
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Marc Klapholz, Christine Gerula, Preet Randhawa, and Edo Kaluski
- Subjects
Bare-metal stent ,medicine.medical_specialty ,medicine.medical_treatment ,education ,Dissection (medical) ,Prosthesis Design ,Coronary Restenosis ,Restenosis ,medicine.artery ,Medicine ,Humans ,cardiovascular diseases ,Angioplasty, Balloon, Coronary ,Coronary Artery Bypass ,Aged ,business.industry ,Graft Occlusion, Vascular ,Percutaneous coronary intervention ,Stent ,Drug-Eluting Stents ,General Medicine ,equipment and supplies ,medicine.disease ,Radiography ,surgical procedures, operative ,Treatment Outcome ,Coronary Occlusion ,Drug-eluting stent ,Metals ,Right coronary artery ,Female ,Stents ,Small vessel ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Until October 2008, coronary drug-eluting stents with a diameter of ≤2.5 mm were not approved by the FDA. Target vessels of ≤2 mm in diameter pose a major challenge in view of high restenosis rates when stented bare metal stents (BMS) are used and distal edge dissection when oversized stents are deployed. Described is a method (“funneling”) to optimize stenting of small vessels. This strategy combines stenting the distal part of the lesion with short (8–12 mm length) 2-mm bare metal stent while stenting with a larger-diameter (≥2.5 mm) drug-eluting stent (DES) with considerable DES–BMS overlap (leaving only the distal 4–6 mm of the BMS not overlapped by a DES). The two stents create a funnel that is for the most part drug eluting. With funneling, both drug elution and larger diameter are attained, minimizing both edge dissection and restenosis.
- Published
- 2008
17. Aortic rupture: comparison of three imaging modalities
- Author
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Monica Sanchez-Ross, Pierre D. Maldjian, Marc Klapholz, Preet Randhawa, Muhamed Saric, Corey D. Eber, Ather Anis, Jasjit Walia, Barry C. Esrig, and Michael C. Banker
- Subjects
Traumatic aortic rupture ,Male ,medicine.medical_specialty ,Aortography ,Rib Fractures ,Helical computed tomography ,Aortic Rupture ,Contusions ,Imaging modalities ,Vehicle accident ,medicine.artery ,otorhinolaryngologic diseases ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Aortic rupture ,Hemothorax ,Aorta ,medicine.diagnostic_test ,Aortic Aneurysm, Thoracic ,business.industry ,Accidents, Traffic ,Lung Injury ,Middle Aged ,Thoracic Surgical Procedures ,medicine.disease ,Surgery ,Blunt trauma ,Emergency Medicine ,Radiology ,business ,Tomography, X-Ray Computed ,Aneurysm, False ,Echocardiography, Transesophageal - Abstract
We report a case of a 56-year-old man with traumatic aortic rupture (TAR) sustained in a motor vehicle accident diagnosed by helical computed tomography, aortography, and transesophageal echocardiography. A large majority of patients with TAR never make it to the hospital, and for those who do, a timely diagnosis is critical for survival. We discuss the merits and pitfalls of the three imaging modalities.
- Published
- 2005
18. Change of glycoprotein IIb/IIIa inhibitors strategies in percutaneous coronary interventions and the rate of ischemic and bleeding complications
- Author
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Preet Randhawa, Christine Gerula, James Reilly, Ceyone Drakes, Marc Klapholz, Michael Benz, Edo Kaluski, Cynthia Cruz, and Dinora Matute
- Subjects
medicine.medical_specialty ,Percutaneous ,business.industry ,Glycoprotein IIb/IIIa inhibitors ,Internal medicine ,medicine ,Cardiology ,Psychological intervention ,General Medicine ,Cardiology and Cardiovascular Medicine ,business ,Gastroenterology ,medicine.drug - Published
- 2011
19. Intracoronary nitroprusside is the preferred vasodilator for fractional flow reserve
- Author
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Salvador Sanchez, Jim Riley, Wojcek Rudzinski, Marc Klapholz, Preet Randhawa, Edo Kaluski, Michael Benz, and Cyndy Cruz
- Subjects
medicine.medical_specialty ,business.industry ,Internal medicine ,Cardiology ,Medicine ,Vasodilation ,General Medicine ,Fractional flow reserve ,Cardiology and Cardiovascular Medicine ,business - Published
- 2011
20. Aortic rupture: comparison of three imaging modalities.
- Author
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Monica Sanchez-Ross, Ather Anis, Jasjit Walia, Preet Randhawa, Barry Esrig, Michael Banker, Corey Eber, Pierre Maldjian, Marc Klapholz, and Muhamed Saric
- Abstract
Abstract We report a case of a 56-year-old man with traumatic aortic rupture (TAR) sustained in a motor vehicle accident diagnosed by helical computed tomography, aortography, and transesophageal echocardiography. A large majority of patients with TAR never make it to the hospital, and for those who do, a timely diagnosis is critical for survival. We discuss the merits and pitfalls of the three imaging modalities. [ABSTRACT FROM AUTHOR]
- Published
- 2006
- Full Text
- View/download PDF
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