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   Table of Contents - Current issue
Coverpage
January-March 2018
Volume 19 | Issue 1
Page Nos. 1-43

Online since Thursday, May 10, 2018

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ORIGINAL ARTICLE  

Procedure time comparison between radial versus femoral access in ST-segment elevation acute myocardial infarction patients undergoing emergent percutaneous coronary intervention: A Meta-analysis of controlled randomized trials p. 1
Mohsen Mohandes, Sergio Rojas, Jordi Guarinos, Francisco Fernández, Cristina Moreno, Mauricio Torres, Germán Cediel, Ramón De Castro, Alfredo Bardaji
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_82_16  PMID:29876023
Introduction: There are inconclusive data about the potential delay of procedure time in emergent percutaneous coronary intervention (PCI) by radial compared with femoral approach in patients with ST-segment elevation myocardial infarction (STEMI). Aims: The purpose of the current study is to conduct a comprehensive meta-analysis of controlled randomized trials (CRTs) comparing the procedure time in STEMI patients undergoing emergent PCI with radial versus femoral access. Methods: Formal search of CRTs through electronic databases (Medline and PubMed) was performed from January 1990 to October 2014 without language restrictions. Mean difference (MD) of procedure time was evaluated as overall effect. Results: Twelve studies were included with 2052 and 2121 patients in radial and femoral group, respectively. Variability in the definition of procedure time was found with unavailability of a precise definition in 41.6% of studies. When all studies were included, no significant longer procedure time in radial approach was detected (MD [95% confidence interval [CI] = 1.6 min [−0.10, 3.3], P = 0.07, P het = 0.56). After deleting RIVAL trial, procedure time was significantly longer in radial group (MD [95% CI] = 1.5 min [0.71, 2.3], P < 0.001, P het = 0.20). Meta-analysis of three studies with similar definition of procedure time showed (MD [95% CI] = 1.26 min [−0.43, 2.95], P = 0.14, P het = 0.85). Conclusions: Although the procedure time in STEMI patients undergoing emergent PCI by radial access is generally comparable with femoral approach, there is an absence of uniformity in its definition, which leads to divergent results. A standardized definition of procedure time is required to elucidate this relevant matter.
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PERSPECTIVE ARTICLE Top

The heart valve clinic at the heart hospital in Doha, Qatar: An evidence-based standard of care p. 8
Alessandro Salustri, Salah El Badri, Abdul Haleem Shawky, Hakam Alzaeem
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_123_17  PMID:29876024
The incidence of degenerative heart valve disease is rising in developing countries and diagnosis, assessment and management are becoming increasingly complex. The availability of new interventional procedures has further expanded the therapeutic armamentarium, but at the same time, it has increased the proportion of high-risk patients, in whom risk-benefit analysis and the choice of the most appropriate therapy are particularly difficult. Accordingly, international societies have recommended dedicated heart valve clinics (HVCs) to meet these needs. The HVC is a specialist outpatient clinic linked with multidisciplinary inpatient care as well as education and training. The main functions of the HVC are to confirm and refine the diagnosis of heart valve disease, follow patients and to determine the correct timing of referral to the appropriate heart valve team. We report on why an HVC was set up at the Heart Hospital in Doha, Qatar.
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CASE REPORTS Top

A rare case of left atrial myxoma vascularity causing acquired coronary cameral fistula: Role of transesophageal echocardiography p. 12
S Subash, Ashwini Thimmarayappa, Guru P Patel, Manasa Dhananjaya, Divya Gopal, N Manjunatha
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_79_17  PMID:29876025
Left atrial myxoma is the common benign tumor of heart. Coronary arteries may supply these tumor. Considering the vascular nature of the tumor, acquired coronary cameral fistula(CCF) can be a possibility postexcision of the left atrial myxoma. Here, we discuss a case of 53-year-old female patient, who developed acquired CCF, following excision of the tumor and the role of transesophageal echocardiography intraoperatively in diagnosis.
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Dacron tube graft-covered stenting of recoarctation of the aorta p. 16
Vimalarani Arulselvam, Neale Nicola Kalis, Saud Rashid Al Amer, Shereen Al Shaik
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_87_17  PMID:29876026
We report a case with recoarctation within a tubed graft. Covered stent placed inside the tube graft safely and effectively treated the recoarctation of the aorta.
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A challenging case of patent ductus arteriosus device closure in an adult with unconventional views and catheters p. 20
Naveen Garg, Deep Chandh Raja, Roopali Khanna, Sudeep Kumar
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_36_17  PMID:29876027
Abnormally oriented patent ductus arteriosus is expected in adults, which can lead to difficulties while attempting a device closure. Alternate angiographic views like the “right anterior oblique view,” “retrograde approach” and in rare cases, as elicited in the following case scenario, special catheters like the “Tiger® catheter” can aid in crossing the lesion and completion of the procedure successfully.
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Radiation-induced coronary artery disease in young patients p. 23
Christina Rodriguez Ruiz, Marcel Mesa-Pabón, Katherine Soto, José Hernández Román, Angel López-Candales
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_64_17  PMID:29876028
Exposure to radiotherapy has been shown to accelerate myocardial damage or injury to the cardiac vasculature. Accelerated coronary artery disease (CAD) is one of the main manifestations of cardiac disease in patients who undergo mediastinal radiation therapy. We present the cases of three young patients who developed severe CAD secondary to remote mediastinal radiotherapy.
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Twiddler's syndrome: Case report and literature review p. 27
Elnur Tahirovic, Ilirijana Haxhibeqiri-Karabdic
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_89_17  PMID:29876029
Twiddler's syndrome is a rare complication after pacemaker implantation usually caused by patient manipulation with generator. We describe a case of 70-year-old female patient with pacemaker who was admitted to the neurological clinic with syncope and suspicion for neurological disease. After neurological diagnostic tests that were negative and consultation with a cardiologist, Twiddler's syndrome was diagnosed.
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A PICTURE IS WORTH A THOUSAND WORDS Top

External left main compression by a dilated pulmonary artery in a female patient with atrial septal defect p. 32
Kunal Mahajan, Sanjeev Asotra, Prakash Negi, Rajesh Sharma
DOI:10.4103/1995-705X.232154  PMID:29876030
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ART AND MEDICINE Top

What has art to do with medicine? p. 34
Rachel Hajar
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_6_18  PMID:29876031
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HISTORY OF MEDICINE Top

The pulse in ancient medicine - part 1 p. 36
Rachel Hajar
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_23_18  PMID:29876032
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