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   2007| Dec-Feb  | Volume 8 | Issue 4  
    Online since June 17, 2010

 
 
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HISTORY OF MEDICINE
The magnificent century of cardiothoracic surgery
Amer Chaikhouni
Dec-Feb 2007, 8(4):161-164
  2,904 137 -
ORIGINAL ARTICLES
Early stroke in patients with acute myocardial infarction: Incidence, risk factors and clinical outcomes
Hisham Mohy, Wafa A Rashed, Mohammad Zubaid
Dec-Feb 2007, 8(4):142-146
Background : Limited data is available about stroke developing after acute myocardial infarction (AMI). We investigated the incidence, risk factors and in-hospital outcome of stroke after AMI in clinical practice with and without use of thrombolysis. Methods and results : We analyzed data from a prospective registry of consecutive patients admitted to the coronary care unit (CCU) at Mubarak Al Kabeer Hospital in Kuwait. Of 2481 patients admitted with AMI between1999 and 2003, 29 (1.2%) developed stroke during their hospital stay. Age older than 60 years (OR 5.5; 95% CI 2.4 to 12.5; P < 0.001) and systolic blood pressure higher than 160 mmHg (OR 3.2; 95% CI 1.1to 9.5; P < 0.04), were identified as independent predictors for stroke among patients with AMI. Patients who received thrombolytic therapy were not at an increased risk for developing stroke (OR 0.7; 95% CI 0.2 to 2.0). Patients developing stroke were 12 times more likely to die during hospitalization compared with patients who did not develop stroke (OR 12.6; 95% CI 5.4 to 26.7; P < 0.001). Conclusions : Stroke is an infrequent but serious complication of AMI. Older age and high systolic blood pressure at admission are independent predictors of stroke.
  1,869 94 -
18 years follow-up results of mitral balloon valvuloplasty in 531 consecutive patients and predictors of long-term outcome
Mohamed Eid Fawzy, Mohamed Shoukri, Fayez El Shaer, Adil Osman, Iman Esmat Ibrahim, Manzoor Memon, Shabir Shah
Dec-Feb 2007, 8(4):130-141
Background : Aim of the study: Long-term echocardiographic follow-up studies of mitral balloon valvuloplasty (MBV) are scarce. The study aim was to assess the long-term results (up to 18 years) of MBV and to identify predictors of restenosis and event-free survival. Methods : The immediate and long-term clinical and echocardiographic results for 531 consecutive patients (mean age 31 ± 11 years) who underwent successful MBV for severe mitral stenosis (MS) and were followed up for a mean of 8.5 ± 4.8 years (range: 1.5 to 18 years) after MBV are reported. Results : Immediately after MBV, the mitral valve area (MVA) was increased from 0.92 ± 0.17 cm2 to 1.95 ± 0.29 cm2 (p < 0.0001). Restenosis occurred in 165 patients (31%), and was less frequent (19%) in patients with a low mitral echo score (MES ≤ 8). Actuarial freedom from restenosis at 10, 15 and 18 years was 77 ± 2%, 46 ۱ 3% and 18 ± 4%, respectively, and was significantly higher in patients with MES ≤ 8 (86 ± 2%, 62 ۱ 4% and 31 ± 7%) than in those with MES > 8 (p < 0.001). Event-free survival (death, redo MBV, mitral valve replacement, NYHA class III or IV) at 10, 15 and 18 years was 88 ± 1%, 53 ± 4%, and 21 ± 5% respectively, and was significantly higher for patients with MES ≤ 8 (93 ± 2%, 65 ± 5% and 38 ± 8%, respectively; p < 0.001). Multivariable Cox regression analysis identified MES > 8 (p < 0.0001) and previous surgery (p = 0.043) as predictors of restenosis, and MES > 8 (p < 0.0001) and baseline atrial fibrillation (p = 0.03) as predictors of combined events. Conclusion : MBV provides excellent long-term results for selected patients with MS. The long-term outcome of this procedure can be predicted from the baseline clinical and echocardiographic characteristics of the mitral valve.
  1,856 87 -
Radiofrequency ablation of ventricular tachycardia in post myocardial infarction patients: Kuwait experience
YA Fawzia, AM Shukkur
Dec-Feb 2007, 8(4):147-152
We evaluated prospectively 5 patients with previous myocardial infarction who had ventricular tachycardia. The objective of this study was to describe the arrhythmogenic areas and ablate the ischemic VT successfully with multiple radiofrequency applications. All patients were considered eligible irrespective of the presence of Automatic implantable cardioverter-defibrillator implants. Coronary artery bypass graft was performed for two patients. One patient had developed ventricular tachycardia/ventricular fibrillation post surgery requiring radiofrequency ablation followed by AICD implantation. Three patients with ischemic cardiomyopathy, who had AICD, developed VT prior to the radio frequency ablation therapy. In 5 patients with ventricular tachyarrhythmias three dimensional mapping was performed using non contact mapping (EnSite). RF ablations targeted the arrhythmogenic areas of infarcted zone. All patients were rendered completely non inducible at the end of the procedure. The mean procedure time measured was 3 hours. No complications were observed in any of those patients. On follow up, all patients improved clinically with regard to the quality of life and number of AICD shocks. One post AICD patient had non sustained ventricular tachycardia, during the follow up period. Conclusion: This is a limited study of our local experience in the successful radio frequency ablation of ischemic ventricular tachycardia.
  1,876 62 -
RESEARCH
Preliminary results from Gulf registry of acute coronary events (Gulf RACE)
Mohammad Zubaid
Dec-Feb 2007, 8(4):155-158
  1,728 100 -
EDITORIAL
Farewell to surgical mitral commissurotomy
Hajar Ahmed Hajar Albinali
Dec-Feb 2007, 8(4):127-129
  1,486 61 -
CASE REPORT
Unusual cause of wide mediastinum: Bilateral aneurysm of innominate veins
KC Garg, Venkatraman Bhat, Rajendra Kumar
Dec-Feb 2007, 8(4):153-154
  1,027 60 -
EDITORIAL
Is there a place for open mitral valvotomy?
Salah Eddin O Arafa
Dec-Feb 2007, 8(4):126-126
  1,011 52 -
A PICTURE IS WORTH A THOUSAND WORDS
Purulent pericarditis in an infant
Muhammad Dilawar
Dec-Feb 2007, 8(4):159-159
  963 56 -
CARDIOVASCULAR NEWS
Cardiovascular news

Dec-Feb 2007, 8(4):124-125
  903 51 -
GHA PAGE
Gulf registry for acute coronary syndrome

Dec-Feb 2007, 8(4):165-165
  859 52 -
ART AND MEDICINE
The man of science
Rachel Hajar
Dec-Feb 2007, 8(4):160-160
  838 42 -
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