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Showing 3 results for Ghaffari

Samad Ghaffari, Reza Zerehpoush,
Volume 7, Issue 4 (Winter 2007)

  Background & Objective: Electrocardiography is a useful method in predicting coronary artery occlusion site, left ventricular function and the prognosis of patients with acute myocardial infarction. Accurate localization of coronary artery occlusion and the extent of ischemic area are very important in decision making for invasive procedures to restore coronary perfusion.

  Methods: In this prospective study the abnormal findings of first recorded electrocardiogram in 100 patients with acute myocardial infarction w ere compared with coronary angiography findings and the value of ST-T changes in predicting coronary artery occlusion site was evaluated.

  Results: In acute anterior wall infarction, ST elevation in aVR (p=0.001), right bundle branch block (p=0.001) and ST depression in V5 strongly predicts LAD occlusion at its proximal part. Also ST depression, especially equal or more than 1 mm, in inferior leads indicates proximal LAD occlusion. The absence of such ST depression in these inferior leads correlates with distal LAD occlusion (p=0.01).ST depression of aVL also is a sign of distal LAD occlusion (p=0.01).In acute inferior wall infarction ≥ 1 mm ST depression in leads I, aVL and greater ST elevation in lead III than lead II refers to RCA involvement.

  Conclusion: In acute anterior myocardial infarction electrocardiography can help to differentiate proximal LAD lesion from its distal involvement. Also it is useful in determining the culprit vessel in acute inferior wall infarction and helps to recognize high risk patients with major benefit from invasive reperfusion strategies.

Mohammadali Karimi Aghdam , Mahmood Samadi, Shamsi Ghaffari , Fariba Mahmoodpoor,
Volume 8, Issue 2 (Summer 2008)

  Background & Objectives: There are several methods for PDA closure. This study compared results, complications and cost effectiveness of surgical and nonsurgical PDA closure with coil.

  Methods: Patients who admitted in Shahid Madani Hospital in 2005 surgical and nonsurgical closure of PDA were included in this study. Data were obtained from patients units. All cases followed up for six months. Data were analyzed thorough SPSS.

  Results: From 21 patients of nonsurgical method in two cases (9.5%), coil embolizations were occurred to pulmonary artery, that they were removed in cath lab and then refered to a surgery unit. One case (4.5%) has residual shunt at PDA, that who was waiting for second coil. In six month follow-up, PDA completely was closed in 18 (86%) patients and no complications were seen.

  In surgical method there were 42 patients. In six month follow-up, there were residual shunt in 2 (4.7%) cases and chylothorax in 1 (2.3%) patient, transient left diaphragmatic paresis in 2 (4.7%) and transient vocal cord paresis in 2 (4.7%) cases were seen.

  Mean at hospitalization and ICU, laboratory tests and radiographic examinations in nonsurgical method were significantly less than surgical method (P<0.0005). There was no significant difference in drug cost between two methods (P= 0.793). Mean cost of instruments and total hospital cost of the patients in nonsurgical method were significantly more than surgical method for high cost of coil (P<0.0005), but men payment of patients to the hospital in two groups did not have any significant difference (P= 0.056).

  Conclusion: In general, PDA closure through nonsurgical method had better and effective results and complications. However, it is more expensive.

Hosein Douste Kami , Adalat Hosseinian , Effat Mazaheri, Naser Aslanabadi , Samad Ghaffari , Bahram Sohrabi , Eiraj Mohammadzadeh , Farhad Pourfarzi , Naser Moaiiednia ,
Volume 13, Issue 3 (autumn 2013)

  Background & Objectives: Coronary bifurcation lesions are important, complex lesions with different therapeutic strategies. In this study, patients with Coronary bifurcation lesions were treated and clinical results in these patients were followed during the nine-month period.

  Methods: This descriptive analytical study was performed between January 2007 to December 2008 at Tabriz Shahid Madani Cardiovascular Center. We have studied 96 patients (83 male and 13 female). Patients on the basis of one or two stents were placed in one group and the other groups were divided based on the use of Drug Eluting Stent and Bare Metal Stent. After diagnostic angiography if coronary bifurcation lesions were present based on Medina classification, appropriate angioplasty treatment was carried out. In a situations including chest pain, electrocardiographic changes or the objective evidence of ischemia and indication of angiography, appropriate diagnostic tests during follow up period were done. Clinical outcomes including acute coronary events were recorded. And result analyzed using SPSS version 16 . Chi-square ، Fisher and T tests were used to compare the relationship between variables.

  Results: In this study 86.5% was male and 13.5% female. The mean age of these patients was 56±9.9 years old. The most prevalent risk factor was HTN with 41.7% incidence and 55.2% of patient had chronic stable angina and 26% of them had history of acute myocardial infarction, 7.2% with history of PCI and 5.2% with history Of CABGS. Most prevalent site of bifurcation was ALD/diagonal with 65.5% incidence. The most prevalent complication was mild bleeding from puncture site with 10.4% and 5.2% of patients had mild hematoma. Among patients with two stents versus one stent presence of AMI presentation with CSA, ST Elevation in ECG was statistically significant. Also involvement of SB (side branch) lesions lengths at SB, kissing ballooning after implantation of two stents were statistically significant. Among patients with DES versus BMS usage of stent in RCA, LAD, lesion lengths at PMB (proximal main branch), DMP (distal main branch) and SB, procedure time, radiation dose, fluoroscopy time were statistically significant. Among two groups MACE (major acute coronary event) in two stents patient between 1-3 month and total MACE at first 6 month were statistically significant

  Conclusion: The age of patients treated with CBL was low, also more usage of BMS and stenting of BFLs with two BMS had weak results in this study but surprisingly total results of BMS and DES did not have significant difference after 9 months follow up between two groups.

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مجله دانشگاه علوم پزشکی اردبیل Journal of Ardabil University of Medical Sciences
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