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| CARDIAC SURGERY |
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| Fetal Arrythmias
Andrej Robida
September-November 2000, 1(9):358-364
As many as 20% of referrals for fetal echocardiography is due to fetal arrhythmias. They may occur in 2% of pregnancies. Indication for echocardiographic evaluation of heart rhythm are sustained fetal heart rate below 100 beats per minute, sustained heart rates above 180 beats per minute, unexplained hydrops fetalis, and frequent and repetitive irregular heart beats. Fetuses with either sustained bradycardia or tachycardia deserve expeditious evaluation. The most important fetal bradycardia is a complete atrioventricular block, which can be associated with a structural heart disease or occur as a consequence of maternal collagen vascular disease and/ or lupus associated antibodies. Fetal therapy is difficult and often unsuccessful. The most common serious fetal tachycardia is orthodromic reciprocating atrioventricular tachycardia followed by atrial flutter. These tachycardias can be treated in utero and proposed protocols for drug management are described. A close fetal and maternal monitoring during treatment and a team approach is advised.
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| IN CONTEXT |
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| Alcohol: Friend or foe? A historical perspective
Rachel Hajar
September-November 2000, 1(9):341-344 Full text not available [PDF] |
| 735 | 66 | - |
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| INTERVENTIONAL CARDIOLOGY |
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| Catheter treatment of hypertrophic obstructive cardiomyopathy
Ulrich Sigwart, Rod Stables
September-November 2000, 1(9):334-340
Non-surgical septal reduction (NSSR) is a promising new therapy for the treatment of classical hypertrophic obstructive cardiomyopathy (HOCM). Patients should have symptoms related to a significant left ventricular outflow tract gradient. The procedure involves the selective injection of absolute alcohol into the hypertrophied basal septum via the epicardial coronary vessels. This results in localized infarction with septal thinning and the other changes that tend to reduce the LVOT gradient. The procedure is well tolerated with low mortality. The principal complication is the development of heart block, which demands pacemaker implantation in around 20% of patients.
Hemodynamic and functional improvement may take some time to become evident and improvement may continue for several months after the procedure. Emerging medium-term follow-up data suggest that the benefits are sustained with no late morbidity. The long-term outcome of the procedure is not known and its value has never been compared to other therapeutic options in randomized controlled trials.
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| CLINICAL DECISION-MAKING |
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| Evidence based strategy of coronary revascularization: The answer to the paradigm shift in the treatment of chronic coronary artery disease
Yukihiro Kaneko, Werner Mohl
September-November 2000, 1(9):345-353
The choice of treatment strategy from medical therapy, percutaneous transluminal coronary angioplasty (PTCA), and coronary artery bypass grafting (CABG) greatly influences outcome of patients with chronic coronary artery disease. Recent randomized trials and registries provide information as to the judgment of optimal treatment strategy. These studies have shown that best outcome is likely when 1- or 2- vessel disease without proximal left anterior descending artery (LAD) stenosis is treated medically. 2-vessel disease with proximal LAD stenosis or 3-vessel disease without proximal LAD stenosis is treated by PTCA or CABG. 3-vessel disease with proximal LAD stenosis or left main coronary stenosis is treated by CABG. CABG is preferred to PTCA in diabetic patients and patients with decreased left ventricular function. Recent advances in the treatment of coronary artery disease are also reviewed as they influence current treatment strategy.
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| 706 | 53 | - |
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| CASE REPORT |
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| Disappearance of left bundle branch block in a patient with refractory unstable angina after abciximab therapy
Gianluca Di Micco, Aniello Ascione, Paolo de Campora, Maurizio D'Ambrosio, Raffaele Sangiuolo, Vincenzo Sepe
September-November 2000, 1(9):354-357 Full text not available [PDF] |
| 569 | 56 | - |
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| CARDIOVASCULAR NEWS |
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| Cardiovascular News
September-November 2000, 1(9):332-333 Full text not available [PDF] |
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| HISTORY OF MEDICINE |
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| Greek and roman surgical instruments
September-November 2000, 1(9):366-369 Full text not available [PDF] |
| 478 | 54 | - |
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| A PICTURE IS WORTH A THOUSAND WORDS |
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| Coil occlusion of residual patent ductus arteriosus after rashkind umbrella
Vikas Kholi
September-November 2000, 1(9):365-365 Full text not available [PDF] |
| 455 | 64 | - |
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| QATAR HEART PAGE |
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| Echocardiography statistics in hamad medical corporation
September-November 2000, 1(9):378-378 Full text not available [PDF] |
| 409 | 59 | - |
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| LETTERS |
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| Tachyarrythmias following coronary artery bypass grafting
Bernard E F Hockings
September-November 2000, 1(9):379-379 Full text not available [PDF] |
| 392 | 59 | - |
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| Anomalous left coronary artery from the pulmonary artery
Vikas Kohli
September-November 2000, 1(9):379-380 Full text not available [PDF] |
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| ART AND MEDICINE |
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| The cave man's art
Rachel Hajar
September-November 2000, 1(9):370-374 Full text not available [PDF] |
| 366 | 56 | - |
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| LETTERS |
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| Heart rate variability follow-ing myocardial infarction
JC Davidson
September-November 2000, 1(9):380-380 Full text not available [PDF] |
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| SPECIAL SECTION |
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| Chairman's Reflections
Hajar A Hajar
September-November 2000, 1(9):375-377 Full text not available [PDF] |
| 320 | 59 | - |
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