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Search Results: 1 - 10 of 172 matches for " Hakimeh Sadeghian "
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Moderate Ischemic Mitral Regurgitation: Repair or no Intervention Concomitant with CABG?
Hakimeh Sadeghian
Journal of Tehran University Heart Center , 2007,
Tricuspid Regurgitation Improvement in Relation to the Amount of Pulmonary Artery Pressure Reduction
Hakimeh Sadeghian,Arezou Zoroufian
Journal of Tehran University Heart Center , 2010,
Interventional Closure of Patent Foramen Ovale (PFO) with Amplatzer PFO Occluder in Patients with Paradoxical Cerebral Embolism
Ali Mohammad Haji Zeinali,Hakimeh Sadeghian
Journal of Tehran University Heart Center , 2006,
Abstract: Background: Percutaneous transcatheter closure has been proposed as an alternative to surgical closure or long-term anticoagulation in patients with presumed paradoxical embolism and patent foramen ovale (PFO). Methods: There were two symptomatic patients (29 and 47 years old) who underwent percutaneous transcatheter closure of PFO after at least two events of cerebral ischemia; one embolic event had occurred under anti-platelet therapy. For both patients, Amplatzer PFO occluder measuring 25 mm in diameter were used. In both cases, complete occlusion by color Doppler and transesophageal contrast echocardiography investigation was achieved after the procedure and lasted at least up to 3 months after implantation as determined by our follow up. Mean fluoroscopy time was 16.7 minutes. Results: Percutaneous transcatheter closure was technically successful in both patients (100%). No residual shunt was seen at the end of the procedure or in follow-ups. In-hospital follow-up was uneventful. At a mean follow-up of 3 months, no recurrent embolic neurological events were observed. Conclusion: Transcatheter closure of PFO with Amplatzer PFO occluder devices is a safe and effective therapy for patients with previous paradoxical embolism PFO. Percutaneous closure is associated with a high success rate, low incidence of hospital complications, and freedom of cerebral ischemic events.
Clinical and Angiographic Characteristics of Myocardial Bridges: a Descriptive Report of 19 Cases and Follow-up Outcomes
Sirus Darabian,Alireza Amirzadegan,Hakimeh Sadeghian,Saeed Sadeghian
Journal of Tehran University Heart Center , 2007,
Abstract: Background: Muscle fibers overlying the intramyocardial segment of an epicardial coronary artery are termed myocardial bridge (MB). The aim of this study was to analyze the mid-term outcome of MB and to examine its possible association with angiographic findings and concomitant cardiac pathologies such as hypertrophic cardiomyopathy (HCM). Methods: From a total of 3218 patients admitted for coronary angiography during 9 consecutive months, 28 (0.9%) were diagnosed with MBs with stenoses >=50%. Of these, 19 referred for follow-up with a median duration of 18 months. Results: HCM was present in 5 patients (26.3%), of whom 4 had MB as the sole finding in angiography. Of the 19 patients, 14 had diastolic dysfunction. In follow-up, 2 patients were treated with revascularization strategies due to the concomitant coronary artery disease and in 2, syncope occurred. For two patients, an intra-cardiac device and a permanent pacemaker were implanted. Three patients with MB as the sole finding in angiography were readmitted because of chest pain. Conclusion: Diastolic dysfunction may contribute to the presentation of symptoms of muscle bridging. Also, myocardial bridging as the only finding in coronary angiography is highly associated with hypertrophic cardiomyopathy and may help to detect this group of patients. The mid-term outcome of myocardial bridges is favorable.
Moderate Mitral Regurgitation and Coronary Disease: Treatment with Coronary Bypass Alone?
Hakimeh Sadeghian,Abbassali Karimi,Hosein Ahmadi,Saeed Sadeghian
Journal of Tehran University Heart Center , 2006,
Abstract: Background: In cases of moderate(2 or 3+ on a scale of 0 to 4+) nonorganic mitral regurgitation (MR) and coronary artery disease, operative strategy continues to be debated between coronary artery bypass grafting alone (CABG) or concomitant valve repair. To clarify the optimal management of these patients, we evaluated the mid-term results of isolated CABG in the study group. Methods: From March 2002 to February 2005, 40 consecutive patients (57.5% male, mean age: 62.45±8.7 years, mean ejection fraction: 44.15±12.6%, mean New York Heart Association class 2.5±0.78) with coronary artery disease and moderate MR without organic mitral valve disease (prolapse, rheumatism, etc.) underwent CABG alone. Thirty one (77.5%) patients had either postoperative or follow-up transthoracic echocardiography with mean follow up time of 10.82±8.12 months. Patient's pre and postoperative data were compared to evaluate the results of isolated CABG on moderate MR. Results: MR was ischemic (with persistent wall motion abnormality) in 25(62.5%) patients and functional (without persistent wall motion abnormality) in 15(31.5%). Considering postoperative and follow up transthoracic echocardiography, 54.8% had no or mild MR (29% MR 1+, 25.8% no MR) and 45.2% had moderate MR (16.1% MR 3+, 29% MR 2+). Resolution of MR was significant (p<0.001), but it had no correlation with ischemic MR (p=0.46), preoperative ejection fraction (p=0.09), LV systolic (p=0.70) and diastolic dimensions (p=0.80). Seven patients died, 2 in hospital and 5 later. Conclusion: Although for coronary artery disease accompanying moderate nonorganic MR, CABG alone reduces severity of MR significantly, many patients are left with moderate MR. Preoperative diagnosis of moderate nonorganic MR may warrant concomitant mitral repair.
Cor Triatriatum: Preoperative Diagnosis and Successful Surgical Correction in a Four-Year-Old Girl
Kiyomars Abbasi,Hakimeh Sadeghian,Neda Ghafari-Marandi,Afsaneh Sadeghian
Journal of Tehran University Heart Center , 2010,
Abstract: Cor triatriatum is defined as a membrane within the left atrium, which might lead to restricted pulmonary venous return.Diagnosis is usually achieved by echocardiography in early infancy. Therapy of choice is the excision of the membrane.Herein, successful correction of cor triatriatum in a 4-year-old girl is presented, and the clinical features, echocardiographic findings, and the surgical treatment are discussed.
Assessment of Myocardial Viability: Selection of Patients for Viability Study and Revascularization
Hakimeh Sadeghian,Jalil Majd-Ardakani,Masoumeh Lotfi-Tokaldany
Journal of Tehran University Heart Center , 2009,
Abstract: The aim of this article is to review the application of current imaging techniques used for the detection of viable myocardium. Each technique is discussed briefly, and the more commonly used techniques are compared. The imaging techniques reviewed herein are dobutamine stress echocardiography, single photon emission tomography, magnetic resonance imaging, positron emission tomography with F-18 fluorodeoxyglucose, and recently introduced tissue Doppler imaging. The estimation of the amount of viable myocardium that could predict a better outcome after revascularization being a challenging issue, the present article also reviews a variety of cut-off points suggested by different investigators as adequate viable myocardium for revascularization and presents a summary of clinical, angiographical, and echocardiographic findings that could assist in selecting patients for viability study.
Transcatheter Closure of Patent Ductus Arteriosus: Initial Study on Echocardiographic Estimation of Device Size
Alimohammad Hajizeinali,Hakimeh Sadeghian,Mehrnaz Rezvanfard,Mohammad Alidoosti
Journal of Tehran University Heart Center , 2010,
Abstract: Background: Transcatheter occlusion of the patent ductus arteriosus (PDA) is a minimally invasive treatment. The appropriate device size is chosen based on the angiographic measurement of the PDA. The current study aimed to assess the relationship between the transthoracic echocardiographic (TTE) measurements of the PDA prior to the occlusion procedure and the actual size of the deployed device.Methods: We reviewed the available records of 7 patients (2 male) who underwent the procedure at our institution (mean age: 21 ± 12.7 years, range: 7 to 46 years). PDA closure was performed successfully using the Amplatzer Duct Occluder (n = 5) and its Chinese copycat, Cardi-O-Fix Occluder (n = 2).Results: The TTE measurement of the aortic end diameter of the PDA showed a good linear regression correlation with the size of the implanted duct occluder [duct occluder size = 0.543 + (0.941× TTE measured diameter), R = 0.907; p value ≤ 0.01].Conclusion: TTE can provide a good estimation of the size of the Amplatzer duct occluder.
Free Wall Rupture and Ventricular Septal Defect Post Acute Anterior Myocardial Infarction
Hakimeh Sadeghian,Kyomars Abbasi,Naghmeh Moshtaghi,Mahmood Shirzad
Journal of Tehran University Heart Center , 2007,
Abstract: Myocardial free wall rupture is a catastrophic complication of acute myocardial infarction, and prognosis will depend on the prompt diagnosis by echocardiography, extension of infarct size, and prompt surgical treatment. Free wall rupture concomitant with ventricular septal defect (VSD) may be more complicated for management. A case of a 69-year-old man with myocardial free wall rupture and VSD following acute anterior myocardial infarction is presented.
Transesophageal Echocardiographic Characteristics of Secundum-Type Atrial-Septal Defect in Adult Patients
Mohammad Sahebjam,Reyhaneh Zavar,Masoumeh Lotfi-Tokaldany,Hakimeh Sadeghian
Journal of Tehran University Heart Center , 2009,
Abstract: Background: Given the dearth of data in the existing literature on the size and morphologic variability of secundumtype atrial-septal defect (ASD-II) in adult patients, we aimed to address this issue in a series of consecutive adult patients evaluated by transesophageal echocardiography (TEE).Methods: A total of 50 patients (68.0% female) with isolated ASD-II underwent TEE for the evaluation of the defect. The morphological characteristics of the defect were evaluated, and the largest defect size was measured. The ASD rim wasdivided into 6 sectors: the superior-anterior, superior-posterior, superior, inferior-anterior, inferior-posterior, and inferior.The minimal length of the defect rims was determined.Results: Mean age at the time of evaluation was 33.62±14.48 years. Mean defect diameter in the all the study patients was 20.80±8.17 mm. Thirteen morphological variations were detected. Deficiency of one rim was detected in 14 (28%) patients,two in 16 (32%), three in 2 (4%), and four in 2 (4%). Deficiency of the superior anterior rim was found in 24% of the patients as the most frequent morphology. There was a significant correlation between the defect size and number of deficient rims (γ=0.558, P value<0.001). Forty-eight (96%) patients emerged for defect closure: 22 (46.2%) suitable for percutaneousclosure and 26 (53.8%) for surgical closure. Two patients with small defects were recommended for medical treatment and follow-up.Conclusion: ASD-II is larger and more morphologically variable in adults than in children. Based on the findings of the present and previous studies and given the advantages of percutaneous treatment, it is advisable to make a decision on ASD-II closure as soon as possible before it outgrows the transcatheter closure suitability criteria.
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