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  • ISSN: 2378-9344
    Volume 3, Issue 3
    Short Communication
    Mostafa M. Zaman*
    A review of all the population and school based studies indicate that prevalence of RHD has been declining in Bangladesh; from 7.5 per 1000 in 1977 to 0.3 per 1000 in 2005. No study is available for last 10 years. A regression line (exponential) has been drawn using prevalence points of all the studies identified. Although the line is very close to the ground, it will presumably take another decade or two to touch the zero line. Studies at five years interval are needed to monitor the trend of RHD.
    Bipin Kumar*
    This research introduces a smart textile for the functional treatment of chronic venous insufficiency (CVI), by providing adjustable and controllable compression benefits. In conventional compression practices for CVI using bandage or stocking, there has been always a problem of achieving the recommended compression level. Herein, we are aiming to overcome these challenges using a memory fabric to provide functional compression benefits including controlled pressure change at selective sites, dynamic compression benefits, and warming therapy. The smart fabric is developed with memory filaments for optimal interfacial pressure management. The fabric allows pressure alteration via an external temperature actuation.Given the compelling need for the treatment and prevention of CVI, this work has the potential to provide a cutting-edge and novel solution to overcome many of the obstacles of pressure management using conventional approaches.
    Case Report
    Kensaku Yoshida* and Hidenori Oishi
    This report describes a rare case of a patient with arteriovenous malformation in the parotid region that received endovascular treatment. A 44-year-old female who presented with cardiac murmur in the left neck on close examination was referred to our hospital. Physical findings included left jugular vein distention, swelling of the left neck, and vascular murmur on auscultation. Cervical magnetic resonance imaging revealed flow voids in dilated vessels in the left parotid region. Angiography showed a high flow shunt between the dilated external carotid artery and the external jugular vein. The patient was diagnosed as having AVM in the parotid region due to AVM localization, and endovascular treatment was performed for the AVM. The postoperative course was uneventful and no recurrence occurred for five years postoperatively. AVMin the parotid region may develop in association with trauma or it may have a genetic predisposition. There are presently many reports on direct shunts. However, the AVM is generally a single channel shunt and some studies have reported that endovascular treatment is effective for the AVM. In the present patient, endovascular treatment was suitable because the AVM consisted of a single channel and the shunt site could be easily identified.
    Research Article
    Trushar Gajjar*
    Objective: Coronary artery fistula is an unusual coronary anomaly. To thespectrum of coronary cameral communications, we want to add this separate entityof coronary cameral fistula by presenting the clinical features, morphologic aspects, diagnostic criteria, management options, and outcome in various clinical settings forbetter understanding of this developmentally intriguing, clinically complex, and therapeutically challenging disorder.
    Methods: From June 1992 through June 2016, 16 patients were treated for coronary cameral fistula at our institution. Ages ranged from 1 to 53 years. There were 8 male subjects and 8 female subjects. Morphologically, isolated fistulas arise from both the right and left coronary arteries, probably with similar frequency, but terminate much more commonly in the right heart or pulmonary artery than in the left heart. But in our series 76.4%(n=13) of the fistula originated from the left coronary artery and 23.6% (n=4) from the right coronary artery. The termination or drainage to the right ventricle in 47% (n=8), to the right atrium in 29.4% (n=5), to the coronary sinus and left atrium in 5.9% each (n=1 each) and to the pulmonary artery in 11.6% (n=2); In all patients the diagnosis was established by means of 2-dimensional echocardiography and transesophageal echocardiography and confirmed by means of angiography and contrast enhanced tomography scan. Fifteen patients were treated surgically, and1 patient was treated with coil embolization. Postoperative echocardiograms obtained for all patients before discharge confirmed complete obliteration of the tunnel.
    Results: There was no early or late mortality. All patients were discharged in stable condition. During follow-up at 3 months, 1year, 5years, 10 years and more than 10 years, all patients were in New York Heart Association class I, and echocardiography showed no residual shunts.
    Conclusions: Coronary cameral fistula is a rare congenital anomaly. It can be seen isolated or in association with other cardiac defects. It may arise from one coronary system or involve both coronary systems. Fistulas draining into the coronary sinus are prone to develop congestive cardiac failure. Fistulas draining in Right atrium or coronary sinus are prone to develop atrial fibrillation& its sequel. Cardiac cath and coronary angiography gives definitive diagnosis and planning management and to rule out other cardiac lesions. Computed tomography angio may replace angiography in the future for noninvasive diagnosis. Surgery is indicated for lesions not amenable to percutaneous closure. Surgical closure can be done with or without cardio pulmonary bypass by ligation, tangential arteriorraphy or closure via cardiac chamber. Most of the fistula can be dealt with in the interventional catheterization laboratory. However, occasionally large fistulas have a difficult origin and may present particular challenges to the interventional catheterization team so that they require surgical management.The location and the size of the fistula dictates technical details. Follow-up reveals excellent functional recovery.
    Mini Review
    Maythem Saeed* and Mark M Wilson
    Coronary microembolization occurs in spontaneous atherosclerosis plaque rupture, valvular disease, endocarditis, arrhythmias, heart-lung bypass surgery, congenital heart disease, hypertension, diabetes, systemic lupus erythematosus and sickle cell disease. Coronary microembolization can also be induced by therapeutic coronary interventions. High intensity transient signals (HITS) derived from Doppler guide wire has the potential to count coronary microemboli in real-time during percutaneous coronary intervention (PCI). Both non-invasive magnetic resonance imaging (MRI) and computed tomography (CT) have the potential for assessing regional perfusion and left ventricular (LV) function after PCI. The visibility of micro infarct on MRI and CT after administration of contrast media, however, is limited and depends on technical and biological factors. Both MRI and CT modalities underestimate total micro infarct size compared with microscopy. MR images revealed that the presence of coronary microemboli in pre-existing large infarct delays the healing process and magnifies LV remodeling. Chronological preclinical studies revealed that coronary microemboli migrate into the extravascular space leading to natural revascularization. Despite current standard of care, existing methods and therapies do not prevent coronary embolization and completely reverse their deleterious effects.
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