No abstract available.
Aneurysm* ; Echocardiography ; Mitral Valve Stenosis*

Acquired bilateral pulmonary artery stenosis in adults due to lung malignancy is infrequently reported. We describe an adult male who presented to us with chief complaints of dyspnea on exertion and one episode of hemoptysis. Two dimensional transthoracic echocardiography with color Doppler showed presence of an extra cardiac mass causing severe extrinsic compression of both the right and left pulmonary artery leading to high pressure severe tricuspid regurgitation and extension of the mass into the left atrium. Three dimensional transthoracic echocardiography clearly delineated the anatomy of the left atrial mass and its surrounding anatomical relationship. The diagnosis of non small cell lung carcinoma was confirmed by multidetector computed tomography (MDCT) and with MDCT guided biopsy with histopathology. Patient succumbed one month later due to an episode of massive hemoptysis.
Adult ; Biopsy ; Carcinoma, Non-Small-Cell Lung ; Constriction, Pathologic* ; Diagnosis ; Dyspnea* ; Echocardiography ; Echocardiography, Three-Dimensional ; Heart Atria ; Hemoptysis ; Humans ; Lung* ; Male ; Multidetector Computed Tomography ; Pulmonary Artery* ; Tricuspid Valve Insufficiency

INTRODUCTIONThis study aimed to examine the long-term clinical outcomes of coronary fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) in a real-world population in an Asian tertiary centre.

MATERIALS AND METHODSAll patients who underwent FFR measurement for intermediate coronary lesions in our centre from June 2002 to December 2009 were enrolled. A threshold of FFR ≤0.75 was used for revascularisation. All the patients were prospectively followed-up for major adverse cardiac events (MACE) of death, myocardial infarction (MI), target vessel revascularisation (TVR) and stent thrombosis.

RESULTSBased on FFR measurement, 368 (57%) patients were treated medically while 278 (43%) underwent revascularisation. At a mean follow-up duration of 29.7 ± 16 months, 53 (14.4%) patients in the medical therapy group and 32 (11.5%) patients in the revascularised group experienced MACE (P = 0.282). There were no statistical differences in all the clinical endpoints between the 2 groups.

CONCLUSIONMedical therapy based on FFR measurement is associated with low incidences of MACE at long-term follow-up.

Adult ; Aged ; Aspirin ; therapeutic use ; Coronary Stenosis ; complications ; diagnosis ; therapy ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; methods ; Platelet Aggregation Inhibitors ; therapeutic use ; Retrospective Studies ; Ticlopidine ; analogs & derivatives ; therapeutic use ; Treatment Outcome