Narendra Kumar, V (2014) Clinical profile and Angiographic characteristics of patients with coronary artery bifurcation lesions. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION : Bifurcation coronary lesions constitute 15 – 20 % of total coronary lesions.Bifurcation lesions have diverse clinical presentation, ECG features and angiographic characteristics which are very important in invasive management either by percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) inthese subset of patients. Bifurcation lesions involving left main may be silent with an unpredictable presentation, which gives a challenge in terms of both the diagnosis and management. Multivessel coronary artery disease in patients with bifurcation lesions depends on presence of left main coronary artery disease and associated traditional coronary risk factors for atherosclerosis3. With left main coronary involvement, it is seen in about 80% of patients. The comprehension of bifurcation lesions relies on the fact that the success rate of percutaneous coronary intervention results are suboptimal due to higher incidence of restenosis and side branch occlusion. AIMS AND OBJECTIVES : To study the risk factors, mode of presentation in patients with bifurcation lesions. To study the clinical profile in patients with bifurcation lesions. To study the angiographic characteristics of patients with bifurcation Lesions. To study the pattern of involvement and hospital outcome in patients presenting with bifurcation lesions. CONCLUSION : The incidence of coronarybifurcation lesions in this study was 16% . The incidence of true bifurcation lesion was seen in 42 patients in a total of 48 patients which gives an overall incidence of 87.5% in our study. The major study population was above 50 years constitutes nearly 65%. Males are the predominant population and females show higher percentage of bifurcation lesions. Nearly 33% had normal ejection fraction and 46% had ejection fraction between 45-55% .Diabetes was a major risk factor noted in 65% of study groups and 100 % incidence of bifurcation lesions among them. Smoking and Hypertension were other two risk factors noted. The incidence of bifurcation lesions was higher in smoking cohorts. Acute coronary syndrome was the dominant group in study population. Of which STEMI contributes 46% and UA 21%. Cardiogenic shock and heart failure noted in STEMI subsets, in which majority had triple vessel disease with left main disease. Single vessel disease noted in 24 patients and triple vessel in 21 patients. The most common coronary artery involved was Left Anterior Descending artery. Left main disease seen in 15% of patients. There is a higher incidence of bifurcation lesions noted in patients with triple and double vessel disease. The most common coronary bifurcation lesion pattern noted in Medina’s classification was1, 1, 1in 37 patients among a total of 48 patients. 77% of study patients had a bifurcation angle < 70 degrees.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | angiographic characteristics ; patients ; coronary artery ; bifurcation lesions ; Clinical profile. |
| Subjects: | MEDICAL > Cardiology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 05 Jul 2017 23:54 |
| Last Modified: | 06 Jul 2017 09:45 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1048 |
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