Sealing coronary perforation by hand-made covered stent: A case report

Coronary artery perforation, a rare but deadly complication of percutaneous coronary intervention (PCI), can be managed by several modalities, including balloon inflation, heparin-reversing agent, thrombin injection, microcoils, fat embolization, covered-stent implantation, or surgery. We share our experience in emergency innovative management of coronary perforation during routine PCI. We faced an Ellis class III perforation of the right coronary artery during PCI. The balloon inflation technique failed to occlude the perforation, and no other facility was available to solve the problem immediately. The patient developed mild pericardial effusion but was hemodynamically stable. We made a covered stent by wrapping it with polyurethane (Tegaderm® skin dressing material) and deployed it. The perforation was sealed. The patient was discharged in stable condition and doing well at a 12-month follow-up examination. Hand-made covered stent may be a good bailout option to seal coronary perforation where premounted covered stents are not readily available

Comparison of serum homocysteine level in young and middle-aged adult patients with coronary artery disease

Deaths due to coronary artery disease have been increasing in young people aged 15 mmol/L) was 16.2% in Group I compared to 12.4% in Group II (P=0.001). Therefore, control measures for keeping homocysteine levels within the normal range in young people might be useful. BSMMU J 2022; 15(3): 197-20

An Incidental Diagnosis of Rheumatic Mitral Stenosis and Secundum Atrial Septal Defect (Lutembacher’s Syndrome) in a Young Woman

Lutembacher’s syndrome is a rare cardiovascular defect comprising of mitral stenosis and atrial septal defect. A combination of acquired mitral stenosis and congenital atrial septal defect is the most well-recognized pattern. As atrial septal defect acts as a pressure relieving gateway, signs and symptoms of mitral stenosis may be attenuated and/or delayed in such patients. We have presented a case with Lutembacher’s syndrome that was incidentally diagnosed as having such defect during outpatient check-up for upper respiratory infection

Comparison of serum homocysteine level in young and middle-aged adult patients with coronary artery disease: Homocysteine in coronary artery disease

Deaths due to coronary artery disease have been increasing in young people aged <40. Studies have reported an association between these deaths with hyperhomocysteinemia. The aim of this study was to compare serum homocysteine levels in middle-aged patients with coronary artery disease. This cross-sectional study was conducted among 52 cardiology inpatients of Bangabandhu Sheikh Mujib Medical University, Dhaka, from March 2021 to February 2022. Among them, 26 were young adults (<40 years, Group I), and 26 were middle-aged (≥40 years, Group II). Serum homocysteine was measured in all of them using an automated immunoassay analyzer. The younger patients had higher (P=0.001) median homocysteine (interquartile range) level, 13.5 (7.7 –28.4 mmol/L) compared to the middle-aged group, 10.0 (5.9 – 38.5 mmol/L). The hyperhomocysteinemia (>15 mmol/L) was 16.2% in Group I compared to 12.4% in Group II (P=0.001). Therefore, control measures for keeping homocysteine levels within the normal range in young people might be useful. BSMMU J 2022; 15(3): 197-20