Publications by authors named "Farshad Jalili-Shahandashti"

2 Publications

  • Page 1 of 1

A rare presentation of late right coronary artery spasm following aortic valve replacement.

ARYA Atheroscler 2015 Jan;11(1):50-3

Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

Background: Coronary artery spasm (CAS) is defined as a reversible, sudden epicardial coronary artery stenosis that causes vessel occlusion or near occlusion.

Case Report: In this article, we present a clinical case of CAS in a 48-year-old woman undergoing elective aortic valve replacement surgery for aortic stenosis. On the 3rd post-operative day, the patient suffered from chest pain and dyspnea. Emergent coronary angiography demonstrated a significant spasm of the ostium portion of the right coronary artery.

Conclusion: This case shows that delayed coronary spasm should be considered as a cause of hemodynamic instability after valvular surgery.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4460353PMC
January 2015

Rotational thromboelastometry in prediction of bleeding after cardiac surgery.

Asian Cardiovasc Thorac Ann 2015 Jun 12;23(5):525-9. Epub 2015 Jan 12.

Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran

Background: Reexploration and its associated complications significantly affect hospital mortality and morbidity. Therefore, to prevent postoperative bleeding and its related complications, using an appropriate modality is essential during cardiac surgery.

Methods: Four hundred patients (296 males and 104 females, mean age 60.8 ± 9 years) scheduled for first-time coronary artery bypass graft surgery were prospectively enrolled. Blood samples were obtained for ROTEM testing before surgery and 30 min after heparin reversal. The patients were divided into 2 groups: group 1 was patients with no abnormal postoperative bleeding and group 2 was patients who required reexploration for abnormal postoperative bleeding. Group 2 patients were divided into 2 subgroups: 2a was patients with surgical bleeding and group 2b was patients with nonsurgical bleeding. Variables were compared between groups.

Results: Among the 400 patients, 42 were reexplored. Hospital stay was significantly longer and hospital deaths more frequent in group 2 patients (p < 0.001 and p = 0.010, respectively). Ten (2.8%) patients had abnormal preoperative results of ROTEM in group 1 compared to 14 (33.3%) in group 2 (p < 0.001). After surgery, the number of patients with abnormal ROTEM results was significantly different between the 2 groups: 6 (1.7%) in group 1 vs. 14 (33.3%) in group 2 (p < 0.001). Four (12.5%) patients in group 2a had abnormal preoperative ROTEM results compared to 10 (100%) in group 2a (p < 0.001).

Conclusion: Measuring coagulation factors by ROTEM both before surgery and after heparin reversal can identify patients at increased risk of postoperative bleeding.
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http://dx.doi.org/10.1177/0218492314566330DOI Listing
June 2015