Page 60 - #Dr Shahid Merchant Biography

Cases
Cases CasesCases

Rescue Angioplasty With Recurrent Chest Pain Post Thrombolysis Management of Congestive Heart Failure

Case 2 : Patient Name : Mrs. Meera Case 5 : Patient Name : Peter D'Souza

Mrs. Meera 68 years old female patient Propped position oxygen, Inj Fentanyl, IV Medozolam, Inj Lasix
CABG done in 2001 presented with
STEMI inferior lateral wall. Thrombolysed Pre load reduction – IV NTG
IV Elaxim Symptoms & ST segment
settled. After two hours chest pain again After load reduction – Rampril / Losartan
with ST segment elevation shifted to
Ionotrops / IABP
Cath Lab CAG patent LIMA to Type – 2
LAD. Vein graft to dominant RCA 95%
Ventilator – PO2 < 45mmHg, PCO2 > 50mmHg
thrombotic occlusion in proximal Cardiac Re synchronization device with ICD
segment. Treated with aspiration, PRE Stent Deployment POST
Intracoronary Integrilin, 3x28mm DES Peter D’souza 44 years old insulin dependent diabetic presented with a heart failure & ventricular
with distal protection device. Patient tachyarrhythmias. 2D – Echo Showed diffuse LV hypokinesia, Ef – 20%. He underwent a successful
shifted to ICU asymptomatic & ST implant with a combo device which consist of cardiac resynchronization therapy with implantable
segment isoelectric. cardiovertor defrillator. 3 months later, patient walks briskly for 30 minutes with no symptoms. LV EF 35%
on 2D – Echo.

Cardiogenic Shock Treated with BVS Scaffolding Management of Bradyarrthymia

Case 3 : Patient Name : Rayappa Samy Case 6 : Patient Name : Moreshwar Raut
Rayappa Samy 71 years old diabetic presented Moreshwar Raut 72 years old male patient
with heart failure and cardiogenic shock presented with syncope & angina. ECG showed
stabilized on ventilator, IABP and Ionotropic sick sinus syndrome with RBBB, Intermitant A-
support, 2D-Echo and angiography reveled V Conduction defect. Initially treated with IV
LVEF-20%, a kinetic thinned out aneurysm Atropine / Inj. Adrenaline / Temporary pacing. Coronary
apex and anterior wall of heart. Patent stent angio showed calcified diffuse LAD stenosis.
in the LAD normal obtuse marginal and Treated with Dual chamber pace maker & 1
week later two overlapping BVS scaffolding
calcified long stenosis in proximal and mid
deployed to LAD stenosis.
segment of dominant RCA. The vascular bed
in the RCA stenosis was calcified, fibrotic and IVUS
needed sequently balloon dilation with 2.5 PRE POST Dual Chamber Pace Maker Implant
x10 mm NC balloon at high pressure to create a good vascular bed to advance two long BVS stents 3x18mm
and 3.5x20mm BVS deployed at 18mm and post dilated the BVS by 3.5x15mm NC balloon at 20 atm good
excellent result.

Pharmaco Invasive approach Management of Ventricular Tachycardia / Fibrillation
Case 4 : Patient Name : Yesare Case 7 : Patient Name : Snehal Patil
Mr. Yesare 55 Years old male patient Snehal Patil 20 years old presented with 3
presented with acute chest pain to clinic episodes of giddiness and syncope. 48 hours
in interior of Maharashtra. Bolus of Inj. holter showed multiple episodes of V. Tach,
Elaxim was given & within 12 hours bigeminy, multifocal VPB. 2D Echo showed
patient was shifted to cath lab, Coronary arthmogenic RV dysplasia. AICD was
angiography showed large load of implanted. She had 3 episodes of sustained
thrombus, treated with intra coronary IV ventricular tachycardia in 6 months and
Angiomax, Intra coronary Integrilin & DES received DC shock to convert to sinus rhythm.
Excellent Final Result.
Stent Deployment
PRE POST

AICD Device