Rabi Malla
Kathmandu
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Featured researches published by Rabi Malla.
Cardiovascular diagnosis and therapy | 2016
Chandra Mani Adhikari; Rabi Malla; Rajib Rajbhandari; Urmila Shakya; Poonam Sharma; Nagma Shrestha; K.C. Bishal; Deepak Limbu; Man Bahadur Kc
BACKGROUND Percutaneous transvenous mitral commissurotomy (PTMC) is a valid alternative to surgical therapy in selected patients with mitral stenosis. Juvenile mitral stenosis (JMS) varies uniquely from adult rheumatic heart disease (RHD). We aimed to evaluate the efficacy of PTMC in JMS patients. METHODS It was a single centre, retrospective study conducted between July 2013 to June 2015 in Shahid Gangalal National Heart Centre, Kathmandu, Nepal. Medical records of all consecutive patients aged less than 21 years who underwent PTMC were included. Mitral valve area (MVA), left atrial pressure and mitral regurgitation (MR) were compared pre and post procedure. RESULTS During the study period 131 JMS patients underwent PTMC. Seventy (53.4%) were female and 61 (46.6%) were male. Among the 131 patients, 40 (30.5%) patients were below the age of 15 years. Patient age ranged between 9 to 20 years with the mean of 16.3±2.9 years. Electrocardiography (ECG) findings were normal sinus rhythm in 115 (87.7%) patients and atrial fibrillation in 16 (12.3%) patients. Left atrial size ranged from 2.9 to 6.1 cm with the mean of 4.5±0.6 cm. The mean MVA increased from 0.8±0.1 cm(2) to 1.6±0.2 following PTMC. Mean left atrial pressure decreased from their pre-PTMC state of 27.5±8.6 to 14.1±5.8 mmHg. Successful results were observed in 115 (87.7%) patients. Suboptimal MVA <1.5 cm(2) in 11 (8.4%) patients and post-procedure MR of more than moderate MR in 5 (3.8%) patients was the reason for unsuccessful PTMC. CONCLUSIONS PTMC in JMS is safe and effective.
Indian heart journal | 2018
Sachin Dhungel; Rabi Malla; Chandramani Adhikari; Arun Maskey; Rajib Rajbhandari; Rashika Sharma; Himanshu Prasad Nepal; B Rauniyar; Dharmanath Yadav; Deepak Limbu; Milan Gautam; Ajay Adhikari; Safal Dhungel; Hari Upadhyay
Background Door-to-balloon (DTB) time of 90 min during primary angioplasty is considered as the benchmark duration. Shorter DTB time is preferable, and longer duration can have poor clinical outcomes. Methods A cross-sectional observational study of three months in Shahid Gangalal National Heart Center was conducted in which all patients undergoing primary angioplasty were included. The DTB time was calculated, and the different determining factors were studied. Results Seventy-nine patients undergoing primary percutaneous intervention were studied. The median DTB time was 79 minutes (Interquartile range [IQR] 59–115 min). Forty-six (58.2%) patients had a DTB time of less than 90 min. DTB time varied significantly with direct visit vs transfer (p = 0.029) and office time visit (9 am–5 pm) vs off time (5 pm–9 am) (p = 0.012). DTB time did not differ between any infarct-related vessels (p = 0.471), number of vessels involved (p = 0.638), and the added procedures (defibrillation, thrombosuction, and temporary pacemaker insertion) (p = 0.682) during angioplasty. No significant differences were recorded according to age (p = 0.330), gender (p = 0.254), hypertension (p = 0.073), diabetes (p = 0.487), heart failure (p = 0.316), and baseline left ventricular ejection fraction (LVEF) (p = 0.819). Conclusion The median DTB time in primary angioplasty was less than 90 minutes. The significant determining factors were timing of hospital visit (office vs off time) and type of visit (direct vs transfer). There can be improvement in factors determining DTB time to lower it further.
The Egyptian Heart Journal | 2017
Chandra Mani Adhikari; Rabi Malla; Raamesh Koirala; Dipanker Prajapati; Navin Gautam
MV repair in the rheumatic population is feasible with acceptable long-term results. Incidence of mitral stenosis (MS) following mitral valve (MV) repair for severe rheumatic mitral regurgitation (MR) and usefulness of percutaneous transluminal mitral valvuloplasty in these patients is not described in literature. We report a case of successful PTMC in severe MS following MV repair for severe rheumatic MR.
The Egyptian Heart Journal | 2017
K.C. Bishal; Rabi Malla; Chandra Mani Adhikari; Binay Kumar Rauniyar; Deepak Limbu
Background Renovascular hypertension due to fibromuscular dysplasia is an uncommon cause of secondary hypertension and is more common in females. This entity is an important treatable cause of secondary hypertension. Case presentation We report the case of a 21-year-old asymptomatic male found to have high blood pressure on routine checkup. Renal angiogram revealed fibromuscular dysplasia involving the right renal artery. He underwent percutaneous angioplasty with complete recovery. The single antihypertensive which he was on was stopped next month. Conclusion Fibromuscular dysplasia causing stenosis of renal artery is uncommon. High degree of suspicion is required for the timely diagnosis and treatment of this potentially treatable cause of secondary hypertension.
Indian heart journal | 2016
Rajib Rajbhandari; Rabi Malla; Arun Maskey; Yadav Bhatta; Yubraj Limbu; Ranjit Sharma; Satish Singh; Chandramani Adhikari; Sundeep Mishra
Background The percutaneous transvenous mitral commissurotomy is an important procedure for the treatment of mitral stenosis. A lot of mitral stenosis cases have left atrial appendage clot which precludes the patient from the benefit of this procedure. The aim of the study was to study the feasibility and safety of the procedure in a patient with appendage clot in the setup of certain urgent conditions. Method All cases of mitral stenosis with significant dyspnea and mitral valve area <1.5 cm2 with left atrial appendage clot and a condition which would preclude the patient from continuing on anticoagulation and needed urgent intervention were included in the study. From January 2011 to December 2013, twenty patients coming to Shahid Gangalal National Heart Centre, Kathmandu were selected for the procedure with conventional sampling technique. Informed written consent was obtained from the patients explaining all possible complications. The approval of the study was taken from the ethical committee of the hospital. Result Mean mitral valve area increased from 0.90 cm2 (SD ± 0.14) to 1.5 cm2 (SD ± 0.21) (p = 0.02). Left atrial mean pressure decreased from mean of 20 to 10 mmHg. Subjective improvement was reported in all. All of the patients had fulfilled criteria for successful PTMC. There was no mortality during hospital stay or in one-week follow-up period. There were no neurological complications or any need for emergency surgery. Conclusion The immediate result of percutaneous transvenous mitral commissurotomy in selected cases of mitral stenosis with left atrial appendage clot is safe and acceptable in certain urgent situations in experienced hands.
Journal of Cardiology and Therapeutics | 2015
Arun Maskey; Mahesh Bhattarai; L. Dubey; B. Rawat; N. Shrestha; Rabi Malla; Rajib Rajbhandari; Y.K.D. Bhatt; H. Nepal; R. Pandey
Introduction : Percutaneous coronary intervention (PCI) is an important aspect of management of ischemic heart disease. The use of PCI has expanded with importance on minimizing post-procedural vascular and bleeding complications while maintaining procedural success. The radial artery has emerged as an alternative to the femoral artery for the access sitefor the procedure. Objectives : The main objective of the study was to assess the trend of PCI, procedural outcome and complications. Methods : This is a retrospective study which included four thousand two hundred and eighty eight patients who had underwent percutaneous coronary intervention during the study period of ten years from 2002 to 2012. The data on demographic profile, angiographic characteristics, outcome and complications of the procedure were analyzed. Results : The mean age of the patients was50 ± 10.5 years ranging from 21 to 91 years. The79.5% (3409) were male and 20.5% (879) were female. The 75.3 % (3228) of the PCI were elective procedure. The 94.38% (4047) of the patient had single vessel PCI and 241(5.62%) had multivessels PCI. The PCI to LAD was the most common in 2153 (47.43%) followed by RCA 1401(30.87%) and then LCX 957 (21.08%). Overall success rate of the procedure was 95.03%. The mortality was observed in 1.07% (46) of the patients. The use of radial artery access for the PCI has a rising trend over years. The 43.5% of the procedure were performed from the radial access in 2012. Conclusion : Percutaneous coronary intervention in Nepal is increasing every year with accepted success rate and complication. With experience more complex cases are being done. Radial PCI has increasing trend.
Indian heart journal | 2003
Bahadur Kc; Sharma D; Shrestha Mp; Gurung S; Rajbhandari S; Rabi Malla; Rajib Rajbhandari; Limbu Yr; Regmi; Koirala B
Indian heart journal | 2006
Sharma D; Bkc M; Rajbhandari S; Raut R; Baidya Sg; Kafle Pm; Baral B; Rajib Rajbhandari; Bhatt Yd; Rabi Malla; Arun Maskey; Yubraj Limbu; Regmi; Koirala B
Journal of Nepal Medical Association | 2009
Rabi Malla; Ranjit Sharma; B Rauniyar; Man Bahadur Kc; Arun Maskey; D D Joshi; S Hamal
Heart & Lung | 2006
Yuba Raj Limbu; Rabi Malla; Shyam Raj Regmi; Ramesh Dahal; Hari L. Nakarmi; Ganesh Yonzan; Ritu P. Gartaula