Jhulan Mukharji

Lutheran Hospital

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Co-Authors

Robert E. Rude

Los Angeles Medical Center

George W. Vetrovec

Virginia Commonwealth University

James T. Willerson

Baylor College of Medicine

Charles H. Croft

The University of Texas Southwestern Medical Center

Michael J. Cowley

Queensland University of Technology

James R. Corbett

Michigan Medicine

Samuel E. Lewis

Kirklin Clinic

Roger B. Rehr

Virginia Commonwealth University Medical Center

Stephen A. Lewis

University of Charleston

Amar Nath

Indira Gandhi National Open University

Cooperative Institutions

Virginia Commonwealth University Medical Center

University of Texas Health Science Center at Dallas

The University of Texas Southwestern Medical Center

Virginia Commonwealth University

Parkland Memorial Hospital

Harvard University

Brigham and Women's Hospital

The University of Texas Health Science Center at Houston

Yale University

United States Department of Veterans Affairs

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Comparison of atrial contribution to cardiac hemodynamics in patients with normal and severely compromised cardiac function

Clinical Cardiology (1990)

Jhulan Mukharji Roger B. Rehr A Hastillo Jeremy Thompson Michael L. Hess

Abstract The importance of atrial contribution to cardiac function in patients with congestive heart failure is controversial. Ten patients with severe congestive failure (Group A) and 10 patients with normal ventricular function (Group B) were studied during atrial and ventricular pacing. Left ventricular ejection fraction, baseline pulmonary capillary wedge pressure, and baseline cardiac index were different between Group A and Group B patients: 22±10 vs. 65±11 (p<0.01); 21±5 vs. 8±4, (p<0.01); and 2.8±0.5 vs. 3.5±1.0 (p=0.05). Compared with atrial pacing, cardiac index decreased from 2.8±0.6 to 2.2±0.5 (p<O.01) in Group A and from 3.6±0.7 to 2.9±0.5 (p<0.01) in Group B, during ventricular pacing. Pulmonary capillary wedge pressure increased by similar amounts in both groups during ventricular pacing. The change in cardiac index, % change in cardiac index, and change in pulmonary capillary wedge pressure from atrial to ventricular pacing, were not different between Group A and Group B patients. By logistic regression analysis, no association was found between the % change in cardiac index and the following variables: left ventricular ejection fraction, left ventricular end‐diastolic volume, baseline pulmonary capillary wedge pressure, change in pulmonary capillary wedge pressure, and baseline cardiac index. The atrial contribution to resting steady‐state cardiac function is similar between patients with severe congestive failure and those with preserved ventricular function.

Pulmonary wedge pressure

Cardiac index

10.1002/clc.4960130910

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Citations (42)

Lyme carditis. Severe conduction disorder.

PubMed (1990)

Jhulan Mukharji J DiGrazia D Galetto Vetrovec Gw

Lyme disease in most cases occurs in the states of Connecticut, Wisconsin, Oregon, California, Missouri and parts of the northeastern coast. Showing the exception to the rule, the authors discuss a case in which a patient acquired the disease on the Eastern Shore of Virginia.

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Citations (3)

Double‐wire angioplasty of the right coronary artery bifurcational stenosis

Catheterization and Cardiovascular Diagnosis (1988)

Amar Nath George W. Vetrovec Michael J. Cowley Mark Newton Germano DiSciascio

Abstract Two cases of distal right coronary artery (RCA) bifurcational stenoses involving ostia of the posterolateral (PLA) and the posterior descending (PDA) branches in patients who underwent successful coronary angioplasty using a double‐wire technique are reported. A single guiding catheter and sequential balloon inflations were utilized in one, and two guiding catheters and simultaneous balloon inflations in the other. The indications, techniques, and outcomes are described.

Balloon catheter

Balloon dilatation

10.1002/ccd.1810140108

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Citations (14)

Percutaneous removal of a large mobile right atrial thrombus using a basket retrieval device

Catheterization and Cardiovascular Interventions (2000)

Jhulan Mukharji John Peterson

This report documents the removal of a large mobile serpiginous right atrial thrombus using percutaneous intravascular techniques with fluoroscopic and transesophageal echocardiographic guidance. Technical aspects and potential complications are discussed.

10.1002/1522-726x(200012)51:4<479::aid-ccd23>3.0.co;2-f

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Citations (20)

Sudden death and its relation to QT-interval prolongation after acute myocardial infarction: Two-year follow-up

The American Journal of Cardiology (1986)

Kevin R. Wheelan Jhulan Mukharji Robert E. Rude W. Kenneth Poole Nancy Gustafson

Sudden Death

10.1016/0002-9149(86)90606-5

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Citations (70)

Simultaneous left ventricular and ascending aortic pressure measurements via single artery access for assessment of aortic stenosis

Catheterization and Cardiovascular Diagnosis (1989)

Amar Nath George W. Vetrovec Jhulan Mukharji Sharon Cole Stephen A. Lewis

Abstract In order to determine the reliability of a single arterial access technique for hemodynamic assessment of aortic stenosis, data obtained from this method was compared with that from dual arterial access in 13 patients. A 59 cm long, 8 Fr. Mullins Transseptal Sheath (MTS) was placed in the ascending aorta (AA) and a 5 Fr. pigtail catheter advanced through the MTS (using a hemostatic “Y” adapter) into the left ventricle for simultaneous pressure recordings. Another 5 Fr. pigtail catheter (PTC) was advanced in the AA from the contralateral femoral artery. Peak pressures, AA pressure‐tracing characteristics, mean gradients, and the aortic valve area using tracings from the MTS and the PTC were compared. Peak pressures 120 ± 8 vs. 119 ± 8 mmHg (r = .998), “T” time .16 ± .01 vs. .15 ± .01 sec. (r = .913), “U” time .36 ± .02 vs. .36 ± .02 sec. (r = .983), mean gradients 38.4 ± 6.1 vs. 39.6 ± 6.9 mmHg (r = .990) and the AV area .78 ± .08 vs. 79 ± .08 cm 2 (r = .994) were similar. Therefore, this single arterial technique provides data comparable to the traditional dual access system for hemodynamic assessment of aortic stenosis.

Aortic pressure

10.1002/ccd.1810170215

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Citations (8)

Stenting of ostial saphenous vein graft disease originating from a dacron aortic prosthesis

Catheterization and Cardiovascular Diagnosis (1998)

Jhulan Mukharji

This case report represents the first documented instance of using a stent to treat an ostial stenosis in a saphenous vein grafted to a dacron aortic prosthesis. Technical issues are discussed. Cathet. Cardiovasc. Diagn. 43:71–72, 1998. © 1998 Wiley-Liss, Inc.

Saphenous vein graft

10.1002/(sici)1097-0304(199801)43:1<71::aid-ccd21>3.3.co;2-r

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Citations (0)

Percutaneous removal of a large mobile right atrial thrombus using a basket retrieval device

Catheterization and Cardiovascular Interventions (2000)

Jhulan Mukharji John Peterson

Right heart

10.1002/1522-726x(200012)51:4<479::aid-ccd23>3.3.co;2-6

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Citations (0)

Continuous high-dose intracoronary nitroglycerin infusion in refractory coronary vasospasm.

PubMed (1999)

Jhulan Mukharji

This case report illustrates the use of continuous high-dose intracoronary nitroglycerin infusion through a 6 French coronary guiding catheter in the treatment of a patient with cocaine-induced refractory coronary vasospasm.

Nitroglycerin (drug)

Coronary vasospasm

Refractory (planetary science)

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Contrast injection bradycardia during coronary angiography: effects in the denervated human heart.

PubMed (1987)

Jhulan Mukharji M D Thames M. Newton Paul D. Hirsh Sharon Lewis

To assess the contribution of cardiac innervation toward understanding the mechanisms of bradycardia during contrast coronary angiography, heart rate (HR) responses in eight patients after heart transplantation were compared with 10 normal patients (control), 10 patients with coronary artery disease (CAD) and normal ventricular function, and 10 patients with congestive cardiomyopathy and normal coronary arteries. The longest P-P interval was measured beat to beat before (HR 1) and after (HR 2) coronary angiography. The coronary vessel perfusing the sinus node did not influence HR 2 responses within each group. HR 1 was significantly different from HR 2 (p less than 0.05) in the control and CAD groups but was not different in the transplant and cardiomyopathy groups. Compared with the control group, the percent decrease in HR was significantly less in transplant patients than in patients with cardiomyopathy. Thus contrast injection bradycardia is absent in denervated patients after heart transplant, and this response is markedly blunted in cardiomyopathy patients who are known to have diminished vasodepressor reflexes. These findings suggest that the bradycardia response is probably a neurally mediated phenomenon.

Sinus bradycardia

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Citations (7)