Stefano Sasso , Marcello Marchetta , Andrea Moretti , Vincenzo Bernardo , Gaetano Chiricolo , Giuseppe Massimo Sangiorgi
{"title":"Abandoned guidewire recapture from aortic root using “Guidewire twirling technique”","authors":"Stefano Sasso , Marcello Marchetta , Andrea Moretti , Vincenzo Bernardo , Gaetano Chiricolo , Giuseppe Massimo Sangiorgi","doi":"10.1016/j.crmic.2024.100048","DOIUrl":"10.1016/j.crmic.2024.100048","url":null,"abstract":"<div><div>Percutaneous coronary intervention (PCI) is a common procedure for treating coronary artery disease, but it can be complicated by the loss and fracture of coronary guidewires within the vascular system, leading to severe complications such as vessel damage, occlusion, and embolization. This case report describes a unique and challenging scenario involving an 81-year-old male patient who, during an elective coronary angiography, was found to have a fractured and partially decoiled coronary guidewire extending from the aortic root to the left subclavian artery. The guidewire had likely been left in place during a previous procedure and was not documented in the patient's medical history. Given the potential for life-threatening complications, including occlusion of the left internal mammary artery graft, a percutaneous retrieval was attempted. Initial efforts using a snare system were unsuccessful. However, the guidewire was successfully retrieved using the “twirling guidewires” technique, which involved entangling the fractured wire with three 0.014-inch guidewires and carefully extracting it through a guide catheter. The patient avoided invasive surgery and was discharged without complications the day after. This case highlights the importance of recognizing and managing lost guidewire fragments using various percutaneous techniques, underscoring the need for interventional cardiologists to be adept in both coronary and peripheral retrieval strategies.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"4 ","pages":"Article 100048"},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142657959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Inverted left atrial appendage developing after mitral valve replacement surgery","authors":"Abdul Rasheed Bahar , Paawanjot Kaur , Manmohan Singh , Shaun Cardozo","doi":"10.1016/j.crmic.2024.100046","DOIUrl":"10.1016/j.crmic.2024.100046","url":null,"abstract":"<div><div>An inverted left atrial appendage (ILAA) is a rare occurrence after cardiac surgery and can be misinterpreted as a left atrial thrombus, mass, or vegetation. Transesophageal echocardiography (TEE) used post-operatively is useful in detailed visualization of the left atrium and any abnormality within it. We present a case in which a patient developed an ILAA post mitral valve replacement (MVR) and was diagnosed using TEE. We want to emphasize the importance of TEE post-operatively and that differentials for a left atrial mass must include ILAA, especially after cardiac surgery. This can help in preventing unnecessary anticoagulation and the need for surgical revision.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"4 ","pages":"Article 100046"},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Akiva Rosenzveig , Shinya Unai , Venu Menon , Grant W. Reed
{"title":"An enigmatic presentation of surgical bioprosthetic aortic valve stenosis","authors":"Akiva Rosenzveig , Shinya Unai , Venu Menon , Grant W. Reed","doi":"10.1016/j.crmic.2024.100047","DOIUrl":"10.1016/j.crmic.2024.100047","url":null,"abstract":"<div><div>A 63 year old woman with a history of atrial flutter, hypertension and bicuspid aortic valve status post aortic valve replacement presented with worsening dyspnea and presyncope and echocardiography findings of bioprosthetic valve dysfunction. Imaging found a non-infectious pseudoaneurysm, with subsequent redo sternotomy finding of BioGlue causing increasing gradients.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"4 ","pages":"Article 100047"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sandeep Kancharla, Matthew Bridges, Christopher Hinson, Alejandro Lemor
{"title":"Conquering acute coronary syndrome in coronary artery ectasia: Thrombus resolution with intracoronary thrombolysis, aspiration thrombectomy, and triple therapy","authors":"Sandeep Kancharla, Matthew Bridges, Christopher Hinson, Alejandro Lemor","doi":"10.1016/j.crmic.2024.100044","DOIUrl":"10.1016/j.crmic.2024.100044","url":null,"abstract":"<div><div>We present a case of acute coronary syndrome in a patient with coronary artery ectasia. Intravascular imaging revealed complete thrombotic occlusion of the right coronary artery. Although initial aspiration thrombectomy was ineffective, intracoronary alteplase improved subsequent aspiration attempts. Medical management with anticoagulation alongside antiplatelet therapy reduced thrombotic burden with sustained effect.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"4 ","pages":"Article 100044"},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Saving right radial cardiac catheterization with tortuous subclavian artery using head left turning maneuver for facilitating wire advancement into the ascending aorta","authors":"Mohammad Reza Movahed","doi":"10.1016/j.crmic.2024.100045","DOIUrl":"10.1016/j.crmic.2024.100045","url":null,"abstract":"<div><div>Cardiac catheterization via the right radial artery is associated with a lower complication rate and is gaining popularity. However, there are unique challenges that can lead to procedural failure. One of the major challenges is advancing guide wire into the ascending aorta in a very tortuous subclavian artery. The deep inspiratory maneuver is one of the important maneuvers to overcome wire advancement into the aorta. However, in some cases, the wire will enter the descending aorta with great difficulty in repositioning in the ascending aorta. In this case, we describe a case of a very tortuous subclavian artery that prevents wire advancement into the ascending aorta despite repositioning the catheter and performing deep inspiratory maneuvers. However, after instructing the patient to move her head to the left, wire advancement into the ascending aorta was easily achieved. In this case report, an easy-to-perform maneuver is described in these tough situations that can save the procedure that was started via the right radial route.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"4 ","pages":"Article 100045"},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000418/pdfft?md5=5ab79eacbf7e1400356819d826cf89d7&pid=1-s2.0-S2950275624000418-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142310863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Grace C. Bloomfield , Bryan J. LeBude , Ramez S.F. Jabaji , Steven R. Potter , Kalyan R. Chitturi , Lowell F. Satler , Ron Waksman , Brian C. Case
{"title":"Cardiac tamponade as the first presentation of allograft intolerance of an old transplanted kidney","authors":"Grace C. Bloomfield , Bryan J. LeBude , Ramez S.F. Jabaji , Steven R. Potter , Kalyan R. Chitturi , Lowell F. Satler , Ron Waksman , Brian C. Case","doi":"10.1016/j.crmic.2024.100040","DOIUrl":"10.1016/j.crmic.2024.100040","url":null,"abstract":"<div><p>We present a case of cardiac tamponade as the presenting sign of intolerance of a failed, non-functioning transplanted kidney. Through this case, we describe a refractory systemic inflammatory response with treatment escalation and ultimate resolution through transplant nephrectomy.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100040"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000364/pdfft?md5=6a65e0002d42d280889856a853014326&pid=1-s2.0-S2950275624000364-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141853076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giuseppe Colletti , Gabriele Gasparini L. , Mihai Cocoi , Alexandre Natalis , Pierpasquale Leone , Claudiu Ungureanu
{"title":"True lumen wiring in spontaneous coronary artery dissection – Keep it true","authors":"Giuseppe Colletti , Gabriele Gasparini L. , Mihai Cocoi , Alexandre Natalis , Pierpasquale Leone , Claudiu Ungureanu","doi":"10.1016/j.crmic.2024.100036","DOIUrl":"10.1016/j.crmic.2024.100036","url":null,"abstract":"<div><p>Spontaneous coronary artery dissection (SCAD) poses a significant challenge in young female patients presenting with acute coronary syndromes. We report a case of a 43-year-old female presenting with non-ST elevation acute coronary syndrome, diagnosed with SCAD. Utilizing a Suoh 0.3 guidewire and microcatheter, successful percutaneous intervention was achieved. Notably, once a position in the true lumen was established, the use of a dual-lumen microcatheter facilitated the identification of the main branch of the true lumen through side-port contrast injection and enabled safe delivery of a second wire within it. This highlights the importance of tailored interventions and innovative tools in managing SCAD effectively.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100036"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000327/pdfft?md5=57e3f7708093f4ec40b1e083319c018d&pid=1-s2.0-S2950275624000327-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Trung Quang Le , Jacob Hayden , Lorenzo Azzalini , Taishi Hirai
{"title":"Improvement of ischemia by subintimal tracking and re-entry in chronic total occlusion percutaneous coronary intervention","authors":"Trung Quang Le , Jacob Hayden , Lorenzo Azzalini , Taishi Hirai","doi":"10.1016/j.crmic.2024.100043","DOIUrl":"10.1016/j.crmic.2024.100043","url":null,"abstract":"<div><p>A 56-year-old male truck driver with history of percutaneous coronary intervention (PCI) to the left circumflex artery presented for worsening angina. A nuclear stress test showed a moderate reversible defect of the inferior wall. A chronic total occlusion of the mid right coronary artery with patent circumflex stent was documented by coronary angiography. After unsuccessful attempts with anterograde and retrograde wiring and dissection re-entry techniques, the subintimal tracking and re-entry (STAR) technique was utilized to advance the guidewire in an extraplaque fashion into the posterior descending artery and posterolateral branch with kissing balloon angioplasty at the bifurcation. A repeat stress test, as required by the state Department of Transportation, demonstrated a resolution of the previous reversible ischemia defect. The patient's symptoms also improved after STAR. Our case highlights an objective improvement of ischemia after STAR.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100043"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S295027562400039X/pdfft?md5=7b187f83085f1f6d76d32fb3bbe42a04&pid=1-s2.0-S295027562400039X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142097318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmed Al-Ogaili , Salman Allana , Yader Sandoval , Emmanouil S. Brilakis
{"title":"Intracoronary snaring to overcome severe tortuosity in chronic total occlusion percutaneous coronary intervention","authors":"Ahmed Al-Ogaili , Salman Allana , Yader Sandoval , Emmanouil S. Brilakis","doi":"10.1016/j.crmic.2024.100041","DOIUrl":"10.1016/j.crmic.2024.100041","url":null,"abstract":"<div><p>Severe tortuosity poses a challenge for chronic total occlusion (CTO) operators and decreases the success rate of CTO percutaneous coronary intervention (PCI). Extreme angulations are more common in patients with prior coronary artery bypass surgery (CABG) especially at the distal graft anastomosis. We present three challenging CTO PCI cases performed in patients with prior CABG during which intracoronary snaring was implemented to overcome severe tortuosity and successfully recanalize the occlusions.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100041"},"PeriodicalIF":0.0,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000376/pdfft?md5=f179ef565498418d0bbb5d3d161eaffb&pid=1-s2.0-S2950275624000376-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mahmut Ekrem Cunetoglu, Volkan Kozluca, Bilge Nazar Ates, Cagdas Ozdol, Ali Timucin Altin
{"title":"An unusual retrieval of semi-detached stent: A multistage procedure","authors":"Mahmut Ekrem Cunetoglu, Volkan Kozluca, Bilge Nazar Ates, Cagdas Ozdol, Ali Timucin Altin","doi":"10.1016/j.crmic.2024.100042","DOIUrl":"10.1016/j.crmic.2024.100042","url":null,"abstract":"<div><p>The occurrence of coronary artery stent detachment from the balloon is infrequent during cardiac procedures, although it poses a potentially grave consequence. It can result in the development of induced coronary thrombosis, myocardial infarction, and disruption of peripheral and cerebral blood circulation. There is no universally accepted procedure for extracting the stent, however, several techniques and their combinations can be employed based on the specific circumstances of the case and the ingenuity of the operator. Various techniques were employed to extract the stripped stent in the right coronary artery (RCA), and ultimately it was effectively retrieved using an untested approach.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100042"},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000388/pdfft?md5=10fa7b9c42f39a3e2c4337efaa7d6877&pid=1-s2.0-S2950275624000388-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141846953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}