Cardiovascular Revascularization Medicine: Interesting Cases最新文献

{"title":"Concomitant balloon mitral and tricuspid valvuloplasty using a single Sym balloon","authors":"Souvik Sardar,&nbsp;Krishna Prasad Akkineni,&nbsp;Alaina Zameer,&nbsp;Sourabh Agstam,&nbsp;Sumit Kumar,&nbsp;Atit A Gawalkar","doi":"10.1016/j.crmic.2025.100069","DOIUrl":"10.1016/j.crmic.2025.100069","url":null,"abstract":"<div><div>A 31-year-old male with severe rheumatic mitral and tricuspid stenosis presented with NYHA class III dyspnea and pedal edema. Echocardiography confirmed severe mitral (MVA: 0.7 cm², MVG: 8.5 mmHg) and tricuspid stenosis (TVG: 5 mmHg). He underwent sequential balloon mitral and tricuspid valvuloplasty using a single Sym balloon following which the MVG reduced to 5.5 mmHg, MVA increased to 1.3 cm², and TVG reduced to 3.5 mmHg. The patient had significant symptomatic improvement and remained clinically stable at one-month follow-up. This case discusses the considerations for planning, feasibility and efficacy of concurrent balloon valvuloplasty in appropriately selected patients.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"7 ","pages":"Article 100069"},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143842750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Back to square one: the role of septal reduction therapy in the era of Mavacamten","authors":"Ryan Wallace ,&nbsp;Ryan Kabir ,&nbsp;Sumbal Janjua ,&nbsp;Patrick Bering ,&nbsp;Toby Rogers","doi":"10.1016/j.crmic.2025.100066","DOIUrl":"10.1016/j.crmic.2025.100066","url":null,"abstract":"<div><div>An 86-year-old-female with hypertrophic cardiomyopathy with persistent obstructive symptoms despite beta blockers and disopyramide was trialed on mavacamten. Although she had improvement in obstructive symptoms, mavacamten was stopped due to reduction in left ventricular ejection fraction even on the lowest dose. Instead, alcohol septal ablation was pursued. This case highlights key considerations surrounding septal reduction therapy in the era of mavacamten.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"7 ","pages":"Article 100066"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Circumflex Aneurysm With Coronary Sinus Fistula In a Middle-aged Man: A Case Report","authors":"Abdulrahman Al-Qaysi ,&nbsp;Desmond Boakye Tanoh ,&nbsp;Hamzah Sultan ,&nbsp;Zainab Al-Qaysi ,&nbsp;Naser Sayeh","doi":"10.1016/j.crmic.2025.100068","DOIUrl":"10.1016/j.crmic.2025.100068","url":null,"abstract":"<div><div>Coronary artery aneurysms (CAAs) and coronary artery fistulas (CAFs) are rare abnormalities. CAA is an abnormal dilatation of the coronary artery while CAF is an unusual connection between a coronary artery and other cardiac structures. We report a case of a 55-year-old male with a history of atrial fibrillation and mitral regurgitation who was diagnosed with a left circumflex artery aneurysm, with a fistula connecting to the coronary sinus. He subsequently underwent an aneurysm resection, along with coronary artery bypass grafting (CABG) and mitral valve replacement. In this case report, we underscore the importance of early identification of this rare condition, as timely intervention mitigates potential complications, including coronary aneurysm rupture.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"7 ","pages":"Article 100068"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracoronary snaring for externalization in Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention","authors":"Prathap Kumar,&nbsp;Manu Rajendran,&nbsp;Blessvin Jino","doi":"10.1016/j.crmic.2025.100067","DOIUrl":"10.1016/j.crmic.2025.100067","url":null,"abstract":"<div><div>A retrograde approach for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is often required in complex CTOs, and it increases the technical success rate of CTO PCI. Wire externalization after crossing the lesion is often required for further balloon dilatations and stenting. When the retrograde guidewire cannot enter the antegrade guide catheter after lesion crossing, guide extension-assisted or snare-assisted externalization is attempted. Snaring the retrograde wire is usually done in the ascending aorta. We report a case of retrograde CTO PCI, where snaring was done inside the coronary due to difficulty in reaching the aorta.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"7 ","pages":"Article 100067"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left main percutaneous coronary intervention after Medtronic CoreValve TAVR: Navigating coronary access challenges","authors":"Ghulam Mujtaba Ghumman ,&nbsp;Sanam Farooq ,&nbsp;Zaid Al-Jebaje ,&nbsp;Mohammed Taleb ,&nbsp;Syed Sohail Ali","doi":"10.1016/j.crmic.2025.100065","DOIUrl":"10.1016/j.crmic.2025.100065","url":null,"abstract":"<div><div>Transcatheter aortic valve replacement (TAVR) is the standard of care for high-risk patients with severe aortic stenosis. However, coronary access post-TAVR remains a challenge, particularly in patients with the Medtronic CoreValve, due to its supra-annular design and extended frame, which can obstruct engagement of the coronary ostia. Managing acute coronary syndromes in this subset of patients often requires advanced procedural techniques. We present the case of a 78-year-old female with a history of TAVR with Medtronic CoreValve who presented with non-ST-segment elevation myocardial infarction (NSTEMI) and underwent successful but challenging percutaneous coronary intervention (PCI) of left main coronary artery due to the difficult coronary engagement and wiring secondary to the presence of CoreValve. This case highlights the procedural difficulties of PCI in patients with CoreValve TAVR, emphasizing the importance of catheter selection and strategic planning for coronary interventions in these patients. As TAVR usage continues to rise, clinicians must be aware of post-TAVR PCI challenges and consider advanced guide catheter techniques and multidisciplinary collaboration to optimize revascularization outcomes in this high-risk population.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"7 ","pages":"Article 100065"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696682","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":"Improvised loop snare and twisting guidewire techniques for management of a fractured coronary intervention guidewire: A case report","authors":"Franklyn A. Colón-Arias,&nbsp;Johan A. De La Rosa-Laureano,&nbsp;Jean P. Fernandez-Rivas,&nbsp;Annerys Perez","doi":"10.1016/j.crmic.2025.100061","DOIUrl":"10.1016/j.crmic.2025.100061","url":null,"abstract":"<div><div>A 75-year-old female underwent a second coronary angiogram which was complicated by fracture and entrapment of a guidewire in the left anterior descending (LAD) artery. A snare loop and twisting guide techniques were utilized with an improvised snare wire to retrieve the entrapped guidewire from the LAD, and two new stents were successfully deployed. The snaring technique and twisting guide are unique methods for percutaneous extraction and can be utilized for stent and fracture guidewire removal. These techniques, outlined in our case, can be used as a safe and effective approach.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"6 ","pages":"Article 100061"},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580280","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":"Severe hemolytic anemia caused by paravalvular leak after transcatheter aortic valve replacement with a new-generation balloon-expandable transcatheter aortic valve requiring surgical aortic valve replacement","authors":"Jumpei Takeda ,&nbsp;Akira Taruya ,&nbsp;Teruaki Wada ,&nbsp;Kentaro Honda ,&nbsp;Ryo Hikida ,&nbsp;Takahiro Nishi ,&nbsp;Mizuho Ikuchi ,&nbsp;Ryo Nakamura ,&nbsp;Hideki Kunimoto ,&nbsp;Kazushi Takemoto ,&nbsp;Hironori Kitabata ,&nbsp;Yoshiharu Nishimura ,&nbsp;Atsushi Tanaka","doi":"10.1016/j.crmic.2025.100062","DOIUrl":"10.1016/j.crmic.2025.100062","url":null,"abstract":"<div><div>Mechanical hemolysis is a rare complication following transcatheter aortic valve replacement (TAVR) and requires redo replacement surgery. We report a case of severe hemolytic anemia caused by a paravalvular leak (PVL) after TAVR requiring surgical aortic valve replacement (SAVR). A female in her 80s who underwent TAVR with a 20 mm balloon-expandable valve for symptomatic severe aortic stenosis developed severe uncontrollable hemolytic anemia as a result of a PVL originating from a tiny gap between the prosthetic valve and small calcifications of the left ventricular outflow tract. SAVR was performed, leading to resolution of hemolysis.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"6 ","pages":"Article 100062"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551897","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":"Snaring to resolve catheter kinking during percutaneous coronary intervention","authors":"Thomas Basala ,&nbsp;Deniz Mutlu ,&nbsp;Ahmed Al-Ogaili ,&nbsp;Muhammad Saad Shaukat ,&nbsp;Yader Sandoval ,&nbsp;Emmanouil Brilakis","doi":"10.1016/j.crmic.2025.100063","DOIUrl":"10.1016/j.crmic.2025.100063","url":null,"abstract":"<div><div>We describe two cases of catheter kinking during percutaneous coronary intervention (PCI). In the first patient, a snare was inserted through contralateral access and captured the distal end of the guide catheter. After pulling the kinked guide catheter with the snare, guidewire advancement and ballooning across the guide catheter resulted in resolution of the kink and successful removal. In the second patient, a snare advanced from the contralateral femoral artery captured the tip of the kinked diagnostic catheter that was pulled through the left femoral sheath, followed by guidewire externalization and removal of the kinked catheter.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"6 ","pages":"Article 100063"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143526555","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":"Bailout side branch ostium stenting in a true 0,0,1 bifurcation lesion: Crush, rewire and kiss as in the DK-crush technique","authors":"Giuseppe Andò,&nbsp;Giulia Alagna","doi":"10.1016/j.crmic.2025.100064","DOIUrl":"10.1016/j.crmic.2025.100064","url":null,"abstract":"<div><div>We report the case an 80-year-old male with troponin-positive acute coronary syndrome due to a tight ostial stenosis of a large diagonal branch. We safely performed the first half of the DK-crush technique to secure with DES implantation the SB of a true 0,0,1 bifurcation lesion in a bailout situation. IVUS confirmed that we could refrain from the subsequent steps as stenting of the main vessel was unnecessary.</div></div><div><h3>Learning objective</h3><div>Percutaneous coronary intervention in true non-left-main 0,0,1 bifurcation lesion poses several challenges for the optimal technique to be employed whenever stent implantation is desired in the side branch. We demonstrate how it is possible to secure with stent implantation the SB of a true 0,0,1 bifurcation lesion by using intravascular imaging guidance and employing the first half of the DK-crush technique.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"6 ","pages":"Article 100064"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519996","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":"Anomalous aortic coronary artery origin: Surgical, anesthetic and echocardiographic considerations. A case report and comprehensive review","authors":"Mark Banoub ,&nbsp;Luke Landolt ,&nbsp;Angela Banoub ,&nbsp;Reed Kamyszek","doi":"10.1016/j.crmic.2025.100059","DOIUrl":"10.1016/j.crmic.2025.100059","url":null,"abstract":"<div><h3>Introduction</h3><div>Anomalous aortic origin of a coronary artery (AAOCA) is an uncommon congenital cardiac anomaly with an estimated prevalence of 0.01 % to 2 % that may occur in isolation or with other congenital cardiac anomalies. Anomalous aortic origin of the right coronary artery (AAORCA) from the opposite sinus of Valsalva is 4 to 5 times more common than anomalous aortic origin of the left coronary artery (AAOLCA) from the opposite sinus of Valsalva. However, SCD and symptoms of ischemia have been more commonly associated with the latter. In a large autopsy study, an anomalous aortic origin of a coronary artery (AAOCA) was the second most common cause of SCD in young competitive athletes with the left CA being most frequently implicated. The majority of deaths occurs during or shortly after peak exercise and may be the first presenting symptoms.</div></div><div><h3>Case description</h3><div>We present the case of a 15-year-old male presenting with exertional angina secondary to an anomalous right coronary artery (RCA) originating from the left sinus of Valsalva with an intramural and interarterial course. We describe the diagnostic imaging, surgical management, and anesthetic considerations for the successful surgical repair of this complex anomaly using intramural unroofing and main pulmonary artery (MPA) translocation. The role of intraoperative two and three-dimensional (2-D, 3-D) transesophageal echocardiography (TEE) is highlighted.</div></div><div><h3>Summary discussion</h3><div>Management guidelines for CAAs have been published by the American and European cardiology societies. Diagnostic and therapeutic decision-making algorithms incorporate the delineation of abnormal anatomy as well as functional assessment of ischemic burden and arrhythmia testing. Therapeutic decisions should be personalized to patient characteristics based on specific anatomy and the demonstration of a causal link between the CAAs and myocardial ischemia. Perioperative management of CAA presents unique challenges due to the dynamic mechanism of ischemia. Several surgical options exist depending on the anatomic variant. Standardization of care is especially important in rare diseases. Surgical management of AAOCA has evolved over time, and can be achieved with low morbidity and mortality. The establishment of coronary artery programs in highly specialized centers has streamlined care.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"6 ","pages":"Article 100059"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580731","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}