European Heart Journal: Case Reports最新文献

{"title":"Kissing balloon technique as rescue strategy to treat left ventricular outflow tract obstruction after transcatheter mitral valve replacement: a case report.","authors":"Sibel Çatalkaya, Hakan Erkan","doi":"10.1093/ehjcr/ytaf021","DOIUrl":"10.1093/ehjcr/ytaf021","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter mitral valve replacement (TMVR) has become a viable, minimally invasive treatment for inoperable patients with severe mitral valve disease, particularly among elderly individuals with significant comorbidities. A key complication of TMVR is left ventricular outflow tract (LVOT) obstruction, necessitating various preventive and therapeutic strategies. This report presents a case of severe LVOT obstruction following TMVR and highlights the effective application of the kissing balloon technique as a therapeutic intervention.</p><p><strong>Case summary: </strong>A 79-year-old female with New York Heart Association Class IV dyspnoea due to severe mitral stenosis and a high operative risk, with a Society of Thoracic Surgeons Risk of Mortality (STS-PROM) score of 6.2%, underwent TMVR. Pre-procedural evaluations indicated significant mitral valve calcification and a mitral valve area of 0.9 cm². After successful TMVR deployment, post-implantation echocardiography revealed an LVOT pressure gradient of 53/85 mmHg, prompting the use of the kissing balloon technique, which reduced the gradient to 28 mmHg. Follow-up assessments showed normal mitral valve function and stable LVOT gradients during short-term follow-up throughout the patient's hospital stay.</p><p><strong>Discussion: </strong>Left ventricular outflow tract obstruction is a potentially life-threatening complication of TMVR, often associated with high mortality rates due to haemodynamic impairment. This complication can arise from various anatomical factors and valve positioning issues. Several strategies have been developed to address LVOT obstruction, including the laceration of the anterior mitral leaflet and alcohol septal ablation. The successful implementation of the kissing balloon technique in this case underscores its potential to improve outcomes in LVOT obstruction.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 2","pages":"ytaf021"},"PeriodicalIF":0.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381868","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":"Evaluation of right ventricular pacing-induced coronary microvascular dysfunction using guide wire-based sensor technology: a case report.","authors":"Takashi Mishina, Naoya Inoue, Shuji Morikawa","doi":"10.1093/ehjcr/ytaf022","DOIUrl":"10.1093/ehjcr/ytaf022","url":null,"abstract":"<p><strong>Background: </strong>The diagnosis of ischaemic non-obstructive coronary artery disease is crucial for the differential diagnosis of chest pain. However, the pathophysiology of chest pain and evaluation of coronary microcirculation in patients with right ventricular pacing (RVP) have not been sufficiently reported.</p><p><strong>Case summary: </strong>The patient was a 53-year-old woman who underwent dual-chamber pacemaker implantation because of sinus node dysfunction. She experienced chest pain before pacemaker implantation; however, the frequency and severity of her chest pain increased after the implantation. She was referred for the evaluation of coronary microvascular dysfunction (CMD). Coronary angiography revealed no significant stenosis of the epicardial vessels. Subsequent evaluation of CMD showed that while the index of microcirculatory resistance [normalized index of microcirculatory resistance (IMR)] in the left anterior descending artery (LAD) was 19 U during the native rhythm, an increase in IMR (normalized IMR: 27 U) was observed during RVP.</p><p><strong>Discussion: </strong>Right ventricular pacing may not only induce left ventricular dyssynchrony due to non-physiological excitation propagation but may also provoke CMD in the LAD territory, particularly in the septal branches, which could contribute to pacing-induced structural CMD and chest pain. However, RVP may well be a contributing but not exclusively a factor of CMD.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 2","pages":"ytaf022"},"PeriodicalIF":0.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364225","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":"Complicated infective endocarditis of the bioprosthetic mitral valve following the transcatheter mitral valve-in-valve procedure: a case report and literature review.","authors":"Mohammad Sahebjam, Yeganeh Karimi, Flora Fallah","doi":"10.1093/ehjcr/ytaf013","DOIUrl":"10.1093/ehjcr/ytaf013","url":null,"abstract":"<p><strong>Background: </strong>Since the transcatheter valve-in-valve (ViV) procedure was introduced in 2007, a few cases of infective endocarditis (IE) following the ViV procedure have been reported, which can be predisposed by older age, pre-existing medical conditions, and procedural techniques. Paravalvular abscesses constitute a rare complication of IE, resulting from extending IE beyond the valve annulus, less commonly caused by <i>Klebsiella</i> species. This complication is more common in prosthetic valves, particularly bioprosthetic valves.</p><p><strong>Case summary: </strong>We describe a 75-year-old woman with Churg-Strauss syndrome and diabetes mellitus who underwent surgical replacement of bioprosthetic aortic and mitral valves 11 years ago. One year ago, she had a transcatheter mitral ViV procedure due to bioprosthetic mitral valve degeneration. The patient was referred to our centre with fatigue and fever, alongside elevated white blood cell count, erythrocyte sedimentation rate, and C-reactive protein. Blood and urine cultures tested positive for <i>Klebsiella oxytoca</i>. Echocardiographic assessments revealed a paravalvular abscess (13 × 8 mm) in the posterolateral side of the bioprosthetic mitral valve, fistulized into the left ventricle. The patient received treatment with vancomycin, meropenem, and colistin and was a candidate for surgery. Eleven days after the patient's admission, she passed away.</p><p><strong>Discussion: </strong>This study underscores the novelty of IE complicated with paravalvular abscess following the ViV procedure. In such cases, a multidisciplinary approach and timely surgical interventions are crucial for optimal patient outcomes.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 1","pages":"ytaf013"},"PeriodicalIF":0.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052056","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":"Correction to: Integration of a surgical bipolar ablation device within an electroanatomical mapping system during epicardial ventricular tachycardia ablation via video-assisted thoracoscopic surgery: a case report.","authors":"","doi":"10.1093/ehjcr/ytae681","DOIUrl":"https://doi.org/10.1093/ehjcr/ytae681","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ehjcr/ytae648.].</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 1","pages":"ytae681"},"PeriodicalIF":0.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002418","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":"Re-sheathing failure with Navitor during transcatheter aortic valve implantation: a case report.","authors":"Hiroshi Onoda, Hiroshi Ueno, Yuki Hida, Teruhiko Imamura, Koichiro Kinugawa","doi":"10.1093/ehjcr/ytaf015","DOIUrl":"10.1093/ehjcr/ytaf015","url":null,"abstract":"<p><strong>Background: </strong>Self-expanding valves used in transcatheter aortic valve implantation (TAVI) are designed to allow recapture and repositioning, facilitating optimal placement and mitigating conduction disturbances and paravalvular leakage. Here, we present a rare case in which the Navitor (Abbott Structural Heart, Santa Clara, CA, USA) could not be recaptured.</p><p><strong>Case summary: </strong>An 81-year-old Japanese woman with very severe aortic stenosis and a massively calcified nodule at the non-coronary cusp (NCC) underwent TAVI with a 25 mm Navitor valve. During the initial deployment attempt, non-uniform expansion (NUE) was observed on the NCC side when the valve was 80% deployed. An attempt was made to recapture and reposition the valve, but the delivery system capsule failed to fully re-sheath the prosthesis, leaving approximately one-third of the valve outside the capsule and preventing complete recapture. The Navitor was promptly redeployed while still within the basal ring. Following redeployment, the NUE resolved, and the valve was successfully positioned 3 mm below the basal ring on the NCC side and 4 mm below the left coronary cusp. We hypothesized that interference between the capsule tip and the calcified nodule on the NCC leaflet inhibited the re-sheathing process.</p><p><strong>Conclusion: </strong>This report documents a rare complication involving the failure to recapture the Navitor valve. In cases with large calcified nodules on the leaflet, caution is essential during the re-sheathing process. We strongly recommend re-deploying the prosthesis rather than attempting to remove it from the basal ring to minimize procedural risks and ensure proper valve placement.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 1","pages":"ytaf015"},"PeriodicalIF":0.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052060","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":"Automatic transition from AAIR to VVI mode: the impact of capture loss in His bundle pacing.","authors":"Sujoy Khasnavis, Samer Saouma, Jay Gross","doi":"10.1093/ehjcr/ytaf018","DOIUrl":"https://doi.org/10.1093/ehjcr/ytaf018","url":null,"abstract":"","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 2","pages":"ytaf018"},"PeriodicalIF":0.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364219","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":"A case report of left ventricular outflow tract obstruction due to early growth of a calcified amorphous tumour despite normal renal function.","authors":"Misayo Hayashi, Takayoshi Kato, Keita Fujimoto, Takatomo Watanabe, Hiroyuki Okura","doi":"10.1093/ehjcr/ytae703","DOIUrl":"10.1093/ehjcr/ytae703","url":null,"abstract":"<p><strong>Background: </strong>Calcified amorphous tumours (CAT) are non-neoplastic cardiac masses that have been the focus of several recent studies. Moreover, CAT is frequently observed in women and in patients undergoing dialysis.</p><p><strong>Case summary: </strong>A woman in her 70 s with normal renal function was referred to our hospital with a chief complaint of shortness of breath upon effort. Echocardiography and contrast-enhanced CT revealed a cardiac mass with calcification in the intervalvular fibrosa (IVF) of the anterior mitral valve, resulting in left ventricular outflow tract (LVOT) obstruction. One year later, the cardiac mass expanded, and the LVOT obstruction worsened. The patient underwent surgical resection of the mass and double-valve replacement with reconstruction of the IVF (commando operation) and myectomy. Histological examination confirmed that the mass was CAT.</p><p><strong>Discussion: </strong>We encountered a patient who underwent valve replacement and a commando operation due to rapidly progressive CAT and consequent progression of LVOT obstruction despite normal renal function. In patients with normal renal function, factors other than calcium and phosphate metabolism contribute to the formation of CAT. Understanding the accumulation of CAT is crucial for understanding its pathogenesis.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 2","pages":"ytae703"},"PeriodicalIF":0.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381879","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":"Exploring the causes of stiff left atrial syndrome: a case series.","authors":"Sukriti Banthiya, Medhat Chowdhury, Dhruva Govil, Harsh Thacker, Souheil Saba","doi":"10.1093/ehjcr/ytae702","DOIUrl":"10.1093/ehjcr/ytae702","url":null,"abstract":"<p><strong>Background: </strong>Stiff left atrial syndrome (SLAS) is a complication that occurs due to left atrial scarring following procedures such as radiofrequency catheter ablation for atrial fibrillation.</p><p><strong>Case summary: </strong>We present a series of four patients with pre-existing conditions that ultimately were diagnosed as SLAS. In each case, clinical manifestations of SLAS may overlapped with other conditions and required a high index of clinical suspicion and diligent hemodynamic assessment to differentiate it from other concomitant cardiac conditions.</p><p><strong>Discussion: </strong>We aim to highlight key differentiating diagnostic features from overlapping cardiac conditions and to summarize current treatment options for patients with SLAS.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 2","pages":"ytae702"},"PeriodicalIF":0.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122606","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":"Acute heart failure due to fulminant eosinophilic myocarditis with mononeuritis: eosinophilic granulomatosis with polyangiitis requiring cardiac multimodality imaging and systemic evaluation: a case report.","authors":"Jun-Ichi Noiri, Hiroki Matsuzoe, Ryo Nishio, Youhei Fujiki, Kenichiro Otani, Mayumi Inaba, Hiroshi Takaishi, Hidekazu Tanaka","doi":"10.1093/ehjcr/ytaf010","DOIUrl":"10.1093/ehjcr/ytaf010","url":null,"abstract":"<p><strong>Background: </strong>Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic vasculitis that affects small-to-medium vessels of various organs and can lead to eosinophilic myocarditis, a rare but life-threatening condition. The diagnosis of EGPA is challenging due to overlapping features with other forms of vasculitis. Additionally, various clinical presentations of EGPA make its management complicated.</p><p><strong>Case summary: </strong>A 55-year-old man with a history of asthma presented with worsening chest pain. Peripheral hyper-eosinophilia, elevated troponin level, refractory pulseless ventricular tachycardia, and severe cardiac dysfunction suggested fulminant eosinophilic myocarditis. A multidisciplinary team comprising rheumatology, respirology, haematology, pathology, and cardiology specialists discussed the underlying cause of eosinophilia and diagnosed EGPA with the pathological findings of endomyocardial biopsy (EMB). Immunosuppressive therapy and optimal medical therapy for acute heart failure resulted in remission of myocarditis, as confirmed by follow-up echocardiography, cardiac magnetic resonance imaging, and EMB. Despite a good clinical course, mononeuritis rapidly worsened just before his discharge, requiring additional therapy. During the 2-year outpatient follow-up, the cardiac function remains well, and mononeuritis also improved.</p><p><strong>Discussion: </strong>The multidisciplinary approach facilitated prompt and accurate diagnosis and treatment, despite the disease's diverse presentation, ultimately saving the patient's life. This case highlights the importance of systemic evaluations in patients with EGPA, potentially affecting multiple organs, for monitoring disease status and guiding its treatment. This case report also emphasizes that close follow-up and careful monitoring with cardiac multimodality imaging are important to ensure optimal management of heart failure caused by EGPA myocarditis.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 2","pages":"ytaf010"},"PeriodicalIF":0.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381889","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":"Aggressive presentation of a thymosarcoma with invasion of right heart chambers: a multimodal imaging approach.","authors":"Víctor Manuel López Espinosa, Antonio Esteban Arriaga Jiménez","doi":"10.1093/ehjcr/ytae699","DOIUrl":"https://doi.org/10.1093/ehjcr/ytae699","url":null,"abstract":"","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 1","pages":"ytae699"},"PeriodicalIF":0.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002394","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}