European Heart Journal: Case Reports最新文献

{"title":"Transcatheter aortic valve implantation for a patient with both severe aortic stenosis and membranous ventricular septal aneurysm: a case report.","authors":"Naoto Murakami, Nobuaki Kokubu, Shunsaku Otomo, Masato Furuhashi","doi":"10.1093/ehjcr/ytaf230","DOIUrl":"10.1093/ehjcr/ytaf230","url":null,"abstract":"<p><strong>Background: </strong>There have been few reports on transcatheter aortic valve implantation (TAVI) for patients with severe aortic stenosis (AS) and a membranous ventricular septal aneurysm (MSA).</p><p><strong>Case summary: </strong>A 77-year-old female complaining of dyspnoea was transferred to our hospital. Transthoracic echocardiography (TTE) showed progressive very severe AS with reduced left ventricular (LV) systolic function. The patient was scheduled for TAVI due to high surgical risk. Preoperative computed tomography showed a MSA located between the right coronary cusp and the non-coronary cusp, therefore a part of the annulus rim was lacking. We draw a virtual annulus line to assess her true annulus size and selected a 29 mm size of Evolut Pro Plus. Since the bottom end of the valve was positioned into the MSA, the valve was begun to expand with a lack of coaxiality and massive paravalvular leak (PVL) occurred. Therefore, we decided to retrieve the 29 mm valve. An up-sized 34 mm Evolut was tried, but it was too large and caused the phenomenon of stent-frame infolding. We had to retrieve the 34 mm valve again, and tried to deploy another 29 mm valve at a position as high as possible and pushed the delivery system during the final release to maintain good coaxiality. Postoperative TTE showed significant recovery of LV systolic function, and the PVL was mild.</p><p><strong>Discussion: </strong>In patients with both MSA and severe AS, it is difficult to measure the precise annulus size for ensuring stability of the self-expanding valve and preventing PVL.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 5","pages":"ytaf230"},"PeriodicalIF":0.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110208","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":"Effective percutaneous treatment of a subacute left internal mammary artery perforation and pseudoaneurysm after coronary artery bypass grafting: a case report.","authors":"Franck Digne, Ariel Nakache, Arthur Darmon, Mohammed Nejjari, Nicolas Bonnet","doi":"10.1093/ehjcr/ytaf224","DOIUrl":"10.1093/ehjcr/ytaf224","url":null,"abstract":"<p><strong>Background: </strong>Perforation of the left internal mammary artery (LIMA) graft is a rare but severe complication of coronary artery bypass grafting (CABG).</p><p><strong>Case summary: </strong>A 75-year-old Caucasian man with hypertension, diabetes, dyslipidaemia, and a history of SARS-CoV-2 presented with exertional dyspnoea. After CABG with a Y-graft anastomosis using the right internal mammary artery, he experienced severe chest pain. A transthoracic echocardiogram revealed a haemopericardium. A computed tomography scan identified a LIMA pseudoaneurysm in contact with the haemopericardium near the anterior and anterolateral left ventricle walls. Angiography confirmed the LIMA pseudoaneurysm and left anterior descending artery (LAD) graft occlusion. The LIMA pseudoaneurysm was treated with a covered stent, and the LAD was revascularized with rotational atherectomy and drug-eluting stent. At the three-year follow-up, the patient remained asymptomatic, and the scan performed at the two-year mark indicated patent grafts with no signs of restenosis.</p><p><strong>Discussion: </strong>This case illustrates the successful percutaneous management of a rare LIMA pseudoaneurysm, preventing high-risk reoperation. It also highlights the importance of multimodal imaging and interventional strategies in managing complex post-CABG complications.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 5","pages":"ytaf224"},"PeriodicalIF":0.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076495","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":"Congenitally corrected transposition of the great arteries and coronary artery disease: a case report in an 83-year-old male.","authors":"Ahmed Alomrani, Mohammed Alshammari, Fahad Bindakhil, Hadi Shabi, Abdullah Alkhodair","doi":"10.1093/ehjcr/ytaf161","DOIUrl":"https://doi.org/10.1093/ehjcr/ytaf161","url":null,"abstract":"<p><strong>Background: </strong>Congenitally corrected transposition of the great arteries (CCTGA), or L-loop TGA, is a rare congenital heart defect, comprising <1% of congenital heart diseases, with an incidence of ∼1 in 33 000 births. It is characterized by atrioventricular and ventriculo-arterial discordance, where the left ventricle connects to a right atrium and pumps deoxygenated blood into the pulmonary artery, while the right ventricle (RV) connects to a left atrium and pumps oxygenated blood into the aorta. Congenitally corrected transposition of the great arteries often coexists with other cardiac anomalies, although ∼10% of cases are isolated. A case report highlights a unique instance of coronary artery disease (CAD) in CCTGA.</p><p><strong>Case summary: </strong>An 83-year-old male with CCTGA presented with persistent nausea, fatigue, poor oral intake, and epigastric pain. He had a history of hypertension, Type II diabetes, dyslipidaemia, ischaemic heart disease, and chronic atrial fibrillation. On examination, he was stable but showed signs of a urinary tract infection. A cardiac workup revealed no ischaemic changes on electrocardiography, but a cardiac computed tomography identified significant CAD involving multiple vessels. A decision was made to perform percutaneous coronary intervention on the right coronary artery, successfully placing two stents.</p><p><strong>Discussion: </strong>In patients with CCTGA, major factors contributing to morbidity and mortality include progressive decline in systemic RV function and systemic tricuspid valve regurgitation. A retrospective study showed that 25% of uncomplicated CCTGA patients develop heart failure by age 45, while approximately two-thirds of complicated cases do. Survival beyond age 70 is rare. Prompt management of CAD through angioplasty is critical to prevent further deterioration of RV function and worsening tricuspid regurgitation. However, the atypical positioning of the aorta and coronary arteries complicates selective coronary angiography, making a challenging diagnosis and treatment.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 5","pages":"ytaf161"},"PeriodicalIF":0.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979017","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":"When the heart becomes suicidal: a case report of severe left ventricular outflow tract obstruction following transcatheter aortic valve implantation.","authors":"Carl Schulz, Fabian J Brunner, Simon Pecha, Nils Sörensen, Niklas Schofer","doi":"10.1093/ehjcr/ytaf164","DOIUrl":"https://doi.org/10.1093/ehjcr/ytaf164","url":null,"abstract":"<p><strong>Background: </strong>Replacement of the aortic valve is a Class I recommendation for treatment of patients suffering from severe, symptomatic aortic stenosis. However, aortic valve replacement can occasionally lead to complications, including development of acute left ventricular outflow tract (LVOT) obstruction. This rare but severe complication is referred to as the so-called 'suicide left ventricle' phenomenon.</p><p><strong>Case summary: </strong>This case report presents an 88-year-old woman who developed severe LVOT obstruction following a successful transcatheter aortic valve implantation (TAVI), complicated by septal anterior motion of the mitral valve resulting in severe mitral regurgitation. Despite initial intensive care management, her symptoms persisted, necessitating the application of transcoronary ablation of septal hypertrophy as a bail-out procedure. Transcoronary ablation of septal hypertrophy, typically used in hypertrophic obstructive cardiomyopathy, successfully reduced the LVOT gradient and relieved symptoms.</p><p><strong>Discussion: </strong>This case emphasizes the importance of pre-operative identification of LVOT obstruction risk factors, awareness for this complication and a well-experience multidisciplinary team for the management of TAVI-associated complications.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 5","pages":"ytaf164"},"PeriodicalIF":0.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957645","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 Kounis syndrome presenting with coronary angina pectoris and coronary microcirculatory disturbance, resulting in takotsubo cardiomyopathy-like changes.","authors":"Rie Aoyama, Horie Kana, Shinichi Okino, Shigeru Fukuzawa","doi":"10.1093/ehjcr/ytaf227","DOIUrl":"10.1093/ehjcr/ytaf227","url":null,"abstract":"<p><strong>Background: </strong>Kounis syndrome is an allergic syndrome leading to acute coronary syndromes (ACS). It includes coronary spasm angina (CSA), plaque erosion or rupture, and coronary stent thrombosis. Takotsubo cardiomyopathy is a myocardial disease without significant stenosis of the coronary arteries and is said to include coronary microvascular dysfunction (CMD) and CSA in its background.</p><p><strong>Case summary: </strong>A 63-year-old woman was urgently brought to our hospital due to chest tightness and loss of consciousness after the appearance of generalized urticaria. She was in anaphylactic shock and her ECG suggested ACS. Emergency coronary angiography showed no significant stenosis and left ventriculography showed takotsubo cardiomyopathy-like wall motion. The diagnosis of Kounis syndrome type I was made. The simultaneous binuclear cardiac scintigraphy of ^99mTc-tetrofosmin and ¹²³I-BMIPP showed atypical images of takotsubo cardiomyopathy. The evaluation of coronary microvascular function showed CMD and the acetylcholine (ACh) stress test showed multivessel CSA. We started a calcium channel blocker, isosorbide mononitrate, and antihistamines. She was discharged from the hospital after cardiac function improved and has remained stable without any recurrence during one year of outpatient follow-up.</p><p><strong>Discussion: </strong>There are few reports of an invasive evaluation in the subacute phase of Takotsubo cardiomyopathy-like clinical presentation. We report a case of takotsubo-like wall motion abnormality due to CSA and CMD in a patient with Kounis syndrome. Simultaneous binuclear myocardial scintigraphy, assessment of the coronary microcirculation, and ACh stress test were useful in the diagnosis, and the coexistence of CSA and CMD suggested her clinical images similar to takotsubo cardiomyopathy.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 5","pages":"ytaf227"},"PeriodicalIF":0.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093213","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":"Left atrial substrate modification in addition to pulmonary vein isolation using a novel circular variable loop pulsed field ablation catheter.","authors":"Alessandro Parlato, Moneeb Khalaph, Philipp Sommer, Christian Sohns","doi":"10.1093/ehjcr/ytaf209","DOIUrl":"10.1093/ehjcr/ytaf209","url":null,"abstract":"<p><strong>Background: </strong>Pulsed field ablation (PFA) is a recently developed technology that causes tissue necrosis through electroporation and has been employed and validated for pulmonary vein isolation (PVI) in atrial fibrillation (AF) ablation. Only few devices have received a CE mark for this use and the Varipulse^TM catheter (Varipulse^TM, Biosense Webster, Irvine, USA), a variable loop PFA catheter, has been recently approved. Despite the growing experience with PVI, evidence is lacking about the use of PFA catheters and linear ablation lesions, which could potentially be performed with PFA catheters, reducing procedure related costs and time.</p><p><strong>Case summary: </strong>A 73-year-old Caucasian woman with multiple cardiovascular risk factors presented with highly symptomatic paroxysmal AF and was scheduled to undergo PFA AF ablation using the new Varipulse catheter. The procedure was performed under deep sedation and the catheters were advanced through trans-septal puncture. 3D electroanatomic mapping of the left atrium showed significant anterior wall fibrosis. After PVI, substrate modification through an anterior mitral line (AML) approach was pursued. The AML was performed with additional PFA applications and successful bidirectional block was confirmed by pacing maneuvers without any procedural complications. The patient was discharged the following day, asymptomatic and in a state of well-being.</p><p><strong>Conclusion: </strong>Individual LA substrate modification, including linear lesion sets, can be delivered in addition to PVI using the novel Varipulse PFA catheter in patients with AF.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 5","pages":"ytaf209"},"PeriodicalIF":0.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119097","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":"Extended support of HeartMate 3 with transseptal left atrial cannulation using a modified wire-reinforced graft: a case report.","authors":"Hsun-Yi Fu, Weng-Kin Lou, Heng-Wen Chou, Yih-Sharng Chen","doi":"10.1093/ehjcr/ytaf225","DOIUrl":"10.1093/ehjcr/ytaf225","url":null,"abstract":"<p><strong>Background: </strong>A small left ventricular cavity is one of the major limitations of HeartMate 3 implantation. Therefore, innovations in implantation techniques are required to expand the use of HeartMate 3, the only durable ventricular assist device approved by the US Food and Drug Administration for use in adults.</p><p><strong>Case summary: </strong>A 65-year-old male was diagnosed with multiple myeloma (MM) and cardiac amyloidosis. Guideline-directed medical therapy was used to treat heart failure secondary to restrictive cardiomyopathy with a small left ventricle (LV). However, after three chemotherapy courses for MM, the patient developed refractory acute decompensated heart failure. He underwent urgent HeartMate 3 implantation as a bridge to chemotherapy. We adopted the left atrium-to-aorta configuration for HeartMate 3 implantation and performed trans-septal left atrial cannulation using a modified Intergard Woven vascular graft. After discharge, the patient resumed chemotherapy on post-operative day 172 and achieved complete response on post-operative day 259. At the time of writing this report, he has been supported with HeartMate 3 for 36 months, and no major adverse events have been recorded.</p><p><strong>Discussion: </strong>In most reports of trans-septal left atrial cannulation for durable ventricular assist device implantation, a 20-mm ringed Gore-Tex graft was used as the interposition conduit. Some technical difficulties with this graft have been described. Thus, we decided to modify the Intergard Woven graft as the interposition conduit. The favourable outcome in our patient could suggest the potential of extended support with the left atrium-to-aorta configuration of HeartMate 3 for patients with a small LV.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 5","pages":"ytaf225"},"PeriodicalIF":0.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110197","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 rare cause of MINOCA: embolism of a thrombus arising from accessory mitral valve tissue.","authors":"En Ze Chan, Giap Swee Kang, Amelia Xin Chun Goh","doi":"10.1093/ehjcr/ytaf222","DOIUrl":"https://doi.org/10.1093/ehjcr/ytaf222","url":null,"abstract":"","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 5","pages":"ytaf222"},"PeriodicalIF":0.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110164","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":"Heart team rescues a bleeding heart: a case report of cardiac angiosarcoma causing life-threatening tamponade.","authors":"Theodore J Sklavos, Sean Lawrence, Vladimir Andelkovic, Chris Cole, Yohan Chacko","doi":"10.1093/ehjcr/ytaf220","DOIUrl":"10.1093/ehjcr/ytaf220","url":null,"abstract":"<p><strong>Background: </strong>There are many causes of pericardial effusion and if the accumulating fluid results in cardiac tamponade, it may lead to life-threatening haemodynamic collapse. Therefore, rapid diagnosis and treatment of cardiac tamponade is critical.</p><p><strong>Case summary: </strong>A 53-year-old woman presented to the emergency department with chest pain and undifferentiated shock. A computer tomography (CT) aortogram showed a pericardial effusion, active contrast extravasation (possibly arising from the right coronary artery), but no aortic dissection. Echocardiography confirmed a large pericardial effusion with tamponade physiology. The consensus between cardiology and cardiothoracic surgery was for urgent coronary angiography to identify the source of bleeding. This showed a network of vessels from the right coronary artery that appeared to supply a mass. Re-review of the CT scan and repeat targeted echocardiography showed the silhouette of a mass adjacent to the right atrium. The patient was taken immediately for cardiac surgery. A cardiac tumour extending through the right atrial wall was identified, resected, and subsequently was diagnosed histologically as a cardiac angiosarcoma.</p><p><strong>Discussion: </strong>Malignancy is responsible for only a small proportion of pericardial effusions and metastatic disease is overwhelmingly more common than primary cardiac neoplasms. This case highlights the use of multi-modality cardiac imaging to guide diagnosis and treatment, and the need to consider the rarer causes of haemopericardium in cases where the more common causes have been excluded.</p>","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 5","pages":"ytaf220"},"PeriodicalIF":0.8,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093238","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":"'Localized' constrictive pericarditis.","authors":"Shuaishuai Yuan, Minxin Wei, Peijun Li","doi":"10.1093/ehjcr/ytaf217","DOIUrl":"https://doi.org/10.1093/ehjcr/ytaf217","url":null,"abstract":"","PeriodicalId":11910,"journal":{"name":"European Heart Journal: Case Reports","volume":"9 5","pages":"ytaf217"},"PeriodicalIF":0.8,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076513","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}