JACC. Case reports最新文献

JACC. Case reports Pub Date : 2026-10-21 DOI: 10.1016/j.jaccas.2026.110415

Federico Napoli MD, Camilo Rojas Bermudez MD, Sebastian Cirio MD

引用次数: 0

The Cascading Hazard of Delayed-Presentation STEMI Unmasked by a Stroke 延迟表现STEMI的级联危害被中风所掩盖

JACC. Case reports Pub Date : 2026-10-21 DOI: 10.1016/j.jaccas.2026.110268

Antonio L. Bartorelli MD

引用次数: 0

Subclavian VA-ECMO–Supported TAVR and Rotational Atherectomy in Cardiogenic Shock 心源性休克中锁骨下va - ecmo支持的TAVR和旋转动脉粥样硬化切除术。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-28 DOI: 10.1016/j.jaccas.2026.110031

Daisuke Fukamachi MD, PhD, Hidesato Fujito MD, PhD, Naoya Matsumoto MD, PhD, Yasuo Okumura MD, PhD

{"title":"Subclavian VA-ECMO–Supported TAVR and Rotational Atherectomy in Cardiogenic Shock","authors":"Daisuke Fukamachi MD, PhD, Hidesato Fujito MD, PhD, Naoya Matsumoto MD, PhD, Yasuo Okumura MD, PhD","doi":"10.1016/j.jaccas.2026.110031","DOIUrl":"10.1016/j.jaccas.2026.110031","url":null,"abstract":"<div><h3>Background</h3><div>Severe aortic stenosis and critical coronary disease can coexist in cardiogenic shock, requiring individualized decisions regarding access, sequencing, and antithrombotic therapy.</div></div><div><h3>Case Summary</h3><div>A 72-year-old man with prior coronary artery bypass grafting developed progressive low-output heart failure with low-flow, low-gradient severe aortic stenosis and critical calcified native left anterior descending artery disease after left internal thoracic artery graft occlusion. Right common iliac artery occlusion limited conventional femoral arterial support. Subclavian venoarterial extracorporeal membrane oxygenation preserved left transfemoral access for transcatheter aortic valve replacement, which was followed by left radial rotational atherectomy–assisted left anterior descending percutaneous coronary intervention.</div></div><div><h3>Discussion</h3><div>This case illustrates individualized access planning and transcatheter aortic valve replacement-first sequencing to facilitate protected complex percutaneous coronary intervention and safe venoarterial extracorporeal membrane oxygenation weaning in cardiogenic shock.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 110031"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839966","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}

引用次数: 0

Coronary Vasospasm in Eosinophilic Granulomatosis With Polyangiitis 嗜酸性肉芽肿病合并多血管炎的冠状血管痉挛：一个4例病例系列。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-28 DOI: 10.1016/j.jaccas.2026.110012

Francesco Saverio Rea MD, Debora Russo MD, Concetta Mammone MD, PhD, Alfredo Fede MD, Mario Arieti MD, Michele Romano MD, Plinio Cirillo MD, PhD, Giovanni Esposito MD, PhD, Corrado Lettieri MD

{"title":"Coronary Vasospasm in Eosinophilic Granulomatosis With Polyangiitis","authors":"Francesco Saverio Rea MD, Debora Russo MD, Concetta Mammone MD, PhD, Alfredo Fede MD, Mario Arieti MD, Michele Romano MD, Plinio Cirillo MD, PhD, Giovanni Esposito MD, PhD, Corrado Lettieri MD","doi":"10.1016/j.jaccas.2026.110012","DOIUrl":"10.1016/j.jaccas.2026.110012","url":null,"abstract":"<div><h3>Background</h3><div>Coronary vasospasm is an uncommon manifestation of eosinophilic granulomatosis with polyangiitis (EGPA), and it may present as recurrent acute coronary syndrome (ACS).</div></div><div><h3>Case Summary</h3><div>We report 4 patients presenting with recurrent ACS caused by angiographically documented coronary vasospasm. Three fulfilled the 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology classification criteria for EGPA, whereas one was classified as having EGPA-like coronary inflammatory disease. Vasospastic episodes were refractory to conventional antianginal therapy but resolved rapidly after initiation of corticosteroids and immunosuppressive therapy. During a follow-up ranging from 2 to 6 years, no patient experienced recurrent cardiovascular events.</div></div><div><h3>Discussion</h3><div>Recurrent ACS in patients with asthma, eosinophilia, or allergic disease should raise suspicion of eosinophilic coronary inflammatory disease. Early recognition and prompt immunosuppressive therapy may prevent recurrent myocardial injury and improve long-term outcomes.</div></div><div><h3>Take-Home Messages</h3><div>Coronary vasospasm may represent the first manifestation of EGPA or EGPA-like coronary inflammatory disease. In patients with recurrent ACS and coexisting asthma or eosinophilic disease, clinicians should maintain a high index of suspicion for eosinophilic coronary inflammation, as timely immunosuppressive therapy is essential for sustained disease control.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 110012"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840313","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}

引用次数: 0

9-Year Serial CMR Monitoring of Cardiac AL Amyloidosis Regression After Teclistamab 替司他抗后心脏AL淀粉样变性消退的9年连续CMR监测。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-27 DOI: 10.1016/j.jaccas.2026.109553

Valentina Silvestri MD, Manuel Toledano MD, Bénédicte Hivert MD, Emmanuelle Bourgeois MD, Benjamin Carpentier MD, Jean Giraud MD, Alexandre Willaume MD, François Delelis MD, Laurent Pascal MD, PhD

{"title":"9-Year Serial CMR Monitoring of Cardiac AL Amyloidosis Regression After Teclistamab","authors":"Valentina Silvestri MD, Manuel Toledano MD, Bénédicte Hivert MD, Emmanuelle Bourgeois MD, Benjamin Carpentier MD, Jean Giraud MD, Alexandre Willaume MD, François Delelis MD, Laurent Pascal MD, PhD","doi":"10.1016/j.jaccas.2026.109553","DOIUrl":"10.1016/j.jaccas.2026.109553","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac amyloid light-chain (AL) amyloidosis carries a poor prognosis and is considered largely irreversible once symptomatic. Long-term serial cardiovascular magnetic resonance (CMR) data following B-cell maturation antigen-directed therapy are lacking.</div></div><div><h3>Case Summary</h3><div>A 64-year-old man with biopsy-proven cardiac AL amyloidosis achieved sustained hematologic complete response after teclistamab following failure of 4 prior lines including daratumumab. Eleven CMR examinations over 9 years documented a biphasic trajectory: progressive infiltration through 2020 (left ventricular mass 186 g, wall thickness 18 mm, global longitudinal strain −4.8%), followed by sustained structural and functional regression through 2025 (left ventricular mass 127 g, wall thickness 13 mm, global longitudinal strain −13.7%).</div></div><div><h3>Discussion</h3><div>This represents the longest serial CMR follow-up in cardiac AL amyloidosis reported to date, demonstrating that cine-derived parameters reliably track cardiac regression in real-world conditions. Native T1 normalized while extracellular volume fraction (ECV) paradoxically increased, suggesting persistent fibril burden beyond hematologic clearance.</div></div><div><h3>Take-Home Message</h3><div>Serial CMR with cine-derived parameters provides robust longitudinal monitoring of cardiac AL amyloidosis regression following novel plasma cell–directed therapy, even without systematic contrast enhancement.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 109553"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840328","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}

引用次数: 0

Percutaneous Closure of a Left Atrial Pseudoaneurysm After Left Atrial Appendage Closure 左心房附件关闭后经皮关闭左心房假性动脉瘤。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-09-05 DOI: 10.1016/j.jaccas.2026.110226

Arturo Giacaman MD, John Dawdy MD, James Lee MD, Bryan Zwieg MD, Georgi Fram MD, Pedro Engel Gonzalez MD, Brian P. O’Neill MD, Pedro A. Villablanca MD, Tiberio M. Frisoli MD

{"title":"Percutaneous Closure of a Left Atrial Pseudoaneurysm After Left Atrial Appendage Closure","authors":"Arturo Giacaman MD, John Dawdy MD, James Lee MD, Bryan Zwieg MD, Georgi Fram MD, Pedro Engel Gonzalez MD, Brian P. O’Neill MD, Pedro A. Villablanca MD, Tiberio M. Frisoli MD","doi":"10.1016/j.jaccas.2026.110226","DOIUrl":"10.1016/j.jaccas.2026.110226","url":null,"abstract":"<div><h3>Background</h3><div>Left atrial appendage closure (LAAC) is increasingly used for stroke prevention in atrial fibrillation, but rare structural complications may occur and require percutaneous treatment.</div></div><div><h3>Case Summary</h3><div>A 76-year-old man with atrial fibrillation/flutter was referred for LAAC after LAA thrombus was found on transesophageal echocardiography despite therapeutic anticoagulation. A “no-touch” strategy was planned. The device was deployed in FLX-ball configuration and advanced gently without resistance. However, transesophageal echocardiography and angiography demonstrated deployment within an outpouching adjacent to the true LAA. The device was recaptured, advanced into the true LAA, and LAAC was completed. Postprocedural computed tomography demonstrated a likely iatrogenic pseudoaneurysm, which was successfully closed 2 days later using an Amplatzer ventricular septal defect occluder.</div></div><div><h3>Discussion</h3><div>This case highlights multimodality imaging and transcatheter management of an iatrogenic left atrial pseudoaneurysm after LAAC.</div></div><div><h3>Take-Home Messages</h3><div>LA pseudoaneurysm is a rare complication of LAAC. Multimodality imaging can identify the defect and guide percutaneous closure.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 110226"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897427","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}

引用次数: 0

Understanding Cardiac Anatomy and Imaging to Improve Safety of Procedures 了解心脏解剖和影像学以提高手术安全性：右心室流出道，第2部分。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-20 DOI: 10.1016/j.jaccas.2026.109877

Yuichiro Miyazaki MD, PhD, Yae Min Park MD, PhD, Mark Rimmer MS, Kyoko Miyazaki MD, PhD, Shintaro Yamagami MD, PhD, Yu Izawa MD, PhD, Norichika Osai MD, Peter Hanna MD, PhD, Michael C. Fishbein MD, Kalyanam Shivkumar MD, PhD, Shumpei Mori MD, PhD

引用次数: 0

Four Synchronous Myxomas Unmasking Carney Complex 四种同步黏液瘤揭露卡尼复合体：何时考虑卡尼复合体？

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-09-03 DOI: 10.1016/j.jaccas.2026.110029

Giulia Ballan MD, Davide Genovese MD, PhD, Alberto Bortolato MD, Alberto Nese MD, Carlo Cernetti MD, Giuseppe Minniti MD

{"title":"Four Synchronous Myxomas Unmasking Carney Complex","authors":"Giulia Ballan MD, Davide Genovese MD, PhD, Alberto Bortolato MD, Alberto Nese MD, Carlo Cernetti MD, Giuseppe Minniti MD","doi":"10.1016/j.jaccas.2026.110029","DOIUrl":"10.1016/j.jaccas.2026.110029","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac myxomas are the most common primary cardiac tumors and are usually solitary and sporadic. The presence of multiple synchronous lesions should raise suspicion for an underlying syndromic condition such as Carney complex (CNC).</div></div><div><h3>Case Summary</h3><div>A 39-year-old asymptomatic man underwent transthoracic echocardiography for recurrent ventricular extrasystoles on electrocardiogram, which incidentally revealed multiple intracardiac masses. Multimodality imaging, including transesophageal echocardiography, computed tomography, and cardiac magnetic resonance, identified 4 distinct, highly mobile lesions involving the left ventricle, the mitro-aortic curtain, and left atrium, with features suggestive of myxomas. Given the high embolic risk, surgical excision was performed with concomitant mitral valve repair. Histopathological analysis confirmed cardiac myxomas, whereas immunohistochemistry showed reduced protein kinase A regulatory subunit 1-alpha expression. Genetic testing subsequently identified a protein kinase A regulatory subunit 1-alpha autosomal mutation, establishing the diagnosis of CNC.</div></div><div><h3>Discussion</h3><div>This case underscores the importance of multimodality imaging for accurate diagnosis and surgical planning. The detection of multiple synchronous cardiac masses should prompt genetic evaluation and long-term surveillance for CNC in clinical practice, because this syndrome may lead to endocrinological diseases such as Cushing syndrome and malignant endocrine tumors.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 110029"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887347","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}

引用次数: 0

Endovascular Salvage of Late Type IA Endoleak After Ascending Aortic TEVAR for Ruptured Penetrating Ulcer 升主动脉TEVAR治疗破裂性穿透性溃疡后晚期IA型腔内漏的血管内抢救。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-26 DOI: 10.1016/j.jaccas.2026.110003

Kyrillos Kaleeny MBBS, MMed, Harish Kamalanathan MD, Jeffrey Lewis MD, Ashley Wilson-Smith MD, Praveen Indraratna MBBS, PhD, Zakir Akhunji MBBS, Shannon Thomas MBBS, Kiran Sarathy MBBS, Gita Mathur MBBS, Virag Kushwaha BSc, MBBS, PhD

{"title":"Endovascular Salvage of Late Type IA Endoleak After Ascending Aortic TEVAR for Ruptured Penetrating Ulcer","authors":"Kyrillos Kaleeny MBBS, MMed, Harish Kamalanathan MD, Jeffrey Lewis MD, Ashley Wilson-Smith MD, Praveen Indraratna MBBS, PhD, Zakir Akhunji MBBS, Shannon Thomas MBBS, Kiran Sarathy MBBS, Gita Mathur MBBS, Virag Kushwaha BSc, MBBS, PhD","doi":"10.1016/j.jaccas.2026.110003","DOIUrl":"10.1016/j.jaccas.2026.110003","url":null,"abstract":"<div><h3>Background</h3><div>Ascending aortic penetrating atherosclerotic ulcers (PAUs) are rare acute aortic syndromes, where guidelines recommend surgical repair. In surgically ineligible patients, endovascular repair has been described; however, data on management of postoperative complications are limited.</div></div><div><h3>Case Summary</h3><div>A frail 75-year-old woman presented with dyspnea, 1 month after emergency endovascular repair of a ruptured ascending aortic PAU. Computed tomography aortography (CTA) demonstrated a late type IA endoleak with associated pseudoaneurysm. Given her prohibitive surgical risk, a staged approach was initially used by creating a scaffold with transcatheter aortic valve implantation and deployment of an atrial septal defect occluder across the pseudoaneurysm's neck, followed by patent foramen ovale occluder implantation, coil packing, and thrombin injection. This achieved complete endoleak exclusion and pseudoaneurysm sealing, confirmed on serial CTAs. The patient remains well after 1 year.</div></div><div><h3>Discussion</h3><div>This is the first case of successful endovascular repair of a type IA endoleak and pseudoaneurysm, following endovascular repair of the ascending aorta.</div></div><div><h3>Take-Home Message</h3><div>Complex ascending aortic complications can be managed endovascularly.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 110003"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818595","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}

引用次数: 0

Sudden Cardiac Death in the Late-Phase Kawasaki Disease 川崎病晚期心源性猝死：尸检无动脉瘤的致命冠状动脉狭窄

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-25 DOI: 10.1016/j.jaccas.2026.110005

Chihiro Mori MD, Teruo Sekimoto MD, PhD, Akihito Kato MD, PhD, Maria Mihara MD, Kenji Dohi MD, PhD, Toshiro Shinke MD, PhD, Taka-aki Matsuyama MD, PhD

{"title":"Sudden Cardiac Death in the Late-Phase Kawasaki Disease","authors":"Chihiro Mori MD, Teruo Sekimoto MD, PhD, Akihito Kato MD, PhD, Maria Mihara MD, Kenji Dohi MD, PhD, Toshiro Shinke MD, PhD, Taka-aki Matsuyama MD, PhD","doi":"10.1016/j.jaccas.2026.110005","DOIUrl":"10.1016/j.jaccas.2026.110005","url":null,"abstract":"<div><h3>Background</h3><div>Long-term coronary complications of Kawasaki disease (KD) remain a critical concern, even after the apparent regression of coronary artery aneurysms (CAAs).</div></div><div><h3>Case Summary</h3><div>A 40-year-old male with a history of childhood KD suffered sudden cardiac arrest. Emergency coronary angiography revealed a \"lotus root\" appearance in the right coronary artery (RCA) and left main trunk (LMT) occlusion. Despite resuscitation efforts, the patient died. Autopsy showed no macroscopic CAAs. Histologically, the RCA demonstrated mature microvessels with distinct elastic laminae, whereas the LMT showed severe intimal thickening and acute thrombus.</div></div><div><h3>Discussion</h3><div>While CAA regression is often considered favorable, persistent, irreversible transmural remodeling can silently progress and lead to fatal ischemic events.</div></div><div><h3>Take-Home Messages</h3><div>Morphological regression of CAAs does not equate to histological healing. Long-term surveillance should evaluate vascular remodeling and myocardial ischemia beyond simple lumen diameter.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 110005"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813140","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}

引用次数: 0