JACC. Case reports最新文献_第3页

Zero Fluoroscopy Radiofrequency Ablation of Paroxysmal Atrial Fibrillation and Epicardial Ventricular Tachycardia 阵发性心房颤动和心外膜室性心动过速的零透视射频消融

JACC. Case reports Pub Date : 2025-10-08 DOI: 10.1016/j.jaccas.2025.105298

Guang-an Liu MD, Bo Shao MD, Ruoxi Zhang MD, Binquan You MD, Feng Liu MD

引用次数: 0

Patent Foramen Ovale Closure in Right Ventricular Failure on Mechanical Circulatory Support 机械循环支持下的右心衰卵圆孔未闭

JACC. Case reports Pub Date : 2025-10-08 DOI: 10.1016/j.jaccas.2025.105301

Erasmus Mutabi MD , Charles Ebersbacher DO , Colin Pesyna MD , Candice Lee MD , Craig Alpert MD , Ryan Watson MD , Karthikeyan Ranganathan MD

{"title":"Patent Foramen Ovale Closure in Right Ventricular Failure on Mechanical Circulatory Support","authors":"Erasmus Mutabi MD , Charles Ebersbacher DO , Colin Pesyna MD , Candice Lee MD , Craig Alpert MD , Ryan Watson MD , Karthikeyan Ranganathan MD","doi":"10.1016/j.jaccas.2025.105301","DOIUrl":"10.1016/j.jaccas.2025.105301","url":null,"abstract":"<div><h3>Background</h3><div>Right-to-left shunting through a patent foramen ovale (PFO) can cause severe hypoxemia in right ventricular (RV) failure; however, closure may worsen RV function and risk hemodynamic collapse.</div></div><div><h3>Case Summary</h3><div>A 40-year-old man with arrhythmogenic RV dysplasia and profound RV failure developed refractory hypoxemia due to a large PFO while supported on venoarterial extracorporeal membrane oxygenation and intra-aortic balloon pump. After multidisciplinary assessment, he underwent successful percutaneous PFO closure, leading to improved oxygenation, RV stability, and decannulation from mechanical circulatory support.</div></div><div><h3>Discussion</h3><div>This rare case involving dual mechanical support illustrates the complexity of managing PFOs in RV failure. It challenges conventional caution against closure and emphasizes the importance of individualized, team-based decision-making guided by careful physiological assessment.</div></div><div><h3>Take-Home Messages</h3><div>PFO closure may be feasible in RV failure with mechanical circulatory support. Multidisciplinary planning is essential to optimize outcomes.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 31","pages":"Article 105301"},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242257","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}

引用次数: 0

Culture-Negative Transcatheter Pulmonary Valve Endocarditis 经导管肺瓣膜心内膜炎培养阴性

JACC. Case reports Pub Date : 2025-10-08 DOI: 10.1016/j.jaccas.2025.105324

Chukwunonyelum Odukwe MD , Ahmed Abdelrahman MD , Ali N. Zaidi MD , Barry Love MD , Ismail El-Hamamsy MD, PhD , Munir Ghesani MD , Kali A. Hopkins MD

{"title":"Culture-Negative Transcatheter Pulmonary Valve Endocarditis","authors":"Chukwunonyelum Odukwe MD , Ahmed Abdelrahman MD , Ali N. Zaidi MD , Barry Love MD , Ismail El-Hamamsy MD, PhD , Munir Ghesani MD , Kali A. Hopkins MD","doi":"10.1016/j.jaccas.2025.105324","DOIUrl":"10.1016/j.jaccas.2025.105324","url":null,"abstract":"<div><h3>Clinical Condition</h3><div>We present a case of transcatheter pulmonary valve endocarditis in a 38-year-old woman with a history of atrial septal defect, pulmonary stenosis, and bicuspid aortic valve, all previously repaired with mechanical and bioprosthetic valve replacements. Despite negative initial studies, <sup>18</sup>F-fluorodeoxyglucose positron emission tomography–computed tomography revealed septic pulmonary emboli and abnormal uptake at the pulmonary valve. Metagenomic sequencing identified <em>Haemophilus parainfluenzae</em> as the pathogen.</div></div><div><h3>Key Questions</h3><div>What is the differential diagnosis of a cardiac mass in this context? How should imaging and laboratory testing be approached in prosthetic valve endocarditis with negative studies? What surgical factors matter in patients with prior cardiac repairs?</div></div><div><h3>Outcome</h3><div>The patient underwent successful replacement of the pulmonary and aortic valves and completed a course of antibiotics, with full recovery.</div></div><div><h3>Take-Home Message</h3><div>Consider bioprosthetic valve endocarditis in patients with persistent fevers and negative cultures. Use advanced diagnostics early when the clinical suspicion is high.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 31","pages":"Article 105324"},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242262","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}

引用次数: 0

Cardiac Mass, Bacteremia, and Embolic Stroke 心脏肿块，菌血症和栓塞性中风

JACC. Case reports Pub Date : 2025-10-08 DOI: 10.1016/j.jaccas.2025.105339

Ngoc Thai Kieu MD , Mahmoud Elamin MD , Syed Haseeb MD , Rija Shahid MBBS , Thuy Hao Nguyen MD , Husam Katib MD , Vien T. Truong MD , Ahmed Ali MBBS , Noman Chaudhary MBBS , Thach Nguyen MD

{"title":"Cardiac Mass, Bacteremia, and Embolic Stroke","authors":"Ngoc Thai Kieu MD , Mahmoud Elamin MD , Syed Haseeb MD , Rija Shahid MBBS , Thuy Hao Nguyen MD , Husam Katib MD , Vien T. Truong MD , Ahmed Ali MBBS , Noman Chaudhary MBBS , Thach Nguyen MD","doi":"10.1016/j.jaccas.2025.105339","DOIUrl":"10.1016/j.jaccas.2025.105339","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac masses may mimic tumors or vegetations. Differentiation is essential, particularly in the context of bacteremia and embolic complications.</div></div><div><h3>Case Summary</h3><div>A 75-year-old man presented with fatigue, myalgia, and new-onset atrial fibrillation. Transesophageal echocardiography revealed a mitral valve mass with features suggestive of fibroelastoma or myxoma. Blood cultures were positive for <em>Streptococcus mitis</em>. The patient subsequently developed an intracerebral hemorrhage requiring craniotomy. Serial imaging demonstrated resolution of the mitral valve mass, supporting a diagnosis of vegetation.</div></div><div><h3>Discussion</h3><div>Diagnosis of infective endocarditis requires integration of clinical context, microbiologic data, and serial imaging rather than reliance on echocardiographic appearance alone. Anticoagulation strategies must be individualized after hemorrhagic events.</div></div><div><h3>Take-Home Messages</h3><div>Cardiac masses in the setting of bacteremia require careful interpretation as lesions that appear benign may represent vegetations. ⁠Accurate diagnosis depends on integration of Duke criteria and serial transesophageal echocardiography evaluations, rather than reliance on a single echocardiogram.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 31","pages":"Article 105339"},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242258","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}

引用次数: 0

Rare Mechanism of Anterior Myocardial Infarction Secondary to Aortic Dissection 主动脉夹层继发于前壁心肌梗死的罕见机制。

JACC. Case reports Pub Date : 2025-10-08 DOI: 10.1016/j.jaccas.2025.105296

Isa Khan MD , Kevin Rajakariar MBBS , Yuvaraj Malaiapan MBBS, MD

引用次数: 0

Persistent Fifth Aortic Arch in a Right-Sided Aortic Arch Associated With Tetralogy of Fallot 法洛四联症伴右侧主动脉弓持续性第五主动脉弓。

JACC. Case reports Pub Date : 2025-10-08 DOI: 10.1016/j.jaccas.2025.105328

Gajon Uthayakumaran MBBS , Matthew Liava'a MBChB, MS , Julian Ayer MBBS, PhD , David Murphy MBBS , Claire Lawley MBBS, PhD

引用次数: 0

Renal Artery Perforation During Transcatheter Aortic Valve Replacement 经导管主动脉瓣置换术中肾动脉穿孔

JACC. Case reports Pub Date : 2025-10-08 DOI: 10.1016/j.jaccas.2025.105299

Saleh Altaf MD, Hammad Shafique MD, Alexander Tindale MD, Konstantinou Konstantinos MD, Tito Kabir MD

{"title":"Renal Artery Perforation During Transcatheter Aortic Valve Replacement","authors":"Saleh Altaf MD, Hammad Shafique MD, Alexander Tindale MD, Konstantinou Konstantinos MD, Tito Kabir MD","doi":"10.1016/j.jaccas.2025.105299","DOIUrl":"10.1016/j.jaccas.2025.105299","url":null,"abstract":"<div><h3>Background</h3><div>Transcatheter aortic valve replacement (TAVR) is a well-established modality to treat severe aortic stenosis.</div></div><div><h3>Case Summary</h3><div>We report a case of a woman in her 70s who underwent TAVR. The procedure was complicated owing to right renal artery perforation by a 0.038-inch angled-tip hydrophilic guidewire during closure of the left femoral artery, requiring implantation of a covered stent in renal artery to achieve hemostasis.</div></div><div><h3>Discussion</h3><div>In cases of shock during TAVR, injury to nonaccess site vessels should be considered. Treatment of iatrogenic renal artery injury with covered stent deployment achieves rapid hemostasis and preserves kidney function.</div></div><div><h3>Take-Home Messages</h3><div>In case of periprocedural hemorrhagic shock during TAVR, injury to nonaccess site vessels should be considered. Meticulous fluoroscopic guidance should always be used when advancing guidewires to prevent vascular damage. Awareness of patient-specific anatomical variation of arteries can help the operator to be more cautious and avoid entering that artery.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 31","pages":"Article 105299"},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242204","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}

引用次数: 0

High-Risk TAV-in-TAV 高风险TAV-in-TAV

JACC. Case reports Pub Date : 2025-10-08 DOI: 10.1016/j.jaccas.2025.105340

Lida Koskina MBBS , Andrew Ndakotsu MD , Antony Kaliyadan MD , John Wang MD , Shaikh B. Iqbal DO

{"title":"High-Risk TAV-in-TAV","authors":"Lida Koskina MBBS , Andrew Ndakotsu MD , Antony Kaliyadan MD , John Wang MD , Shaikh B. Iqbal DO","doi":"10.1016/j.jaccas.2025.105340","DOIUrl":"10.1016/j.jaccas.2025.105340","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study is to describe a high-risk transcatheter aortic valve-in-valve in a Lotus valve requiring coronary artery protection.</div></div><div><h3>Key Steps</h3><div>Thorough preoperative assessment for valve sizing and coronary obstruction risk assessment are performed. Access is obtained for a pigtail catheter, a guiding catheter for percutaneous coronary intervention, and the transcatheter aortic valve replacement delivery system. Coronary access is secured with a coronary wire and a guide extension catheter before valve deployment. Proper alignment of the new valve is ensured. A snorkel stent is deployed and maximal expansion is ensured.</div></div><div><h3>Potential Pitfalls</h3><div>Coronary artery anatomy, which is at high risk for obstruction, can lead to coronary ischemia or sequestration after valve deployment. Improper alignment of the new valve can lead to poor apposition and paravalvular leak. Injury to the aorta during valve deployment or when postdilation is required.</div></div><div><h3>Take-Home Message</h3><div>Successful transcatheter aortic valve-in-valve in a Lotus valve is feasible with proper preoperative planning, individualized device selection, and coronary protection when indicated.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 31","pages":"Article 105340"},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242206","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}

引用次数: 0

ALCAPA Diagnosed in an Elderly Patient 1例老年患者诊断为ALCAPA

JACC. Case reports Pub Date : 2025-10-08 DOI: 10.1016/j.jaccas.2025.105361

Thomas C. Pointer , John F. Keaney III MD, MPH , Samuel W. Reinhardt MD , Tony Pastor MD

引用次数: 0

Full-Scale 3D Printing as a Guide to Right Ventricular Pseudoaneurysm Due to Chronic Pacemaker Lead Erosion 全尺寸3D打印作为慢性起搏器铅侵蚀引起的右心室假性动脉瘤的指南。

JACC. Case reports Pub Date : 2025-10-08 DOI: 10.1016/j.jaccas.2025.105335

Yuktesh V. Kalidindi BS , Rida Khan BA , Ece Isin Akduman MD , Divya Ratan Verma MD , Ramy Shoela MD

{"title":"Full-Scale 3D Printing as a Guide to Right Ventricular Pseudoaneurysm Due to Chronic Pacemaker Lead Erosion","authors":"Yuktesh V. Kalidindi BS , Rida Khan BA , Ece Isin Akduman MD , Divya Ratan Verma MD , Ramy Shoela MD","doi":"10.1016/j.jaccas.2025.105335","DOIUrl":"10.1016/j.jaccas.2025.105335","url":null,"abstract":"<div><h3>Background</h3><div>Ventricular pseudoaneurysm formation due to longstanding lead erosion is rare, and standardized guidelines for diagnosis and management are limited.</div></div><div><h3>Case Summary</h3><div>We present a case of a right ventricular pseudoaneurysm noted on computed tomography after a patient with a pacemaker, originally placed in 2013, was admitted for respiratory failure. PolyJet three-dimensional printing was employed to assist in presurgical planning and evaluating the spatial anatomic relationship of the lead to the ventricular outpouching. The pseudoaneurysm was eventually excised, and the myocardial defect was closed.</div></div><div><h3>Discussion</h3><div>Pseudoaneurysms lack both standardized clinical presentations and management guidelines, making diagnosis challenging. Imaging is crucial for timely diagnosis and treatment.</div></div><div><h3>Take-Home Messages</h3><div>Cardiac-gated computed tomography is particularly valuable in diagnosing right ventricular pseudoaneurysms when other imaging modalities are technically challenging or inconclusive. Three-dimensional printing enhances the diagnosis of and preoperative planning for rare conditions such as pseudoaneurysms.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 31","pages":"Article 105335"},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006150","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}

引用次数: 0