JACC. Case reports最新文献_第4页

Left Atrial Mass as the Initial Presentation of Poorly Differentiated Nonsmall Cell Lung Carcinoma 左房肿块是低分化非小细胞肺癌的最初表现。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-27 DOI: 10.1016/j.jaccas.2026.110007

Manjunath Bagur MD, DM, Ajmal Sahaban MD, Vallabh Anil Manathkar MD, Ashwin Shivamurthy Banakar MD, Ashok Upadhyaya MBBS, Vishnu Sharma MD, Krishnaraj Upadhyaya MD

{"title":"Left Atrial Mass as the Initial Presentation of Poorly Differentiated Nonsmall Cell Lung Carcinoma","authors":"Manjunath Bagur MD, DM, Ajmal Sahaban MD, Vallabh Anil Manathkar MD, Ashwin Shivamurthy Banakar MD, Ashok Upadhyaya MBBS, Vishnu Sharma MD, Krishnaraj Upadhyaya MD","doi":"10.1016/j.jaccas.2026.110007","DOIUrl":"10.1016/j.jaccas.2026.110007","url":null,"abstract":"<div><h3>Background</h3><div>Lung carcinoma is a leading cause of cancer-related mortality globally. Although metastasis to the bone, brain, and adrenal glands is common, secondary cardiac involvement is exceptionally rare, particularly within the left atrium.</div></div><div><h3>Case Presentation</h3><div>A 62-year-old female patient, a known case of hypothyroidism, presented with a 6-month history of class II dyspnea on exertion and easy fatigability. She also reported a 2-month history of giddiness, chest discomfort, and weight loss. Initial 2-dimensional echocardiography revealed a large left atrial mass, suspected to be a tumor thrombus. Subsequent diagnostic evaluations, including a chest computed tomography scan and positron emission tomography, identified a primary lung carcinoma. A bronchoscopic biopsy confirmed poorly differentiated nonsmall cell lung cancer.</div></div><div><h3>Conclusions</h3><div>This case highlights the importance of integrating multimodal imaging to accurately diagnose atypical intracardiac masses. It also emphasizes the clinical necessity of including metastatic lung malignancy in the differential diagnosis when an intracavitary cardiac mass is discovered.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 110007"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840454","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

Late Failure of Decellularized Cryopreserved Aortic Homograft 脱细胞冷冻主动脉同种异体移植的晚期失败。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-09-02 DOI: 10.1016/j.jaccas.2026.109897

Fotios Kalafatakis MD, Uzma Rahman MD, Sriharsha Talapaneni, Hazar Kadirogullari, Ahmet Kilic MD

{"title":"Late Failure of Decellularized Cryopreserved Aortic Homograft","authors":"Fotios Kalafatakis MD, Uzma Rahman MD, Sriharsha Talapaneni, Hazar Kadirogullari, Ahmet Kilic MD","doi":"10.1016/j.jaccas.2026.109897","DOIUrl":"10.1016/j.jaccas.2026.109897","url":null,"abstract":"<div><h3>Background</h3><div>Decellularized aortic homografts were developed to reduce immunogenicity, but very long-term outcomes remain incompletely characterized.</div></div><div><h3>Case Summary</h3><div>A 54-year-old woman underwent aortic root replacement with a 22-mm SynerGraft decellularized homograft for bicuspid aortic valve disease and aortic root aneurysm. Nineteen years later, she presented with acute heart failure caused by severe aortic insufficiency. Preoperative imaging demonstrated a heavily calcified retrosternal aortic root, guiding a bilateral thoracosternotomy for redo root replacement. Operative and histopathologic findings showed extensive calcific degeneration with left coronary leaflet disruption. Recovery was uneventful.</div></div><div><h3>Discussion</h3><div>This case illustrates a possible very late failure pattern of a decellularized homograft and underscores the importance of meticulous preoperative imaging and individualized operative planning.</div></div><div><h3>Take-Home Messages</h3><div>Decellularized aortic homografts may remain susceptible to very late structural degeneration. Careful imaging and tailored surgical planning are essential for complex redo aortic root surgery.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 109897"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880451","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

Psychosocial Stress–Induced Takotsubo Syndrome in a Male Patient 男性患者的心理社会压力诱发Takotsubo综合征：打破刻板印象。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-09-03 DOI: 10.1016/j.jaccas.2026.110015

Hassan Beesley MD, Minel Soroa MD, Stamatios Lerakis MD, PhD, Deepak L. Bhatt MD, MPH, MBA, Solomon W. Bienstock MD

{"title":"Psychosocial Stress–Induced Takotsubo Syndrome in a Male Patient","authors":"Hassan Beesley MD, Minel Soroa MD, Stamatios Lerakis MD, PhD, Deepak L. Bhatt MD, MPH, MBA, Solomon W. Bienstock MD","doi":"10.1016/j.jaccas.2026.110015","DOIUrl":"10.1016/j.jaccas.2026.110015","url":null,"abstract":"<div><h3>Background</h3><div>Takotsubo syndrome (TTS) predominantly affects postmenopausal women after emotional or physical stress; men account for only ∼10% of cases and are usually triggered by physical precipitants.</div></div><div><h3>Case Summary</h3><div>A 48-year-old man presented with 24 hours of dyspnea following psychosocial stress related to financial and occupational strain. He was diagnosed with TTS complicated by dynamic left ventricular outflow tract obstruction and 4 discrete apical thrombi identified on cardiac magnetic resonance, and recovered fully with β-blockade and anticoagulation.</div></div><div><h3>Discussion</h3><div>This case is doubly atypical in sex and trigger. Severe complications arose despite a lower-risk trigger profile, and cardiac magnetic resonance was essential to detect thrombi and exclude infarction and myocarditis.</div></div><div><h3>Take-Home Message</h3><div>Male patients with psychosocial stress–triggered TTS are rare but face significant risk of severe complications, and multimodality imaging including cardiac magnetic resonance is helpful in this underrecognized population.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 110015"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887309","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

Saphenous Vein Graft-to-Pulmonary Artery Fistula 隐静脉移植物肺动脉瘘

JACC. Case reports Pub Date : 2026-10-21 DOI: 10.1016/j.jaccas.2026.110240

Jun Takaki MD, Toshihiro Fukui MD

引用次数: 0

AF-Triggered Bundle Branch Re-Entrant Ventricular Tachycardia Prevented by Atrial Fibrillation Ablation 房颤消融预防af触发的束支再入性室性心动过速。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-12 DOI: 10.1016/j.jaccas.2026.109802

Satoshi Sakai MD, PhD, Taku Nishida MD, PhD, Akihiro Takitsume MD, Tsunenari Soeda MD, PhD, Hiroyuki Kawata MD, PhD, Shungo Hikoso MD, PhD

{"title":"AF-Triggered Bundle Branch Re-Entrant Ventricular Tachycardia Prevented by Atrial Fibrillation Ablation","authors":"Satoshi Sakai MD, PhD, Taku Nishida MD, PhD, Akihiro Takitsume MD, Tsunenari Soeda MD, PhD, Hiroyuki Kawata MD, PhD, Shungo Hikoso MD, PhD","doi":"10.1016/j.jaccas.2026.109802","DOIUrl":"10.1016/j.jaccas.2026.109802","url":null,"abstract":"<div><h3>Background</h3><div>Bundle branch re-entrant ventricular tachycardia (BBR-VT) is a macroreentrant tachycardia involving the right and left bundle branches,<span><span><sup>1</sup></span></span> with the right bundle branch typically targeted for ablation.</div></div><div><h3>Case Summary</h3><div>A 68-year-old man with prior myocardial infarction presented with recurrent ventricular tachycardia (VT). Electrophysiological study suggested BBR-VT. VT was inducible only by atrial pacing and occurred clinically exclusively during atrial fibrillation (AF). Therefore, AF ablation alone was performed, resulting in complete suppression of VT.</div></div><div><h3>Discussion</h3><div>Previous reports have described BBR-VT induced by atrial pacing<span><span><sup>2</sup></span></span> or AF.<span><span><sup>3</sup></span></span> When BBR-VT is triggered exclusively by AF, AF ablation may be an effective therapeutic strategy.</div></div><div><h3>Take-Home Messages</h3><div>In patients with BBR-VT that is triggered exclusively by atrial fibrillation or atrial pacing, elimination of the triggering atrial arrhythmia may suppress VT without the need for bundle branch ablation. Even when AF ablation is effective, implantable cardioverter-defibrillator implantation and careful long-term follow-up remain essential because recurrence of atrial tachyarrhythmias may precipitate VT recurrence.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 109802"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722809","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

Electrocautery-Assisted Percutaneous Vacuum Aspiration of Dual Aortic Valve Fibroelastomas 电灼辅助下经皮真空抽吸治疗双主动脉瓣纤维弹性瘤。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-20 DOI: 10.1016/j.jaccas.2026.109885

Joshua H. Arnold MD, MS, Ereni Abuiata DO, Jean-Luc Germany MD, Khalil Ibrahim MD, Hema Krishna MD, Joaquim Spadoni Barboza MD

{"title":"Electrocautery-Assisted Percutaneous Vacuum Aspiration of Dual Aortic Valve Fibroelastomas","authors":"Joshua H. Arnold MD, MS, Ereni Abuiata DO, Jean-Luc Germany MD, Khalil Ibrahim MD, Hema Krishna MD, Joaquim Spadoni Barboza MD","doi":"10.1016/j.jaccas.2026.109885","DOIUrl":"10.1016/j.jaccas.2026.109885","url":null,"abstract":"<div><h3>Objective</h3><div>To describe a stepwise approach to electrocautery-assisted vacuum aspiration for percutaneous removal of multiple aortic valve papillary fibroelastomas (PFEs) using cerebral embolic protection.</div></div><div><h3>Key Steps</h3><div>Bilateral femoral arterial access; 22-F sheath (right femoral artery) and 16-F venous cannula (left femoral vein, extracorporeal membrane oxygenation). Bilateral cerebral embolic protection deployed via right radial approach into common carotids. A 20-mm snare (JR4 catheter) encircles the aspiration cannula. Once tumor engagement is confirmed, the snare is advanced over the cannula and connected to an electrocautery generator (70 W) to sever the stalk, facilitating aspiration. Repeated sequentially, one tumor at a time, to limit embolization risk.</div></div><div><h3>Potential Pitfalls</h3><div>Simultaneous multitumor engagement increases embolization risk, requiring single-tumor targeting. Papillary fibroelastomas are highly adherent to tissue and resistant to aspiration alone; cautery severance overcomes this. Cerebral protection must precede instrumentation of left-sided lesions.</div></div><div><h3>Take-Home Message</h3><div>Electrocautery-assisted vacuum aspiration with cerebral embolic protection is feasible approach for percutaneous removal of multiple aortic valve papillary fibroelastomas in nonsurgical candidates.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 109885"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793420","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

Myocardial Calcification After Severe Sepsis 严重脓毒症后心肌钙化：3例病例系列、多模态成像和文献回顾。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-21 DOI: 10.1016/j.jaccas.2026.109933

Adrià Ruiz-López MD, Mario Salido Iniesta MD, Sònia Gómez Revelles MD, Álvaro Rodríguez-Pérez MD, Dánae García Cosculluela MD, Juan Fernández-Martínez MD, Horacio Majul MD, Lluis Simón Pascua MD, David Viladés Medel MD, PhD, Rubén Leta MD

引用次数: 0

Transcatheter Sinus Venosus ASD Closure in Severe Pulmonary Hypertension 经导管静脉窦封堵严重肺动脉高压。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-09-01 DOI: 10.1016/j.jaccas.2026.110220

Hadeel Allam MBBCh, BAO, Eli Fredman MD, Daisuke Kobayashi MD, MPH, MHA, Manish Aggarwal MD, Ronald Grady MD, David Balzer MD

{"title":"Transcatheter Sinus Venosus ASD Closure in Severe Pulmonary Hypertension","authors":"Hadeel Allam MBBCh, BAO, Eli Fredman MD, Daisuke Kobayashi MD, MPH, MHA, Manish Aggarwal MD, Ronald Grady MD, David Balzer MD","doi":"10.1016/j.jaccas.2026.110220","DOIUrl":"10.1016/j.jaccas.2026.110220","url":null,"abstract":"<div><h3>Background</h3><div>Data on sinus venosus atrial septal defect (SVASD) closure in patients with coexistent pulmonary arterial hypertension (PAH) are scarce because current guidelines restrict closure to a pulmonary vascular resistance (PVR) of <5 WU.</div></div><div><h3>Case Summary</h3><div>A 20-year-old woman with severe PAH and a PVR of 12.6 WU underwent successful transcatheter SVASD and partial anomalous pulmonary venous return correction. A small atrial communication was intentionally created as a temporary safety “pop-off,” enabling aggressive postprocedural escalation of PAH therapy.</div></div><div><h3>Why Beyond the Guidelines?</h3><div>Patients with severe PAH may still benefit from transcatheter SVASD closure despite guidelines. These patients require highly individualized, nonguideline-directed interventions.</div></div><div><h3>Discussion</h3><div>Current guidelines restrict ASD closure to PVR <5 WU, and prior data on closure at higher resistances are largely limited to secundum defects. This successful fenestrated SVASD closure at a baseline PVR of 12.6 WU challenges the utility of relying on a single hemodynamic threshold. Creating a temporary, controlled fenestration provides an essential safety margin, expanding interventional options for high-risk patients who would otherwise be precluded from care.</div></div><div><h3>Take-Home Message</h3><div>Transcatheter closure of SVASD in patients with severe PAH can effectively reduce the left-to-right shunt and facilitate escalation of PAH-targeted therapies.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 110220"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905987","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

Slow Progression of Eruptive and Noneruptive Calcified Nodules After Atherectomy Monotherapy 单纯动脉粥样硬化切除术后爆发性和非爆发性钙化结节的缓慢进展。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-09-11 DOI: 10.1016/j.jaccas.2026.110197

Daiki Niizeki BSc, Masataka Nakano MD, PhD, Tetsuya Kawamata MD, Kota Fukushima BSc, Shinji Nakano MSc, Kotaro Miyashita MD, Kotaro Kagiyama MD, Nobuhiko Ogata MD, PhD

{"title":"Slow Progression of Eruptive and Noneruptive Calcified Nodules After Atherectomy Monotherapy","authors":"Daiki Niizeki BSc, Masataka Nakano MD, PhD, Tetsuya Kawamata MD, Kota Fukushima BSc, Shinji Nakano MSc, Kotaro Miyashita MD, Kotaro Kagiyama MD, Nobuhiko Ogata MD, PhD","doi":"10.1016/j.jaccas.2026.110197","DOIUrl":"10.1016/j.jaccas.2026.110197","url":null,"abstract":"<div><h3>Background</h3><div>Eruptive calcified nodules (CNs) are associated with poor outcomes after conventional stent- and balloon-based percutaneous coronary intervention, leaving optimal treatment strategies uncertain.</div></div><div><h3>Case Summary</h3><div>A 76-year-old woman presented with non–ST-segment elevation myocardial infarction. Coronary angiography and optical coherence tomography identified an eruptive CN, which was localized as the culprit lesion through functional assessment. Considering the risk of stent- and balloon-related failure, atherectomy-alone strategy, without adjunctive therapy, was performed. Serial optical coherence tomography demonstrated effective debulking with preserved vessel morphology at 5-month and 4-year follow-up without luminal compromise or recurrent events.</div></div><div><h3>Discussion</h3><div>Given the inherently latent pathology of eruptive CN, atherectomy monotherapy, devoid of superfluous stimuli and permanent scaffolding, may be a viable strategy for selected lesions, provided sufficient ablation was obtained.</div></div><div><h3>Take-Home Message</h3><div>A minimal atherectomy-alone strategy for the eruptive CN may yield maximal legacy, facilitating treatment options and straightforward lifetime management should recurrences occur.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"31 42","pages":"Article 110197"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919658","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

Cath-Lab Clues to Type A Aortic Dissection Presenting as Acute Myocardial Infarction 超声心动图提示A型主动脉夹层表现为急性心肌梗死。

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-22 DOI: 10.1016/j.jaccas.2026.109923

Yingdong Wang MD, Yuhe Sheng MD, Yaling Han MD, PhD, Xiaozeng Wang MD, Bin Wang MD

引用次数: 0