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ST-Segment Elevation Myocardial Infarction With Acute Stent Thrombosis as the Initial Presentation of Essential Thrombocythemia
JACC. Case reports Pub Date : 2025-02-19 DOI: 10.1016/j.jaccas.2024.102953
Samira Teeri MD , Rama Alashqar MD , Mohamad Al-Otaibi MD , Salem Kim MD , Sonia Samtani MD
{"title":"ST-Segment Elevation Myocardial Infarction With Acute Stent Thrombosis as the Initial Presentation of Essential Thrombocythemia","authors":"Samira Teeri MD ,&nbsp;Rama Alashqar MD ,&nbsp;Mohamad Al-Otaibi MD ,&nbsp;Salem Kim MD ,&nbsp;Sonia Samtani MD","doi":"10.1016/j.jaccas.2024.102953","DOIUrl":"10.1016/j.jaccas.2024.102953","url":null,"abstract":"<div><div>This paper presents a patient with acute coronary syndrome and 100% mid-left anterior descending artery occlusion, complicated by acute stent thrombosis. Subsequent work-up revealed essential thrombocythemia. This case highlights the increased risk of acute coronary syndrome and stent thrombosis in essential thrombocythemia, emphasizing the need for multidisciplinary management.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 4","pages":"Article 102953"},"PeriodicalIF":0.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445982","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
Right Atrial Mass as Manifestation of Sarcoidosis
JACC. Case reports Pub Date : 2025-02-19 DOI: 10.1016/j.jaccas.2024.102695
Shyla Saini MD , Erin Eschbach MD , Barry Love MD , Krishna Patel MD, MSc , Adam Jacobi MD , Noah Moss MD , Adam S. Morgenthau MD
{"title":"Right Atrial Mass as Manifestation of Sarcoidosis","authors":"Shyla Saini MD ,&nbsp;Erin Eschbach MD ,&nbsp;Barry Love MD ,&nbsp;Krishna Patel MD, MSc ,&nbsp;Adam Jacobi MD ,&nbsp;Noah Moss MD ,&nbsp;Adam S. Morgenthau MD","doi":"10.1016/j.jaccas.2024.102695","DOIUrl":"10.1016/j.jaccas.2024.102695","url":null,"abstract":"<div><div>Cardiac involvement is relatively common in patients with sarcoidosis; however, cardiac masses are rare. Herein, we demonstrate a case of a right atrial mass with extension into the inferior vena cava, which prompted a transjugular biopsy that demonstrated non-necrotizing granulomas consistent with sarcoidosis.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 4","pages":"Article 102695"},"PeriodicalIF":0.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445989","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
Rescue of Iatrogenic Spiral Dissections Using an Intravascular Ultrasound-Guided Parallel Wire Technique
JACC. Case reports Pub Date : 2025-02-05 DOI: 10.1016/j.jaccas.2024.103121
Harish Sharma BMBCh, MA (Oxon), PhD , Arif Khan MBBS , Benjamin Wrigley MBChB, MD , Sohail Q. Khan MB ChB, MD
{"title":"Rescue of Iatrogenic Spiral Dissections Using an Intravascular Ultrasound-Guided Parallel Wire Technique","authors":"Harish Sharma BMBCh, MA (Oxon), PhD ,&nbsp;Arif Khan MBBS ,&nbsp;Benjamin Wrigley MBChB, MD ,&nbsp;Sohail Q. Khan MB ChB, MD","doi":"10.1016/j.jaccas.2024.103121","DOIUrl":"10.1016/j.jaccas.2024.103121","url":null,"abstract":"<div><div>Percutaneous coronary intervention carries a risk of iatrogenic catheter dissection. A spiral aorto-ostial dissection can completely occlude the vessel and cause ischemia with significant hemodynamic compromise. The mortality from such dissections is approximately 6.5%. The situation can be rescued percutaneously by stenting the true lumen open, but this relies on having a wire within the true lumen. Large dissections often have a small true lumen that is hard to wire and a large false lumen that wires easily. There is a paucity of literature outlining the necessary steps to achieve procedural success. This case series includes 2 spiral dissections and demonstrates a step-by-step approach to manage this situation successfully.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 3","pages":"Article 103121"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143341896","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
tMCS Causing Myocardial Extramedullary Hematopoiesis Secondary to Massive Hemolysis
JACC. Case reports Pub Date : 2025-02-05 DOI: 10.1016/j.jaccas.2024.103127
Raphael Rothenberger MD , Yara Banz MD, PhD , Jolie Bruno MD , Lukas Capek MD , Monika Fürholz MD , Alexandra-Maria Neagoe MD , Lukas Hunziker MD , Michele Martinelli MD , Bruno Schnegg MD , Annatina Schnegg-Kaufmann MD
{"title":"tMCS Causing Myocardial Extramedullary Hematopoiesis Secondary to Massive Hemolysis","authors":"Raphael Rothenberger MD ,&nbsp;Yara Banz MD, PhD ,&nbsp;Jolie Bruno MD ,&nbsp;Lukas Capek MD ,&nbsp;Monika Fürholz MD ,&nbsp;Alexandra-Maria Neagoe MD ,&nbsp;Lukas Hunziker MD ,&nbsp;Michele Martinelli MD ,&nbsp;Bruno Schnegg MD ,&nbsp;Annatina Schnegg-Kaufmann MD","doi":"10.1016/j.jaccas.2024.103127","DOIUrl":"10.1016/j.jaccas.2024.103127","url":null,"abstract":"<div><div>In severe heart failure with hemodynamic failure, when inotropic therapies no longer suffice (INTERMACS [Interagency Registry for Mechanically Assisted Circulatory Support] 1), temporary mechanical support is used as a bridging measure until a more definitive treatment, such as a left ventricular assist device, a total artificial heart or transplantation, is performed. Due to shear stress during the passage of blood through the pump, limited hemolysis is to be expected. We describe the case of a 37-year-old patient with terminal heart failure who suffered severe hemolysis during treatment with temporary mechanical support. Examination of the cardiac apex after left ventricular assist device implantation revealed a poorly differentiated tumor. Histopathologic examination revealed underlying extramedullary hematopoiesis, triggered by severe hemolytic anemia. Following exclusion of neoplasia, the patient subsequently underwent heart transplantation. Post-transplantation, the patient was diagnosed with alpha-thalassemia and heterozygote hemoglobin E. This combination can result in mild thalassemia with chronic low-level hemolysis and mild anemia, probably severely exacerbated in the presence of high-shear stress.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 3","pages":"Article 103127"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143341704","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
Right Ventricular Pseudoaneurysm
JACC. Case reports Pub Date : 2025-02-05 DOI: 10.1016/j.jaccas.2024.103131
Lada Kozmek MD , Charles Vidoni MD , Matthieu Besutti MD , Fortunato Di Caterino MD , Giovanni Vitale MD , Nicolas Meneveau MD, PhD , Romain Chopard MD, PhD
{"title":"Right Ventricular Pseudoaneurysm","authors":"Lada Kozmek MD ,&nbsp;Charles Vidoni MD ,&nbsp;Matthieu Besutti MD ,&nbsp;Fortunato Di Caterino MD ,&nbsp;Giovanni Vitale MD ,&nbsp;Nicolas Meneveau MD, PhD ,&nbsp;Romain Chopard MD, PhD","doi":"10.1016/j.jaccas.2024.103131","DOIUrl":"10.1016/j.jaccas.2024.103131","url":null,"abstract":"<div><h3>Background</h3><div>Right ventricular pseudoaneurysm is a rare and poorly documented condition.</div></div><div><h3>Case Summary</h3><div>This paper reports a case of right ventricular pseudoaneurysm of iatrogenic origin, which developed after placement of internal jugular central venous catheter. The patient underwent successful percutaneous closure.</div></div><div><h3>Discussion</h3><div>The formation of a pseudoaneurysm is potentially fatal. The main causes are ischemic, postsurgical, infectious, and after percutaneous valve replacement. Diagnosis is based on nonspecific symptoms and multimodal imaging. Treatment may be medical, surgical, or percutaneous, depending on the clinic, imaging, and decision of the heart team.</div></div><div><h3>Take-Home Messages</h3><div>Right ventricular pseudoaneurysm is a rare and poorly documented condition that can complicate even a routine procedure (eg, central venous line placement). Due to its lethal potential, treatment is primarily interventional, requiring careful multimodal imaging assessment. Coil embolization appears to be an effective and safe therapeutic option for managing small-sized pseudoaneurysms in patients at high surgical risk.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 3","pages":"Article 103131"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143341897","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
Acute Severe Aortic Regurgitation Post-PCI
JACC. Case reports Pub Date : 2025-02-05 DOI: 10.1016/j.jaccas.2024.103101
Robert Ambrogetti MBBS , Gareth Squire MA, MBChB, PGCAPP, MD , Nick Harvey MBChB , Amerjeet Banning BSc (Hons), MBBS, PhD , Andrew Ladwiniec MA, MBBS, MD , Gavin J. Murphy BSc, MBChB, MD , Iain Squire BSc, MBChB, MD
{"title":"Acute Severe Aortic Regurgitation Post-PCI","authors":"Robert Ambrogetti MBBS ,&nbsp;Gareth Squire MA, MBChB, PGCAPP, MD ,&nbsp;Nick Harvey MBChB ,&nbsp;Amerjeet Banning BSc (Hons), MBBS, PhD ,&nbsp;Andrew Ladwiniec MA, MBBS, MD ,&nbsp;Gavin J. Murphy BSc, MBChB, MD ,&nbsp;Iain Squire BSc, MBChB, MD","doi":"10.1016/j.jaccas.2024.103101","DOIUrl":"10.1016/j.jaccas.2024.103101","url":null,"abstract":"<div><div>The ability to manage more complex coronary disease has evolved with the development of new technologies, techniques, and practitioner experience. The increasing technical difficulty of interventional procedures is known to be associated with an increased risk of complications. This can include coronary perforation, coronary dissection, coronary thrombosis, and aortic valve dysfunction. Permanent aortic valve damage caused by guide catheter, wire instrumentation or stent migration is a rare occurrence. We report the case of a woman in her 50s who developed acute severe aortic regurgitation requiring aortic valve replacement post–percutaneous coronary intervention.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 3","pages":"Article 103101"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143341899","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
When 3 Fundamentals of Disaster Meet During Elective PCI
JACC. Case reports Pub Date : 2025-02-05 DOI: 10.1016/j.jaccas.2024.103126
Max Wagener MD, Jasper Boeddinghaus MD, Gregor Leibundgut MD
{"title":"When 3 Fundamentals of Disaster Meet During Elective PCI","authors":"Max Wagener MD,&nbsp;Jasper Boeddinghaus MD,&nbsp;Gregor Leibundgut MD","doi":"10.1016/j.jaccas.2024.103126","DOIUrl":"10.1016/j.jaccas.2024.103126","url":null,"abstract":"<div><div>The disaster risk is probabilistically defined as a function of hazard, vulnerability, and capacity. Here, we report a case of a vulnerable patient who underwent elective percutaneous coronary intervention for symptomatic ischemic heart disease in whom a series of 5 percutaneous coronary intervention–related hazards occurred: distal coronary perforation; ischemia-driven electrical storm; no reflow; coronary vessel rupture; and stent dislodgement. These complications were managed using several interventional techniques including immediate balloon occlusion, distal vessel coiling, drug-eluting stent implantation, recovery of a dislodged drug-eluting stent on the fractured wire using a self-made snare and finally crushing of a stent graft against the vessel wall. Despite these efforts, prolonged resuscitation and limited patient-related capacities were unfavorable and the patient died due to cardiogenic shock.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 3","pages":"Article 103126"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143342162","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
Crush Technique as Ultimate Bailout Treatment for Rotablator Burr Entrapment
JACC. Case reports Pub Date : 2025-02-05 DOI: 10.1016/j.jaccas.2024.103129
Ziad Boueri MD , Rami Mazloum MD , Philippe Riccini MD , Geraud Souteyrand MD, PhD , Nicolas Amabile MD, PhD
{"title":"Crush Technique as Ultimate Bailout Treatment for Rotablator Burr Entrapment","authors":"Ziad Boueri MD ,&nbsp;Rami Mazloum MD ,&nbsp;Philippe Riccini MD ,&nbsp;Geraud Souteyrand MD, PhD ,&nbsp;Nicolas Amabile MD, PhD","doi":"10.1016/j.jaccas.2024.103129","DOIUrl":"10.1016/j.jaccas.2024.103129","url":null,"abstract":"<div><div>This case demonstrates the feasibility of a crush technique as an ultimate bailout treatment for Rotablator (Boston Scientific) burr entrapment during a complex percutaneous coronary intervention of the left main artery. This paper reports the case of a 77-year-old patient successfully treated by crushing the burr by a stent in the left main artery after complete burr entrapment. The patient had a calcified distal stenosis of the left main coronary with stenosis of the distal anastomosis of the saphenous vein graft to the obtuse marginal artery. The patient had several controls with optical coherence tomography imaging at 3 months. Immediate and 1-year clinical outcomes were satisfying. To our knowledge, this case is the first report of crushing technique as bail out option for entrapped rotablation burr.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 3","pages":"Article 103129"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143342164","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
Laryngospasm During Pulsed Field Ablation of the Left Superior Pulmonary Vein
JACC. Case reports Pub Date : 2025-02-05 DOI: 10.1016/j.jaccas.2024.103095
Bartosz Żuchowski MD, PhD , Małgorzata Połetek MD, PhD , Mateusz Dziarmaga MD, PhD , Adrianna Jęchorek MSc , Jakub Szrama MD, PhD , Przemysław Guzik MD, PhD , Andrzej Minczykowski MD, PhD , Andrzej Wykrętowicz MD, PhD
{"title":"Laryngospasm During Pulsed Field Ablation of the Left Superior Pulmonary Vein","authors":"Bartosz Żuchowski MD, PhD ,&nbsp;Małgorzata Połetek MD, PhD ,&nbsp;Mateusz Dziarmaga MD, PhD ,&nbsp;Adrianna Jęchorek MSc ,&nbsp;Jakub Szrama MD, PhD ,&nbsp;Przemysław Guzik MD, PhD ,&nbsp;Andrzej Minczykowski MD, PhD ,&nbsp;Andrzej Wykrętowicz MD, PhD","doi":"10.1016/j.jaccas.2024.103095","DOIUrl":"10.1016/j.jaccas.2024.103095","url":null,"abstract":"<div><h3>Background</h3><div>Pulsed field ablation (PFA) is an innovative, nonthermal, and effective method for pulmonary vein isolation, with a favorable safety profile in the treatment of atrial fibrillation (AF).</div></div><div><h3>Case Summary</h3><div>A 74-year-old woman underwent elective pulmonary vein isolation with PFA for paroxysmal AF under general anesthesia with a laryngeal mask airway. During PFA delivery to the left superior pulmonary vein, a vocal cord spasm occurred, requiring immediate airway intervention. Ventilation was restored with a muscle relaxant followed by endotracheal intubation.</div></div><div><h3>Discussion</h3><div>Although muscle contractions and vasospasms have been documented previously during PFA, this case is the first to be reported of laryngospasm. We hypothesize that it may result from direct stimulation of the recurrent laryngeal or vagus nerve owing to the superior vein course and deep catheter positioning.</div></div><div><h3>Take-Home Message</h3><div>Because laryngospasm may occur, preparation for acute airway obstruction management is essential during PFA for AF.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 3","pages":"Article 103095"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143342174","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
Supersaturated Oxygen Therapy as a Treatment for No Reflow
JACC. Case reports Pub Date : 2025-02-05 DOI: 10.1016/j.jaccas.2024.103102
Megha Prasad MD, MS , Natali Sorajja MS , Sandeep Nathan MD, MS , Jeffrey Chambers MD
{"title":"Supersaturated Oxygen Therapy as a Treatment for No Reflow","authors":"Megha Prasad MD, MS ,&nbsp;Natali Sorajja MS ,&nbsp;Sandeep Nathan MD, MS ,&nbsp;Jeffrey Chambers MD","doi":"10.1016/j.jaccas.2024.103102","DOIUrl":"10.1016/j.jaccas.2024.103102","url":null,"abstract":"<div><div>No reflow, an interruption in epicardial and microvascular blood flow, during percutaneous coronary intervention (PCI) is associated with adverse outcomes but continues to have limited therapeutic options. We present a case of a patient with multiple comorbidities, multivessel disease and reduced left ventricular function with calcified left anterior descending stenosis who was treated with rotational atherectomy, complicated by slow flow after balloon dilatation. Infusion of supersaturated oxygen (SSO<sub>2</sub>) into the left main was instituted as an adjunct to PCI, along with pharmacologic vasodilators. Subsequently, there was resolution of the patient’s symptoms and improvement in ejection fraction postprocedurally. The potential role of SSO<sub>2</sub> in treating patients with intraoperative no reflow is intriguing, given no reflow’s current limited treatment options and known increased risk of adverse events (major adverse cardiovascular events, cardiogenic shock, and so on). SSO<sub>2</sub> may be a promising therapy for PCI complicated by no reflow.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 3","pages":"Article 103102"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143341898","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
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