JACC. Case reports最新文献_第7页

Percutaneous Orthotopic Transcatheter Tricuspid Valve Replacement for Native Valve Destruction After Endocarditis 心内膜炎后原位瓣膜破坏的经皮原位经导管三尖瓣置换术

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105280

Andrea Ruberti MD , Laura Sanchis MD, PhD , Andrea Arenas-Loriente MD , Blanca Domenech-Ximenos MD, PhD , Eduardo Flores-Umanzor MD, PhD , Ander Regueiro MD, PhD , Marta Farrero MD, PhD , Marta Sitges MD, PhD , Xavier Freixa MD, PhD , Omar Abdul-Jawad Altisent MD, PhD

{"title":"Percutaneous Orthotopic Transcatheter Tricuspid Valve Replacement for Native Valve Destruction After Endocarditis","authors":"Andrea Ruberti MD , Laura Sanchis MD, PhD , Andrea Arenas-Loriente MD , Blanca Domenech-Ximenos MD, PhD , Eduardo Flores-Umanzor MD, PhD , Ander Regueiro MD, PhD , Marta Farrero MD, PhD , Marta Sitges MD, PhD , Xavier Freixa MD, PhD , Omar Abdul-Jawad Altisent MD, PhD","doi":"10.1016/j.jaccas.2025.105280","DOIUrl":"10.1016/j.jaccas.2025.105280","url":null,"abstract":"<div><h3>Background</h3><div>Transcatheter tricuspid valve replacement (TTVR) is emerging as an option for treating severe tricuspid regurgitation (TR) in patients at high surgical risk.</div></div><div><h3>Case Summary</h3><div>A 59-year-old man with torrential TR and right heart failure following <em>Staphylococcus aureus</em> tricuspid valve infective endocarditis and extensive leaflet destruction was successfully treated with orthotopic TTVR using the LuX-Valve Plus system (Jenscare), resulting in significant clinical improvement and favorable right ventricular remodeling.</div></div><div><h3>Discussion</h3><div>The LuX-Valve Plus, delivered via transjugular access, enables optimal coaxial alignment during deployment. Its unique features—leaflet graspers, a septal anchoring mechanism, and a flexible frame—provide stability and preserve right ventricular function, making it suitable for complex tricuspid anatomies.</div></div><div><h3>Take-Home Messages</h3><div>Orthotopic TTVR with the LuX-Valve Plus offers a viable option for patients with severe TR and extensive leaflet destruction, previously considered ineligible for surgical or transcatheter repair. Multimodality imaging is essential for procedural planning and optimal outcomes.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105280"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195799","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

Hypoxia Following Mitral Transcatheter Edge-to-Edge Repair 二尖瓣经导管边缘对边缘修复术后缺氧

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105305

Fajer J. Almoosa MD , Mamdouh A. Elsmaan MD, MSc , Michael L. Rigby MD , Saeed Mirsadraee MD, PhD , Ali H. Vazir MB, BS, PhD

引用次数: 0

Delayed-Onset ICI-Associated Myocarditis 迟发性ici相关心肌炎

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105307

Fadi W. Adel MD, Ghasaq Saleh MD, Nandan S. Anavekar MBBCh, Sharonne N. Hayes MD

{"title":"Delayed-Onset ICI-Associated Myocarditis","authors":"Fadi W. Adel MD, Ghasaq Saleh MD, Nandan S. Anavekar MBBCh, Sharonne N. Hayes MD","doi":"10.1016/j.jaccas.2025.105307","DOIUrl":"10.1016/j.jaccas.2025.105307","url":null,"abstract":"<div><h3>Background</h3><div>Immune checkpoint inhibitors (ICIs) are increasingly used in cancer therapy, but they may cause immune-related adverse events, including myocarditis, a rare but potentially fatal complication.</div></div><div><h3>Case Summary</h3><div>A 74-year-old man with lung adenocarcinoma treated with durvalumab presented with acute-on-chronic hypoxemic respiratory failure and hypotension. He was recently diagnosed with ICI pneumonitis and was taking corticosteroids. Evaluation revealed elevated troponins, new T-wave inversions, and reduced left ventricular ejection fraction. Coronary angiography showed no obstructive disease. Cardiac magnetic resonance revealed diffuse myocardial edema with nonischemic late gadolinium enhancement. Endomyocardial biopsy confirmed lymphohistiocytic infiltrates consistent with ICI myocarditis.</div></div><div><h3>Discussion</h3><div>ICI-associated myocarditis can mimic acute coronary syndrome or stress cardiomyopathy. Cardiac magnetic resonance and biopsy are essential for accurate diagnosis. Early recognition and initiation of high-dose corticosteroids are critical for improved outcomes.</div></div><div><h3>Take-Home Messages</h3><div>ICI myocarditis should be considered in patients with prior ICI exposure and new cardiomyopathy. Multimodal imaging and biopsy are key to timely diagnosis and management.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105307"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195842","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

Infective Endocarditis 19 Months After Transcatheter Ostium Secundum Atrial Septal Defect Closure in a 6-Year-Old 1例6岁儿童经导管第二口房间隔缺损闭合后19个月的感染性心内膜炎

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105273

Camille Gery MD , Anne Sophie Leborgne MD , Grégoire Albenque MD, PhD , Julie Lourtet-Hascoet MD , Clément Batteux MD, PhD , Régine Roussin MD , Sébastien Hascoet MD, PhD

{"title":"Infective Endocarditis 19 Months After Transcatheter Ostium Secundum Atrial Septal Defect Closure in a 6-Year-Old","authors":"Camille Gery MD , Anne Sophie Leborgne MD , Grégoire Albenque MD, PhD , Julie Lourtet-Hascoet MD , Clément Batteux MD, PhD , Régine Roussin MD , Sébastien Hascoet MD, PhD","doi":"10.1016/j.jaccas.2025.105273","DOIUrl":"10.1016/j.jaccas.2025.105273","url":null,"abstract":"<div><h3>Background</h3><div>Infective endocarditis (IE) after transcatheter atrial septal defect (ASD) closure is rare.</div></div><div><h3>Case Summary</h3><div>We report the case of a 6-year-old girl who developed methicillin-resistant <em>Staphylococcus aureus</em> IE 19 months after ASD closure with an Amplatzer device. She presented with severe sepsis, a large vegetation on the right atrial side of the occluder, and moderate tricuspid regurgitation. Despite empirical antibiotic therapy, persistent bacteremia mandated surgical removal of the device, ASD closure with a pericardial patch, and tricuspid valve repair. Six weeks of targeted antibiotics led to a favorable 1-year outcome.</div></div><div><h3>Discussion</h3><div>This case, alongside other reports of late-onset IE after transcatheter ASD closure, highlights that although rare, such infections can occur well beyond 6 months postprocedure. This observation questions current guidelines restricting prophylactic measures to the early postimplant period.</div></div><div><h3>Take-Home Message</h3><div>Patients with septal occluders may require prolonged vigilance and reinforced education on skin and dental hygiene to minimize the risk of late IE.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105273"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195845","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

Pregnant Patient With Infrarenal Abdominal Aortic Aneurysm Successfully Treated With EVAR 妊娠期腹主动脉瘤EVAR治疗成功

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105287

Tomomi Ueda MD , Hiroki Yagi MD, PhD , Nana Akiyama PhD , Naoya Akiba MD, PhD , Katsuyuki Hoshina MD, PhD , Hiroshi Akazawa MD, PhD , Norifumi Takeda MD, PhD , Norihiko Takeda MD, PhD

{"title":"Pregnant Patient With Infrarenal Abdominal Aortic Aneurysm Successfully Treated With EVAR","authors":"Tomomi Ueda MD , Hiroki Yagi MD, PhD , Nana Akiyama PhD , Naoya Akiba MD, PhD , Katsuyuki Hoshina MD, PhD , Hiroshi Akazawa MD, PhD , Norifumi Takeda MD, PhD , Norihiko Takeda MD, PhD","doi":"10.1016/j.jaccas.2025.105287","DOIUrl":"10.1016/j.jaccas.2025.105287","url":null,"abstract":"<div><h3>Background</h3><div>Pregnancy management in patients with a history of untreated aortic aneurysm or dissection is not established.</div></div><div><h3>Clinical Condition</h3><div>A patient with a chronic infrarenal abdominal aortic aneurysm and dissection was referred to our hospital at 13 weeks' gestation.</div></div><div><h3>Key Questions</h3><div>What are the treatment options for infrarenal abdominal aortic aneurysm with dissection in a pregnant patient? What tests are needed for treatment strategy? What are the safety considerations when performing endovascular aneurysm repair (EVAR) during pregnancy?</div></div><div><h3>Outcome</h3><div>Genetic testing for established hereditary aortopathy genes was negative. After carvedilol treatment, EVAR was performed under ultrasound guidance with minimal radiation exposure at 19 weeks' gestation, allowing for adequate fetal growth. She had an uncomplicated vaginal delivery under epidural anesthesia at 39 weeks' gestation.</div></div><div><h3>Take-Home Messages</h3><div>EVAR could be an effective treatment option during pregnancy if radiation exposure is properly minimized. Multidisciplinary collaboration, including early evaluation for connective tissue diseases, is essential to evaluate treatment strategy.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105287"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195899","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

Hypereosinophilic Syndrome Presenting as Coronary Artery Spasm and ST-Segment Elevation Myocardial Infarction 高嗜酸性粒细胞综合征表现为冠状动脉痉挛和st段抬高型心肌梗死

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105308

Matthew P. Czaja MD, MPH , Yogamaya Mantha MD , Mark L. Canales MD , Robert J. Chilton DO

{"title":"Hypereosinophilic Syndrome Presenting as Coronary Artery Spasm and ST-Segment Elevation Myocardial Infarction","authors":"Matthew P. Czaja MD, MPH , Yogamaya Mantha MD , Mark L. Canales MD , Robert J. Chilton DO","doi":"10.1016/j.jaccas.2025.105308","DOIUrl":"10.1016/j.jaccas.2025.105308","url":null,"abstract":"<div><h3>Background</h3><div>Hypereosinophilic syndrome (HES) is characterized by high absolute eosinophil count and multiorgan damage. Energy drink consumption (EDC) is associated with adverse cardiovascular events, including coronary artery spasm (CAS).</div></div><div><h3>Case Summary</h3><div>A 31-year-old man with asthma and excessive EDC presented with chest pain, hypotension, and inferior ST-segment elevation myocardial infarction with elevated troponin to 1,081 ng/L. Given persistent CAS refractory to coronary vasodilators, he underwent balloon angioplasty of the right coronary artery and first diagonal branch. Despite initial improvement, his absolute eosinophil count and systemic symptoms worsened. Gastrointestinal, pulmonary, and bone marrow biopsies demonstrated eosinophilic infiltration. He achieved remission with corticosteroids.</div></div><div><h3>Discussion</h3><div>ST-segment elevation myocardial infarction from CAS is a rare cardiac manifestation of HES. The multidisciplinary management requires pharmacologic and interventional therapies to reduce inflammation and prevent cardiovascular sequelae.</div></div><div><h3>Take-Home Message</h3><div>This case highlights the importance of early recognition and treatment HES in patients with unexplained myocardial infarction, particularly when associated with EDC and the absence of atherosclerotic risk factors.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105308"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195811","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

Acute Occlusion of Right Coronary Artery During Transcatheter Aortic Valve Replacement of a Bicuspid Valve 经导管主动脉瓣置换术中急性右冠状动脉闭塞

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105313

Yousuke Taniguchi MD , Anna Lena Lahmann MD , Hector A. Alvarez-Covarrubias MD, MSc, PhD , Salvatore Cassese MD , Erion Xhepa MD , Massimiliano Fusaro MD , Michael Joner MD

{"title":"Acute Occlusion of Right Coronary Artery During Transcatheter Aortic Valve Replacement of a Bicuspid Valve","authors":"Yousuke Taniguchi MD , Anna Lena Lahmann MD , Hector A. Alvarez-Covarrubias MD, MSc, PhD , Salvatore Cassese MD , Erion Xhepa MD , Massimiliano Fusaro MD , Michael Joner MD","doi":"10.1016/j.jaccas.2025.105313","DOIUrl":"10.1016/j.jaccas.2025.105313","url":null,"abstract":"<div><h3>Background</h3><div>Coronary artery occlusion following transcatheter aortic valve replacement is a severe complication.</div></div><div><h3>Case Summary</h3><div>We present a case of coronary artery occlusion that occurred unexpectedly despite thorough preprocedural planning under the anatomically unique condition of a bicuspid aortic valve. Several factors that warrant reconsideration during preprocedural planning became clearer through the case analysis and subsequent autopsy findings.</div></div><div><h3>Discussion</h3><div>Despite best practice in preprocedural planning, exact simulation of procedural work flow and precise risk assessment remains restricted owing to patient-specific anatomical and functional characteristics not amenable to preprocedural projection.</div></div><div><h3>Take-Home Messages</h3><div>When transcatheter aortic valve replacement is performed in the setting of a bicuspid aortic valve, coronary artery–related complications may be at increased risk for failed percutaneous bailout procedures. When assessing the risk of coronary artery occlusion in bicuspid aortic valves, it is important to consider not only coronary artery height, but also the distribution of calcification.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105313"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195849","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

KCNQ1 and GJA1 Variants Associated With Arrhythmogenic Right Ventricular Cardiomyopathy With a Lethal Outcome KCNQ1和GJA1变异与致心律失常性右室心肌病的致命结果相关

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105304

Lucas Tramèr MD , Dominik Zumstein MD , Argelia Medeiros-Domingo MD, PhD , Annina S. Vischer MD , Firat Erdogan , Felix C. Tanner MD , Robert Manka MD , Lisa Prampolini MD , Firat Duru MD , Ardan M. Saguner MD

{"title":"KCNQ1 and GJA1 Variants Associated With Arrhythmogenic Right Ventricular Cardiomyopathy With a Lethal Outcome","authors":"Lucas Tramèr MD , Dominik Zumstein MD , Argelia Medeiros-Domingo MD, PhD , Annina S. Vischer MD , Firat Erdogan , Felix C. Tanner MD , Robert Manka MD , Lisa Prampolini MD , Firat Duru MD , Ardan M. Saguner MD","doi":"10.1016/j.jaccas.2025.105304","DOIUrl":"10.1016/j.jaccas.2025.105304","url":null,"abstract":"<div><h3>Background</h3><div>Arrhythmogenic right ventricular cardiomyopathy (ARVC) is mainly caused by desmosomal variants. Nondesmosomal ARVC is rare.</div></div><div><h3>Case Summary</h3><div>A 31-year-old athlete experienced sudden cardiac death. Autopsy revealed ARVC and syndactyly. Genetic testing identified a heterozygous pathogenic <em>KCNQ1</em> variant associated with long QT syndrome, and a heterozygous likely pathogenic <em>GJA1</em> variant encoding connexin-43, a gap junction protein. No relative had ARVC or prolonged QTc interval; however, <em>GJA1</em>-positive relatives had either syndactyly or a gait disorder; both of these pathologies are associated with <em>GJA1</em>.</div></div><div><h3>Discussion</h3><div>Connexin-43 is essential for desmosomal function; however, ARVC causation has not been established. Cascade genetic and clinical testing suggests that the combination of both variants and lifelong endurance exercise may have precipitated the ARVC phenotype.</div></div><div><h3>Take-Home Messages</h3><div>This is the first documented case linking <em>GJA1</em> and <em>KCNQ1</em> variants to ARVC. Comprehensive genetic and clinical family screening is vital for assessing the individual contribution of each variant to the diagnosis and arrhythmic risk.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105304"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195854","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

Straightening Misfolded Microaxial Flow Pump in the Aorta Using a Snare Catheter 用圈套导管矫直主动脉错折微轴流泵

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105218

Marko Šustić MD, PhD , Tomislav Jakljević MD, PhD , Zoran Miovski MD, PhD , Davorka Lulić MD , David Gobić MD, PhD , Luka Bastiančić MD , Josip Aničić MD , Vjekoslav Tomulić MD, PhD

{"title":"Straightening Misfolded Microaxial Flow Pump in the Aorta Using a Snare Catheter","authors":"Marko Šustić MD, PhD , Tomislav Jakljević MD, PhD , Zoran Miovski MD, PhD , Davorka Lulić MD , David Gobić MD, PhD , Luka Bastiančić MD , Josip Aničić MD , Vjekoslav Tomulić MD, PhD","doi":"10.1016/j.jaccas.2025.105218","DOIUrl":"10.1016/j.jaccas.2025.105218","url":null,"abstract":"<div><h3>Background</h3><div>In patients with cardiogenic shock, misfolding of a microaxial flow pump within the aorta after deployment is a rare but serious complication that presents a significant therapeutic challenge.</div></div><div><h3>Case Summary</h3><div>A 35-year-old woman was hospitalized with influenza myocarditis. Although initially hemodynamically stable, she developed cardiogenic shock 24 hours later, requiring implantation of an Impella CP device. She was transferred to the intensive care unit, where signs of device malfunction soon appeared. Fluoroscopy revealed a distorted, Z-shaped configuration of the Impella CP in the ascending aorta. Using a snare technique, the device was straightened in the descending aorta and successfully retrieved via the femoral sheath.</div></div><div><h3>Discussion</h3><div>Currently, no established guidelines exist for managing microaxial flow pump misfolding. This case demonstrates a safe and effective percutaneous retrieval approach for this complication.</div></div><div><h3>Take-Home Message</h3><div>The snare technique provides a safe and effective percutaneous method for retrieving a kinked microaxial flow pump device.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105218"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195897","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

Measuring Transmitral Gradient With Single Radial Access Using a Dual-Lumen Catheter 使用双腔导管测量单径向通道的透射梯度

JACC. Case reports Pub Date : 2025-10-01 DOI: 10.1016/j.jaccas.2025.105219

Khaldoon Rashid MD , Sheena Amin MD , Rumman Syed MD , Eric Rothstein MD

{"title":"Measuring Transmitral Gradient With Single Radial Access Using a Dual-Lumen Catheter","authors":"Khaldoon Rashid MD , Sheena Amin MD , Rumman Syed MD , Eric Rothstein MD","doi":"10.1016/j.jaccas.2025.105219","DOIUrl":"10.1016/j.jaccas.2025.105219","url":null,"abstract":"<div><h3>Objective</h3><div>To measure the transmitral gradient (TMG) with a dual-lumen pigtail catheter with single radial-arterial access to obtain simultaneous left atrial (LA)/left ventricular (LV) pressures.</div></div><div><h3>Key Steps</h3><div>Key steps include the following: 1) with radial arterial access, use a 5-F TIG 4.0 diagnostic catheter, and advance a 0.035-inch J-wire across the aortic valve in a retrograde fashion; 2) advance catheter into LV; 3) advance floppy 0.035-inch Tru-Torque wire beyond the mitral valve into the LA and pulmonary vein; 4) advance TIG catheter over the wire into the LA; 5) exchange TIG catheter for a Langston dual-lumen catheter; 6) place distal pigtail portion into the LA and proximal pressure port in the LV, obtain concurrent LA/LV pressures, and calculate TMG and MVA with Gorlin equation.</div></div><div><h3>Potential Pitfalls</h3><div>In patients with atrial fibrillation, advancing the catheter across the mitral valve presents risk of dislodging a preexisting thrombus from the left atrial appendage.</div></div><div><h3>Take-Home Message</h3><div>This method offers a simple and efficient approach to a direct TMG assessment.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 105219"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195901","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