JACC. Case reports最新文献_第9页

Successful Use of Ruxolitinib for Steroid-Refractory Immune Checkpoint Inhibitor-Associated Myocarditis. Ruxolitinib成功用于类固醇难治性免疫检查点抑制剂相关心肌炎。

JACC. Case reports Pub Date : 2025-09-30 DOI: 10.1016/j.jaccas.2025.105543

Thomas Vockenhuber, Lukas Baldinger, Johannes Clausen, Georgios Kollias, Martin Schmid, Stefanie Schneiderbauer-Porod, Margarethe Strießnig, Martin Martinek, Christian Ebner

{"title":"Successful Use of Ruxolitinib for Steroid-Refractory Immune Checkpoint Inhibitor-Associated Myocarditis.","authors":"Thomas Vockenhuber, Lukas Baldinger, Johannes Clausen, Georgios Kollias, Martin Schmid, Stefanie Schneiderbauer-Porod, Margarethe Strießnig, Martin Martinek, Christian Ebner","doi":"10.1016/j.jaccas.2025.105543","DOIUrl":"https://doi.org/10.1016/j.jaccas.2025.105543","url":null,"abstract":"Background: Immune checkpoint inhibitors (ICIs) can trigger life-threatening immune-related adverse events, including myocarditis. Steroid-refractory cases pose significant therapeutic challenges.Case summary: A 57-year-old woman with metastatic non-small cell lung cancer developed fulminant myocarditis with bidirectional ventricular tachycardia and biventricular dysfunction after pembrolizumab therapy. Despite early high-dose corticosteroids, cardiac biomarkers remained elevated and arrhythmias persisted. Second-line agents (mycophenolate mofetil, intravenous immunoglobulin) were discontinued owing to adverse effects. Off-label ruxolitinib was initiated after interdisciplinary discussion. This led to sustained clinical improvement, return to sinus rhythm, and recovery of biventricular function.Discussion: This case highlights the therapeutic challenges in steroid-refractory ICI-associated myocarditis. Ruxolitinib may offer a promising option in these settings, though prospective data are lacking.Take-home messages: ICI-associated myocarditis can present with ventricular arrhythmia and heart failure. Ruxolitinib may be considered in steroid-refractory cases.","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":" ","pages":"105543"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199424","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

Bradycardia-Associated Pulmonary Hypertension. 心动过缓相关性肺动脉高压。

JACC. Case reports Pub Date : 2025-09-29 DOI: 10.1016/j.jaccas.2025.105540

Yuliang Long, Wei Li, Yingnan Bai, Daxin Zhou, Wenzhi Pan, Junbo Ge

引用次数: 0

Kidney Autotransplantation and "Debranch-First" Technique for Thoracoabdominal Stent-Graft Infection: Surgical Management of a 22-Year-Old Man With Midaortic Syndrome and Infection of Aortic and Renal Stent Grafts. 自体肾移植和“先去分支”技术治疗胸腹支架感染：一例22岁男性主动脉中部综合征并发主动脉和肾脏支架感染的手术治疗。

JACC. Case reports Pub Date : 2025-09-26 DOI: 10.1016/j.jaccas.2025.105530

Pietro Dioni, Apollonia Verrengia, Andrea Melloni, Franco Nodari, Stefano Bonardelli, Luca Bertoglio

{"title":"Kidney Autotransplantation and \"Debranch-First\" Technique for Thoracoabdominal Stent-Graft Infection: Surgical Management of a 22-Year-Old Man With Midaortic Syndrome and Infection of Aortic and Renal Stent Grafts.","authors":"Pietro Dioni, Apollonia Verrengia, Andrea Melloni, Franco Nodari, Stefano Bonardelli, Luca Bertoglio","doi":"10.1016/j.jaccas.2025.105530","DOIUrl":"https://doi.org/10.1016/j.jaccas.2025.105530","url":null,"abstract":"Objective: To present the surgical management of a 22-year-old patient with midaortic syndrome, symptomatic for claudication and renovascular hypertension, with infected aortic and renal stent grafts.Key steps: Procedures were performed as follows: 1) right renal autotransplantation through a transperitoneal approach and midline abdominal incision; 2) thoracotomy with left visceral rotation and visceral vessel exposure; 3) left-heart bypass and \"debranch-first\" technique, with warm blood perfusion for the splanchnic vessels and cold Custodiol solution for renal perfusion; 4) aortic replacement with a tubular xenopericardium graft; and 5) separate reattachment of visceral vessel to the main tubular graft.Potential pitfalls: Recurrent infections of the xenopericardium graft, kidney parenchyma loss, and major complications such as spinal cord ischemia, represent potential pitfalls to this procedure.Take-home message: Kidney autotransplantation allows right renal-infected stent graft removal before in situ thoracoabdominal reconstruction through left thoracoabdominal access, preserving renal function against renovascular hypertension.","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":" ","pages":"105530"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149197","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

Organ-Restricted Hypereosinophilic Syndrome: A Case of Recurrent Hypereosinophilic Myopericarditis. 器官限制性嗜酸性细胞增多综合征：复发性嗜酸性细胞增多性心包炎一例。

JACC. Case reports Pub Date : 2025-09-26 DOI: 10.1016/j.jaccas.2025.105535

Noora Alhajri, Samah Fadlelseed, Noha Abokhater, Shady Hegazi, Fulvio Salvo, Mohamed El Khashab

{"title":"Organ-Restricted Hypereosinophilic Syndrome: A Case of Recurrent Hypereosinophilic Myopericarditis.","authors":"Noora Alhajri, Samah Fadlelseed, Noha Abokhater, Shady Hegazi, Fulvio Salvo, Mohamed El Khashab","doi":"10.1016/j.jaccas.2025.105535","DOIUrl":"https://doi.org/10.1016/j.jaccas.2025.105535","url":null,"abstract":"Background: Eosinophilic myocarditis (EM) is a rare inflammatory condition that is characterized by eosinophilic myocardial infiltration. We present a case of hypereosinophilic syndrome (HES) presenting as EM, complicated by cardiac tamponade.Case summary: A 22-year-old man with a history of asthma presented with hypotension and chest pain. Work-up revealed myopericarditis with tamponade, eosinophil-rich pericardial effusion, and infection with influenza A. Despite initial improvement, he had recurrent episodes with elevated troponin, eosinophilia, and reduced left ventricular ejection fraction. Extensive work-up excluded malignancy and revealed biopsy-confirmed EM suggestive of HES. He responded to corticosteroids and was managed with guideline-directed heart failure medications.Discussion: Cardiac involvement as the initial presentation of HES is uncommon and represents a major contributor to morbidity and mortality.Take-home message: In patients presenting with acute heart failure and cardiac tamponade of uncertain etiology, a diagnostic work-up for EM should be initiated regardless of the presence of hypereosinophilia on the peripheral blood smear.","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":" ","pages":"105535"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149201","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

Percutaneous Levoatrial Cardinal Vein Closure for Stroke Prevention. 经皮左房主静脉闭塞术预防脑卒中。

JACC. Case reports Pub Date : 2025-09-26 DOI: 10.1016/j.jaccas.2025.105533

Spencer Chee, Amir Hasani, Alexander Ellis, David Adler

引用次数: 0

Late Thrombosis of First-Generation Bioresorbable Scaffold Site Treated With Novel Resorbable Magnesium Scaffold. 新型可吸收镁支架治疗第一代生物可吸收支架部位晚期血栓形成。

JACC. Case reports Pub Date : 2025-09-25 DOI: 10.1016/j.jaccas.2025.105531

Jorgo Kostov, Biljana Zafirovska, Sasko Kedev

{"title":"Late Thrombosis of First-Generation Bioresorbable Scaffold Site Treated With Novel Resorbable Magnesium Scaffold.","authors":"Jorgo Kostov, Biljana Zafirovska, Sasko Kedev","doi":"10.1016/j.jaccas.2025.105531","DOIUrl":"https://doi.org/10.1016/j.jaccas.2025.105531","url":null,"abstract":"Background: To the best of our knowledge, this is the first reported experience of a patient with late thrombosis of previous Absorb (Abbott Vascular) bioresorbable scaffold (BRS) implantation site, treated with second-generation Magmaris (Biotronik) resorbable magnesium scaffold (RMS).Case summary: A 55-year-old man with a previously implanted Absorb BRS stent presented with a non-ST-elevation myocardial infarction. Coronary angiography showed thrombotic lesion at the BRS stent site. After intravascular optical coherence tomography (OCT) imaging, a decision was made to implant a second-generation RMS stent. OCT follow-up was performed, with excellent long-term results.Discussion: Randomized controlled trials have connected early BRS implantation to a higher rate of stent thrombosis. In recent years, the newer generation RMS has confirmed a good safety profile and long-term patency. The idea behind this treatment was to assess the novel RMS technology with serial OCT imaging.Take-home messages: This case adds new options for the treatment of coronary arteries with novel RMS technology. Intravascular imaging with OCT is essential for optimized treatment and follow-up.","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":" ","pages":"105531"},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137634","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

Pacing-Induced Cardiomyopathy in a Transplanted Heart Treated With Left Bundle Branch Pacing. 左束支起搏治疗移植心脏起搏诱发的心肌病。

JACC. Case reports Pub Date : 2025-09-25 DOI: 10.1016/j.jaccas.2025.105537

Nicholas Tomassoni, Roy Sun, Marc Erickson, Pugazhendhi Vijayaraman

引用次数: 0

Intracoronary Full Physiology and Imaging Unveiling a Rare Cause of MINOCA Presenting as Ventricular Fibrillation. 冠状动脉内全生理和成像揭示了一种罕见的以心室颤动为表现的MINOCA病因。

JACC. Case reports Pub Date : 2025-09-25 DOI: 10.1016/j.jaccas.2025.105481

Maria Federica Crociani, Carlo Di Mario, Niccolò Ciardetti, Giulia Nardi, Silvia Maiani, Francesca Di Muro, Matteo Orlandi, Lucrezia Biagiotti, Francesco Meucci, Alessio Mattesini

{"title":"Intracoronary Full Physiology and Imaging Unveiling a Rare Cause of MINOCA Presenting as Ventricular Fibrillation.","authors":"Maria Federica Crociani, Carlo Di Mario, Niccolò Ciardetti, Giulia Nardi, Silvia Maiani, Francesca Di Muro, Matteo Orlandi, Lucrezia Biagiotti, Francesco Meucci, Alessio Mattesini","doi":"10.1016/j.jaccas.2025.105481","DOIUrl":"https://doi.org/10.1016/j.jaccas.2025.105481","url":null,"abstract":"Background: Nonobstructive coronary artery disease is diagnostically challenging, especially in patients with recurrent chest pain and inconclusive imaging. Coronary functional abnormalities, such as vasospasm, microvascular dysfunction, and myocardial bridging, are key contributors to ischemia.Case summary: A 57-year-old man with cardiovascular risk factors and a 10-year history of chest pain, empirically treated with vasodilators, presented with ST-segment elevation and ventricular fibrillation. Coronary angiography showed normal arteries. Invasive assessment with optical coherence tomography and coronary physiology revealed diffuse, nonobstructive lipid-rich atherosclerosis and a myocardial bridge in the mid left anterior descending artery. Ischemia was confirmed by resting full-cycle ratio. Coronary function testing showed microvascular dysfunction. Beta-blockers normalized indices, with symptom resolution at 6 months.Discussion: This case illustrates the diagnostic value of invasive imaging and physiology in patients with myocardial infarction/myocardial ischemia with no obstructive coronary artery disease (INOCA/MINOCA).Take-home messages: Invasive physiology and imaging are crucial for diagnosing ischemia mechanisms in nonobstructive coronary artery disease. Empirical therapy without functional assessment may delay effective, personalized treatment.","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":" ","pages":"105481"},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149206","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

Mechanism of Typical Atrial Flutter in a Patient After Cardiac Transplant: Functional Slowing From Geometric Distortion. 心脏移植后典型心房扑动的机制：由几何畸变引起的功能减慢。

JACC. Case reports Pub Date : 2025-09-25 DOI: 10.1016/j.jaccas.2025.105487

Alejandro Plana, Jeremy S Treger, Jonathan Grinstein, Mark Belkin, Valluvan Jeevanandam, Gaurav A Upadhyay

{"title":"Mechanism of Typical Atrial Flutter in a Patient After Cardiac Transplant: Functional Slowing From Geometric Distortion.","authors":"Alejandro Plana, Jeremy S Treger, Jonathan Grinstein, Mark Belkin, Valluvan Jeevanandam, Gaurav A Upadhyay","doi":"10.1016/j.jaccas.2025.105487","DOIUrl":"https://doi.org/10.1016/j.jaccas.2025.105487","url":null,"abstract":"Background: Atrial flutter and atrial fibrillation occur after orthotopic heart transplant (OHT) in 25% of patients. Hemodynamic and medication restrictions in this unique population limit treatment.Case summary: A patient experienced prolonged episodes of paroxysmal atrial flutter and hypotension 8 days after OHT. Electrophysiology study demonstrated typical cavotricuspid isthmus (CTI)-dependent flutter, with slowing at the CTI midportion. Intracardiac echocardiography revealed that this site was distant from any suture lines or anastomoses. The slowing appeared to be secondary to geometric distortion (ie, \"buckling\" of the atrial wall) of the CTI.Discussion: Typical atrial flutter caused by functional slowing from structural distortion is distinct from prior reports of atrial flutter attributed to conduction block from suture lines. Computational models support the hypothesis that tissue curvature changes can lead to altered atrial conduction properties.Take-home message: Functional slowing from geometric distortion should be considered as a cause of atrial flutter in the post-OHT setting.","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":" ","pages":"105487"},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137795","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

Vacuum-Assisted Aspiration of Intracardiac Masses as a Bridge or Alternative to Surgery 心脏内肿块的真空辅助抽吸作为手术的桥梁或替代方法

JACC. Case reports Pub Date : 2025-09-24 DOI: 10.1016/j.jaccas.2025.105095

Mohammad Al-Termanini MD , Yusra Magdi , Hakam Alzaeem MD , Cheikh Maaly MD , Mohamed Salah Abdelghani MD , Samira Al-Maraghi , Yasser Shouman MD , Nazar Mohammad MD , Mohammed Al-Hijji MD

{"title":"Vacuum-Assisted Aspiration of Intracardiac Masses as a Bridge or Alternative to Surgery","authors":"Mohammad Al-Termanini MD , Yusra Magdi , Hakam Alzaeem MD , Cheikh Maaly MD , Mohamed Salah Abdelghani MD , Samira Al-Maraghi , Yasser Shouman MD , Nazar Mohammad MD , Mohammed Al-Hijji MD","doi":"10.1016/j.jaccas.2025.105095","DOIUrl":"10.1016/j.jaccas.2025.105095","url":null,"abstract":"<div><h3>Background</h3><div>Infective endocarditis may lead to embolic events and valve destruction by the formation of vegetation on valvular tissue. The conventional course of therapy for infective endocarditis often involves the use of both antimicrobial medications and/or surgical intervention. However, managing large valvular vegetations may be challenging because of the potential risk associated with urgent surgery, particularly in patients with comorbid illnesses. Mechanical and vacuum-assisted aspiration devices have been used with limited experience in both diagnosing and treating selected patients by effectively removing or reducing the vegetation size.</div></div><div><h3>Case Summary</h3><div>We report a case series of 6 patients with either right-sided or left-sided infective endocarditis who were treated successfully with vacuum-assisted aspiration catheter.</div></div><div><h3>Discussion</h3><div>Our case series highlights the use of the AngioVac system (AngioDynamics) as a potential novel treatment approach in managing high-risk patients with infective endocarditis. We demonstrate the techniques used for effective vegetation extraction using the AngioVac.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 29","pages":"Article 105095"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145128147","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