Jonathan Senior, Marina Roelas Guillamo, Angie Ghattas, Luke Tapp
{"title":"Dislodged Coronary Artery Stent Retrieved With an Endovascular Snare.","authors":"Jonathan Senior, Marina Roelas Guillamo, Angie Ghattas, Luke Tapp","doi":"10.14503/THIJ-17-6587","DOIUrl":"https://doi.org/10.14503/THIJ-17-6587","url":null,"abstract":"<p><p>Advances in stent design and technology have made stent loss during percutaneous coronary intervention rare. When stent loss occurs, the risk of life-threatening procedural complications is high. We describe the use of an endovascular snare system to retrieve a dislodged stent from the proximal right coronary artery of a 54-year-old man during percutaneous coronary intervention after other conventional retrieval techniques had failed.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"47 3","pages":"213-215"},"PeriodicalIF":0.9,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529073/pdf/i1526-6702-47-3-213.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38437792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"High-Grade Atrioventricular Block Associated With Acute Influenza.","authors":"Kevin Ergle, Janelle Y Gooden, Mustafa M Ahmed","doi":"10.14503/THIJ-18-6658","DOIUrl":"https://doi.org/10.14503/THIJ-18-6658","url":null,"abstract":"<p><p>Influenza causes cardiac and pulmonary complications that can lead to death. Its effect on the conduction system, first described a century ago, has long been thought to be fairly benign. We report 2 cases of high-grade atrioventricular block associated with acute influenza infection. Both patients-a 50-year-old woman with no history of cardiac disease or conduction abnormalities and a 20-year-old man with a history of complex congenital heart disease and conduction abnormalities-received a permanent pacemaker. In the first case, pacemaker interrogation at 4 months revealed persistent atrioventricular block. In the second case, pacemaker interrogation at 3 months suggested resolution. Whether such influenza-associated changes are transient or permanent remains unknown. We recommend keeping a careful watch on influenza patients with cardiac rhythm abnormalities and monitoring them closely to see if the problem resolves.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"47 3","pages":"220-223"},"PeriodicalIF":0.9,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529078/pdf/i1526-6702-47-3-220.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38437793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Use of Large Balloon Catheter to Treat Infants With Pulmonary Valve Stenosis.","authors":"Yuji Ohnishi, Seigo Okada, Takashi Furuta, Yasuo Suzuki, Yuki Iwaya, Shunji Hasegawa, Jun Muneuchi","doi":"10.14503/THIJ-18-6599","DOIUrl":"https://doi.org/10.14503/THIJ-18-6599","url":null,"abstract":"<p><p>Balloon pulmonary valvuloplasty is a safe and effective treatment for isolated pulmonary valve stenosis. Several balloon catheters are available for this procedure in neonates and infants. However, obtaining additional vascular access for the double-balloon technique in this population is troublesome, and tricuspid valve injury is a concern. We used a TMP PED balloon catheter to perform valvuloplasty in 2 infants with isolated pulmonary valve stenosis. This thin-walled, relatively large 12-mm balloon catheter can be delivered through a small-diameter sheath. In both cases, the transpulmonary pressure gradient was reduced without causing any valvular or vascular injuries. Neither patient had recurrent pulmonary valve stenosis. Together, these cases highlight the suitability and feasibility of using the 12-mm TMP PED balloon catheter for treating young infants with valvular stenosis.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"47 3","pages":"216-219"},"PeriodicalIF":0.9,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529066/pdf/i1526-6702-47-3-216.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38437794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Omar Ray Kahaly, Dilesh Patel, Ralph S Augostini, Gregory D Rushing, Mahmoud M Houmsse
{"title":"Intra-Aortic Migration of a Clipped Epicardial Pacing Wire.","authors":"Omar Ray Kahaly, Dilesh Patel, Ralph S Augostini, Gregory D Rushing, Mahmoud M Houmsse","doi":"10.14503/THIJ-17-6507","DOIUrl":"https://doi.org/10.14503/THIJ-17-6507","url":null,"abstract":"A 76-year-old man presented for electrophysiologic evaluation of a temporary pacemaker wire detected in his aorta. His medical history included coronary artery disease, 2-vessel coronary artery bypass grafting (CABG) 16 years previously, congestive heart failure (left ventricular ejection fraction, 0.35–0.40), hyperlipidemia, hypertension, frequent premature ventricular contractions, and singlechamber implantable cardioverter-defibrillator placement. His primary care physician had ordered chest computed tomograms to evaluate shortness of breath, chest pain, and hemoptysis. The images revealed mild infiltrative disease in the right upper lung lobe and a temporary pacemaker wire in the aortic arch. The proximal end of the wire terminated in the right ventricular wall, and the distal end was floating in the descending aorta (Fig. 1). Transesophageal echocardiograms (TEE) showed the wire in the lumen of the descending aorta (Fig. 2). At the time of CABG, the patient’s epicardial pacemaker wires had been clipped at skin level and left in place. From that time to the current presentation, he had experienced no stroke symptoms, nor had he undergone TEE or dedicated aortic scanning procedures until the current presentation. We concluded that the imaging findings were incidental. We then consulted our cardiac surgery colleagues regarding the high risks of percutaneous lead extraction, and they surmised that the epicardial lead had Images in Cardiovascular Medicine","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"47 3","pages":"239-240"},"PeriodicalIF":0.9,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529080/pdf/i1526-6702-47-3-239.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38534957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kainat Khalid, Nadeen Faza, Nasser M Lakkis, Rashed Tabbaa
{"title":"Cardiac Involvement by Burkitt Lymphoma in a 49-Year-Old Man.","authors":"Kainat Khalid, Nadeen Faza, Nasser M Lakkis, Rashed Tabbaa","doi":"10.14503/THIJ-17-6448","DOIUrl":"https://doi.org/10.14503/THIJ-17-6448","url":null,"abstract":"<p><p>Malignant metastases are among the most common cardiac masses. We report a rare case of cardiac involvement by Burkitt lymphoma in a 49-year-old man who presented with a 2-month history of dyspnea and palpitations. A transthoracic echocardiogram revealed 2 intracardiac masses in the right atrium (one of which partially encased the tricuspid valve), myocardial infiltration, and pericardial disease. Results of pleural fluid cytology and flow cytometry confirmed involvement by Burkitt lymphoma. Subsequent chemotherapy markedly reduced the intracardiac tumor burden and resolved the patient's presenting symptoms. Our case highlights the importance of cardiac imaging in diagnosing systemic illness, initiating early and appropriate treatment, and monitoring disease progression in patients with intracardiac Burkitt lymphoma.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"47 3","pages":"210-212"},"PeriodicalIF":0.9,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529070/pdf/i1526-6702-47-3-210.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38534958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rajiv A Kabadi, Mital Shah, Gregary D Marhefka, Gautam George, Bharat Awsare, Mizue Terai, Takami Sato
{"title":"Rapid, Fatal Acute Right Ventricular Failure After Locoregional Cytokine Therapy for Uveal Melanoma Liver Metastases.","authors":"Rajiv A Kabadi, Mital Shah, Gregary D Marhefka, Gautam George, Bharat Awsare, Mizue Terai, Takami Sato","doi":"10.14503/THIJ-18-6762","DOIUrl":"https://doi.org/10.14503/THIJ-18-6762","url":null,"abstract":"<p><p>Locoregional cytokine treatment, or immunoembolization, is an experimental targeted therapy for uveal melanoma metastatic to the liver. Unlike systemic cytokine treatments that have been associated with substantial toxicity, this method of drug delivery appears to be better tolerated. Because this newer therapy is being prescribed more widely, oncologists, interventional radiologists, cardiologists, pulmonologists, critical care specialists, and other providers should become familiar with potential adverse reactions. We describe the case of a 67-year-old man who had metastatic uveal melanoma. Before he underwent liver-directed immunoembolization, he had elevated markers of endothelial dysfunction. He died after the rapid onset of acute right ventricular failure from severe pulmonary hypertension with possible superimposed isolated right ventricular takotsubo cardiomyopathy. In discussing this rare case, we focus on the differential diagnosis.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"47 3","pages":"224-228"},"PeriodicalIF":0.9,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529077/pdf/i1526-6702-47-3-224.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38437795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Posttraumatic Subacute Effusive-Constrictive Pericarditis After a Motor Vehicle Accident.","authors":"Melroy S D'Souza, Kaitlin Shinn, Anup D Patel","doi":"10.14503/THIJ-19-7002","DOIUrl":"https://doi.org/10.14503/THIJ-19-7002","url":null,"abstract":"<p><p>Effusive-constrictive pericarditis is typically caused by tuberculosis or other severe inflammatory conditions that affect the pericardium. We report a case of effusive-constrictive pericarditis consequent to a motor vehicle accident. A 32-year-old man with gastroesophageal reflux disease presented with severe substernal chest pain of a month's duration and dyspnea on exertion for one week. Echocardiograms revealed a moderate pericardial effusion, and the diagnosis was subacute effusive-constrictive pericarditis. After thorough tests revealed nothing definitive, we learned that the patient had been in a motor vehicle accident weeks before symptom onset, which made blunt trauma the most likely cause of pericardial injury and effusion. Medical management resolved the effusion and improved his symptoms. To our knowledge, this is the first report of effusion from posttraumatic constrictive pericarditis associated with a motor vehicle accident. We encourage providers to consider recent trauma as a possible cause of otherwise idiopathic pericarditis.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"47 3","pages":"233-235"},"PeriodicalIF":0.9,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529076/pdf/i1526-6702-47-3-233.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38437796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Improper Atrial Pacing: Differential Diagnosis.","authors":"Sanket Borgaonkar, Mark Pollet, Yochai Birnbaum","doi":"10.14503/THIJ-19-7006","DOIUrl":"https://doi.org/10.14503/THIJ-19-7006","url":null,"abstract":"A 73-year-old man with a medical history of ischemic cardiomyopathy (left ventricular ejection fraction, 0.20–0.24), coronary artery disease with percutaneous coronary intervention to the left anterior descending coronary artery, end-stage renal disease, hypertension, and diabetes mellitus presented at a routine clinical visit. We interrogated his biventricular implantable cardioverter-defibrillator (ICD) (Medtronic Claria MRI CRT-D SureScan), which was programmed in DDDR mode (dual-chamber, sensed, rate-adaptive). The patient’s electrocardiogram (ECG) raised concerns about improper pacing (Fig. 1).","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"47 3","pages":"236-237"},"PeriodicalIF":0.9,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529074/pdf/i1526-6702-47-3-236.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38534954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anthony H Masso, Carlo Uribe, James T Willerson, Benjamin Y Cheong, Barry R Davis
{"title":"Left Ventricular Noncompaction Detected by Cardiac Magnetic Resonance Screening: A Reexamination of Diagnostic Criteria.","authors":"Anthony H Masso, Carlo Uribe, James T Willerson, Benjamin Y Cheong, Barry R Davis","doi":"10.14503/THIJ-19-7157","DOIUrl":"https://doi.org/10.14503/THIJ-19-7157","url":null,"abstract":"<p><p>In a previous cross-sectional screening study of 5,169 middle and high school students (mean age, 13.1 ± 1.78 yr) in which we estimated the prevalence of high-risk cardiovascular conditions associated with sudden cardiac death, we incidentally detected by cardiac magnetic resonance (CMR) 959 cases (18.6%) of left ventricular noncompaction (LVNC) that met the Petersen diagnostic criterion (noncompaction:compaction ratio >2.3). Short-axis CMR images were available for 511 of these cases (the Short-Axis Study Set). To determine how many of those cases were truly abnormal, we analyzed the short-axis images in terms of LV structural and functional variables and applied 3 published diagnostic criteria besides the Petersen criterion to our findings. The estimated prevalences were 17.5% based on trabeculated LV mass (Jacquier criterion), 7.4% based on trabeculated LV volume (Choi criterion), and 1.3% based on trabeculated LV mass and distribution (Grothoff criterion). Absent longitudinal clinical outcomes data or accepted diagnostic standards, our analysis of the screening data from the Short-Axis Study Set did not definitively differentiate normal from pathologic cases. However, it does suggest that many of the cases might be normal anatomic variants. It also suggests that cases marked by pathologically excessive LV trabeculation, even if asymptomatic, might involve unsustainable physiologic disadvantages that increase the risk of LV dysfunction, pathologic remodeling, arrhythmias, or mural thrombi. These disadvantages may escape detection, particularly in children developing from prepubescence through adolescence. Longitudinal follow-up of suspected LVNC cases to ascertain their natural history and clinical outcome is warranted.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"47 3","pages":"183-193"},"PeriodicalIF":0.9,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529067/pdf/i1526-6702-47-3-183.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38534955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}