Journal of Cardiology Cases最新文献

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Asymptomatic left ventricular dysfunction 48 years after the onset in an adult patient with three-vessel giant aneurysms caused by Kawasaki disease 一例由川崎病引起的三血管巨动脉瘤的成人患者发病48 年后无症状左心室功能障碍
Journal of Cardiology Cases Pub Date : 2025-10-01 DOI: 10.1016/j.jccase.2025.06.015
Naoki Tsuboya MD , Etsuko Tsuda MD, PhD , Shuichi Yoneda MD, PhD , Satoshi Kainuma MD, PhD, FJCC , Midori Fukuyama MD , Toru Iwasa MD , Kenichi Kurosaki MD, PhD
{"title":"Asymptomatic left ventricular dysfunction 48 years after the onset in an adult patient with three-vessel giant aneurysms caused by Kawasaki disease","authors":"Naoki Tsuboya MD ,&nbsp;Etsuko Tsuda MD, PhD ,&nbsp;Shuichi Yoneda MD, PhD ,&nbsp;Satoshi Kainuma MD, PhD, FJCC ,&nbsp;Midori Fukuyama MD ,&nbsp;Toru Iwasa MD ,&nbsp;Kenichi Kurosaki MD, PhD","doi":"10.1016/j.jccase.2025.06.015","DOIUrl":"10.1016/j.jccase.2025.06.015","url":null,"abstract":"<div><div>Although giant coronary aneurysms caused by Kawasaki disease (KD) often lead to symptomatic or asymptomatic occlusion within the first year of the acute KD, the long-term fate of giant aneurysms remains unknown. A 51-year-old man with giant coronary aneurysms in three major coronary arteries developed asymptomatic left ventricular dysfunction with complete left bundle branch block (CLBBB) 48 years after the onset of acute KD. He had been treated with antiplatelet therapy. The <sup>13</sup>N-ammonia positron emission tomography findings revealed significant ischemia with a reduced left ventricular ejection fraction (LVEF). The coronary angiograms showed an almost complete occlusion of the right coronary artery (RCA) and localized stenosis of the left anterior descending artery (LAD). The fractional flow reserve (FFR) in the LAD was 0.75. After coronary artery bypass grafting of the RCA and LAD was performed, CLBBB and a low LVEF improved. Although the grafting to the RCA was patent, the graft to the LAD developed a string sign. The progression of localized stenosis in adults continues slowly more than 40 years after the onset of KD. The value of the FFR, which has localized stenosis with giant aneurysms, can be overestimated and should be further investigated.</div></div><div><h3>Learning objective</h3><div>Asymptomatic left ventricular dysfunction with complete left bundle branch block due to a right coronary artery occlusion occurred in an adult patient more than 40 years after the onset of Kawasaki disease. They improved after coronary artery bypass grafting. The value of the flow fraction ratio for localized stenosis with giant aneurysms can be overestimated in this population. Coronary risk factors such as hypertension, dyslipidemia, and diabetes mellitus associated with aging must be avoided.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 4","pages":"Pages 167-170"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189718","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
Clinical challenge of benign metastasizing leiomyoma with cardiac and hepatic involvement: A case report 良性转移性平滑肌瘤累及心脏和肝脏的临床挑战:1例报告
Journal of Cardiology Cases Pub Date : 2025-10-01 DOI: 10.1016/j.jccase.2025.06.019
Huong Thi Thu Vu MD , Hanh Thi Song Bui MD , Hien Quang Nguyen MD , Hai Phuong Huynh MD , Duc Tan Vo MD, PhD , Dinh Hoang Nguyen MD, PhD , Thang Nhat Tran MD, PhD , Minh Huu Nhat Le MD, PhD candidate
{"title":"Clinical challenge of benign metastasizing leiomyoma with cardiac and hepatic involvement: A case report","authors":"Huong Thi Thu Vu MD ,&nbsp;Hanh Thi Song Bui MD ,&nbsp;Hien Quang Nguyen MD ,&nbsp;Hai Phuong Huynh MD ,&nbsp;Duc Tan Vo MD, PhD ,&nbsp;Dinh Hoang Nguyen MD, PhD ,&nbsp;Thang Nhat Tran MD, PhD ,&nbsp;Minh Huu Nhat Le MD, PhD candidate","doi":"10.1016/j.jccase.2025.06.019","DOIUrl":"10.1016/j.jccase.2025.06.019","url":null,"abstract":"<div><div><span><span><span><span>Benign metastasizing leiomyoma<span> (BML) is a rare disorder occurring in women with a history of </span></span>uterine leiomyomas and having detection of leiomyomas in extrauterine locations. This case report describes a 39-year-old female with a six-month history of fatigue and worsening exertional dyspnea. She had undergone a previous </span>myomectomy due to multiple uterine fibroids. A transthoracic </span>echocardiogram<span><span> revealed a large mass involving the right atrium and the </span>inferior vena cava<span><span>. Chest and abdominal computed tomography scans<span><span> demonstrated the presence of this mass in the right hepatic vein, along with a nodule in the right lobe of the liver and multiple uterine fibroids. She underwent surgery to remove the cardiovascular mass, and histopathological results confirmed the benign nature of the </span>smooth muscle cells. Immunohistochemical staining was positive for actin, </span></span>progesterone receptor, </span></span></span>desmin<span><span>, and Ki67, consistent with a diagnosis of BML. Subsequently, she underwent hysterectomy and bilateral salpingo-oophorectomy, revealing a benign leiomyoma and </span>endometriosis. This case emphasizes the importance of imaging in accurately diagnosing and preoperatively evaluating cardiac mass.</span></div></div><div><h3>Learning objective</h3><div>Benign metastasizing leiomyoma should be considered in patients presenting with an atypical cardiac mass and a history of uterine leiomyoma, myomectomy, or hysterectomy. Multiple imaging modalities are crucial for diagnosis, preoperative evaluation, and surgical treatment guidance.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 4","pages":"Pages 179-182"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189721","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
Improvement of propionic acidemia-associated dilated cardiomyopathy through nutritional adjustment and heart failure medication: A case report 通过营养调整和心力衰竭药物治疗改善丙酸血症相关性扩张型心肌病1例报告
Journal of Cardiology Cases Pub Date : 2025-10-01 DOI: 10.1016/j.jccase.2025.06.016
Kazuyoshi Saito MD, PhD , Yoko Nakajima MD, PhD , Katsuyuki Yokoi MD, PhD , Meiko Hoshino MD, PhD , Yuta Sudo MD , Yasuhiro Maeda PhD , Tetsuya Ito MD, PhD , Tetsushi Yoshikawa MD, PhD , Akira Yamada MD, PhD
{"title":"Improvement of propionic acidemia-associated dilated cardiomyopathy through nutritional adjustment and heart failure medication: A case report","authors":"Kazuyoshi Saito MD, PhD ,&nbsp;Yoko Nakajima MD, PhD ,&nbsp;Katsuyuki Yokoi MD, PhD ,&nbsp;Meiko Hoshino MD, PhD ,&nbsp;Yuta Sudo MD ,&nbsp;Yasuhiro Maeda PhD ,&nbsp;Tetsuya Ito MD, PhD ,&nbsp;Tetsushi Yoshikawa MD, PhD ,&nbsp;Akira Yamada MD, PhD","doi":"10.1016/j.jccase.2025.06.016","DOIUrl":"10.1016/j.jccase.2025.06.016","url":null,"abstract":"<div><div><span><span><span>Propionic acidemia (PA) is a known cause of secondary </span>dilated cardiomyopathy<span> (DCM). However, little is known about how diet and heart failure treatment impact long-term cardiac outcomes in adult PA patients. We report the successful treatment of metabolic disease and secondary DCM-associated heart failure in a 20-year-old male patient with neonatal-onset PA and </span></span>intellectual disability<span><span>. At age 19 years, echocardiography<span> had revealed DCM without impaired cardiac contractility. At age 20 years, he developed heart failure, presumably from a </span></span>common cold<span> infection, and was hospitalized. Acute heart failure treatment improved his symptoms, leading to discharge, but they worsened again, necessitating re-admission. He then was discharged only after successfully adding </span></span></span>carvedilol<span> and pimobendan<span><span><span> to his medication. Six weeks later, however, he developed hyperammonemia with elevated serum propionyl </span>carnitine<span> and decreased free carnitine levels. He received acute phase treatment for this metabolic crisis and his diet therapy was readjusted, including by reducing natural protein. In the following 5 years, while continuing and slightly adapting heart failure medication and dietary regimens, the patient's cardiac function stably improved and his </span></span>diuretic dose could be reduced. Our findings support that careful diet therapy and modulation of heart failure medication can improve cardiac function in PA patients with DCM.</span></span></div></div><div><h3>Learning objective</h3><div><span>Neonatal-onset propionic acidemia (PA) tends to be the most severe form of PA and life-threatening metabolic disease. Even if the impact of the disease can be ameliorated by adapting the diet, later in life these patients often develop symptoms such as </span>intellectual disability, metabolic crises, and dilated cardiomyopathy (DCM), as observed in this case. This case demonstrates that heart failure medication and dietary therapy can help protect against metabolic disease and DCM-associated heart failure in an adult patient with neonatal-onset PA.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 4","pages":"Pages 187-190"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189786","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
Successful percutaneous closure of ventricular septal defects associated with pulmonary hypertension using different atrial septal defect Occluders: A report of two cases 使用不同的房间隔缺损封堵器成功经皮关闭与肺动脉高压相关的室间隔缺损:两例报告
Journal of Cardiology Cases Pub Date : 2025-10-01 DOI: 10.1016/j.jccase.2025.06.010
José Luis Colín-Ortiz MD , Rogelio Zúñiga-Gordillo MD , Linda Fabiola Pérez-Pérez MD , Carlos Balcázar-Ochoa MD , Roberto Tepatzi-Carranco MD , Rosa María García-Mejía MD
{"title":"Successful percutaneous closure of ventricular septal defects associated with pulmonary hypertension using different atrial septal defect Occluders: A report of two cases","authors":"José Luis Colín-Ortiz MD ,&nbsp;Rogelio Zúñiga-Gordillo MD ,&nbsp;Linda Fabiola Pérez-Pérez MD ,&nbsp;Carlos Balcázar-Ochoa MD ,&nbsp;Roberto Tepatzi-Carranco MD ,&nbsp;Rosa María García-Mejía MD","doi":"10.1016/j.jccase.2025.06.010","DOIUrl":"10.1016/j.jccase.2025.06.010","url":null,"abstract":"<div><div><span>We present two cases of children with muscular ventricular septal defects (mVSD) and severe pulmonary hypertension. Both children successfully underwent percutaneous closure using different atrial septal occluder devices. The patients were a 7-month-old boy with growth failure and </span>cyanosis<span><span>, and a 4-year-old boy with heart murmur and mild cyanosis. Their management was based on percutaneous defect closure using an Amplatzer septal occluder; Abbott Structural Heart, Plymouth, MN, USA and an Occlutech Figulla Flex-II occluder; Occlutech GmbH, Jena, Germany, respectively. </span>Atrial septal defect occluder devices are feasible for the closure of large or atypical mVSD associated with pulmonary hypertension.</span></div></div><div><h3>Learning objective</h3><div>Information in the literature shows a brief and no clear evidence about the primary closure of congenital mVSD with atrial septal occluder devices in pediatric patients. This brief report demonstrates that this approach is a safe and effective alternative for the treatment of mVSD cases associated with pulmonary hypertension using different atrial septal occluder devices.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 4","pages":"Pages 171-174"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189719","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
Partial arch replacement for type A aortic dissection with cold agglutinin disease after sutimlimab A型主动脉夹层合并冷凝集素疾病的部分动脉弓置换术
Journal of Cardiology Cases Pub Date : 2025-10-01 DOI: 10.1016/j.jccase.2025.06.011
Tatsuya Ozaki MD , Taro Nakazato MD, PhD , Koji Hashimoto MD, PhD , Takuya Higuchi MD, PhD , Mutsunori Kitahara MD, PhD
{"title":"Partial arch replacement for type A aortic dissection with cold agglutinin disease after sutimlimab","authors":"Tatsuya Ozaki MD ,&nbsp;Taro Nakazato MD, PhD ,&nbsp;Koji Hashimoto MD, PhD ,&nbsp;Takuya Higuchi MD, PhD ,&nbsp;Mutsunori Kitahara MD, PhD","doi":"10.1016/j.jccase.2025.06.011","DOIUrl":"10.1016/j.jccase.2025.06.011","url":null,"abstract":"<div><div><span><span>Cold agglutinin disease (CAD) is a rare autoimmune </span>hemolytic<span><span> anemia that can lead to significant complications due to hemolysis during aortic surgery, requiring hypothermic circulatory arrest. </span>Sutimlimab<span><span>, a humanized monoclonal IgG4 antibody that binds to and inactivates the complement protein </span>C1s<span><span>, is a complement inhibitor<span> used for the treatment of CAD. However, there are no reports of its use in aortic surgery that required hypothermic circulatory arrest. We describe the case of an 80-year-old female with acute type A aortic dissection and a 55-mm ascending </span></span>aortic aneurysm. The patient was scheduled to undergo urgent surgery for type A aortic dissection and aortic aneurysm; however, CAD was detected. Under consultation with hematologists, sutimlimab was initiated three days before surgery for CAD. Partial arch replacement was performed by using the elephant trunk technique under mild hypothermic circulatory arrest with </span></span></span></span>cerebral perfusion<span> and cold cardioplegia. The postoperative course was uneventful. On postoperative day 18, the patient was discharged without any hemolysis-related deficits. Herein, we report a case of partial arch replacement with mild hypothermic circulatory arrest for type A aortic dissection and an aortic aneurysm with CAD after sutimlimab treatment.</span></div></div><div><h3>Learning objective</h3><div><span>There are no established methods for the perioperative management of patients with preexisting cold agglutination disease undergoing </span>cardiovascular surgery<span> requiring hypothermic circulatory arrest. Sutimlimab, an anti-complement (C1s) monoclonal antibody, is relatively easy to administer and may help avoid postoperative hemolytic complications.</span></div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 4","pages":"Pages 157-159"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189740","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
ST-elevation myocardial infarction caused by plaque erosion in a 23-year-old male st段抬高型心肌梗死,由斑块侵蚀引起
Journal of Cardiology Cases Pub Date : 2025-10-01 DOI: 10.1016/j.jccase.2025.06.007
Genya Sunagawa MD, PhD , Daisuke Nagatomo MD , Keiji Oi MD, PhD , Shinki Nishioka CE , Masatsugu Nozoe MD, PhD , Koki Gondo MD, PhD , Nobuhiro Suematsu MD, PhD , Toru Kubota MD, PhD
{"title":"ST-elevation myocardial infarction caused by plaque erosion in a 23-year-old male","authors":"Genya Sunagawa MD, PhD ,&nbsp;Daisuke Nagatomo MD ,&nbsp;Keiji Oi MD, PhD ,&nbsp;Shinki Nishioka CE ,&nbsp;Masatsugu Nozoe MD, PhD ,&nbsp;Koki Gondo MD, PhD ,&nbsp;Nobuhiro Suematsu MD, PhD ,&nbsp;Toru Kubota MD, PhD","doi":"10.1016/j.jccase.2025.06.007","DOIUrl":"10.1016/j.jccase.2025.06.007","url":null,"abstract":"<div><div>Intravascular imaging techniques, such as optical frequency domain imaging (OFDI), are essential for understanding the pathophysiology of acute coronary syndrome, including plaque rupture, plaque erosion, and calcified nodules. Plaque erosion is more common in younger patients than plaque rupture. We report a case of ST-elevation myocardial infarction caused by plaque erosion in a 23-year-old man. The patient presented with sudden-onset chest pain at work. Electrocardiography revealed ST-segment elevations in leads I, aVL, and V2–4. Coronary angiography identified thrombus formation in the left anterior descending artery (LAD) and total occlusion of the diagonal branch (D1). OFDI confirmed thrombus and plaque erosion in the LAD. Thrombus aspiration of the D1 restored thrombolysis in myocardial infarction grade 3 flow. Aspirated thrombus analysis revealed evidence of platelet aggregation and fibrin deposition. The absence of atherosclerosis or calcification on OFDI and a negative ergonovine provocation test supported the diagnosis of plaque erosion. Follow-up OFDI after three months showed thrombus resolution and residual fibrous plaque. This case highlights the role of OFDI in evaluating vascular characteristics during acute and chronic phases, enabling a precise diagnosis of plaque erosion.</div></div><div><h3>Learning objective</h3><div>We report a case of ST-elevation myocardial infarction caused by plaque erosion in a 23-year-old patient. This case is noteworthy as it likely represents the first instance of thrombus originating from the left anterior descending artery and embolizing to the diagonal branch. The use of optical frequency domain imaging during both the acute and chronic phases allowed for precise assessment of the pathology.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 4","pages":"Pages 147-151"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189738","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
Wearable cardioverter defibrillator prevented sudden cardiac death in a pediatric case of takotsubo cardiomyopathy in Japan 日本可穿戴式心律转复除颤器预防了一例小儿takotsubo心肌病的心源性猝死
Journal of Cardiology Cases Pub Date : 2025-10-01 DOI: 10.1016/j.jccase.2025.06.018
Kazuyoshi Saito MD, PhD , Daijiro Suzuki MD, PhD , Arisa Kojima MD, PhD , Hidetoshi Uchida MD, PhD , Yoichi Nakajima MD, PhD , Tadayoshi Hata MD, PhD , Tetsushi Yoshikawa MD, PhD
{"title":"Wearable cardioverter defibrillator prevented sudden cardiac death in a pediatric case of takotsubo cardiomyopathy in Japan","authors":"Kazuyoshi Saito MD, PhD ,&nbsp;Daijiro Suzuki MD, PhD ,&nbsp;Arisa Kojima MD, PhD ,&nbsp;Hidetoshi Uchida MD, PhD ,&nbsp;Yoichi Nakajima MD, PhD ,&nbsp;Tadayoshi Hata MD, PhD ,&nbsp;Tetsushi Yoshikawa MD, PhD","doi":"10.1016/j.jccase.2025.06.018","DOIUrl":"10.1016/j.jccase.2025.06.018","url":null,"abstract":"<div><div><span><span>As an alternative to implantable cardioverter defibrillators<span>, the wearable cardioverter defibrillator (WCD; LifeVest®, Asahi KASEI Zoll Medical Co., Tokyo, Japan) is the only noninvasive cardioverter defibrillator available that can be worn directly on the skin. The first consensus statement on WCD use in Japan was published in 2014, and, similar to guidelines in other countries, its recommendations focus on adult patients. </span></span>Pediatric<span> cases involving WCD remain limited, and appropriate indications for its use in children are yet to be established. Here, we report the first pediatric case in Japan where WCD monitored a patient and delivered an appropriate shock<span> to terminate a life-threatening ventricular tachycardia<span> and ventricular fibrillation episode. During this time, the patient was recovering from </span></span></span></span>takotsubo cardiomyopathy<span><span>, presumably associated with refeeding syndrome secondary to </span>Crohn's disease<span>. No inappropriate shocks were delivered during the three-month monitoring period, and the WCD use was deemed safe. The continuous monitoring function of WCD aided in understanding the patient's conditions. Following treatment, the patient has recovered from Crohn's disease<span> and his cardiac function has stabilized, and he has not experienced neurological sequelae or heart failure symptoms since. This case highlights the potential of WCD use in pediatric patients.</span></span></span></div></div><div><h3>Learning objective</h3><div><span>The wearable cardioverter defibrillator (WCD; LifeVest®) is the only noninvasive cardioverter defibrillator available. However, current guidelines around the world primarily focus on adult patients. Cases of pediatric patients who are rescued by an appropriate shock by WCD are still limited and many aspects, such as device set-up, effectiveness, and risks require further study. This case supports that WCD in children can be safe and effective, demonstrating its potential to protect against ventricular tachycardia<span> and ventricular fibrillation and prevent </span></span>sudden cardiac death.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 4","pages":"Pages 183-186"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189785","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
Subacute left main trunk occlusion following surgical aortic valve replacement 手术主动脉瓣置换术后的亚急性左主干闭塞
Journal of Cardiology Cases Pub Date : 2025-10-01 DOI: 10.1016/j.jccase.2025.06.012
Keisuke Nakabayashi MD, PhD, Takeshi Sasaki MD, Taro Takeyama MD, Yoshiki Hori MD, Hiroshi Furuhata MD, Kei Akiyoshi MD, Nobuhito Kaneko MD, Kenichiro Sato MD, PhD, Hiroshi Ando MD, PhD
{"title":"Subacute left main trunk occlusion following surgical aortic valve replacement","authors":"Keisuke Nakabayashi MD, PhD,&nbsp;Takeshi Sasaki MD,&nbsp;Taro Takeyama MD,&nbsp;Yoshiki Hori MD,&nbsp;Hiroshi Furuhata MD,&nbsp;Kei Akiyoshi MD,&nbsp;Nobuhito Kaneko MD,&nbsp;Kenichiro Sato MD, PhD,&nbsp;Hiroshi Ando MD, PhD","doi":"10.1016/j.jccase.2025.06.012","DOIUrl":"10.1016/j.jccase.2025.06.012","url":null,"abstract":"<div><div><span><span><span><span>Coronary artery occlusion is a rare but potentially fatal complication after surgical </span>aortic valve replacement<span><span> (SAVR), and subacute left main trunk (LMT) occlusion after SAVR has not been reported. A 70-year-old woman was diagnosed with severe aortic valve stenosis<span> caused by a bicuspid valve. SAVR with a supra-annular EPIC valve (19 mm; Abbott, Abbott Park, IL, USA) placement was performed. The patient developed acute dyspnea and </span></span>cardiogenic shock<span> on postoperative day 6. Coronary computed tomography<span> (CT) revealed LMT occlusion with extensive severe subendocardial ischemia. Emergent percutaneous coronary intervention was performed, revealing a </span></span></span></span>thrombus in the LMT and a hyperechoic structure near the LMT entrance on intravascular </span>ultrasonography. After </span>thrombus aspiration<span> and laser atherectomy, a drug-eluting stent protruding into the aorta was deployed. The patient was discharged from the hospital on day 39 after heart failure compensation. CT performed 3 months after discharge revealed the proximity of the support structure of the EPIC valve to the LMT, without significant stenosis. This case report suggests some potential etiologies of subacute coronary artery occlusion after SAVR.</span></div></div><div><h3>Learning objective</h3><div>Subacute left main trunk (LMT) occlusion rarely occurs after surgical aortic valve replacement (SAVR). Although it is difficult to explain this phenomenon using a single etiology, we hypothesized that an unrecognized injury during coronary cannulation<span><span> or the proximity of the support structure of the EPIC valve to LMT entrance could be potential etiologies contributing to endothelial damage and subsequent thrombus formation. This case highlights that </span>coronary obstruction, as a complication following SAVR, can occur at various time points.</span></div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 4","pages":"Pages 152-156"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189739","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
Myocardial ischemia after arterial switching operation in transposition of great arteries associated with the upstairs-downstairs relationship of the ventricles and abnormal coronary distribution 大动脉转位动脉转换术后心肌缺血与心室上下关系及冠状动脉分布异常的关系
Journal of Cardiology Cases Pub Date : 2025-10-01 DOI: 10.1016/j.jccase.2025.06.009
Kosuke Yonehara MD , Kiyohiro Takigiku MD, PhD, FJCC , Yohei Akazawa MD, PhD , Takeshi Konuma MD, PhD
{"title":"Myocardial ischemia after arterial switching operation in transposition of great arteries associated with the upstairs-downstairs relationship of the ventricles and abnormal coronary distribution","authors":"Kosuke Yonehara MD ,&nbsp;Kiyohiro Takigiku MD, PhD, FJCC ,&nbsp;Yohei Akazawa MD, PhD ,&nbsp;Takeshi Konuma MD, PhD","doi":"10.1016/j.jccase.2025.06.009","DOIUrl":"10.1016/j.jccase.2025.06.009","url":null,"abstract":"<div><div><span><span><span><span>A 3-month-old boy was diagnosed with transposition of the great arteries and an upstairs-downstairs relationship of the ventricles. He experienced </span>ischemic heart failure and </span>complete atrioventricular block following </span>arterial switch operation. Selective </span>coronary angiography<span> revealed stenosis in the right coronary artery<span><span><span><span><span>, supplying the entire right ventricle and a wide portion of the </span>left ventricle<span>. This stenosis in the right coronary artery was the cause of the prolonged reduction of </span></span>left ventricular ejection fraction, while the flow in the </span>left coronary artery remained preserved. </span>Coronary artery bypass grafting<span> from right internal thoracic artery to right coronary artery was performed and significantly improved the ischemic heart failure.</span></span></span></div></div><div><h3>Learning objective</h3><div>A comprehensive assessment of the peripheral coronary artery is essential before the implementation of arterial switch operation in transposition of great arteries cases with upstairs-downstairs relationship of the ventricles, and the inclusion of cusp shot or selective coronary angiography should be contemplated. Furthermore, despite a small body size, coronary artery bypass grafting can be employed to restore adequate coronary perfusion in a case with coronary artery stenosis.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 4","pages":"Pages 175-178"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189720","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
Pulmonary tumor thrombotic microangiopathy associated with endometrial carcinoma: A case report 肺肿瘤血栓性微血管病变与子宫内膜癌:1例报告
Journal of Cardiology Cases Pub Date : 2025-10-01 DOI: 10.1016/j.jccase.2025.06.013
Risa Beppu MD , Kayoko Kubota MD, PhD , Noriko Iwatani MD, PhD , Sunao Miyanaga MD, PhD , Mari Kirishima MD, PhD , Akihide Tanimoto MD, PhD , Mitsuru Ohishi MD, PhD, FJCC
{"title":"Pulmonary tumor thrombotic microangiopathy associated with endometrial carcinoma: A case report","authors":"Risa Beppu MD ,&nbsp;Kayoko Kubota MD, PhD ,&nbsp;Noriko Iwatani MD, PhD ,&nbsp;Sunao Miyanaga MD, PhD ,&nbsp;Mari Kirishima MD, PhD ,&nbsp;Akihide Tanimoto MD, PhD ,&nbsp;Mitsuru Ohishi MD, PhD, FJCC","doi":"10.1016/j.jccase.2025.06.013","DOIUrl":"10.1016/j.jccase.2025.06.013","url":null,"abstract":"<div><div>Pulmonary tumor thrombotic microangiopathy (PTTM) is a rapidly progressive fatal cancer-related complication. Diagnosing PTTM is challenging, with most cases diagnosed postmortem. Gastric, breast, and lung cancers are the most common primary tumors associated with PTTM. To the best of our knowledge, this is the first case report of PTTM arising from an endometrial carcinoma. A patient with advanced respiratory failure and pulmonary hypertension was diagnosed with endometrial carcinoma. This case highlights the importance of suspecting PTTM in patients with pulmonary hypertension accompanied by rapidly progressive dyspnea when pulmonary embolism has been excluded. In such cases, identifying the primary cancer is crucial for establishing an appropriate treatment plan. It also emphasizes the importance of investigating systemic cancers, extending beyond the frequently encountered cancers, even in the absence of active cancer.</div></div><div><h3>Learning objective</h3><div>Pulmonary tumor thrombotic microangiopathy (PTTM) is a rapidly fatal complication of cancer. This is the first case report of PTTM arising from an endometrial carcinoma. Clinicians should consider PTTM in patients with respiratory failure and pulmonary hypertension, even in the absence of active cancer. Early investigation for underlying malignancy and prompt pathological evaluation are essential for the rapid diagnosis of PTTM.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 4","pages":"Pages 160-162"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189744","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
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