Journal of Cardiology Cases最新文献

{"title":"Mixed shock after alcohol septal ablation for hypertrophic obstructive cardiomyopathy: Impella in crisis management","authors":"Junya Matsuda MD, PhD ,&nbsp;Jun Nakata MD ,&nbsp;Takeshi Yamamoto MD, PhD, FJCC ,&nbsp;Kuniya Asai MD, PhD","doi":"10.1016/j.jccase.2025.01.005","DOIUrl":"10.1016/j.jccase.2025.01.005","url":null,"abstract":"<div><div>Alcohol septal ablation (ASA) for hypertrophic obstructive cardiomyopathy (HOCM) can lead to complex hemodynamic challenges. This report describes a case of a 79-year-old woman who developed mixed cardiogenic and distributive shock following ASA. Cardiogenic shock occurred due to complete atrioventricular block with insufficient cardiac output despite temporary right ventricular pacing. Concurrently, distributive shock developed secondary to bacterial pneumonia and exacerbation of polymyositis-associated interstitial lung disease. Fluid resuscitation, antibiotics, vasopressors, and hydrocortisone were ineffective. Inotropes, intra-aortic balloon pump, and veno-arterial extracorporeal membrane oxygenation were contraindicated because of the risk of worsening left ventricular outflow tract obstruction. An Impella 2.5 (Abiomed Inc., Danvers, MA, USA) was deployed, achieving hemodynamic stabilization without worsening left ventricular outflow tract obstruction. The patient recovered successfully through comprehensive intensive care and was discharged. This case highlights the potential efficacy of Impella support in managing complex mixed shock states after ASA. It emphasizes the multiple challenges in HOCM management, including addressing hemodynamic complexities due to left ventricular outflow tract obstruction, managing ASA-related complications, and simultaneously treating concurrent distributive shock. This comprehensive approach is crucial for developing effective individualized management strategies for patients with HOCM when dealing with postprocedural complications.</div></div><div><h3>Learning objective</h3><div>This case illustrates complex hemodynamic complications following alcohol septal ablation for hypertrophic obstructive cardiomyopathy. It emphasizes the importance of recognizing and managing mixed cardiogenic and distributive shock when standard treatments fail. The case highlights the potential role of Impella (Abiomed Inc., Danvers, MA, USA) support in stabilizing hemodynamics without exacerbating left ventricular outflow tract obstruction.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 5","pages":"Pages 134-138"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892159","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}

{"title":"Histopathological findings of biodegradable polymer sirolimus eluting stent 7 years after stent implantation","authors":"Yo Kawahara MD ,&nbsp;Sho Torii MD, PhD ,&nbsp;Yasutomo Sekido MD ,&nbsp;Gaku Nakazawa MD, PhD","doi":"10.1016/j.jccase.2025.01.007","DOIUrl":"10.1016/j.jccase.2025.01.007","url":null,"abstract":"<div><div>This report analyzes a biodegradable polymer coated drug-eluting stent (DES), Ultimaster (Terumo, Tokyo, Japan), seven years after implantation in a 73-year-old man who died from acute myocardial infarction after discontinuing his medications. Autopsy revealed no in-stent thrombosis or restenosis. Two stents exhibited neoatherosclerosis with calcifying necrotic core and foamy macrophages, indicating a lesser risk of very late stent thrombosis. The findings support the notion that third-generation DES might result in healthier long-term vessel healing and reduced neoatherosclerosis compared to earlier generations, consistent with prior animal studies. This suggests a sustained benefit and safety of the biodegradable polymer coated DES over an extended period.</div></div><div><h3>Learning objectives</h3><div>A 65-year-old male received three 3rd generation biodegradable polymer coated drug-eluting stents (BP-DES), Ultimaster (Terumo, Tokyo, Japan), during percutaneous coronary intervention. Seven years post-implantation, post-mortem histopathological analysis revealed well-healed arterial tissue with near-complete endothelialization and minimal neoatherosclerosis. No significant inflammation or late stent thrombosis was observed, with stent struts embedded in the neointima, indicating favorable long-term vessel healing. This case underscores the long-term biocompatibility of BP-DES, highlighting reduced risks of late stent thrombosis and neointimal hyperplasia over extended follow-up periods.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 5","pages":"Pages 142-144"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892210","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}

{"title":"Switching antiplatelet therapy based on P2Y12 reaction unit monitoring for recurrent acute thrombosis due to prasugrel resistance: A case report","authors":"Tomomi Watanabe MD, PhD,&nbsp;Satoshi Kobara MD,&nbsp;Ryosuke Amisaki MD,&nbsp;Kazuhiro Yamamoto MD, PhD, FJCC","doi":"10.1016/j.jccase.2025.01.006","DOIUrl":"10.1016/j.jccase.2025.01.006","url":null,"abstract":"<div><div>Dual antiplatelet therapy including P2Y12 inhibitor is mandatory to prevent stent thrombosis in acute coronary syndrome and prasugrel is more frequently used in Japanese patients than clopidogrel due to its poor metabolizer profile. We describe a case of a patient with prasugrel resistance who was switched to an appropriate antiplatelet therapy based on platelet function testing. Although prasugrel resistance is rare and platelet function test is not common in daily practice, it is important to be familiar with alternative drugs for prasugrel resistance and how to suspect and treat these patients.</div></div><div><h3>Learning objective</h3><div>Effects of antiplatelet therapy can be assessed by platelet function test (platelet aggregation test, VerifyNow, etc.).</div><div>Although routine use of platelet function test has not been recommended, it might be useful in cases with repeated thrombotic events.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 5","pages":"Pages 139-141"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892160","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}

{"title":"Transient accessory pathway conduction block caused by internal electrical cardioversion","authors":"Tetsuya Kishigami MD,&nbsp;Iwanari Kawamura MD,&nbsp;Tasuku Yamamoto MD, PhD,&nbsp;Takashi Ikenouchi MD, PhD,&nbsp;Kentaro Goto MD, PhD,&nbsp;Takuro Nishimura MD, PhD,&nbsp;Susumu Tao MD, PhD,&nbsp;Masateru Takigawa MD, PhD,&nbsp;Shinsuke Miyazaki MD, PhD, FJCC,&nbsp;Tetsuo Sasano MD, PhD, FJCC","doi":"10.1016/j.jccase.2025.01.003","DOIUrl":"10.1016/j.jccase.2025.01.003","url":null,"abstract":"<div><div>Pulsed field ablation (PFA) has been in the spotlight as an alternative to conventional thermal energy ablation given its unique tissue selectivity. The concept of current-day PFA is based on traditional direct electric current catheter ablation, creating nanopores in the cell membrane and resulting in cell death. Membrane pores that are created via electroporation can be either permanent, if the electric field is high enough, or only temporary if the fields are sub-threshold. We report a transient block of the accessory pathway after internal electrical cardioversion via a multipolar catheter placed along the tricuspid annulus.</div></div><div><h3>Learning objective</h3><div>We report a rare case that exhibited a transient accessory pathway conduction block after internal electrical cardioversion via a multipolar catheter placed along the tricuspid annulus. Transient conduction block may be observed by internal electrical cardioversion due to reversible electroporation.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 5","pages":"Pages 125-128"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892322","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}

{"title":"Transcatheter closure of a large bioprosthetic tricuspid paravalvular leak","authors":"Tara Talebi-Talghian BS ,&nbsp;Timothy William Hegeman DO ,&nbsp;Amy Ketron BS ,&nbsp;Cihan Cevik MD","doi":"10.1016/j.jccase.2025.01.008","DOIUrl":"10.1016/j.jccase.2025.01.008","url":null,"abstract":"<div><div>Paravalvular leaks (PVLs) typically occur after valve replacement surgery and are often asymptomatic. However, larger defects can result in significant hemodynamic instability and heart failure, necessitating surgical intervention. Tricuspid PVLs are particularly rare and present unique clinical challenges. In this report, we describe the case of a 31-year-old woman who successfully underwent closure of a tricuspid PVL using the Amplatzer VSD Occluder device. This case underscores the importance of meticulous patient selection and pre-procedural planning to achieve optimal outcomes in tricuspid PVL cases. It also contributes to the growing literature on tricuspid PVL closures, highlighting the need for ongoing innovation and long-term studies to improve patient outcomes.</div></div><div><h3>Learning objective</h3><div>After reading this case report, readers will understand the clinical presentation and unique challenges of managing tricuspid paravalvular leaks (PVLs) in high-risk surgical patients. The case emphasizes the importance of advanced imaging and pre-procedural planning for successful percutaneous interventions in complex tricuspid PVL cases. Additionally, readers will appreciate the growing potential of innovative transcatheter techniques as viable alternatives to traditional surgical approaches.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 5","pages":"Pages 145-147"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892211","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}

{"title":"Simultaneous transcatheter aortic valve replacement and thoracic endovascular aortic repair by the transcarotid approach for aortic stenosis with chronic type-A aortic dissection","authors":"Suguru Hirose MD, PhD ,&nbsp;Yusuke Takei MD, PhD ,&nbsp;Masahiro Tezuka MD ,&nbsp;Takahisa Nasuno MD, PhD ,&nbsp;Michiaki Tokura MD, PhD ,&nbsp;Masashi Sakuma MD, PhD ,&nbsp;Ikuko Shibasaki MD, PhD ,&nbsp;Shigeru Toyoda MD, PhD, FJCC ,&nbsp;Hirotsugu Fukuda MD, PhD, FJCC","doi":"10.1016/j.jccase.2025.01.009","DOIUrl":"10.1016/j.jccase.2025.01.009","url":null,"abstract":"<div><div>Frail patients presenting with ascending aortic dissection and aortic stenosis (AS) are usually treated with a minimally invasive approach. Although transcatheter aortic valve replacement (TAVR) is becoming the standard treatment for AS, reports of catheter-only treatment for patients with AS complicated by chronic type-A aortic dissection (TAAD) are scarce. We present a case of a patient who underwent simultaneous TAVR and thoracic endovascular aortic repair (TEVAR) using a transcarotid approach. An 86-year-old woman was hospitalized for syncope due to severe AS. Computed tomography revealed chronic TAAD. We considered TAVR appropriate because of the invasive nature of open thoracic surgery; however, TAVR was associated with a risk of chronic TAAD exacerbation due to catheter manipulation. Our heart team decided to simultaneously perform TAVR and TEVAR using the transcarotid approach. The procedure involved using a short stent graft Excluder cuff to cover the dissection entry, followed by the placement of a CoreValve Evolut R 26-mm valve. The operation was successfully completed without complications. The patient was discharged on postoperative day 16. TAVR and TEVAR, using the transcarotid approach, can be performed depending on the anatomic conditions and device selection.</div></div><div><h3>Learning objective</h3><div>Reports on the catheter-only treatment of severe aortic stenosis complicated by chronic type-A aortic dissection are limited. We herein report a case in which transcatheter aortic valve replacement and thoracic endovascular aortic repair were simultaneously performed. Depending on anatomical conditions, this technique is beneficial, particularly for elderly patients who cannot undergo open thoracic surgery.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 5","pages":"Pages 129-133"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892230","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}

{"title":"Clinical implication of catheter ablation for atrial fibrillation in patients with cardiac amyloidosis","authors":"Naoya Kataoka MD,&nbsp;Teruhiko Imamura MD, FJCC","doi":"10.1016/j.jccase.2025.02.002","DOIUrl":"10.1016/j.jccase.2025.02.002","url":null,"abstract":"","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 5","pages":"Page 152"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891292","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}

{"title":"An infantile case of myocardial ischemia associated with hypoplastic left coronary cusp","authors":"Hiroyuki Yamada MD ,&nbsp;Jun Maeda MD, PhD ,&nbsp;Masaru Miura MD, PhD ,&nbsp;Yukihiro Yoshimura MD, PhD ,&nbsp;Kazuhiko Shibuya MD, PhD","doi":"10.1016/j.jccase.2025.02.001","DOIUrl":"10.1016/j.jccase.2025.02.001","url":null,"abstract":"<div><div>We report a fatal case of myocardial ischemia in a 1-month-old infant caused by a hypoplastic left coronary cusp, a rare, congenital anomaly. The infant presented with acute respiratory failure and hemodynamic instability. Transpericardial echocardiography revealed occlusion of the left coronary ostium by a hypoplastic left cusp. Despite emergency aortic valvuloplasty, refractory cardiogenic shock developed, resulting in death. The present case highlights the importance of considering hypoplastic coronary cusp in the differential diagnosis of infantile myocardial ischemia and the need for careful echocardiographic evaluation of suspected cases.</div></div><div><h3>Learning objective</h3><div>Hypoplastic aortic valve cusp should be borne in mind as a potential cause of myocardial ischemia in children.</div><div>Meticulous echocardiographic assessment should be performed for any coronary artery of anomalous origin and for the morphology of the aortic valve cusp.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 5","pages":"Pages 148-151"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892212","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}

{"title":"Amyloid and Anderson-Fabry disease: Can there be a CMR phenotypic overlap?","authors":"Saed Alnaimat MD ,&nbsp;Mariah Mascara MD ,&nbsp;Srijana Maharjan MD ,&nbsp;Abdallah Naser MD ,&nbsp;Valentyna Ivanova MD ,&nbsp;Moneal Shah MD ,&nbsp;Robert W.W. Biederman MD","doi":"10.1016/j.jccase.2024.12.005","DOIUrl":"10.1016/j.jccase.2024.12.005","url":null,"abstract":"<div><div>A 53-year-old female had an atypical presentation of cardiac amyloidosis on cardiac magnetic resonance imaging. As opposed to the usual diffuse heterogenous late gadolinium enhancement (LGE) seen in cases of cardiac amyloidosis, the patient had localized LGE in the inferolateral left ventricular wall classically resembling Anderson Fabry's disease. However, other cardiac magnetic resonance features raised the suspicion for cardiac amyloidosis which was later confirmed by endomyocardial biopsy. This case highlights that cardiac amyloidosis can have atypical imaging features that may lead to incorrect diagnosis. Clinicians should maintain a high index of suspicion and pay attention to certain supportive findings such as atrial wall thickening, valve leaflet thickening, pericardial effusion, as well as abnormal strain pattern.</div></div><div><h3>Learning objectives</h3><div><ul><li><span>•</span><span><div>Cardiac amyloidosis can have atypical imaging features and strain pattern that may lead to incorrect diagnosis.</div></span></li><li><span>•</span><span><div>Clinicians should maintain a high index of suspicion and pay attention to certain supportive findings such as atrial wall thickening, valve leaflet thickening, pericardial effusion, as well as abnormal strain pattern.</div></span></li></ul></div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 4","pages":"Pages 109-112"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739086","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}

{"title":"Left atrial appendage occlusion devices: one size doesn't fit all? The turning point of a custom-made device","authors":"Silvia Maiani MD ,&nbsp;Giulia Nardi MD ,&nbsp;Miroslava Stolcova MD ,&nbsp;Francesca Ristalli MD ,&nbsp;Maria Federica Crociani MD ,&nbsp;Niccolò Ciardetti MD ,&nbsp;Alessio Mattesini MD ,&nbsp;Carlo Di Mario MD, PhD ,&nbsp;Francesco Meucci MD","doi":"10.1016/j.jccase.2024.12.001","DOIUrl":"10.1016/j.jccase.2024.12.001","url":null,"abstract":"<div><div>Left atrial appendage occlusion (LAAO) has as a comparable efficacy and safety profile compared with oral anticoagulation therapy in patients with atrial fibrillation. The procedural success rate is high, but some challenging anatomies may preclude optimal closure with standard devices. Our patient underwent a first LAAO attempt with Amplatzer Amulet 34 mm (St. Jude Medical, Saint Paul, MN, USA) and Watchman FLX 35 mm (Boston Scientific, Marlborough, MA, USA), but device anchoring was not feasible or sub-optimal due to the oversized LAA. The procedure was postponed in order to perform a cardiac computed tomography angiography and a custom-made LAmbre Closure System 42/52 mm (Lifetech Scientific, Shenzhen, China), specifically fitted with patient's LAA anatomy, was successfully implanted. The procedure was straightforward, and the device perfectly adapted to our patient's anatomy, with no residual leak.</div></div><div><h3>Learning objective</h3><div>Left atrial appendage presents several morphologies and procedural success rate of left atrial appendage occlusion is high, but challenging anatomies may preclude optimal closure with standard devices. Our case emphasizes the importance of pre-procedural planning and the safety and feasibility of custom-made devices, overcoming procedural failure of a previous attempt with standard devices.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 4","pages":"Pages 97-100"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739085","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}