Journal of Cardiology Cases最新文献

{"title":"A breast cancer patient with chemotherapy-induced chronic lymphocytic myocarditis successfully treated with steroid therapy","authors":"Risako Kobata MD ,&nbsp;Haruhiko Abe MD ,&nbsp;Haruya Yamane MD ,&nbsp;Masayuki Nakamura MD ,&nbsp;Kiyoshi Mori MD, PhD ,&nbsp;Tsuyoshi Mishima MD ,&nbsp;Kuniyasu Ikeoka MD, PhD ,&nbsp;Koichi Inoue MD, PhD ,&nbsp;Yasunori Ueda MD, PhD, FJCC ,&nbsp;Yasushi Matsumura MD, PhD","doi":"10.1016/j.jccase.2024.11.005","DOIUrl":"10.1016/j.jccase.2024.11.005","url":null,"abstract":"<div><div>A 63-year-old female patient with a history of postoperative recurrence of breast cancer after radiation therapy underwent chemotherapy with epirubicin (total 960 mg) and low-dose cyclophosphamide. She developed acute decompensated heart failure with reduced ejection fraction. Despite initial treatment with diuretics and inotropic drugs, her condition worsened, leading to low-output syndrome and frequent paroxysmal atrial fibrillation (AF). The patient underwent an endomyocardial biopsy and catheter ablation for AF. The endomyocardial biopsy revealed predominant lymphocyte invasion rather than cardiomyocyte injury, indicating drug-induced chronic lymphocytic myocarditis. The clinical course and biopsy findings indicated that other potential causes were unlikely, such as viral infection, collagen disease, and immune checkpoint inhibitor use. Following steroid pulse therapy, maintenance therapy with a starting dose of 80 mg of methylprednisolone (mPSL) led to a significant improvement in hemodynamics, resulting in her discharge on the 82nd day with an improved ejection fraction from 20 % to 42 %. A second endomyocardial biopsy under 20 mg of mPSL showed a marked improvement in lymphocytic infiltration. This case serves to illustrate the significance of endomyocardial biopsy in the context of refractory heart failure with an onco-cardiology case, whereby an appropriate diagnosis can be made and successful steroid therapy can be initiated.</div></div><div><h3>Learning objective</h3><div>Although heart failure after chemotherapy is frequently reported, reports of chronic lymphocytic myocarditis after chemotherapy are relatively uncommon. Endomyocardial biopsy has enabled the differential diagnosis of cardiac toxicity and has led to the diagnosis of lymphocytic myocarditis. Currently, the optimal treatment for chronic lymphocytic myocarditis remains unestablished. However, in this case, it was found that steroid therapy was effective.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 3","pages":"Pages 57-60"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519711","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":"A case of rapidly progressive Salmonella aortic aneurysm with acute pericarditis manifesting as a precursor","authors":"Koshiro Harada MD ,&nbsp;Katsuya Kawagoe MD ,&nbsp;Yunosuke Matsuura MD, PhD ,&nbsp;Mana Kawano MD ,&nbsp;Yosuke Suiko MD ,&nbsp;Hiroki Tanaka MD ,&nbsp;Kohei Moribayashi MD ,&nbsp;Hirohito Ishii MD ,&nbsp;Takeshi Ideguchi MD ,&nbsp;Koji Furukawa MD, PhD ,&nbsp;Koichi Kaikita MD, PhD, FJCC","doi":"10.1016/j.jccase.2024.11.006","DOIUrl":"10.1016/j.jccase.2024.11.006","url":null,"abstract":"<div><div>We report a case of Salmonella cardiovascular infection presenting with acute pericarditis as a precursor to the rapid progression of aortic aneurysm. An 81-year-old man presented with persistent fever and chest pain worsened with inspiration and was admitted to a nearby hospital with a diagnosis of bacterial pericarditis. However, hoarseness emerged two days later, and the patient was transferred to our hospital because of concerns about extracardiac inflammatory foci. Computed tomography (CT) revealed a periaortic exudate and aortic arch aneurysm. After transfer, blood cultures confirmed Salmonella infection. Ampicillin (ABPC) was initiated for long-term treatment of Salmonella infection, and pericarditis was treated with ibuprofen and colchicine for approximately one month. The associated symptoms and inflammatory blood data significantly improved, but five weeks later, follow-up CT revealed enlargement of the arch aneurysm. Due to the patient's age and nutritional status, thoracic endovascular aortic repair (TEVAR) was performed along with continued ABPC. Postoperatively, the infection was well-controlled, and follow-up CT revealed a size reduction in the treated aneurysm. No recurrent Salmonella-related vascular events were observed for two years after TEVAR.</div></div><div><h3>Learning objective</h3><div>Acute pericarditis can present as a precursor to life-threatening vascular lesions associated with Salmonella infection and requires timely and appropriate diagnosis of the etiology behind the manifestation. Patients with aortic aneurysms caused by Salmonella often do not tolerate invasive surgical treatment when diagnosed, and the lesions progress rapidly. Therefore, endovascular treatment combined with long-term antibiotic therapy may be a practical option.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 3","pages":"Pages 76-79"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pacemaker lead fracture caused by strong lead bending in the pocket with the fixation of the generator in the low prothoracic position","authors":"Shun Akai MD ,&nbsp;Takahiko Nagase MD ,&nbsp;Yukio Sekiguchi MD ,&nbsp;Mitsunori Ishino MD ,&nbsp;Ryuichi Kato MD, FJCC","doi":"10.1016/j.jccase.2024.11.009","DOIUrl":"10.1016/j.jccase.2024.11.009","url":null,"abstract":"<div><div>Lead fractures of pacemakers can occur over time. However, the entire mechanisms or sites of lead fractures remain unclear. In addition, fixation of the pacemaker generators and leads depends on the operators and the tips on proper fixation remain unclear. A 64-year-old male underwent permanent dual-chamber pacemaker implantation for complete atrioventricular block by extrathoracic axillary vein puncture eight years previously. The generator was routinely fixed to the pectoralis major muscle within the left anterior chest pacemaker pocket by suturing a nylon ligature through the suture hole. However, five months ago, complete atrial lead failure was confirmed. The chest X-ray and X-ray fluoroscopy revealed strong lead bending of the atrial lead in the pacemaker pocket with the fixation of the generator in the low prothoracic position. We successfully extracted the fractured atrial lead by using an excimer laser and implanted a new atrial pacemaker lead in the right atrium. In the extraction of the fractured atrial lead, the atrial lead was almost disconnected along with strong lead bending in the pacemaker pocket as expected from preprocedural X-rays. This report indicates the precautions in fixation of pacemaker leads in the pacemaker pocket.</div></div><div><h3>Learning objective</h3><div>The stress-free fixation of pacemaker leads should be cautious to avoid the risk of lead failure in the long-term after the procedure. In addition, less tortuous vascular lead path, more caudal can location, and large angle of lead exit from the pocket associated with the puncture site or angle of axillary vein in the pacemaker implantation can cause strong lead bending and lead fractures. These findings can be detected in the X-ray.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 3","pages":"Pages 65-67"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519713","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":"Mitral valve transcatheter edge-to-edge repair as bridge therapy in a middle-aged patient with Marfan syndrome","authors":"Takuma Iwaya MD ,&nbsp;Makoto Amaki MD, PhD ,&nbsp;Hideaki Kanzaki MD, PhD, FJCC ,&nbsp;Chisato Izumi MD, PhD, FJCC","doi":"10.1016/j.jccase.2024.12.002","DOIUrl":"10.1016/j.jccase.2024.12.002","url":null,"abstract":"<div><div>A 45-year-old man was hospitalized at our institution due to congestive heart failure. He had a history of Marfan syndrome and four previous cardiovascular surgeries, including aortic valve replacement with a bioprosthetic valve 9 years previously. Transthoracic echocardiography revealed a myxomatous change of the mitral valve and severe mitral regurgitation (MR). After a thorough discussion, including the durability of a bioprosthetic valve, mitral valve transcatheter edge-to-edge repair (M-TEER) was performed as a bridge to the next cardiovascular surgeries. After the procedure, MR was reduced to mild, and his symptoms significantly improved. The patient has been doing well for 2 years after M-TEER.</div></div><div><h3>Learning objective</h3><div>The development of catheterization therapy for valvular disease has been remarkable. As the indication of transcatheter therapy for valvular heart disease is extending to lower-risk and relatively younger patients, a heart team should thoughtfully discuss lifetime management with each patient, especially relatively young patients.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 3","pages":"Pages 88-91"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519790","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":"A novel SMAD9 nonsense variant in an 11-year-old Japanese patient with diffuse pulmonary arteriovenous malformation: A case report","authors":"Yumiko Asai MD ,&nbsp;Kazuyoshi Saito MD, PhD ,&nbsp;Keiko Ohta-Ogo MD, PhD ,&nbsp;Kinta Hatakeyama MD, PhD ,&nbsp;Eiko Sakurai MD, PhD ,&nbsp;Hokuto Akamatsu 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;Yasushi Hoshikawa MD, PhD ,&nbsp;Tetsushi Yoshikawa MD, PhD","doi":"10.1016/j.jccase.2024.11.010","DOIUrl":"10.1016/j.jccase.2024.11.010","url":null,"abstract":"<div><div>Most cases of pulmonary arteriovenous malformation (PAVM) are associated with hereditary hemorrhagic telangiectasia (HHT). HHT is typically caused by loss-of-function gene mutations in the genes <em>ENG</em>, <em>ACVRL1</em>, or <em>SMAD4</em>, all participating in transforming growth factor β (TGF-β) family signaling pathways. We describe the case of an 11-year-old Japanese girl with PAVM, with no known family history of HHT or similar disease. She was found to carry a novel nonsense variant in <em>SMAD9</em> (SMAD9-p. T267*), which we speculate contributed to her disease, because <em>SMAD9</em> also participates in TGF-β family signaling pathways. <em>SMAD9</em> mutations have been linked with pulmonary arterial hypertension (PAH), and, hence, mutations in <em>SMAD9</em>—as for <em>ENG</em>, <em>ACVRL1</em>, and <em>SMAD4</em>—may predispose to both PAH and HHT(−characteristic) disease features. The PAVM in our patient spread diffusely inside the lower lobe of the left lung, and coil embolization was considered difficult. Therefore, after feasibility assessment by performing a balloon occlusion test during cardiac catheterization, left lower lobectomy was performed. The patient's dyspnea recovered well postoperatively, and two years later an increase in left lung volume was observed and disease symptoms had not recurred. Thus, if PAVM spreads diffusely in a certain lung area, surgical treatment can be a viable option.</div></div><div><h3>Learning objective</h3><div><em>SMAD9</em> gene mutations have been linked to pulmonary arterial hypertension (PAH). However, their associations with hereditary hemorrhagic telangiectasia (HHT) or pulmonary arteriovenous malformation (PAVM), which usually is HHT-associated, have not been reported previously. Our PAVM patient carrying a <em>SMAD9</em> variant suggests that mutations in this gene, like in others participating in TGF-β family signaling pathways (like <em>ENG</em>, <em>ACVRL1</em>, and <em>SMAD4</em>), predispose to both PAH and HHT(−characteristic) disease features. Diffuse PAVM confined to a lung area may be treated by lobectomy.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 3","pages":"Pages 80-83"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519717","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":"Recurrent syncope attributed to torsade de pointes induced by worsened long QT interval after switching from peritoneal dialysis to hemodialysis: A case report","authors":"Katsunori Ishii MD ,&nbsp;Tatsuya Onuki MD, PhD ,&nbsp;Eri Nakamura MD ,&nbsp;Akihito Yamanouchi MD ,&nbsp;Tomoyasu Osada MD ,&nbsp;Hiroto Sugiyama MD ,&nbsp;Ayumi Omura MD ,&nbsp;Rihito Mitsuhashi CE ,&nbsp;Hiroshi Mase MD ,&nbsp;Masaaki Kurata MD, PhD ,&nbsp;Hiroshi Suzuki MD, PhD, FJCC","doi":"10.1016/j.jccase.2024.12.003","DOIUrl":"10.1016/j.jccase.2024.12.003","url":null,"abstract":"<div><div>A 46-year-old female patient with chronic renal failure was admitted to our hospital to switch from peritoneal dialysis (PD) to hemodialysis (HD). She reported no history of syncope, but she experienced syncope with palpitation during and after HD following discharge. The 24-h Holter electrocardiography (ECG) detected no arrhythmia-inducing syncope. She was admitted to our hospital to receive shunting for HD. However, she developed torsade de pointes (Tdp)-induced syncope during HD and immediately received electrical cardioversion. Her 12-lead ECG demonstrated a QTc interval of 557 ms (QT: 457 ms), blood examination revealed 3.5 mEq/L of potassium and 8.5 mEq/L of calcium, and echocardiography showed an ejection fraction of 46 %, which was lower than before. The coronary artery was normal, and temporary right ventricular pacing therapy was immediately performed. Evocalcet was discontinued because it is known to induce long QT, and bisoprolol was initiated. Additionally, her potassium level was corrected. However, long QT in the sinus rhythm did not improve, and daily ECGs detected T-wave changes. Nonsustained Tdp with presyncope developed after HD while pacing off. Thus, an implantable cardioverter defibrillator was implanted. We present a case of recurrent Tdp-induced syncope related to worsened long QT after switching from PD to HD.</div></div><div><h3>Learning objective</h3><div>Prolonged QT intervals are caused by various factors and are more prevalent in patients undergoing hemodialysis (HD). The present case developed torsade de pointes-related syncope that was induced by worsened, prolonged QT interval after switching to HD. The worsening of long QT is mainly attributed to fluctuation in potassium levels before and after HD. Thus, carefully monitoring the QT interval and changes in the serum potassium level is crucial, particularly, when initiating HD.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 3","pages":"Pages 84-87"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter closure of an aorta to left atrial fistula with a cocoon membranous ventricular septal defect occluder in a septuagenarian patient","authors":"Anil Kumar Singhi MD, FNB ,&nbsp;Soumya Kanti Mohapatra MD ,&nbsp;Soumyajit Ghosh MD ,&nbsp;Arnab De MBA","doi":"10.1016/j.jccase.2024.11.003","DOIUrl":"10.1016/j.jccase.2024.11.003","url":null,"abstract":"<div><div>Aorta-to-left atrial fistula is a rare cardiac anomaly that can be either congenital or acquired. It often presents with symptoms of left heart volume overload and heart failure. Early diagnosis is crucial for effective management. This case report describes a septuagenarian patient with an aorta-to-left atrial fistula. Detailed multimodality imaging was instrumental in establishing the diagnosis. The fistula was successfully closed percutaneously using a Cocoon membranous ventricular septal defect occluder (Vascular Innovations Co. Ltd., Nonthaburi, Thailand). This case emphasizes the importance of a high index of suspicion and comprehensive multimodality imaging for the diagnosis and treatment of this rare condition.</div></div><div><h3>Learning objective</h3><div>Aorta-to-left atrial fistula is a rare but potentially life-threatening cardiac anomaly that can manifest with symptoms of heart failure. Accurate diagnosis requires a high index of suspicion and detailed imaging modalities, such as echocardiography, computed tomographic, and conventional aortography, to precisely identify the fistula's location and size. Even in elderly patients with complex medical histories, percutaneous closure of an aorta-to-left atrial fistula is a viable treatment option. Multidisciplinary care is essential for correct diagnosis and effective management of this condition.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 3","pages":"Pages 61-64"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519712","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":"Rescue from sudden ventricular tachycardia and fibrillation using wearable cardioverter-defibrillator in male late-onset Fabry disease patient","authors":"Toraaki Okuyama MD ,&nbsp;Eiko Fukuro MD ,&nbsp;Kenichi Tokutake MD, PhD ,&nbsp;Masahisa Kobayashi MD, PhD ,&nbsp;Hiroshi Kobayashi MD, PhD ,&nbsp;Michihiro Yoshimura MD, PhD, FJCC ,&nbsp;Kenichi Hongo MD, PhD","doi":"10.1016/j.jccase.2024.11.004","DOIUrl":"10.1016/j.jccase.2024.11.004","url":null,"abstract":"<div><div>Fabry disease is an important secondary cardiomyopathy characterized by the accumulation of glycosphingolipids due to a pathogenic mutation in the <em>GLA</em> gene. Lethal ventricular arrhythmia is the most common cause of sudden death in patients with Fabry disease. We herein report a case of a man in his 40s with late-onset Fabry disease who had polymorphic ventricular tachycardia and fibrillation during enzyme replacement therapy. After recovery from successful cardiopulmonary resuscitation, we recommended implantation of an implantable cardioverter-defibrillator; however, the patient refused to undergo implantation at that time. We administered a wearable cardioverter-defibrillator at his discharge, and he was successfully rescued from polymorphic ventricular tachycardia and fibrillation. He was finally given an implantable cardioverter-defibrillator.</div></div><div><h3>Learning objective</h3><div>In Fabry disease, lethal ventricular arrhythmia is an important cause of sudden death. Ventricular tachycardia and fibrillation during enzyme replacement therapy have not been reported. Furthermore, secondary prevention of lethal ventricular arrhythmia using a wearable cardioverter-defibrillator has not been reported in Fabry disease. Therefore, this case report has implications for the possible incidence and prevention of lethal ventricular arrhythmias in patients with Fabry disease.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 2","pages":"Pages 53-56"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149307","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":"Pemafibrate and cardiac reverse remodeling in patients with systolic heart failure receiving guideline-directed medical therapy","authors":"Yuki Hida MD,&nbsp;Teruhiko Imamura MD, PhD, FJCC,&nbsp;Koichiro Kinugawa MD, PhD, FJCC","doi":"10.1016/j.jccase.2024.10.001","DOIUrl":"10.1016/j.jccase.2024.10.001","url":null,"abstract":"<div><div>Pemafibrate is a selective peroxisome proliferator-activated receptor alpha (PPARα) activator. Pemafibrate has been shown to reduce serum triglyceride levels to an equivalent or greater extent than traditional fibrates, with a lower incidence of drug-related adverse events. Pemafibrate may have the potential to improve clinical outcomes in carefully selected patients with cardiovascular diseases by ameliorating dyslipidemia and stabilizing systemic arteriosclerosis. Additionally, several experimental studies have demonstrated a novel potential for pemafibrate in improving heart failure through its pleiotropic effects. We encountered two patients with systolic heart failure that was refractory to guideline-directed medical therapy. Both patients experienced further cardiac reverse remodeling and an improvement in hypertriglyceridemia following a six-month course of pemafibrate add-on therapy. Pemafibrate might facilitate cardiac reverse remodeling when incorporated into conventional heart failure medications. Further prospective randomized controlled studies are warranted to evaluate the clinical implications of incorporating pemafibrate into medical therapy for heart failure patients. Future research should also explore the long-term effects of pemafibrate on cardiovascular outcomes, the underlying mechanisms of its pleiotropic benefits, and its efficacy in diverse patient populations to solidify its role in heart failure management.</div></div><div><h3>Learning objective</h3><div>Pemafibrate, a recently introduced selective peroxisome proliferator-activated receptor alpha activator that improves hypertriglyceridemia, may facilitate cardiac reverse remodeling when incorporated into conventional heart failure medications.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 2","pages":"Pages 42-45"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149308","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":"Advanced retrieval technique using pacemaker lead extraction methods for a long-term implanted inferior vena cava filter with caval penetration of the pancreas","authors":"Yasuhiro Shimotori MD ,&nbsp;Ayako Okada MD, PhD ,&nbsp;Koji Yoshie MD, PhD ,&nbsp;Takanori Tomatsu MD ,&nbsp;Sho Suzuki MD ,&nbsp;Kiu Tanaka MD ,&nbsp;Toshinori Komatsu MD ,&nbsp;Keisuke Machida MD ,&nbsp;Hideki Kobayashi MD, PhD ,&nbsp;Yasutaka Oguchi MD, PhD ,&nbsp;Tatsuya Saigusa MD, PhD ,&nbsp;Souichiro Ebisawa MD, PhD ,&nbsp;Hirohiko Motoki MD, PhD ,&nbsp;Morio Shoda MD, PhD ,&nbsp;Koichiro Kuwahara MD, PhD, FJCC","doi":"10.1016/j.jccase.2024.11.001","DOIUrl":"10.1016/j.jccase.2024.11.001","url":null,"abstract":"<div><div>Inferior vena cava (IVC) filters are sometimes implanted in patients with deep vein thrombosis (DVT) to prevent pulmonary embolism (PE). Long-term filter placement is associated with various complications and retrieval failure using conventional methods. We describe a novel method for retrieval of long-term implanted IVC filters. A 41-year-old woman was diagnosed with left common iliac DVT. A temporary IVC filter was implanted to prevent life-threatening PE in parallel with anticoagulation therapy, followed by the long-term retrievable IVC filter (Denali, Bard Medical, Georgia, IN, USA). After successful anticoagulation therapy, the retrieval of the Denali by conventional methods failed due to adhesion to the vessel wall. We decided to remove the Denali using pacemaker lead extraction methods. Twenty months after the Denali implantation, extraction was performed under general anesthesia. A snare catheter (Lassos, Osypka, Berlin, Germany) was used to capture the proximal hook. The severe adhesions around the anchors were carefully dissected using a mechanical sheath (Byrd Dilator Sheaths, Cook Medical, Bloomington, IN, USA). The Denali was extracted using the counter-traction technique. The post-operative course was uneventful. This technique may be useful for uneventful removal of long-term implanted IVC filters, potentially avoiding open surgery. Additional experience is needed to overcome the limitation of a single case report.</div></div><div><h3>Learning objective</h3><div>Inferior vena cava (IVC) filters are sometimes used to reduce the risk of life-threatening pulmonary embolism. Long-term implanted IVC filters are associated with filter-related complications and can be difficult to remove by conventional methods due to adhesion around the filter. We describe a novel IVC filter retrieval technique using pacemaker lead extraction tools that has the potential to avoid highly invasive open surgery.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 2","pages":"Pages 49-52"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149309","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}