Journal of Cardiology Cases最新文献

{"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":"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":"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":"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}

{"title":"Dynamic ECG change from de Winter to Wellens - Rare ECG change in acute coronary syndrome","authors":"Naoki Arima MD,&nbsp;Naohito Yamasaki MD, PhD,&nbsp;Tomoki Furushima MD,&nbsp;Yuya Miyamoto MD,&nbsp;Toshihiro Moriki MD,&nbsp;Kazuya Miyagawa MD,&nbsp;Tatsuya Noguchi MD, PhD,&nbsp;Toru Kubo MD, PhD, FJCC ,&nbsp;Hiroaki Kitaoka MD, PhD, FJCC","doi":"10.1016/j.jccase.2024.12.004","DOIUrl":"10.1016/j.jccase.2024.12.004","url":null,"abstract":"<div><div>A 70-year-old male complained of chest pain. His electrocardiogram (ECG) revealed the De Winter pattern, which indicates left anterior descending artery occlusion. His symptoms spontaneously resolved within 30 min. This time, his ECG showed Wellens's sign. It is rare to see a change from De Winter to Wellens in one patient.</div></div><div><h3>Learning objectives</h3><div>Recognize de Winter's and Wellens' electrocardiogram (ECG) patterns as high-risk ECG for acute coronary syndrome (ACS), specifically related to left anterior descending artery lesions. Obtain serial ECGs in ACS patients to detect newly emerging changes in the coronary artery.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 4","pages":"Pages 93-96"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739185","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":"A rare case of cytomegalovirus myocarditis complicating rejection after heart transplantation: Case report and review of literature","authors":"Raffaele Abete MD ,&nbsp;Attilio Iacovoni MD ,&nbsp;Claudia Vittori MD ,&nbsp;Roberta Sebastiani MD ,&nbsp;Elisabetta Candiago MD ,&nbsp;Andrea Gianatti MD ,&nbsp;Amedeo Terzi MD ,&nbsp;Michele Senni MD","doi":"10.1016/j.jccase.2024.12.007","DOIUrl":"10.1016/j.jccase.2024.12.007","url":null,"abstract":"<div><div>A 49-year-old female with terminal hypertrophic cardiomyopathy underwent orthotopic heart transplantation. The patient developed early acute rejection. Intensifying therapy led to improvement, but cytomegalovirus (CMV) myocarditis emerged. Aggressive management, including high-dose ganciclovir and intravenous immunoglobulin, resulted in negativization of CMV and rejection markers. Cardiac function recovered, emphasizing the challenges and successful multidisciplinary approach in managing complex post-transplant complications.</div></div><div><h3>Learning objectives</h3><div>To diagnose and treat complications in heart transplantation, such as opportunistic infections and cellular and/or antibody-mediated rejection. To underline role of endomyocardial biopsy in heart transplant monitoring.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 4","pages":"Pages 105-108"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739088","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":"Renal cell carcinoma with cardiac metastasis and near right heart obliteration: A case report","authors":"Maren Downing MEng ,&nbsp;Kristen M. Quinn MD ,&nbsp;Micheal Odle MD","doi":"10.1016/j.jccase.2025.01.004","DOIUrl":"10.1016/j.jccase.2025.01.004","url":null,"abstract":"<div><div>Renal cell carcinoma (RCC) is the most common type of primary kidney cancer with up to 30 % of patients having metastatic disease at the time of diagnosis. Metastasis to the heart is extremely rare with only a few cases ever reported. Most patients with cardiac metastases of any origin do not develop symptoms of cardiac dysfunction. The classic triad of presentation for RCC is hematuria, flank pain, and a palpable mass. We report a rare occurrence of cardiac involvement of RCC infiltrating both the right atrium and right ventricle in an otherwise healthy female patient whose presenting symptom was dyspnea. Dyspnea, although a vague presenting symptom with a large differential diagnosis, is the most common presenting symptom of cardiac tumors and a sudden presentation of dyspnea in a patient with RCC should encourage the consideration of cardiac metastasis. The importance of repeat imaging and cross-disciplinary care in a patient with RCC with cardiac involvement is well displayed. A delay in cancer diagnosis may lead to delay in therapy and the result may be associated with significant morbidity and mortality. Quick action including evaluation and treatment for RCC is imperative to increase the chance for survival.</div></div><div><h3>Learning objective</h3><div>Metastasis to the heart is extremely rare and most patients do not develop cardiac symptoms. Dyspnea is a vague presenting symptom requiring a broad differential to determine underlying pathology. Here, acute dyspnea in a patient with renal cell carcinoma was the presenting symptom of cardiac metastasis and continued repeat imaging in this patient with supplemental oxygen requirements showed fast spread into the right heart.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 4","pages":"Pages 117-120"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739183","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":"Surgical management of hypertrophic obstructive cardiomyopathy with anomalous papillary muscle: A case report","authors":"Katsuya Kawagoe MD ,&nbsp;Koji Furukawa MD, PhD ,&nbsp;Hirohito Ishi MD ,&nbsp;Shuhei Sakaguchi MD ,&nbsp;Tomoaki Taniguchi MD ,&nbsp;Risa Meiri MD ,&nbsp;Yoshimasa Yamamura MD","doi":"10.1016/j.jccase.2024.12.006","DOIUrl":"10.1016/j.jccase.2024.12.006","url":null,"abstract":"<div><div>Anomalous papillary muscles (PMs), in which the PMs are directly attached to the anterior mitral valve (MV) leaflet, can cause obstruction of the left ventricular outflow tract (LVOT). Accurately diagnosing of anomalous PMs, understanding their pathology, and performing appropriate surgery are essential for relieving LVOT obstruction effectively.</div><div>A 71-year-old man with hypertrophic obstructive cardiomyopathy was referred to our hospital. Transthoracic echocardiography revealed LVOT obstruction with a peak outflow pressure gradient of 63 mm Hg at rest and 96 mm Hg during the Valsalva maneuver. Furthermore, an anomalous PM was suspected to be the cause of LVOT obstruction. Three- and four-dimensional cardiac computed tomography (CT) images clearly demonstrated that an anomalous PM from the anterior PMs was directly attached to the body of the anterior MV leaflet and that the anomalous PM, together with the thickened ventricular septum, caused a dynamic obstruction of the LVOT. We resected the anomalous PM from the anterior PMs and the subaortic ventricular septum using a transaortic approach.</div><div>In this case, preoperative three-dimensional and four-dimensional cardiac CT images were effective at revealing the presence of an anomalous PM and its pathology in patient with LVOT obstruction, leading to accurate and smooth surgical procedures and improved patient outcomes.</div></div><div><h3>Learning objective</h3><div><ul><li><span>•</span><span><div>Anomalous PMs are classified by their attachment patterns and appropriate surgical methods are recommended for each type, providing valuable insights for clinical decision-making.</div></span></li><li><span>•</span><span><div>This report emphasizes the significance of 3D and 4D cardiac CT in identifying the causes of LVOTO. This imaging technique provides important information regarding the location of the anomalous PM and dynamic impact, leading to a successful surgical outcome.</div></span></li></ul></div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"31 4","pages":"Pages 101-104"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739087","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}