Journal of Cardiology Cases最新文献

{"title":"Proximal superficial femoral artery puncture using an ascending approach for stent re-occlusion in the common femoral artery","authors":"Hiroki Okabe MD, PhD ,&nbsp;Hideki Doi MD, PhD ,&nbsp;Miyu Umeda MD ,&nbsp;Masahiro Takeo MD ,&nbsp;Yuki Nakamura MD ,&nbsp;Kota Motozato MD, PhD ,&nbsp;Shotaro Furukawa MD ,&nbsp;Kazunobu Kawakami MD ,&nbsp;Koji Abe MD, PhD ,&nbsp;Toshiyuki Matsumura MD, PhD ,&nbsp;Masaharu Kataoka MD, PhD, FJCC","doi":"10.1016/j.jccase.2024.01.003","DOIUrl":"10.1016/j.jccase.2024.01.003","url":null,"abstract":"<div><p><span>We aimed to describe a technique for approaching the common femoral artery (CFA) in cases where doing so is difficult owing to an occluded lesion caused by a previously implanted stent. A 72-year-old woman had severe stenotic lesions in both </span>iliac arteries<span> that required an approach via the bilateral femoral arteries. The right CFA had a previously implanted stent and a completely occluded lesion that extended from the superficial femoral artery<span> (SFA). A 20G needle was inserted through the proximal SFA, and the needle tip was advanced into the CFA stent and passed through the occluded lesion using a microcatheter and guide wire (GW). This allowed us to insert a guide catheter via the GW into the occluded lesion. No complications, such as bleeding, were observed after the procedure. When the CFA is occluded by a stent, an ascending approach through the proximal SFA is a viable treatment option.</span></span></p></div><div><h3>Learning objective</h3><p>An occluded lesion due to a previously implanted stent makes approaching the common femoral artery difficult. Hence, alternative approaches are needed. In this regard, an approach via the proximal superficial femoral artery may prove useful.</p></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"29 5","pages":"Pages 205-208"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139820245","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 acute purulent pericarditis due to MRSA treated with daily pericardial lavage for one month followed by pericardial fenestration","authors":"Soki Inoue MD,&nbsp;Koichi Tachibana MD,&nbsp;Nobutaka Masunaga MD, PhD,&nbsp;Yukinori Shinoda MD,&nbsp;Tomoko Minamisaka MD,&nbsp;Hirooki Inui MD,&nbsp;Keisuke Ueno MD,&nbsp;Ryohei Amiya MD,&nbsp;Arisa Murakami MD,&nbsp;Shiro Hoshida MD, PhD, FJCC","doi":"10.1016/j.jccase.2024.01.008","DOIUrl":"10.1016/j.jccase.2024.01.008","url":null,"abstract":"<div><p>Acute purulent pericarditis is a rare infection in developed countries. We herein report a case with diabetic nephropathy under maintenance hemodialysis who suffered from acute purulent pericarditis caused by methicillin-resistant <em>Staphylococcus aureus</em> (MRSA). The treatment of purulent pericarditis mainly involves rapid administration of appropriate antibiotics and drainage. However, in this case, the patient was unresponsive to vancomycin and performing early surgical intervention was challenging due to highly pathogenic MRSA. Therefore, we performed pericardial fenestration in the chronic phase to suppress the risk of fatal secondary infections after daily irrigation for one month to reduce bacterial load mechanically.</p></div><div><h3>Learning objective</h3><p>In a case of purulent pericarditis caused by highly pathogenic methicillin-resistant <em>Staphylococcus aureus</em> resistant to antibiotics and resulting in constrictive pericarditis, it was possible to perform pericardial fenestration in the chronic phase, while mitigating the risk of fatal secondary infections, by controlling the inflammation through daily irrigation for a long time to reduce the bacterial load mechanically.</p></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"29 5","pages":"Pages 231-233"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1878540924000094/pdfft?md5=cceb222a5e57728f63d9e2cf5283fc54&pid=1-s2.0-S1878540924000094-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139821784","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":"Takotsubo cardiomyopathy as the primary manifestation of decompensated Graves' disease","authors":"Frederick M. Lang BS ,&nbsp;Brian Joseph Revilla Sajorda MD ,&nbsp;Maria Pagan-Mendez MD ,&nbsp;Hyesoo Lowe MD ,&nbsp;Shah R. Ali MD","doi":"10.1016/j.jccase.2023.12.004","DOIUrl":"10.1016/j.jccase.2023.12.004","url":null,"abstract":"<div><p><span>Takotsubo cardiomyopathy (TCM) is characterized by transient </span>left ventricular dysfunction<span> with apical ballooning, usually observed in postmenopausal women<span> after a stressful event. We discuss a rare presentation of TCM induced by thyrotoxicosis secondary to Graves' disease. This case raises interesting questions about the pathogenesis, diagnosis, and management of TCM.</span></span></p></div><div><h3>Learning objectives</h3><p>1. To recognize hyperthyroidism as a possible etiology of takutsubo cardiomyopathy.</p><p>2. To identify the effect of radioiodine contrast on diagnosis of some types of takutsubo cardiomyopathy.</p></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"29 4","pages":"Pages 178-181"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139634714","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":"Complete remission of giant cell myocarditis by prednisolone monotherapy: A case with mild inflammation demonstrated by mismatch between T2-high intensity areas and late gadolinium enhancement","authors":"Takanobu Soma MD ,&nbsp;Takahiko Kinjo MD, PhD ,&nbsp;Shintaro Goto MD, PhD ,&nbsp;Shingo Sasaki MD, PhD, FJCC ,&nbsp;Hirofumi Tomita MD, PhD, FJCC","doi":"10.1016/j.jccase.2023.12.007","DOIUrl":"10.1016/j.jccase.2023.12.007","url":null,"abstract":"<div><p><span><span>Giant cell myocarditis<span><span> (GCM) is a potentially lethal subtype of myocarditis. Herein, we report a case of a 22-year-old woman with GCM who was successfully treated with prednisolone<span> monotherapy. The patient had a fever and shortness of breath and was referred to our hospital. Laboratory test results revealed elevated </span></span>troponin<span> I levels. Cardiac magnetic resonance<span> (CMR) showed high intensity in the inferoseptal segment of the left ventricle on T2-weighted short tau inversion recovery imaging without late </span></span></span></span>gadolinium enhancement (LGE), suggesting predominant edema rather than necrosis. The patient was diagnosed with GCM based on an </span>endomyocardial biopsy<span>, which revealed lymphocyte infiltration<span> and multinucleated giant cells in the absence of granuloma formation. Subsequently, the patient received intravenous methylprednisolone<span><span> at 1000 mg/day for 3 days followed by oral prednisolone at 30 mg/day, which normalized troponin levels. Follow-up CMR revealed improved cardiac inflammation; therefore, the patient was discharged without prescribing another </span>immunosuppressive agent<span>. Prednisolone was tapered and terminated three years after discharge. The patient went one year without medication and had no recurrence of GCM on follow-up. This case highlights the presence of mild GCM, successfully treated by steroid monotherapy, in which the mismatch between high-intensity T2 areas and LGE suggests mild inflammation.</span></span></span></span></p></div><div><h3>Learning objective</h3><p>Giant cell myocarditis (GCM) is potentially lethal and usually requires multiple immunosuppressive agents. Here, we report a patient with GCM with preserved left ventricular ejection fraction. Cardiac magnetic resonance revealed focal high T2 signal intensity areas without late gadolinium enhancement, indicating myocardial edema without necrosis. The patient remained in remission with prednisolone monotherapy for 2 years. Our report indicates that “mild” GCM may be treated with prednisolone monotherapy.</p></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"29 4","pages":"Pages 182-185"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139636794","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":"Ischemia with nonobstructive coronary arteries in a patient with a history of Kawasaki disease","authors":"Ayumi Omuro MD, PhD ,&nbsp;Tetsuya Matsuyama MD ,&nbsp;Seigo Okada MD, PhD ,&nbsp;Takayuki Okamura MD, PhD, FJCC","doi":"10.1016/j.jccase.2023.12.011","DOIUrl":"10.1016/j.jccase.2023.12.011","url":null,"abstract":"<div><p><span>A 34-year-old man with a history of Kawasaki disease<span> had been experiencing chest pain at rest since middle school. Multidetector-row computed tomography showed no aneurysm formation; however, the </span></span>right coronary artery<span><span> had an anomalous origin with moderate stenosis. Invasive coronary angiography<span> revealed moderate right coronary artery stenosis<span> with a fractional flow reserve of 0.97. Finally, with a positive </span></span></span>acetylcholine<span><span><span> provocation test and elevated index of microvascular resistance, the patient was diagnosed with microvascular and epicardial vasospastic angina in the endotypes<span> of ischemia with nonobstructive </span></span>coronary arteries. This is the first reported case of both microvascular and epicardial vasospastic angina after Kawasaki disease. </span>In patients<span> with a history of Kawasaki disease, even those without cardiac sequelae, coronary endothelial and microvascular dysfunctions should be taken into consideration.</span></span></span></p></div><div><h3>Learning objective</h3><p>We report the first case of both microvascular and epicardial vasospastic angina in the endotypes of ischemia with nonobstructive coronary arteries after Kawasaki disease.</p><p>Coronary endothelial and microvascular dysfunctions should be taken into consideration in patients with a history of Kawasaki disease, even those without cardiac sequelae.</p></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"29 4","pages":"Pages 197-200"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139635575","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 spontaneous coronary artery dissection that later turned out to be Takayasu arteritis","authors":"Takahiro Tezuka MD ,&nbsp;Hiroyoshi Mori MD, PhD ,&nbsp;Hiroki Nishiwaki MD, MPH, PhD ,&nbsp;Yosuke Takei MD ,&nbsp;Natsuki Taira MD ,&nbsp;Ayumi Omura MD ,&nbsp;Daisuke Wada MD ,&nbsp;Hiromoto Sone MD ,&nbsp;Kazuma Tashiro MD, PhD ,&nbsp;Tokutada Sato MD, PhD ,&nbsp;Yoshitaka Iso MD, PhD, FJCC ,&nbsp;Mio Ebato MD, PhD, FJCC ,&nbsp;Hiroshi Suzuki MD, PhD, FJCC","doi":"10.1016/j.jccase.2023.12.009","DOIUrl":"10.1016/j.jccase.2023.12.009","url":null,"abstract":"<div><p><span>Spontaneous coronary artery dissection<span> (SCAD) is a rare cause of acute coronary syndrome<span> (ACS), which typically occurs in women at low risk of atherosclerosis<span><span>. We herein report a case of SCAD in a 57-year-old man who later developed Takayasu arteritis<span>. The patient presented to our hospital complaining of chest pain<span> and was diagnosed with unstable angina. Emergent </span></span></span>coronary angiography<span><span><span> was performed, and optical coherence tomography revealed that ACS was caused by SCAD. The patient was treated medically without further ballooning or stenting. Because there was a bilateral difference in blood pressure, the systemic artery was screened by contrast-enhanced </span>computed tomography<span>, which showed left subclavian artery occlusion<span>, proximal stenosis of the superior mesenteric artery, right common </span></span></span>iliac artery<span> dissection, and left external iliac artery dissection. Based on these results and </span></span></span></span></span></span>¹⁸<span>F-fluorodeoxyglucose positron emission tomography<span><span> findings, we diagnosed Takayasu arteritis. Prednisolone and </span>tocilizumab<span> were selected for medical treatment, and the patient was in a good condition at one year after the diagnosis. Takayasu arteritis can cause dissection of various arteries and should be suspected when atypical SCAD or multiple dissections are present. Early initiation of immunosuppressive therapy can control disease activity.</span></span></span></p></div><div><h3>Learning objective</h3><p>Spontaneous coronary artery dissection (SCAD) is an important cause of acute coronary syndrome. In this case, we experienced a case of SCAD which turned out to be the first symptom of Takayasu arteritis. Immunosuppressive therapy was effective for both coronary lesion and systemic vasculitis<span>. Not only fibromuscular dysplasia, but also various types of vasculitis should therefore be considered in the differential diagnosis when encountering atypical SCAD cases.</span></p></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"29 4","pages":"Pages 186-189"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139638269","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":"Iatrogenic acute limb ischemia with complete traumatic rupture of the popliteal artery associated with total knee arthroplasty","authors":"Tatsuro Takei MD ,&nbsp;Takashi Kajiya MD ,&nbsp;Toshiko Ninomiya MD ,&nbsp;Keisuke Yamamoto MD ,&nbsp;Katsuyuki Imamura MD, PhD ,&nbsp;Nobuhiko Atsuchi MD, PhD","doi":"10.1016/j.jccase.2023.12.010","DOIUrl":"10.1016/j.jccase.2023.12.010","url":null,"abstract":"<div><p>Acute limb ischemia (ALI) related to total knee arthroplasty (TKA) is rare. Most occlusions are caused by thrombus formation in the popliteal artery (PA). Currently such cases are revascularized using less invasive approaches such as endovascular therapy or Fogarty thrombectomy. We report a case of ALI in a 65-year-old woman with complete rupture of the PA due to a TKA procedure. She had resting pain and motor paralysis in her right lower extremity after TKA. Contrast-enhanced computed tomography showed occlusion of the right femoropopliteal artery. Subsequently, she was referred to our hospital with a diagnosis of ALI. Initially, a less invasive revascularization procedure was unsuccessfully attempted. Therefore, we performed an emergency distal bypass and succeeded in revascularization. Intraoperative examination revealed a complete rupture of the PA. Postoperatively, the patient exhibited no signs of myonephropathic metabolic syndrome. Although there was significant motor impairment, the affected limbs were successfully salvaged. ALI with complete rupture of the PA associated with TKA has not been reported previously. In cases of iatrogenic ALI after TKA, it would be essential to consider diagnostic and revascularization methods that account for the possibility of severe injury to the PA.</p></div><div><h3>Learning objective</h3><p>Acute limb ischemia after total knee arthroplasty is a rare and life- and limb-threatening condition. The underlying pathological mechanism is often thrombus occlusion due to mechanical stimuli of the popliteal artery (PA). There are no established treatments for this condition, and less invasive approaches such as endovascular procedures and Fogarty thrombectomy are often used. However, in cases involving severe damage to the PA, bypass surgery may be necessary, and revascularization procedures should be considered accordingly.</p></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"29 4","pages":"Pages 193-196"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1878540923001585/pdfft?md5=a09fd3b3be5cce2734fba5be52d280d9&pid=1-s2.0-S1878540923001585-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139538877","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":"Ductal stenting with bilateral pulmonary artery banding as a life-saving management for hypoplastic left heart syndrome with congenital esophageal atresia: A case series","authors":"Mamoru Muraoka MD ,&nbsp;Ayako Kuraoka MD, PhD ,&nbsp;Kenichiro Yamamura MD, PhD ,&nbsp;Makoto Hayashida MD, PhD ,&nbsp;Toshihide Nakano MD, PhD ,&nbsp;Koichi Sagawa MD, PhD","doi":"10.1016/j.jccase.2023.10.012","DOIUrl":"https://doi.org/10.1016/j.jccase.2023.10.012","url":null,"abstract":"<div><p>We present three cases of hypoplastic left heart syndrome (HLHS) complicated by congenital esophageal atresia and trachea-esophageal fistula (EA/TEF). The standard treatment for HLHS involves a staged surgical approach, eventually reaching Fontan completion. There is no report of patients with both HLHS and EA/TEF, and no established treatment strategy exists for such cases. Given the significant risk of simultaneously operating on HLHS and EA/TEF, we elected to pursue staged repair for each condition separately. Initially, soon after birth, we performed gastrostomy to secure the nutritional pathway for EA/TEF and stabilize breathing. Subsequently, we conducted bilateral pulmonary artery banding (bil-PAB) and ductal stenting for HLHS, as the Norwood operation carried an unacceptably high risk in these patients. Two of these patients were able to transition to home care, while the other patient died during hospitalization due to complications after EA repair. A combination of bil-PAB with ductal stenting for HLHS and staged repair for EA/TEF may provide effective management for patients with both conditions.</p></div><div><h3>Learning objective</h3><p>Hypoplastic left heart syndrome (HLHS) and congenital esophageal atresia (EA) are both life-threatening conditions that require early intervention after birth. There are few reports of patients with both conditions, and no treatment strategy is established. Although the procedure carries a high risk, we successfully performed ductal stenting with bilateral pulmonary artery banding for HLHS, as well as staged repair procedures for EA. Our approach may be a viable strategy for these conditions.</p></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"29 4","pages":"Pages 153-156"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140332521","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":"The first case report of de novo Crohn's disease after heart transplantation successfully treated with ustekinumab","authors":"Shun Okamura MD ,&nbsp;Chie Bujo MD, PhD ,&nbsp;Eisuke Amiya MD, PhD ,&nbsp;Ken Kurokawa MD, PhD ,&nbsp;Masaru Hatano MD, PhD, FJCC ,&nbsp;Junichi Ishida MD, PhD ,&nbsp;Masaki Tsuji MD, PhD ,&nbsp;Sozaburo Ihara MD, PhD ,&nbsp;Keita Murakami MD ,&nbsp;Chihiro Shiomi MD ,&nbsp;Yoku Hayakawa MD, PhD ,&nbsp;Mitsuhiro Fujishiro MD, PhD ,&nbsp;Minoru Ono MD, PhD, FJCC ,&nbsp;Issei Komuro MD, PhD, FJCC","doi":"10.1016/j.jccase.2023.12.005","DOIUrl":"10.1016/j.jccase.2023.12.005","url":null,"abstract":"<div><p><span><span><span>Inflammatory bowel disease (IBD) is a complex chronic inflammatory </span>intestinal disease<span>. The development of de novo IBD after solid organ transplantation with </span></span>immunosuppressive agents<span> has been rarely reported. We present the case of a 65-year-old man with repeated colitis<span> after heart transplantation<span> (HTx) who was diagnosed with Crohn's disease (CD). The patient underwent HTx due to non-ischemic dilated cardiomyopathy. Six months after HTx, he developed serious diarrhea and a transient fever, which persisted for about 6 months. </span></span></span></span>Valganciclovir<span><span> or any antibiotic agents were not effective for his symptoms<span><span> and longitudinal ulcers in colonoscopy aggravated during the course, so that we made a diagnosis of CD. We started 5-aminosalicylic acid and found improvement in his symptoms and colonoscopic findings. However, 7 months after improvement, CD worsened. We started </span>ustekinumab by which his condition successfully went into remission again. While oral immunosuppressive drugs are thought to suppress autoimmune diseases in general, IBD should be included in the differential diagnoses for recurring </span></span>enterocolitis<span> after HTx. Poorly controlled CD can lead to serious and potentially fatal complications, but in this case, ustekinumab has been used safely and effectively for the treatment of CD.</span></span></p></div><div><h3>Learning objective</h3><p><span>Colitis is a common complication after heart transplantation (HTx). Although cytomegalovirus colitis or </span>posttransplant lymphoproliferative disorder<span> are observed commonly, de novo inflammatory bowel disease (IBD) should be considered when serious refractory colitis occurs. Not only 5-aminosalicylic acid but also ustekinumab, which is a monoclonal antibody to the p40 subunit of interleukin (IL)-12 and IL-23, may be a safe and effective treatment for de novo IBD after HTx.</span></p></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"29 4","pages":"Pages 174-177"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139638179","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":"Infolding of Evolut PRO+ during transcatheter aortic valve implantation and bailout by post-balloon dilation: A case report","authors":"Kengo Tosaka MD, PhD,&nbsp;Ryo Ninomiya MD, PhD,&nbsp;Tetsuya Fusazaki MD, PhD, FJCC,&nbsp;Yoshihiro Morino MD, PhD, FJCC","doi":"10.1016/j.jccase.2023.12.008","DOIUrl":"10.1016/j.jccase.2023.12.008","url":null,"abstract":"<div><p>An 89-year-old man with symptomatic severe aortic stenosis underwent transcatheter aortic valve implantation due to old age and a history of coronary artery bypass grafting. Computed tomography showed a tricuspid aortic valve and severe calcification at the aortic valve annulus, with a perimeter of 88.7 mm. The 34-mm Evolut PRO+ (Medtronic Inc., Minneapolis, MN, USA) was selected. After balloon aortic valvuloplasty, deployment of the Evolut PRO+ was attempted, but significant expansion failure was observed. Upon retraction and removal of the Evolut PRO+ from the body, frame deformation was observed. A new Evolut PRO+ was tried again, but a similar finding was noted as a magatama-like infolding on transesophageal echocardiography. Fortunately, the patient's hemodynamics were relatively stable. Post-dilation was performed using a 25 mm <em>Z</em>-MED II (NuMED, Inc., Montreal, Canada) for reshaping.</p></div><div><h3>Learning objective</h3><p>In self-expanding transcatheter aortic valves (TAVs), bending of the TAV frame is widely known as one of the key problems. However, this is rare and infrequently encountered. In this case, TAV frame infolding occurred repeatedly, and the morphology of the infolding was evaluated in vitro and in vivo. Furthermore, we report that some TAVs can be reshaped by post-dilation.</p></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"29 4","pages":"Pages 190-192"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139966136","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}