Journal of cardiology and cardiovascular medicine最新文献

{"title":"How to manage balloon entrapment during percutaneous coronary intervention of a calcified lesion “Case report”","authors":"Zaoui Nassime, Boukabous Amina, Bachir Nadhir, I. Nabil, T. Ali","doi":"10.29328/journal.jccm.1001142","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001142","url":null,"abstract":"Percutaneous coronary angioplasty is a minimally invasive procedure aimed at unclogging a coronary artery with a low complication rate (with a serious complication rate of 3% to 7% and a mortality rate of 1.2%). Device entrapment during PCI is a rare but life-threatening complication that occurs in < 1% of PCIs and balloon entrapment comes second after coronary guidewires. We present the case of 68-years-old man, smoker, hypertensive and type2 diabetic that presents angina with evidence of ischemia on myocardial tomoscintigraphy and in whom the radial coronary angiography reveals a tight calcified mid LAD stenosis. During his PCI and after dilatation with an NC balloon 2.5 × 12 the latter refuses to deflate and remains trapped in the lesion with the appearance of pain and ST-elevation despite several attempts to dilute the product in the inflator and to burst it by overexpansion. Traction on the balloon resulted in the deep intubation of the guiding-catheter, which comes in contact with the trapped balloon, and the rupture of the latter’s hypotube, which remains inflated at the site of the lesion and mounted on the 0.014 guidewire. We put a second 0.014 guidewire distally in the LAD and twisted with the distal part of the first guidewire, then we introduced a second balloon 2.0 × 20 over the second guidewire until the distal part of the guiding-catheter and inflated to trap the stucked balloon. We gradually removed this emergency assembly that allowed us to retrieve the trapped balloon. The control injection revealed a thrombotic occlusion of the LAD treated by thrombectomy and anti-GPIIbIIIa followed by a DES 2.75 × 28 placement. The patient was discharged 48 hours later with a good LVEF. The possible balloon entrapment mechanisms are an acute recoil of a highly calcified lesion with compression of the incompletely deflated balloon, which seems to be the case in our patient, strangulation of the proximal balloon end by the guiding-catheter if the balloon is removed before complete deflation and break or bend of the hypotube. The solutions in case of undeflatable balloon entrapment are to dilute the product in the inflator, to burst it by overexpansion, to pierce it through a stiff guidewire (or through its other end on a Microcatheter or OTW balloon), to cut its outer part and let it empty passively, to introduce a second guide-wire and perform a Buddy-Balloon or to transfer the patient to Surgery. Material entrapment remains a rare but life-threatening complication, its eviction requires the choice of material size and gentle manipulations (small balloons in the event of a calcified lesion) and its management uses different techniques, the choice of which depends on the clinical and anatomical situation.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49666453","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":"Percutaneous Atrial Septal Defect (ASD) closure technique in case of association with an azygos continuation of the inferior vena cava “case report”","authors":"Zaoui Nassime, Boukabous Amina, Bachir Nadhir, T. Ali, I. Nabil","doi":"10.29328/journal.jccm.1001143","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001143","url":null,"abstract":"Introduction: Atrial Septal Defect (ASD) is the most common congenital heart disease, accessible to percutaneous closure in 90% of cases. The closure procedure is performed usually under local anesthesia and TTE by femoral access. The association of OS-ASD with an azygos continuation of the inferior vena cava is very rare (< 0.1/1000 births) making femoral access impossible. Only a few cases are mentioned in the literature, here we describe the procedure as faithfully as possible. Important clinical finding: We present a case of a 32-years-old female candidate for percutaneous closure of OS-ASD with right cavity dilatation who present during her procedure an unusual guidewire path suspecting an azygos continuation of the inferior vena cava, confirmed by CT angiography, making impossible the closure via the femoral approach. Therapeutic intervention: After being confronted with the categorical patient refusal of the surgery, we performed successfully the procedure; one month later; under general sedation by internal jugular approach. We finished with manual compression before extubating the patient. Outcomes: The follow-up was favorable at the cost of a hematoma at the puncture site and brachial plexus compression, which regressed after 3 days. Conclusion: We opted for general anesthesia and intubation to guide the procedure by TEE. We placed it in the aorta, which gave us good stability to continue successfully the procedure. We underestimated the risk of complication at the puncture site, which could have been avoided by using a vascular suture device or more prolonged compression. Main takeaway lesson: Percutaneous closure is the reference treatment for OS-ASD. In case of is associated with an azygos continuation of the inferior vena cava, the right internal jugular vein remains a reasonable approach; it requires discussion and rigorous preparation by the whole team. The management of the puncture site in this situation remains delicate and requires great concentration.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44207578","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":"Oncocardiology: Far beyond the cardiotoxicity","authors":"Wei Jing, W. Pan, Pan Min","doi":"10.29328/journal.jccm.1001141","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001141","url":null,"abstract":"CVD in cancer patients can precede the diagnosis of cancer or can be related to the malignancy itself or its therapy. Many cardiovascular phenotypes have been identi ied as common across different cancer treatments. Lipshultz, et al. [6] found that survivors of childhood cancer, regardless of exposure to cardiotoxic treatments, had cardiovascular abnormalities related not only to abnormal left ventricular structure and function but also to increased traditional risk factors for atherosclerotic disease and systemic in lammation. Most recently, the relationship between atrial ibrillation (AF) and Stroke/ transient ischemic attacks (TIA) in cancer patients was conducted in a case-control study, the CHA2DS2-VASc score, which components such as heart failure, hypertension, old age, and diabetes mellitus were found to be associated with stroke in the general population, signi icantly increases the risk of stroke in cancer patients regardless of the presence of AF [7].","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49170739","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":"Acute ischemic stroke for alteplase or medical care alone or intervention with/without alteplase in Palestine (AIS-AMI Palestine)","authors":"H. Mohammed","doi":"10.29328/journal.jccm.1001140","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001140","url":null,"abstract":"Background: Stroke is the most common cause of permanent disability and the third most common cause of death in Palestine. We aimed to examine patterns of stroke presentation, causes, management and outcomes at the largest public Mistry of health hospitals in Palestine. Methods: Comprehensive data from all patients with acute ischemic stroke who were admitted to al-Shifa hospital between November 2021 and July 2022 and treated with alteplase alone or endovascular intervention with or without alteplase were prospectively collected and compare with acute ischemic stroke patients who were treated with medical care alone at Palestine medical complex hospital at 2018. Acute ischemic stroke presentation patterns, in-hospital evaluation and management, mortality, and morbidity were evaluated. Results: Medical care alone group: 138 patients with acute ischemic stroke, mean age was 65 ± 14 years and 49% were women. Most of the patients received antiplatelet therapy (98%), although none received thrombolysis. Only 17% received physical therapy evaluation. In-hospital mortality was 13%, and a modified ranking score of 0 -2 was in 44 patients (32%). Endovascular intervention with/without alteplase group: 56 patients with acute ischemic stroke. The mean age was 61 ± 12 years and 41% were women. All patients received brain computed tomography scans, although few received other investigations such as carotid Doppler (13%). Most patients with ischemic stroke received antiplatelet therapy (99%), although 39 patients (70%) received thrombolysis. Only 61% received physical therapy evaluation. In-hospital mortality was 7%. The modified ranking score 0 - 2: 32 patients (57%). Conclusion: This study conducted in Palestine showed that among patients with acute ischemic stroke, functional outcomes according to modified ranking score 0 - 2 were better by endovascular therapy with/without alteplase than with medical care alone.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41551598","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":"Quantitative nuclear cardiology and assessment of areas under risk via adenosine stress protocol-A pictorial assay for cardiologists and cardiovascular surgeons during era of COVID","authors":"Karabacak Nese İlgin, Ibıs Edanur Tuncay, Demir Salih, Balım Merve Uluç, Kücükali Bariş, Yalçin Ridvan","doi":"10.17352/2455-2976.000187","DOIUrl":"https://doi.org/10.17352/2455-2976.000187","url":null,"abstract":"Coronary Artery Disease (CAD) is one of the most important causes of mortality and morbidity in the world. Nevertheless, Myocardial Perfusion Scintigraphy (MPS) using Single-Photon Emission Computed Tomography (SPECT) with radiopharmaceuticals is still widely used for the non-invasive diagnosis of obstructive CAD and functional imaging of the myocardium at stress.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"92 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76274769","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":"Atrial fibrillation in elite athletes. What is missing?","authors":"Tsougos E, Giallafos E, Paraskevaidis I","doi":"10.29328/journal.jccm.1001139","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001139","url":null,"abstract":"Although the beneficial effect of physical activity in the general population is well established, in elite athletes under vigorous physical activity, the effect on the electrical system of the heart is controversial. Indeed, several studies have shown an increased rate of atrial fibrillation among athletes, whereas others suggest that improved exercise capacity with training reduces atrial fibrillation recurrence. The pathophysiologic explanation of that discrepancy is missing, although several underlying mechanisms have been proposed. Taking into account the current knowledge, it seems that, although the beneficial effects of exercise are well recognized, there are conflicting data regarding the relation of the occurrence - the rate of atrial fibrillation to high-volume exercise and too long-term training. Its significance on the quality of life especially in highly trained athletes remains to be elucidated. Therefore, this short review will try to discuss this discrepancy and hopefully underlie the arising arguments.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48891220","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":"In Silico modeling of immune-cardiovascular-endocrine interactions","authors":"Windoloski Kristen A, Ottesen Johnny T, Olufsen Mette S","doi":"10.17352/2455-2976.000186","DOIUrl":"https://doi.org/10.17352/2455-2976.000186","url":null,"abstract":"The immune system provides an intricate, balanced response to combat the effects of inflammatory stimuli. It incorporates both positive and negative feedback from multiple physiological systems such as the cardiovascular and endocrine systems including mechanisms functioning on a variety of time scales. They have been studied individually via scientific experiments and using mathematical modeling. However, more analysis is needed to study the interactions between these three systems during an inflammatory event. We present the first dynamical systems model studying immune, cardiovascular and endocrine responses to a 2 ng/kg bolus dose of endotoxin. The model is calibrated to experimental data from two endotoxin challenge studies and we use this model to investigate the effects of endotoxin dosage, administration timing and administration method. Our model shows that most repercussions of endotoxin administration clear the system within 24 hours, but effects can linger for up to 72 hours.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"111 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84295612","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":"New cases of rare dyslipidemias in clinical practice","authors":"R. C, Sanguino J, Sevilla-Alonso E, A. F, García-Polo I, Mostaza Jm, R. S.","doi":"10.17352/2455-2976.000185","DOIUrl":"https://doi.org/10.17352/2455-2976.000185","url":null,"abstract":"Lipid metabolism can experience different disorders resulting in changes in the function and concentrations of plasma lipoproteins. These changes affect alone or interact with other cardiovascular risk factors involved in the development of atherosclerosis. Therefore, dyslipidemias cover a wide spectrum of disorders lipids. Some of them have a genetic origin and very low prevalence. The main objective of this article is to report new cases of rare dislipemias of genetic origin in our population. Genetic analysis was performed by Next Generation Sequencing (NGS) using a customized panel of 436 genes in DNA samples of four patients. The results confirmed the genetic origin of the following dyslipidemias: fish-eye disease, primary hypoalphalipoproteinemia-2, familial hypercholesterolemia by a variant in STAP1 and Sitosterolemia. This approach allows us to confirm the genetic diagnosis of four patients with alterations in lipid metabolism, this will help to improve patient management, achieving early diagnosis in the study of family members","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90711466","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 features and outcome of prosthetic pulmonary valve infective endocarditis","authors":"Pastor Daniel, Castillo Juan Carlos, González-Tajuelo Rafael, López-Aguilera José, Mesa Dolores, Anguita-Maeso Manuel, Pan Manuel","doi":"10.17352/2455-2976.000183","DOIUrl":"https://doi.org/10.17352/2455-2976.000183","url":null,"abstract":"Background: Infective endocarditis is a serious complication in patients with prostheses in the right ventricle outflow tract. The aim of our study is to assess clinical features in these patients. Methods: We have analyzed all cases of prosthetic pulmonary valve infective endocarditis (PPVIE) and compared them to the rest of the patients with IE. Since the year 2000, 375 cases of IE have been diagnosed in our center and nine patients had a PPVIE.: 3 patients with Melody percutaneous prostheses, 5 with a homograft (3 after a Rastelli procedure, 2 a Ross procedure), and 1 patient with a heterograft (Contegra conduit). Results: Mean age of PPVIE patients was 31±15 years old and 89% were male. A presumed portal of entry could only be identified in 4 of the 9 patients with PPVIE. The most common was a dental origin (3 patients). A causative microorganism was detected in all but one PPVIE patient: 3 S.viridans, 2 S.aureus, 2 coagulase-negative staphylococci, and 1 enterococcus. Most patients suffered complications during the in-hospital phase: 7 out of 9 PPVIE patients (78 vs.75% of the rest of IE patients), the most common congestive heart failure (5 patients), and persistent sepsis (4 patients). Six patients were operated on during hospitalization (67 vs. 55%) with a mean time from admission to surgery of 15 days. In-hospital mortality was similar (22 vs. 26%). Conclusions: Prevalence of PPVIE is low, with a clinical outcome, surgery rate, and survival similar to the rest of patients with IE.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90380547","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 lower limb BOLD-MRI tissue perfusion protocol correlate to clinical disease stage, objective functional limitations, and health-related quality of life in patients with peripheral arterial occlusive disease","authors":"Nordanstig Joakim, Törngren Kristina, Arvidsson Jonathan, Eriksson Stefanie, Falkenberg Mårten, Johnsson Åse, Lagerstrand Kerstin","doi":"10.17352/2455-2976.000184","DOIUrl":"https://doi.org/10.17352/2455-2976.000184","url":null,"abstract":"While peripheral artery occlusive disease (PAOD) by large is a clinical diagnosis, further characterization of the ischemic state, procedural planning, and longitudinal follow-up after revascularisation are mainly based on imaging that delineates the arterial vasculature. Although several potential techniques have been suggested [1], there is still no clearly established imaging technique that directly quantifies the crucial PAOD pathophysiological process-tissue perfusion in the lower limb.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88949138","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}