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https://www.readbyqxmd.com/read/29351101/a-case-report-of-sudden-death-from-intracardiac-leiomyomatosis
#1
Thomas Shi, Michael J Shkrum
Sudden death resulting from intracardiac leiomyomatosis is rare. In this case, a 50-year-old woman was found to have intracardiac leiomyomatosis, which originated in veins in the broad ligament. Tumor filled the entire inferior vena cava and extended into the right heart where it had embolized and occluded the right main pulmonary artery. The mechanism of death was sudden right heart failure.
January 18, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29349525/value-of-ct-pulmonary-angiography-to-predict-short-term-outcome-in-patient-with-pulmonary-embolism
#2
Ahmed M Osman, Emad H Abdeldayem
To evaluate the role of CT pulmonary angiography (CTPA) in the assessment of pulmonary embolism (PE) severity and the related CT cardiac changes, reflecting the clinical status of the patients and predicting the outcome. A prospective study of 184 patients presented with suspicious acute PE. All patients underwent CTPA followed by ECHO. Pulmonary artery obstructive index (PAOI) using Qanadli Score was calculated and cardiac changes recorded. The patients' outcome was followed up for 30 days. Only 150 patients completed the study; 26...
January 18, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29344712/usefulness-of-hydrogel-coated-coils-in-embolization-of-pulmonary-arteriovenous-malformations
#3
Masashi Shimohira, Tatsuya Kawai, Takuya Hashizume, Masahiro Muto, Masanori Kitase, Yuta Shibamoto
PURPOSE: To evaluate the usefulness of hydrogel-coated coils for preventing recanalization after coil embolization of pulmonary arteriovenous malformations (PAVMs). MATERIALS AND METHODS: Thirty-seven consecutive patients with 57 untreated PAVMs underwent coil embolization with hydrogel-coated coils between January 2013 and Jun 2017. The mean age was 49 years (range 9-83 years), and there were seven male patients and 30 female patients. The median size of the feeding artery was 3...
January 17, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29340276/clinical-value-of-ultrasonography-in-diagnosis-of-pulmonary-embolism-in-critically-ill-patients
#4
Ran Zhu, Xiao-Chun Ma
Pulmonary embolism (PE) is a clinical emergency that will increase the mortality if complicated with unstable hemodynamics. Because of its nonspecific clinical symptoms, it's a great challenge to make a PE diagnosis. The golden standard to diagnose PE is computed tomography of pulmonary artery (CTPA), but a diagnosis of PE also composed of evaluation of PE risk factors, possibilities, and risk stratification. Ultrasonography may detect right ventricle strain related to hemodynamic change, intravascular thrombosis, thrombosis in right heart or pulmonary arteries, pulmonary infarction, and local pleural effusion...
December 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/29332925/pulmonary-artery-pseudoaneurysm-secondary-to-lung-inf-lammation
#5
Shinichirou Ishimoto, Hiroyuki Sakurai, Ryouta Higure, Riken Kawachi, Mie Shimamura
Pulmonary artery aneurysms (PAA) and pseudoaneurysms (PAP) are caused by infections, vasculitis, trauma, pulmonary hypertension, congenital heart disease, and connective tissue disease. Most cases of such aneurysm occur in the trunk or major branches of the pulmonary artery, while the peripheral type is less common. The treatment modalities are medical therapy, surgery, and percutaneous catheter embolization. The mortality rate associated with rupture is approximately 50%. We encountered a case of a 53-year-old man with a pulmonary artery pseudoaneurysm secondary to pneumonia and cavity formation during chemotherapy for acute myeloid leukemia (AML)...
January 15, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29331359/quantitative-ct-evaluation-of-small-pulmonary-vessels-in-patients-with-acute-pulmonary-embolism
#6
Shin Matsuoka, Akiyuki Kotoku, Tsuneo Yamashiro, Shoichiro Matsushita, Atsuko Fujikawa, Kunihiro Yagihashi, Yasuo Nakajima
RATIONALE AND OBJECTIVES: The objective of this study was to investigate the correlation between the computed tomography (CT) cross-sectional area (CSA) of small pulmonary vessels and the CT obstruction index in patients with acute pulmonary embolism (PE) and the correlation between the changes in these measurements after anticoagulant therapy. MATERIALS AND METHODS: Fifty-two patients with acute PE were selected for this study. We measured the CSA less than 5 mm2 on coronal reconstructed images to obtain the percentage of the CSA (%CSA < 5)...
January 10, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29321409/pulmonary-embolism-caused-by-intravenous-leiomyosarcoma-of-the-lower-limb
#7
Soichiro Kado, Masahide Goto, Hidetsugu Yamao, Toru Tsukada, Masataka Sato, Yoshifumi Uekusa
Pulmonary embolism (PE) is usually caused by thrombosis or tumor. We report the long-term survival of a patient with PE due to a leiomyosarcoma in the deep vein. A 71-year-old woman complained of dyspnea and swelling of the left lower limb. Computed tomography revealed filling defects in the pulmonary arteries and deep vein. She was diagnosed with PE caused by venous thrombosis and treated with anticoagulant therapy. Her symptoms were prolonged, and D-dimer tests remained negative. Biopsy of the substance in the deep vein revealed leiomyosarcoma...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29318931/lessons-learned-from-a-critical-analysis-of-the-fontan-operation-over-three-decades-in-a-single-institution
#8
Luiz Fernando Caneo, Aida L R Turquetto, Rodolfo A Neirotti, Maria A Binotto, Leonardo A Miana, Carla Tanamati, Juliano G Penha, João B D Silveira, Thais M Alexandre E Silva, Fabio B Jatene, Marcelo B Jatene
BACKGROUND: The Fontan operation (FO) has evolved and many centers have demonstrated improved results relative to those from earlier eras. We report a single-institution experience over three decades, describing the outcomes and evaluating risk factors. METHODS: Successive patients undergoing primary FO were divided into era I (1984-1994), era II (1995-2004), and era III (2005-2014). Clinical and operative notes were reviewed for demographic, anatomic, and procedure details...
May 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29316215/oxidized-low-density-lipoprotein-in-inflammation-driven-thrombosis
#9
Georg Obermayer, Taras Afonyushkin, Christoph J Binder
Thrombosis is the defining feature of the most prevalent causes of cardiovascular mortality, such as myocardial infarction, stroke and pulmonary artery embolism. While platelet activation as well as activation of the plasmatic coagulation system are the hallmarks of thrombus formation, inflammatory processes and the cellular responses involved are increasingly recognized as critical modulators of thrombosis. In the context of many chronic inflammatory diseases that are associated with a high thrombotic risk, oxidized lipoproteins represent a prominent sterile trigger of inflammation...
January 6, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29312721/retrospective-review-of-the-diagnosis-and-treatment-of-pulmonary-sequestration-in-28-patients-surgery-or-endovascular-techniques
#10
Shi-Xin Zhang, Hai-Dong Wang, Kang Yang, Wei Cheng, Wei Wu
Background: Pulmonary sequestration (PS) is a rare congenital pulmonary malformation. In this study, we aimed to retrospect and evaluate the diagnosis, treatment, and outcomes of PS in 28 patients at our institute. Methods: The files of 28 patients with PS who were treated with surgery (21 cases) or endovascular intervention (7 cases) between May 2005 and June 2016 from a single institute were retrospectively reviewed. The following data of all patients were analyzed: age, sex, clinical symptoms, diagnostic methods, operative techniques, and treatment outcomes...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29310336/removal-of-a-subdermal-contraceptive-implant-implanon-nxt-that-migrated-to-the-axilla-by-c-arm-guidance-a-case-report-and-review-of-the-literature
#11
Ji Ung Park, Han Sol Bae, Seung Mi Lee, Jaehoon Bae, Jeong Woo Park
RATIONALE: To report the distant migration of a subdermal contraceptive implant and to suggest that C arm-guided technique is one of the feasible options for removal of the device migrated to the axilla. PATIENT CONCERNS: A 41-year-old multipara with tingling sensation in the left axilla was referred for removal of an Implanon NXT which could not be palpated by physical examination or detected by ultrasound scanning. Finally, the device was detected by computed tomography and found migrating to the left axilla...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29305367/embolic-stroke-in-a-postpartum-patient-with-fontan-physiology
#12
Katherine VanHise, Linda Li, Emily Smith, Niamh Condon
In cardiac physiology, single ventricle typically refers to the presence of a dominant systemic ventricle along with a hypoplastic ventricle. The Fontan operation is used to repair the single ventricle by directing deoxygenated systemic venous flow to the pulmonary arterial circulation. Normal pregnancy physiology, particularly increased intravascular volume, increased heart rate, increased cardiac output, hypercoagulability and decreased systemic vascular resistance, can exacerbate cardiac disease in patients with Fontan circulation, leading to pregnancy complications...
January 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29304524/amino-fucoidan-as-a-vector-for-rtpa-induced-fibrinolysis-in-experimental-thrombotic-events
#13
Radouane Ghebouli, Stephane Loyau, Murielle Maire, Pierre Saboural, Jean-Philippe Collet, Martine Jandrot-Perrus, Didier Letourneur, Frédéric Chaubet, Jean-Baptiste Michel
Acute ischaemic stroke, myocardial infarction and pulmonary embolism are the main causes of mortality and morbidity worldwide. Thrombolysis by intravenous injection of recombinant tissue plasminogen activator (rtPA) remains the most common non-interventional treatment to recanalize occluded vessels. However, this procedure is limited by significant drawbacks, including high doses and bleeding complications. Recent studies showed that fucoidan targets the intraluminal thrombus in vivo. We have developed a chimaera covalently linking fucoidan, able to target platelets within the thrombus, to dilysine, able to non-covalently bind rtPA...
January 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29302122/rvad-support-in-the-setting-of-submassive-pulmonary-embolism
#14
Antonio Salsano, Elena Sportelli, Guido Maria Olivieri, Nicola Di Lorenzo, Silvia Borile, Francesco Santini
Patients with submassive pulmonary embolism (PE), although normotensive, are characterized by right ventricular (RV) dysfunction and elevated levels of biomarkers of cardiac damage. The best treatment option in these cases is still a subject of debate and the use of thrombolysis in submassive PE remains controversial. A 57-year-old Caucasian male with unprovoked PE, normal blood pressure, and elevated troponin I values was referred to the cardiovascular department. In view of the presence of a right atrium thrombus, the patient underwent surgical embolectomy under extracorporeal circulation, with the extraction of a huge thrombus together with fragmented thrombi from both pulmonary arteries...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29299826/differentiation-of-antemortem-pulmonary-thromboembolism-and-postmortem-clot-with-unenhanced-mri-a-case-report
#15
Ingo von Both, Silvio Giancarlo Bruni, Jayantha C Herath
We report a case of a 39-year-old woman who died of fulminant pulmonary thromboembolism (PE). Autopsy showed classical findings of fulminant PE with occlusion of the bilateral main stem pulmonary arteries. Ancillary testing revealed inherited thrombophilia (Prothrombin 20,210 G > A and MTHFR 677 C > T mutation). Pre-autopsy postmortem computed tomography was used to test whether virtual imaging studies alone (virtual autopsy) would be sufficient to detect PE. Our studies show that computed tomography (CT) can differentiate antemortem clots from a postmortem clot in certain cases, particularly when combined with magnetic resonance imaging (MRI), which is superior in the assessment of soft tissue...
January 4, 2018: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/29297660/overview-of-venous-thromboembolism
#16
Haley M Phillippe
Venous thromboembolism (VTE) describes the diagnoses of deep vein thrombosis (DVT) or pulmonary embolism (PE). DVT is the formation of thrombi in the deep veins, most commonly the large veins of the legs or pelvis. PE develops when thrombi dislodge from clots in vein walls and travel through the heart to pulmonary arteries. In many patients, the presenting manifestation of PE is sudden death. VTE may be categorized as provoked or unprovoked. This categorization influences the risk of recurrent VTE and duration of anticoagulation therapy...
December 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29296053/nonfatal-pulmonary-embolism-associated-with-the-use-of-compression-stockings-in-the-lithotomy-position-after-spinal-anesthesia
#17
I-Wen Chen, Cheuk-Kwan Sun, Jen-Yin Chen, Chien-Ming Lin, Kuo-Chuan Hung
A 73-year-old male (height, 156 cm; body weight, 51 kg), without a history of cardiovascular disease or thromboembolic events, was scheduled for transurethral resection of the prostate under spinal anesthesia. Spinal anesthesia was administered with hyperbaric bupivacaine, resulting in an upper anesthetic level of T6. Before surgery, compression stockings were applied to both lower limbs, and the patient was placed in the lithotomy position. Approximately 15 min later, he complained of intolerable chest tightness, followed by tachycardia (heart rate, 110 beats/min) and desaturation (oxygen saturation [SaO2], 90%)...
October 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/29287600/pulmonary-arterial-hypertension-in-a-patient-treated-with-dasatinib-a-case-report
#18
Andris Skride, Matiss Sablinskis, Kristaps Sablinskis, Krista Lesina, Aivars Lejnieks, Sandra Lejniece
BACKGROUND: There have been several reports on dasatinib-induced reversible pulmonary hypertension. This is the first reported case in Latvia; the patient did not discontinue the drug after the first adverse effects in the form of pleural effusions, which we speculate led only to partial reversion of the disease. CASE PRESENTATION: A 67-year-old white man with chronic myelogenous leukemia was treated with the dual Src and BCR-ABL tyrosine kinase inhibitor dasatinib...
December 29, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29284886/monitored-anesthesia-care-for-the-acute-ischemic-stroke-patient-with-end-stage-pulmonary-disease
#19
Kevin C Lee, Brian C Lee, Steven E Miller
The majority of patients who suffer acute ischemic stroke (AIS) from large vessel occlusion are at a significant risk for disability or death. Because patients on veno-arterial extracorporeal membrane oxygenation (VA ECMO) are therapeutically anticoagulated, intravenous recombinant tissue plasminogen activator is contraindicated. For AIS management, these patients must undergo emergent intra-arterial therapy. Presented is a patient on VA ECMO who subsequently suffered a large vessel embolic stroke requiring emergent surgical intervention...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29279077/platypnea-orthodeoxia-syndrome-after-complicated-cholecystectomy-an-unsuspected-diagnosis
#20
Catarina Queirós, Elsa Francisco, João Almeida
A 65-year-old woman with no significant prior medical history presented, in the postoperative course of a complicated cholecystectomy, several episodes of arterial desaturation. Pulmonary embolism was repeatedly suspected, but there was no evidence of pulmonary thrombus on the chest computed tomography angiographies obtained. As these episodes were mainly induced by postural changes, a platypnea-orthodeoxia syndrome was suspected. A transthoracic echocardiogram was performed and revealed a patent foramen ovale...
November 29, 2017: Acta Médica Portuguesa
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