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https://www.readbyqxmd.com/read/29026892/prompt-diagnosis-of-st-elevation-myocardial-infarction-with-papillary-muscle-rupture-by-point-of-care-ultrasound-in-the-emergency-department
#1
Koon Ho Cheung, Colin Graham Alexander
A previously healthy 61-year-old man presented to the emergency department with chest pain and dyspnoea for 6 hours. Examination revealed distress with an apical pansystolic murmur. Initial electrocardiogram showed sinus tachycardia and ST elevation in leads II, III, and aVF compatible with an inferior ST-elevation myocardial infarction. Point-of-care echocardiography in the emergency department showed a flail anterior mitral leaflet and severe mitral regurgitation, leading to a provisional diagnosis of papillary muscle rupture...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29026622/lower-extremity-mycotic-aneurysm-in-a-patient-with-listeria-monocytogenes-associated-prosthetic-valve-endocarditis
#2
Elham Rahmati, P Jan Geiseler, Rosemary C She
Introduction.Listeria monocytogenes is a rare etiology of infectious endocarditis with only 30 cases of prosthetic valve and about twice as many native valve infections described in the literature. We describe an unusual presentation of an endovascular embolic phenomenon with associated lower extremity mycotic aneurysm due to Listeria monocytogenes prosthetic aortic valve and aortic endograft infection. Case presentation. This is a case of an elderly gentleman with prior history of bioprosthetic aortic valve placement and aortic arch repair who was admitted with several weeks of constitutional symptoms and left lower leg pain...
May 2017: JMM Case Reports
https://www.readbyqxmd.com/read/28993035/outcomes-of-hybrid-procedure-for-type-b-aortic-dissection-with-an-aberrant-right-subclavian-artery
#3
Huanyu Ding, Songyuan Luo, Yuan Liu, Wenhui Huang, Minchun Jiang, Jie Li, Nianjin Xie, Xiaoping Fan, Ruixin Fan, Jianfang Luo
OBJECTIVE: To report our single-center experience of the hybrid procedure for type B aortic dissection (TBAD) with an aberrant right subclavian artery (ARSA) and the early to midterm outcomes in these patients. METHODS: From December 2011 to February 2016, 16 patients (12 males; median age, 51 years; range, 40-66 years) underwent thoracic endovascular aortic repair and extraanatomic bypass hybrid procedure for TBAD with an ARSA in our center. Demographics, coexisting medical conditions, imaging features, operation details, and follow-up outcomes of these patients were collected retrospectively and analyzed...
October 6, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28984768/the-safety-and-feasibility-of-guidezilla-catheter-in-complex-coronary-interventions-and-an-observational-study
#4
Jianying Ma, Lei Hou, Juying Qian, Lei Ge, Feng Zhang, Shufu Chang, Rende Xu, Qing Qin, Junbo Ge
The monorail Guidezilla guide extension catheter was designed to provide additional backup and facilitate device delivery in percutaneous coronary intervention (PCI) for complex coronary anatomy such as chronic total occlusion (CTO), extreme vessel tortuosity, diseased bypass grafts, and anomalous coronary arteries, among others.The present retrospective, single-center study included 188 consecutive patients who underwent PCI using the Guidezilla catheter from March 2015 to August 2016. Study outcomes were rates of target lesion crossing success, procedural success, and complications...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28973478/roux-en-y-gastric-bypass-surgery-in-the-management-of-familial-partial-lipodystrophy-type-1-fpld1
#5
Audrey Melvin, Claire Adams, Catherine Flanagan, Lisa Gaff, Barbara Gratton, Fiona Gribble, Geoffrey Roberts, Robert K Semple, Stephen O'Rahilly, Francesco Rubino, Anna Stears, David B Savage
Introduction: Familial partial lipodystrophy type 1 is an extreme form of central adiposity with peripheral lipodystrophy associated with severe manifestations of the metabolic syndrome, often poorly responsive to standard therapeutic approaches. Body mass index in FPLD1 varies but in many cases is below the level at which metabolic surgery is usually considered as a therapeutic option. Materials and Methods: We detailed the metabolic response to gastric bypass surgery of three patients with FPLD1, refractory to medical therapy...
July 26, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28965800/short-and-long-term-readmission-rates-after-infrainguinal-bypass-in-a-safety-net-hospital-are-higher-than-expected
#6
Brianna M Krafcik, Sevan Komshian, Kimberly Lu, Lauren Roberts, Alik Farber, Jeffrey A Kalish, Denis Rybin, Jeffrey J Siracuse
OBJECTIVE: Readmission rates are expected to have an increasing effect on both the hospital bottom line and physician reimbursements. Safety net hospitals may be most vulnerable. We examined readmissions at 30 days, 90 days, and 1 year in a large safety net hospital to determine the magnitude and effect of short and long-term readmission rates after lower extremity infrainguinal bypass in this setting. METHODS: All nonemergent extremity infrainguinal bypass performed at a large safety net hospital between 2008 and 2016 were identified...
September 28, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28964617/tibiodistal-vein-bypass-in-critical-limb-ischemia-and-its-role-after-unsuccessful-tibial-angioplasty
#7
Florian K Enzmann, Sebastian K Eder, Thomas Aschacher, Manuela Aspalter, Patrick Nierlich, Klaus Linni, Thomas J Hölzenbein
OBJECTIVE: Technical progress in angioplasty expanded its application to very distal arterial lesions of the lower extremity. In cases of unsuccessful angioplasty tibiodistal bypass surgery may be required for limb salvage. We investigated the long-term outcome of this technique in patients with critical limb ischemia. The purpose of this study was to evaluate whether tibiodistal bypasses done after unsuccessful tibial angioplasty had inferior patency, limb salvage, or survival rates compared with primary tibiodistal bypasses...
September 27, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28947228/outcomes-after-first-time-lower-extremity-revascularization-for-chronic-limb-threatening-ischemia-between-patients-with-and-without-diabetes
#8
Jeremy D Darling, Thomas C F Bodewes, Sarah E Deery, Raul J Guzman, Mark C Wyers, Allen D Hamdan, Hence J Verhagen, Marc L Schermerhorn
OBJECTIVE: The effect of diabetes type and insulin dependence on short- and long-term outcomes after lower extremity revascularization for chronic limb-threatening ischemia (CLTI) warrants additional study and more targeted focus. We sought to address this paucity of information by evaluating outcomes in insulin-dependent and noninsulin-dependent patients after any first-time revascularization. METHODS: We reviewed all limbs undergoing first-time infrainguinal bypass grafting (BPG) or percutaneous transluminal angioplasty with or without stenting (PTA/S) for CLTI at our institution from 2005 to 2014...
September 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28941784/patients-transferred-for-upper-extremity-amputation-participation-of-regional-trauma-centers
#9
Shantum Misra, Suzanne C Wilkens, Neal C Chen, Kyle R Eberlin
PURPOSE: Level-I trauma centers are required to provide hand and microsurgery capability at all times. We examined transfers to our center to better understand distant patient referrals and, indirectly, study referrals in our region. METHODS: Records were reviewed from 2010 to 2015 to evaluate patients transferred to our level-I institution for upper extremity amputation. Patients were referred from 6 states to our institution over this period. We measured the straight-line distance from each patient's transferring facility to our facility and compared this distance with the straight-line distances from the zip code of the transferring facility to the zip code of each level-I trauma center...
September 20, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28927349/hospital-readmissions-after-elective-lower-extremity-vascular-procedures
#10
Todd R Vogel, Jamie B Smith, Robin L Kruse
Background This study evaluated risk factors associated with 30-day readmission after open and endovascular lower extremity revascularization. Methods Patients admitted with peripheral artery disease and lower extremity procedures were selected from national electronic medical record data, Cerner Health Facts® (2008-2014). Thirty-day readmission was determined. Logistic regression models identified characteristics independently associated with readmission. Results There were 2781 open and 2611 endovascular procedures...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28927214/direct-anastomosis-using-occipital-artery-for-additional-revascularization-in-moyamoya-disease-after-combined-superficial-temporal-artery-middle-cerebral-artery-and-indirect-bypass
#11
Ken Kazumata, Hiroyasu Kamiyama, Hisayasu Saito, Katsuhiko Maruichi, Masaki Ito, Haruto Uchino, Naoki Nakayama, Satoshi Kuroda, Kiyohiro Houkin
BACKGROUND: The posterior cerebral artery (PCA) is involved in approximately 30% of moyamoya disease (MMD) cases. However, there have been insufficient reports describing revascularization techniques in the posterior portion of the brain, particularly of direct anastomosis. OBJECTIVE: To perform a technical assessment in patients with MMD who underwent either occipital artery (OA)-PCA bypass or OA-middle cerebral artery (MCA) bypass. METHODS: A total of 428 revascularization procedures in 368 patients were retrospectively assessed by reviewing clinical charts and radiological data...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28920529/surgical-interventions-for-organ-and-limb-ischemia-associated-with-primary-and-secondary-antiphospholipid-antibody-syndrome-with-arterial-involvement
#12
Carlos A Hinojosa, Javier E Anaya-Ayala, Karla Bermudez-Serrato, Ramón García-Alva, Hugo Laparra-Escareno, Adriana Torres-Machorro, Rene Lizola
OBJECTIVE: The association of antiphospholipid antibody syndrome (APS) and hypercoagulability is well known. Arterial compromise leading to ischemia of organs and/or limbs in patients with APS is uncommon, frequently unrecognized, and rarely described. We evaluated our institutional experience. METHODS: Retrospective review was conducted. From August 2007 to September 2016, 807 patients with diagnosis of APS were managed in our Institution. Patients with primary and secondary APS who required interventions were examined...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28903884/successful-outcome-of-severe-intra-cerebral-bleeding-associated-with-acquired-factor-v-inhibition-utilization-of-multiple-therapeutic-agents
#13
Panagiotis Andreadis, Katerina Kafantari, Aleka Agapidou, Sofia Vakalopoulou, Efthymia Vlachaki
BACKGROUND: Acquired coagulation Factor inhibitors are antibodies that either inhibit the activity or increase the clearance of a clotting factor leading to an increased risk of bleeding. Most of the times, the disorder is attributed to Factor VIII inhibition (Acquired Hemophilia A), however other coagulation factors could also be implicated. CASE REPORT: We herein would like to report an interesting case of a patient who underwent Coronary Artery Bypass Graft and received antibiotic treatment after surgery with a third-generation cephalosporin...
September 13, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28894061/-successful-repair-of-chronic-expanding-hematoma-after-coronary-artery-bypass-grafting-by-lower-partial-sternotomy-approach-report-of-a-case
#14
Takateru Yamamoto, Kouhei Takahashi, Katsuaki Tsukioka, Tetsuya Kono
Chronic expanding hematoma (CEH) after coronary artery bypass grafting (CABG) is extremely rare. We reported a case of successful surgical repair of CEH through lower partial sternotomy approach. The patient was a 73-year-old man who underwent CABG. Fifteen years after the operation, he was admitted to referral hospital because of dyspnea on exertion. Echocardiography and computed tomography revealed a giant intrapericardial mass, which was pressing on the inferior wall of the ventricle. To avoid injury of the aorta and the patent bypass graft in the reentry of the chest, we selected lower partial sternotomy approach...
September 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28893709/novel-application-of-branched-endograft-for-preservation-of-pelvic-circulation
#15
Roy Miler, Jeanwan Kang, Patrick Sowa, Matthew Eagleton, F Ezequiel Parodi
INTRODUCTION/OBJECTIVES: Endovascular repair of a proximal anastomotic pseudoaneurysm of an end-to-side aortobifemoral bypass (ABF) can lead to pelvic ischemia. We present a novel application of branched aortic endograft to repair such pseudoaneurysm while preserving flow into the ABF and native aortoiliac system. METHODS: A 71 year old male with history of aortoiliac occlusive disease resulting in lifestyle limiting claudication was treated with an aortobifemoral bypass in 1999...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28893702/risk-factors-associated-with-perioperative-myocardial-infarction-in-major-open-vascular-surgery
#16
Danielle C Sutzko, Elizabeth A Andraska, Andrea T Obi, Peter K Henke, Nicholas H Osborne
BACKGROUND: Among patients undergoing non-cardiac surgery, major vascular surgery is associated with a high risk of perioperative myocardial infarction (MI). Currently there are no perioperative MI risk calculators accounting for intraoperative and postoperative risk factors in vascular surgery patients. We aimed to investigate specific risk factors for perioperative MI after major open vascular surgery to determine which patients are at highest risk of MI, and the association of perioperative MI with perioperative transfusion...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28890062/national-utilization-and-outcomes-of-redo-lower-extremity-bypass-vs-endovascular-intervention-after-previous-failed-bypass-redo-lower-extremity-bypass-superior-to-endovascular-intervention
#17
J Hunter Mehaffey, Alexander Shannon, Robert B Hawkins, Anna Fashandi, Margret C Tracci, Irving L Kron, Gilbert R Upchurch, William P Robinson
BACKGROUND: Redo Lower extremity bypass (LEB) and infrainguinal endovascular intervention (IEI) are options to treat critical limb ischemia after a failed prior lower extremity bypass but the utilization and outcomes of each are poorly described. The purpose of this study was to compare 30-day Major Adverse Limb Events (MALE) and Major Adverse Cardiovascular Events (MACE) after LEB and IEI in patients with a failed prior ipsilateral LEB and determine risk factors for each composite outcome...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28890056/giant-chest-wall-arteriovenous-malformation-a-case-report-and-literature-review
#18
Cullen McCarthy, Subrato Deb, Suhair Maqusi, Joshua Gierman
INTRODUCTION: We present an interesting case of a 55 year-old male with a large left chest mass after significant cutaneous bleeding. CT angiogram of the chest revealed arteriovenous malformation with blood supply from subbranches of the left subclavian artery, left internal mammary artery and left external carotid artery. Measuring 5.0x14.0x10.8cm, the mass extended superior to the clavicle and inferior to the third rib with medial and lateral borders at the level of the clavicular head and coracoid, respectively...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28886389/localized-constrictive-pericarditis-compressing-and-obstructing-the-right-ventricular-inflow-tract-due-to-a-giant-anterior-calcified-cardiac-mass-a-case-report
#19
Klodian Krakulli, Edvin Prifti, Hortensa Gjergo, Endri Hasimi
INTRODUCTION: Localized pericardial constriction is a rare form of constrictive pericarditis CP. Depending on the CP location, clinical presentation may be variable, including compression and obstruction of right ventricular inflow tract(RVIT), coronary obstruction, or pulmonary stenosis. CASE PRESENTATION: A 72-year-old man presented a 2-year history of dyspnea and atrial fibrillation. A contrast enhanced angio computerized tomography clearly demonstrated a large spherical mass about 11×9×4cm in the anterior pericardium, presenting as a mediastinal tumor causing compression and obstruction of the RVIT...
August 25, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28882138/a-dual-therapy-of-off-pump-temporary-left-ventricular-extracorporeal-device-and-amniotic-stem-cell-for-cardiogenic-shock
#20
Toshinobu Kazui, Phat L Tran, Tia R Pilikian, Katie M Marsh, Raymond Runyan, John Konhilas, Richard Smith, Zain I Khalpey
BACKGROUND: Temporary mechanical circulatory support device without sternotomy has been highly advocated for severe cardiogenic shock patient but little is known when coupled with amniotic stem cell therapy. CASE PRESENTATION: This case reports the first dual therapy of temporary left ventricular extracorporeal device CentriMag with distal banding technique and human amniotic stem cell injection for treating a severe refractory cardiogenic shock of an 68-year-old female patient...
September 7, 2017: Journal of Cardiothoracic Surgery
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