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https://www.readbyqxmd.com/read/28804970/arrhythmogenic-gene-remodelling-in-elderly-patients-with-type-2-diabetes-with-aortic-stenosis-and-normal-left-ventricular-ejection-fraction
#1
R Ashrafi, P Modi, A Y Oo, D M Pullan, K Jian, H Zhang, J Yanni Gerges, G Hart, M R Boyett, G K Davis, J P H Wilding
Type 2 diabetes is associated with higher rate of ventricular arrhythmias and this is hypothesised to be independent of coronary artery disease or hypertension. To investigate further we compared changes in left ventricular myocardial gene expression in Type 2 diabetes to patients in a control group with left ventricular hypertrophy. 9 control patients and 7 patients with type 2 diabetes with aortic stenosis undergoing aortic valve replacement had standard ECGs, signal averaged ECGs and echocardiograms prior to surgery...
August 14, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28764236/clinical-significance-of-the-forsaken-avr-in-evaluation-of-tachyarrhythmias-a-reminder
#2
Dharmendra Jain, Pradeep Nigam, Manoj Indurkar, Riyas Chiramkara
INTRODUCTION: Mechanism of a regular, monomorphic Wide QRS Complex Tachycardia (WCT) is an important diagnostic challenge in day to day practice for the clinicians and affects further management and prognosis. Many of the WCT and Narrow Complex Tachycardia (NCT) produce certain characteristic changes in lead aVR by which we can differentiate between them. AIM: The present study was aimed to evaluate tachyarrhythmias in relation to lead aVR and to highlight the clinical significance of lead aVR, "The Neglected Lead"...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28761561/coronary-perforation-of-distal-diagonal-branch-followed-by-prolonged-recurrent-cardiac-tamponade-finally-resolved-with-pericardiotomy-the-potential-risk-of-hydrophilic-guide-wires
#3
Rafał Januszek, Krzysztof Bartuś, Radosław Litwinowicz, Artur Dziewierz, Łukasz Rzeszutko
PURPOSE: Coronary artery perforation (CAP) is a complication of percutaneous coronary interventions (PCIs). Hydrophilic guide-wires have been shown to increase the probability of CAP. Depending on the size of perforations we adopt different treatments. CASE: We present the case of a 73-year old male with coronary artery disease and severe aortic valve stenosis. The patient was in the process of qualifying for a transcatheter aortic valve implantation. Unfortunately, CAP of the first diagonal branch of the LAD occurred during PCI...
2017: Open Cardiovascular Medicine Journal
https://www.readbyqxmd.com/read/28757765/pulseless-electrical-activity-in-acute-massive-pulmonary-embolism-during-thrombolytic-therapy
#4
Han-Hua Yu, Jing-Ren Jeng
We report a case of acute pulmonary embolism with hemodynamic instability diagnosed by a computed tomography pulmonary angiogram. The patient developed pulseless electrical activity during systemic thrombolytic therapy with recombinant tissue plasminogen activator. Successful return of spontaneous circulation was achieved after immediate cardiopulmonary resuscitation with chest compressions for 6 min. His electrocardiogram (ECG) on arrival in the emergency department displayed sinus tachycardia, an S wave in lead I, a Q wave in lead III, incomplete right bundle branch block (RBBB), T-wave inversion (TWI) in leads V1-V3, ST elevation in leads aVR and V1, and ST depression in leads I, II, III, aVF, and V4-V6...
January 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28755616/endotracheal-hamartoma-case-report-two-contrasting-clinical-presentations-of-a-rare-entity
#5
Curtis Hon, Carl J O'Hara, Virginia R Litle
INTRODUCTION: The majority of tracheal tumors in adults are malignant. The finding of a benign tumor in the trachea is uncommon and endotracheal hamartomas are rare. PRESENTATION OF CASE: We report two cases presenting within six months at our institution. The first patient is a 67 year-old man who was found to have an asymptomatic endotracheal hamartoma on chest imaging for aortic valve replacement. The second patient is a 46 year-old man with an extensive continued tobacco use disorder and a known endotracheal lesion identified 8 years prior to intervention...
July 20, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28739246/three-dimensional-measurement-of-aortic-annulus-dimensions-using-area-or-circumference-for-transcatheter-aortic-valve-replacement-valve-sizing-does-it-make-a-difference
#6
Alexandros Papachristidis, Michael Papitsas, Damian Roper, Yanzhong Wang, Rafal Dworakowski, Jonathan Byrne, Olaf Wendler, Philip MacCarthy, Mark J Monaghan
BACKGROUND: The use of transcatheter aortic valve replacement (TAVR) is increasing worldwide. We present our 6-year experience using three-dimensional (3D) transesophageal echocardiography (TEE) and investigate whether different sizing methods of the aortic annulus lead to different prosthesis size that may impact outcome. METHODS: We investigated 262 patients who underwent TAVR and had 3D TEE data sets of the aortic annulus. We have used the area-derived diameter (Darea = 2(area/π)) and the circumference-derived diameter (Dcirc = Circumference/π) to size the prosthesis in separate populations in different time periods...
July 21, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28687077/joint-analysis-of-left-ventricular-expression-and-circulating-plasma-levels-of-omentin-after-myocardial-ischemia
#7
Louis A Saddic, Sarah M Nicoloro, Olga T Gupta, Michael P Czech, Joshua Gorham, Stanton K Shernan, Christine E Seidman, Jon G Seidman, Sary F Aranki, Simon C Body, Timothy P Fitzgibbons, Jochen D Muehlschlegel
BACKGROUND: Omentin-1, also known as Intelectin-1 (ITLN1), is an adipokine with plasma levels associated with diabetes, obesity, and coronary artery disease. Recent studies suggest that ITLN1 can mitigate myocardial ischemic injury but the expression of ITLN1 in the heart itself has not been well characterized. The purpose of this study is to discern the relationship between the expression pattern of ITLN1 RNA in the human heart and the level of circulating ITLN1 protein in plasma from the same patients following myocardial ischemia...
July 7, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28684437/the-role-and-clinical-implications-of-diastolic-dysfunction-in-aortic-stenosis
#8
REVIEW
Polydoros N Kampaktsis, Damianos G Kokkinidis, Shing-Chiu Wong, Manolis Vavuranakis, Nikolaos J Skubas, Richard B Devereux
Diastolic dysfunction in aortic stenosis results primarily from left ventricular hypertrophy and myocardial fibrosis due to chronically elevated left ventricular systolic pressure. Currently, diastolic dysfunction does not have an explicit clinical role in management of patients with aortic stenosis. Studies have shown that improvement in diastolic dysfunction follows left ventricular remodelling after aortic valve replacement and that it occurs gradually or incompletely. Retrospective studies suggest that advanced grades of diastolic dysfunction at baseline are associated with increased mortality and adverse events even after aortic valve replacement...
July 6, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28658116/an-interesting-implantable-cardioverter-defibrillator-treatment-for-lethal-ventricular-arrhythmias-caused-by-coronary-artery-spasm-a-case-report
#9
Jie Sun, Li Feng, Fei Li, Yanchun Zhang, Jianting Dong
RATIONALE: Coronary artery spasm (CAS) could cause serious lethal ventricular arrhythmias. While implantable cardioverter defibrillators (ICDs) have been recommend for secondary prevention of sudden cardiac death related to lethal ventricular arrhythmias. However, in resuscitated sudden cardiac death caused by CAS, the effect of ICD is still not well clear. PATIENT CONCERNS: A 60-year-old male presented with 2 episodes of syncope. Coronary angiography showed normal coronary arteries...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28655532/surgical-relief-of-left-ventricular-outflow-tract-obstruction-in-adults-with-congenital-aortic-stenosis-and-associated-aortic-annulus-hypoplasia-and-or-subaortic-obstruction
#10
Tanveer Ahmad, Amalan Thuraisingam, Marco Larobina, Peter Skillington
BACKGROUND: In children and adolescents, a Ross/Konno operation is commonly done to both enlarge the aortic root and provide a competent aortic valve with relief of left ventricular outflow tract obstruction (LVOTO). Optimum management is not so straightforward in adults. METHODS: Between 1995 and 2014, 16 patients of mean age 39.4 years (18-57 years) with hypoplastic aortic annulus (AA) measuring 20mm and less, and mean aortic valve/LVOT gradient of 61mmHg (30-70mmHg) presented for surgery...
June 3, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28636475/surgical-aortic-valve-replacement-for-stenosis-of-tavi-device
#11
M Sooknunden, M A Radermecker, J O Defraigne, Vincent Tchana-Sato
We here report the case of a stenosis of the CoreValve(®) system due to reduced mobility of prosthesis cusps for which a surgical replacement of the aortic valve was proposed. The exact mechanism leading to this impaired mobility of the leaflets is yet to be determined. We also underline the fact a transcatheter aortic valve implantation (TAVI) device can be replaced by a surgical replacement without excessive operative risks despite the patient being initially considered as high-risk.
March 1, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28611879/pitfalls-in-electrocardiographic-diagnosis-of-acute-coronary-syndrome-in-low-risk-chest-pain
#12
REVIEW
Semhar Z Tewelde, Amal Mattu, William J Brady
Less than half of patients with a chest pain history indicative of acute coronary syndrome have a diagnostic electrocardiogram (ECG) on initial presentation to the emergency department. The physician must dissect the ECG for elusive, but perilous, characteristics that are often missed by machine analysis. ST depression is interpreted and often suggestive of ischemia; however, when exclusive to leads V1-V3 with concomitant tall R waves and upright T waves, a posterior infarction should first and foremost be suspected...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28610762/early-trifecta-valve-failure-report-of-a-cluster-of-cases-from-a-tertiary-care-referral-center
#13
Ankur Kalra, Hasan Rehman, Mahesh Ramchandani, Colin M Barker, Gerald M Lawrie, Ross M Reul, Michael J Reardon, Neal S Kleiman
BACKGROUND: The Trifecta valve (St Jude Medical, Inc, St Paul, Minn) was approved for commercial use by the US Food and Drug Administration in 2011. Several isolated cases have been reported since then, describing early structural valve deterioration. We report a case series of 8 Trifecta valve failures, describing patients' clinical substrate and management, and the pathologic characteristics of the explanted valves. METHODS: Trifecta valve failure occurred in 7 patients (8 valves) receiving 19-mm (n = 2), 21-mm (n = 3), 23-mm (n = 1), and 25-mm (n = 2) valves...
May 22, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28606674/transcatheter-aortic-valve-implantation-in-patients-with-an-extremely-small-native-aortic-annulus-the-ocean-tavi-registry
#14
Fumiaki Yashima, Masanori Yamamoto, Makoto Tanaka, Ryo Yanagisawa, Takahide Arai, Hideyuki Shimizu, Keiichi Fukuda, Yusuke Watanabe, Toru Naganuma, Shinichi Shirai, Motoharu Araki, Norio Tada, Futoshi Yamanaka, Kentaro Hayashida
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been reported to be advantageous over surgical aortic valve replacement owing to the low incidence of prosthesis-patient mismatch (PPM) and large effective orifice area (EOA). However, data on TAVI for extremely small annuli are limited. The present study aimed to compare post-procedural hemodynamics and morphology between 20-mm and 23-mm Sapien XT (SXT) transcatheter heart valves (THVs) with extremely small annuli (<314mm(2))...
August 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28597767/increased-mortality-from-complications-of-pulmonary-hypertension-in-patients-undergoing-transcatheter-aortic-valve-replacement
#15
Raj Parikh, Benson Varghese, Huma N Khatoon, Julie A Kovach, Clifford J Kavinsky, Rajive Tandon
Aortic stenosis (AS) leads to pulmonary hypertension (PH) and right ventricle (RV) failure. Our goal was to describe mortality related to postoperative complications in PH patients undergoing transcatheter aortic valve replacement (TAVR). Ninety-three TAVR patients were analyzed (controls, sPAP < 50 mmHg; cases, sPAP ≥ 50 mmHg). Significant findings in cases included increased mortality (365 days), post-TAVR atrioventricular block (AVB) and acute kidney injury (AKI), and increased mean length of stay (LOS)...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28597027/-low-flow-low-gradient-aortic-valve-stenosis-current-evidence
#16
F Tillwich, M A Sherif, S Yücel, A Öner, H Ince
Many patients with severe aortic stenosis have a "low-flow, low-gradient" aortic stenosis. The management of these patients can be quite difficult, as these patients often show impairment of the left ventricle, which can lead to false measurements of the severity of stenosis and also leads to a higher risk during aortic valve replacement. More diagnostic tools than only standard echocardiography are needed to correctly differentiate true severe aortic stenosis from pseudo severe aortic stenosis.
June 9, 2017: Herz
https://www.readbyqxmd.com/read/28591059/left-sinus-of-valsalva-aneurysm-ruptured-into-left-ventricle-a-case-report-of-320-multidetector-ct-findings
#17
Kyungsoo Bae, Kyung Nyeo Jeon, Hyang-Im Lee, Jeong Yoon Jang, Sung Eun Park, Kyeong Hwa Ryu, Hye Jin Baek, Bo Hwa Choi, Jin Il Moon, Soo Buem Cho
RATIONALE: Ruptured aneurysm originating from the left coronary sinus of Valsalva into the left ventricle (LV) is extremely rare. Imaging features of sinus aneurysm has been commonly reported using echocardiography or angiography. Here, we report multidetector computed tomography (MDCT) findings of left sinus of Valsalva aneurysm extending into the LV and caused severe aortic regurgitation (AR) in a 44-year-old male with latent infective endocarditis. The role of MDCT in preoperative surgical planning was also emphasized...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28583685/usefulness-of-the-r-wave-sign-as-a-predictor-for-ventricular-tachyarrhythmia-in-patients-with-brugada-syndrome
#18
Ahmed A Y Ragab, Charlotte A Houck, Lisette J M E van der Does, Eva A H Lanters, Danielle E Burghouwt, Agnes J Q M Muskens, Natasja M S de Groot
Brugada syndrome (BrS) is an autosomal dominant channelopathy which is responsible for a large number of sudden cardiac deaths in young subjects without structural abnormalities. The most challenging step in management of patients with BrS is identifying who is at risk for developing malignant ventricular tachyarrhythmia (VTA). In patients with BrS, conduction delay in the right ventricular outflow tract (RVOT) causes a prominent R wave in lead aVR. This electrocardiographic parameter can be useful to detect these high-risk patients...
August 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28570525/full-root-aortic-valve-replacement-by-stentless-aortic-xenografts-in-patients-with-small-aortic-roots
#19
Reza Tavakoli, Peiman Jamshidi, Max Gassmann
In patients with small aortic roots who need an aortic valve replacement with biological valve substitutes, the implantation of the stented pericardial valve might not meet the functional needs. The implantation of a too-small stented pericardial valve, leading to an effective orifice area indexed to a body surface area less than 0.85 cm(2)/m(2), is regarded as prosthesis-patient mismatch (PPM). A PPM negatively affects the regression of left ventricular hypertrophy and thus the normalization of left ventricular function and the alleviation of symptoms...
May 21, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28545282/-electrocardiogram-characteristics-of-patients-with-ventricular-arrhythmia-originating-from-the-distal-great-cardiac-vein
#20
R L Zheng, D P Zhou, J X Lin, Y C Li, J Li, J Li, R P Yin, J F Lin
Objective: To explore the electrocardiographic characteristics of patients with idiopathic ventricular arrhythmias (VAs) originating from different portions of distal great cardiac veins (DGCV). Methods: The study included 49 patients underwent successful RFCA of premature ventricular complex(PVCs)/ventricular tachycardia(VT) from different portions of the DGCV in our department from July 2009 to March 2016. The surface 12-lead electrocardiogram (ECG) and intraventricular ablation mapping features were analyzed...
April 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
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