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Acute right ventricular failure

Varun Kumar, Santosh Sinha, Prakash Kumar, Mohammed Razi, Chandra Mohan Verma, Ramesh Thakur, Umeshwar Pandey, Rajpal Singh Bhardwaj, Mohammed Ahmad, R K Bansal, Shalini Gupta
OBJECTIVE: The primary aim of the present study was to evaluate the complications, particularly conduction blocks, subsequent morbidity and mortality, and effect of thrombolytic therapy in Indian patients with inferior wall myocardial infarction (IWMI). METHODS: This was a prospective, observational, single-center study conducted at LPS Institute of Cardiology, Kanpur, from December 2011 to May 2014. Patients who presented with typical chest pain and were subsequently diagnosed by standardized diagnostic criteria as having IWMI were enrolled...
October 12, 2016: Anatolian Journal of Cardiology
Domenico Acanfora, Pietro Scicchitano, Gerardo Casucci, Bernardo Lanzillo, Nicola Capuano, Giuseppe Furgi, Chiara Acanfora, Marialaura Longobardi, Raffaele Antonelli Incalzi, Giuseppe Piscosquito, Marco Matteo Ciccone
BACKGROUND: The aim of this study was to evaluate the effect of exercise training on cardiac function in heart failure (HF) patients recently suffering from acute decompensation. Radionuclide ambulatory ventricular function monitoring (VEST) was used to detect variations in cardiac hemodynamics during training period. METHODS: This was a monocentric, randomized, controlled trial. We enrolled 72 HF patients [left ventricle ejection fraction (LVEF) <40%] within two weeks after acute cardiogenic pulmonary edema: 40 in the elderly group, 32 in the middle-aged group...
October 11, 2016: International Journal of Cardiology
Nobuyuki Kagiyama, Hiroyuki Okura, Yuya Matsue, Tomoko Tamada, Koichiro Imai, Ryotaro Yamada, Teruyoshi Kume, Akihiro Hayashida, Yoji Neishi, Kiyoshi Yoshida
BACKGROUND: Various unfavorable echocardiographic findings other than apical ballooning, such as right ventricular involvement, mitral regurgitation, left ventricular outflow tract obstruction, and left ventricular thrombus, occur in takotsubo cardiomyopathy. Occasionally, these findings are observed simultaneously in a single patient. This study was performed to investigate the prevalence and characteristics of patients with multiple unfavorable echocardiographic findings in takotsubo cardiomyopathy and their associations with adverse outcomes...
October 11, 2016: Journal of the American Society of Echocardiography
Janus Adler Hyldebrandt, Nicolaj Brejnholt Støttrup, Christian Alcaraz Frederiksen, Johan Heiberg, Rune Isak Dupont Birkler, Mogens Johannsen, Michael Rahbek Schmidt, Hanne Berg Ravn
OBJECTIVES: Myocardial infarction and chronic heart failure induce specific metabolic changes in the neonatal myocardium that are closely correlated to outcome. The aim of this study was to examine the metabolic responses to noninfarct heart failure and inotropic treatments in the newborn heart, which so far are undetermined. DESIGN: A total of 28 newborn pigs were instrumented with a microdialysis catheter in the right ventricle, and intercellular citric acid cycle intermediates and adenosine metabolite concentrations were determined at 20-minute intervals...
October 12, 2016: Pediatric Critical Care Medicine
James Wever-Pinzon, Craig H Selzman, Greg Stoddard, Omar Wever-Pinzon, Anna Catino, Abdallah G Kfoury, Nikolaos A Diakos, Bruce B Reid, Stephen McKellar, Michael Bonios, Antigone Koliopoulou, Deborah Budge, Aaron Kelkhoff, Josef Stehlik, James C Fang, Stavros G Drakos
BACKGROUND: Small-scale studies focused mainly on nonischemic cardiomyopathy (NICM) have shown that a subset of left ventricular assist device (LVAD) patients can achieve significant improvement of their native heart function, but the impact of ischemic cardiomyopathy (ICM) has not been specifically investigated. Many patients with acute myocardial infarction are discharged from their index hospitalization without heart failure (HF), only to return much later with overt HF syndrome, mainly caused by chronic remodeling of the noninfarcted region of the myocardium...
October 18, 2016: Journal of the American College of Cardiology
Fabrizio Drago, Mario Salvatore Russo, Irma Battipaglia, Gino Grifoni, Massimo Stefano Silvetti, Romolo Remoli, Vincenzo Pazzano, Fabio Anselmo Saputo, Michele Ciani
AIMS: Transcatheter cryoablation is a well-established technique for the treatment of AV nodal reentry tachycardia (AVNRT) in children. Nevertheless, A-V nodal slow pathway conduction may recur after an acutely successful procedure. The aim of this study was to evaluate the long-term outcome of acutely successful AVNRT cryoablations in pediatric patients in case of focal cryolesion and in case of need for High Density Linear Lesion (HDLL) cryoablation due to focal failure. METHODS: ...
September 22, 2016: Pacing and Clinical Electrophysiology: PACE
Sebnem Albeyoglu, Mustafa Aldag, Ufuk Ciloglu, Hakan Kutlu, Sabri Dagsali
BACKGROUND: Pericardial decompression syndrome is defined as paradoxical hemodynamic instability, left ventricular or bi ventricular systolic dysfunction and pulmonary edema after pericardial fluid drainage. Pericardial Decompression Syndrome is an unexpected clinical scenario with an incidence less than 5% in all surgically or percutaneously managed pericardial tamponade patients. The aim of this manuscript was to describe a case with cardiac tamponade in whom acute biventricular heart failure and pulmonary edema developed after surgical creation of a pericardial window, and to discuss this case in light of the literature...
September 30, 2016: International Journal of Surgery Case Reports
Poovendran Saththasivam, Elizabeth Herrera, Gerald Lawrie, Odeaa Al Jabbari, Collin M Barker, Roy Sheinbaum
The MitraClip procedure is an emerging endovascular technique for treating mitral regurgitation and an attractive alternative for patients who are at high risk for open heart mitral valve repair or replacement. We present the case of a failed redo MitraClip procedure that led to acute right ventricular failure in a patient with homozygous familial hypercholesterolemia and a preexisting secundum atrial septal defect. We highlight the sequelae of the failed redo MitraClip procedure and the anesthetic challenges associated with the emergent redo sternotomy and cardiopulmonary bypass procedure required to replace the mitral valve and repair the tricuspid valve and atrial septal defect...
September 23, 2016: A & A Case Reports
Aditya Bansal, Jay K Bhama, Rajan Patel, Sapna Desai, Stacy A Mandras, Hamang Patel, Tyrone Collins, John P Reilly, Hector O Ventura, P Eugene Parrino
BACKGROUND: Outcomes of traditional mechanical support paradigms (extracorporeal membrane oxygenation, intraaortic balloon pump [IABP], and permanent left ventricular assist device [LVAD]) in acute decompensated heart failure have generally been suboptimal. Novel approaches, such as minimally invasive LVAD therapy (Impella 5.0 device), promise less invasive but equivalent hemodynamic support. However, it is yet unknown whether the outcomes with such devices support widespread acceptance of this new technology...
2016: Ochsner Journal
Kevin L Sack, Brian Baillargeon, Gabriel Acevedo-Bolton, Martin Genet, Nuno Rebelo, Ellen Kuhl, Liviu Klein, Georg M Weiselthaler, Daniel Burkhoff, Thomas Franz, Julius M Guccione
PURPOSE: Heart failure is a worldwide epidemic that is unlikely to change as the population ages and life expectancy increases. We sought to detail significant recent improvements to the Dassault Systèmes Living Heart Model (LHM) and use the LHM to compute left ventricular (LV) and right ventricular (RV) myofiber stress distributions under the following 4 conditions: (1) normal cardiac function; (2) acute left heart failure (ALHF); (3) ALHF treated using an LV assist device (LVAD) flow rate of 2 L/min; and (4) ALHF treated using an LVAD flow rate of 4...
October 10, 2016: International Journal of Artificial Organs
Abhay A Divekar
In this report, we describe a 15-year-old patient who underwent a Ross procedure for a regurgitant bicuspid aortic valve and ascending aortic dilation. After the operation was over, he could not be separated from cardiopulmonary bypass and was noted to have isolated right ventricular failure. This report takes the reader through the diagnostic evaluation, highlights the importance of invasive assessment in the immediate postoperative period, and discusses successful transcatheter intervention in the acute postoperative setting...
September 2016: Annals of Pediatric Cardiology
William R Auger, Jess Mandel, Joanna Pepke-Zaba
Chronic thromboembolic pulmonary hypertension is a progressive and life-threatening condition that is believed to be related to inadequate dissolution of acute pulmonary thromboemboli, followed by fibrotic organization. Without appropriate treatment, progressive pulmonary hypertension, right ventricular failure, and death may occur. While the disorder was initially described nearly a century ago in autopsy studies, antemortem diagnosis became feasible with the advent of cardiac catheterization and angiography techniques in the 1940s, while surgical thromboendarterectomy was not attempted until the 1960s...
July 2016: Annals of the American Thoracic Society
Nir Flint, Natalia Kaufman, Amir Gal-Oz, Gilad Margolis, Yan Topilsky, Gad Keren, Yacov Shacham
OBJECTIVE: Increased transmitral flow velocity (E) to the early mitral annulus velocity (e') ratio (E/e'), signifying increased cardiac filling pressure, was previously found to be associated with deterioration of renal function in patients with congestive heart failure. No study, however, included patients with acute myocardial ischemia. We hypothesized that elevated E/e' ratio would be associated with an increased risk of acute kidney injury (AKI) in ST elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI)...
August 22, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Kenta Nakamura, Jonathan J Passeri, Ignacio Inglessis-Azuaje
We report a case of acute aorto-right ventricular fistula following transcatheter bicuspid aortic valve replacement and subsequent percutaneous closure. The diagnosis and treatment of this rare complication is illustrated through multi-modality imaging. We hypothesize that the patient's heavily calcified bicuspid aortic valve anatomy led to asymmetric deployment of the transcatheter aortic valve replacement (TAVR) prosthesis, traumatizing the right sinus of Valsalva at the distal edge of the TAVR stent and ultimately fistulized to the right ventricle...
August 22, 2016: Catheterization and Cardiovascular Interventions
Stephen C Brown, Benedicte Eyskens, Derize Boshoff, Bjorn Cools, Ruth Heying, Filip Rega, Bart Meyns, Marc Gewillig
OBJECTIVES: To determine the outcome of a bailout procedure using the right ventricle to re-assist the left ventricle in neonates after technically adequate coarctectomy but a failing borderline left heart. METHODS: The surgical procedure was performed on bypass. A 'reversed' 6-mm surgical shunt was inserted between the pulmonary trunk and the descending aorta together with bilateral branch pulmonary artery banding. RESULTS: Over a 10-year period, 89 neonates presented with coarctation and small left hearts...
August 19, 2016: Interactive Cardiovascular and Thoracic Surgery
Philippe Vignon, Xavier Repessé, Antoine Vieillard-Baron, Eric Maury
Acute respiratory failure (ARF) is a leading indication for performing critical care ultrasonography (CCUS) which, in these patients, combines critical care echocardiography (CCE) and chest ultrasonography. CCE is ideally suited to guide the diagnostic work-up in patients presenting with ARF since it allows the assessment of left ventricular filling pressure and pulmonary artery pressure, and the identification of a potential underlying cardiopathy. In addition, CCE precisely depicts the consequences of pulmonary vascular lesions on right ventricular function and helps in adjusting the ventilator settings in patients sustaining moderate-to-severe acute respiratory distress syndrome...
August 15, 2016: Critical Care: the Official Journal of the Critical Care Forum
Moacyr Magno Palmeira, Hellen Yuki Umemura Ribeiro, Yan Garcia Lira, Fernando Octávio Machado Jucá Neto, Ivone Aline da Silva Rodrigues, Letícia Nazareth Fernandes da Paz, Maria da Conceição Nascimento Pinheiro
BACKGROUND: Cardiac complications constitute a rare clinical manifestation of cytomegalovirus (CMV) infection. This virus is usually asymptomatic in immunocompetent individuals. We report a case of myocarditis and cardiac insufficiency due to primary CMV infection. Serological tests by using ELISA method showed positive results for the virus. CASE PRESENTATION: A 41-year-old man with no prior comorbidities presenting with dyspnoea, fever, and oedema was admitted to the cardiac emergency service...
2016: BMC Research Notes
Mariana Pintalhao, Paulo Castro-Chaves, Francisco Vasques-Novoa, Francisco Gonçalves, Luís Mendonça, Ricardo Fontes-Carvalho, Patrícia Lourenço, Pedro Almeida, Adelino Leite-Moreira, Paulo Bettencourt
AIMS: Despite the promising results of serelaxin as a new potential acute heart failure (HF) therapy, its clinical use preceded the understanding of the endogenous relaxin system in HF. We aimed to evaluate relaxin circulating levels in a population of acute HF and their association with clinical and echocardiographic parameters. METHODS AND RESULTS: We included 117 patients from a registry of acute HF. Admission serum relaxin was measured using an enzyme-linked immunosorbent assay (ELISA) kit...
August 4, 2016: European Journal of Heart Failure
Alexis Paternot, Xavier Repessé, Antoine Vieillard-Baron
Pulmonary vascular dysfunction is associated with ARDS and leads to increased right-ventricular afterload and eventually right-ventricular failure, also called acute cor pulmonale. Interest in acute cor pulmonale and its negative impact on outcome in patients with ARDS has grown in recent years. Right-ventricular function in these patients should be closely monitored, and this is helped by the widespread use of echocardiography in intensive care units. Because mechanical ventilation may worsen right-ventricular failure, the interaction between the lungs and the right ventricle appears to be a key factor in the ventilation strategy...
October 2016: Respiratory Care
Jana Svetlichnaya, Munir Janmohammed, Teresa De Marco
Despite rapid advances in medical therapy, pregnancy and right ventricular (RV) failure predicts a poor prognosis in patients with pulmonary arterial hypertension. Evidence-based therapy for pulmonary arterial hypertension should be initiated early in the disease course to decrease RV wall stress and prevent RV remodeling and fibrosis. In patients with acutely decompensated RV failure, an aggressive and multifaceted approach must be used; a thorough search for triggering factors for the decompensation is a key part of the successful management strategy...
August 2016: Cardiology Clinics
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