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ventricular thrombus anticoagulation

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https://www.readbyqxmd.com/read/28918617/right-ventricular-thrombosis-combined-with-fetal-death-and-acrocyanosis-in-pregnancy
#1
Feridoun Sabzi, Aghigh Heidari
Prepartum or postpartum right ventricular thrombosis (RVT) is an exceedingly rare and potentially lethal phenomenon in pregnancy. We here report a case of a pregnant patient with near term pregnancy admitted for dyspnea, amniotic fluids discharge and labor pain in a gynecology center that an eight-month dead fetus was diagnosed and delivered vaginally by induction. A post delivery period was complicated by aggravation of her dyspnea and pleuritic chest pain that she referred for further evaluation in our cardiac center...
July 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28891451/fibrinolytic-and-anticoagulation-therapy-in-patients-undergoing-ultrasound-assisted-catheter-directed-thrombolysis-for-pulmonary-embolism
#2
Kimberly Terry, Leo F Buckley, Ahmed Aldemerdash, John Fanikos, Heather Dell Orfano
BACKGROUND: Ultrasound-assisted, catheter-directed thrombolysis (UA-CDT) relieves right ventricular stress without a significant increase in the risk of bleeding compared to systemic thrombolysis. Although concomitant anticoagulation is provided to prevent thrombus expansion, the optimal anticoagulation regimen in patients receiving UA-CDT remains unknown. OBJECTIVE: We sought to describe anticoagulation practices for patients receiving UA-CDT. METHODS: Patients receiving UA-CDT for acute pulmonary embolism (PE) between Jan 1, 2013 to Sept 30, 2014 at a single center were analyzed...
September 7, 2017: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/28844524/mechanical-thrombectomy-for-pediatric-acute-stroke-and-ventricular-assist-device
#3
Robert Clinton Stowe, Peter Kan, Day Burruss Breen, Sonika Agarwal
BACKGROUND: Certain pediatric populations have increased risk of ischemic strokes, including those with cardiac disease and those dependent on mechanical circulatory devices such as ventricular assist devices. Due to their need for chronic anticoagulation, patients with mechanical circulatory devices are not candidates for systemic thrombolysis and thus treatment of acute ischemic stroke is limited. CASE: A 9-year-old boy with a ventricular assist device presented with acute onset of dense right hemiparesis, global aphasia, and a pediatric NIHSS score of 23...
August 24, 2017: Brain & Development
https://www.readbyqxmd.com/read/28818863/detection-of-left-ventricular-thrombus-by-cardiac-magnetic-resonance-in-embolic-stroke-of-undetermined-source
#4
Junji Takasugi, Hiroshi Yamagami, Teruo Noguchi, Yoshiaki Morita, Tomotaka Tanaka, Yoshinori Okuno, Satoshi Yasuda, Kazunori Toyoda, Yasufumi Gon, Kenichi Todo, Manabu Sakaguchi, Kazuyuki Nagatsuka
BACKGROUND AND PURPOSE: We aimed to use contrast-enhanced cardiac magnetic resonance (CE-CMR) imaging to elucidate the prevalence of left ventricular (LV) thrombus in patients suspected of embolic stroke of undetermined source (ESUS) with previous myocardial infarction or LV dysfunction (LV ejection fraction [LVEF] <50%). METHODS: We prospectively investigated 797 consecutive patients who presented to our hospital with acute ischemic stroke between 2014 and 2015...
September 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28817542/safety-of-transesophageal-echocardiography%C3%A2-guided-electrical-cardioversion-in-patients-with-atrial-fibrillation-and-inadequate-anticoagulation
#5
Joanna Zaprutko, Artur Baszko, Michał Michalak, Karol Kochman, Radosław Szymański, Jan Kłopocki, Anna Nowicka, Rafał Dankowski, Marek Michalski, Piotr Kałmucki, Andrzej Szyszka
INTRODUCTION    Restoring sinus rhythm in patients with atrial fibrillation (AF)/atrial flutter (AFl) requires adequate oral anticoagulation prior to direct current cardioversion (DCC). Some patients eligible for DCC are not properly anticoagulated. OBJECTIVES    The aim of the study was to assess risk factors for thrombus and spontaneous echo contrast (SEC) in the left atrium (LA) as well as the safety profile of transesophageal echocardiography (TEE)-guided DCC in patients with inadequate anticoagulation...
August 9, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28799449/the-impact-of-the-latest-echocardiographic-chamber-quantification-recommendations-on-the-prediction-of-left-atrial-appendage-thrombus-presence-by-transthoracic-echocardiography
#6
Karolina Kupczynska, Jaroslaw D Kasprzak, Blazej W Michalski, Dawid L Miskowiec, Piotr Lipiec
INTRODUCTION: The latest recommendations for echocardiographic chamber quantification have implemented updated normal values for all cardiac chambers. PURPOSE: To evaluate the incidence of normal and abnormal values of routine echocardiographic parameters such as left ventricular ejection fraction (LVEF) and left atrial volume indexed to body surface area (LAVi) in patients with non-valvular atrial fibrillation (AF) and to determine the influence of LVEF and LAVi reclassification on the prediction of LAAT by transthoracic echocardiography...
August 11, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28765479/early-intracardiac-thrombus-and-pulmonary-embolus-after-trauma
#7
Neel Desai, Julia Heid, Andrew Leitch
Here, we present the case of a patient with the findings of an early intracardiac thrombus and a pulmonary embolus after major trauma. A large clot was identified extending from the inferior vena cava into the right atrium and ventricle in the setting of preserved right ventricular function. Post-traumatic intracardiac thrombus is extremely rare and no comparable cases have previously been described in the absence of a congenital heart defect and obvious myocardial injury. Best practice afterpost-traumatic intracardiac thrombus is not well established but we found that early inferior vena cava filter placement and treatment with therapeutic coagulation resulted in clinical improvement, resolution of the thrombus and no further emboli...
July 31, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28673899/outcomes-and-prognostic-impact-of-prophylactic-oral-anticoagulation-in-anterior-st-segment-elevation-myocardial-infarction-patients-with-left-ventricular-dysfunction
#8
Jay S Shavadia, Erik Youngson, Kevin R Bainey, Jeffrey Bakal, Robert C Welsh
BACKGROUND: The contemporary role of prophylactic anticoagulation following extensive anterior wall ST-segment myocardial infarction (STEMI) is unclear. METHODS AND RESULTS: We evaluated anterior STEMI patients with left ventricle dysfunction (left ventricular ejection fraction ≤40%) ("high risk"), categorized by prophylactic warfarin use, within a regional STEMI. Patients with pre-existing atrial fibrillation were excluded. The primary outcome was an adjusted (for Global Registry of Acute Coronary Events risk score) 1-year composite of recurrent ischemia, stroke/transient ischemic attack/systemic embolism, or all-cause death...
July 3, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28673245/takotsubo-cardiomyopathy-complicated-with-apical-thrombus-formation-on-first-day-of-the-illness-a-case-report-and-literature-review
#9
H M M T B Herath, S P Pahalagamage, Laura C Lindsay, S Vinothan, Sampath Withanawasam, Vajira Senarathne, Milinda Withana
BACKGROUND: Takotsubo cardiomyopathy is characterized by transient systolic dysfunction of the apical and mid segments of the left ventricle in the absence of obstructive coronary artery disease. Intraventricular thrombus formation is a rare complication of Takotsubo cardiomyopathy and current data almost exclusively consists of isolated case reports and a few case series. Here we describe a case of Takotsubo cardiomyopathy with formation of an apical thrombus within 24 h of symptom onset, which has been reported in the literature only once previously, to the best of our knowledge...
July 3, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28664012/cerebral-infarction-arising-from-takotsubo-cardiomyopathy-case-report-and-literature-review
#10
Yoshihiro Otani, Koji Tokunaga, Satoshi Kawauchi, Satoshi Inoue, Kyoichi Watanabe, Hideki Kiriyama, Kosuke Sakane, Kiyoaki Maekawa, Isao Date, Kengo Matsumoto
Although most patients with takotsubo cardiomyopathy have a favorable outcome, complications are not uncommon. Recent studies have reported an increase in incidence of cardioembolic complications; however, the association between takotsubo cardiomyopathy and stroke, in particular thromboembolic cerebral infarction, remains unclear. We reported a 44-year-old woman who had a cerebral infarction resulting from takotsubo cardiomyopathy. She had felt chest discomfort a few days prior to infarction, and later developed left hemiparesis...
October 2016: NMC Case Rep J
https://www.readbyqxmd.com/read/28635023/risk-stratification-of-patients-with-left-atrial-appendage-thrombus-prior-to-catheter-ablation-of-atrial-fibrillation-an-approach-towards-an-individualized-use-of-transesophageal-echocardiography
#11
Melanie A Gunawardene, Jannis Dickow, Benjamin N Schaeffer, Ruken Ö Akbulak, Marc Lemoine, Jana M Nührich, Mario Jularic, Christoph Sinning, Christian Eickholt, Christian Meyer, Julia M Moser, Boris A Hoffmann, Stephan Willems
INTRODUCTION: The need for transesophageal echocardiography (TEE) before catheter ablation of atrial fibrillation (CA-AF) is still being questioned. The aim of this study is to analyze patients' (pts) risk factors of left atrial appendage thrombus (LAAT) prior to CA-AF in daily clinical practice, according to oral anticoagulation (OAC) strategies recommended by current guidelines. METHODS AND RESULTS: All pts scheduled for CA-AF from 01/2015-12/2016 in our center were included and either treated with NOACs (novel-OAC; paused 24-hours pre-ablation) or continuous vitamin K-antagonists (INR 2...
June 21, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28616561/left-atrial-appendage-function-assessment-and-thrombus-identification
#12
Jacek Kurzawski, Agnieszka Janion-Sadowska, Marcin Sadowski
BACKGROUND: The diagnosis of thrombus in the left atrium in patients with persistent atrial fibrillation (AF) and may be inconsistent because of variability in thrombus morphology. In some cases it is challenging and requires unusual approach. New Doppler-derived methods might be helpful to identify such thrombi. We evaluated quantitative differences in mechanical function of the left atrial appendage (LAA) basal segments using tissue Doppler imaging (TDI)and speckle tracking echocardiography (STE) in patients with non-valvular AF with and without LAA thrombus and compared them with SR patients...
March 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/28595772/prevention-of-early-complications-and-late-consequences-after-acute-pulmonary-embolism-focus-on-reperfusion-techniques
#13
Stavros V Konstantinides, Stefano Barco
Pulmonary embolism (PE) is a major cause of acute cardiovascular mortality and long-term morbidity. Right ventricular (RV) dysfunction is the key determinant of prognosis in the acute phase of PE, and residual RV dysfunction is associated with the development of post-PE functional impairment, chronic thromboembolic disease, and higher costs of treatment over the long term. Patients with clinically overt RV failure, i.e. hemodynamic collapse at presentation (high-risk PE), necessitate immediate thrombolytic treatment to relieve the obstruction in the pulmonary circulation; surgical or catheter-directed removal of the thrombus can be an alternative option...
June 1, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28546529/the-safety-of-electrical-cardioversion-under-the-control-of-transesophageal-echocardiography-in-patients-with-atrial-fibrillation-and-inadequate-anticoagulation
#14
Joanna Zaprutko, Artur Baszko, Michał Michalak, Karol Kochman, Radosław Szymański, Jan Kłopocki, Anna Nowicka, Rafał Dankowski, Marek Michalski, Piotr Kałmucki, Andrzej Szyszka
INTRODUCTION    Restoring sinus rhythm in patients with atrial fibrillation (AF)/atrial flutter (AF) requires adequate oral anticoagulation (OAC) prior to direct current cardioversion (DCC). Some patients eligible for DCC are not properly anticoagulated. OBJECTIVES    Assessment of risk factors for thrombus and spontaneous echo contrast (SEC) in the left atrium (LA) as well as the safety profile of DCC under transesophageal echocardiography control (TEE) in patients with inadequate anticoagulation. PATIENTS AND METHODS    From the cohort of 316 patients admitted for DCC, 139 (age 63...
May 25, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28540312/rivaroxaban-as-an-antithrombotic-agent-in-a-patient-with-st-segment-elevation-myocardial-infarction-and-left-ventricular-thrombus-a-case-report
#15
Rajeev Seecheran, Valmiki Seecheran, Sangeeta Persad, Naveen Anand Seecheran
The incidence of left ventricular (LV) thrombi in the setting of an anterior myocardial infarction has declined significantly since the advent of primary percutaneous coronary intervention coupled with contemporary antithrombotic strategies in ST-segment elevation myocardial infarctions (STE-ACS). Despite oral anticoagulation with the currently accepted, standard-of-care vitamin K antagonist, warfarin, major bleeding complications still arise. Rivaroxaban is a novel, direct oral factor X anticoagulant that has several advantageous properties, which can attenuate bleeding risk...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28501493/prophylactic-warfarin-post-anterior-st-elevation-myocardial-infarction-a-systematic-review-and-meta-analysis
#16
Nathaniel Moulson, Stephen A LaHaye, Olivier F Bertrand, Jimmy MacHaalany
OBJECTIVES: To determine the role of warfarin (WF) prophylaxis in the prevention of left ventricular thrombus (LVT) formation and subsequent embolic complications following an anterior ST elevation myocardial infarction (STEMI) complicated by reduced left ventricular ejection fraction (LVEF) and wall motion abnormalities. BACKGROUND: The role of oral anticoagulation prophylaxis, in addition to dual antiplatelet therapy (DAPT), in the current era of percutaneous coronary intervention has not been well studied, despite being a class IIb recommendation in the AHA/ACC STEMI guidelines...
May 9, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28488003/daily-transient-discontinuation-of-extracorporeal-lvad-to-prevent-thromboembolism-of-mechanical-aortic-valve-prosthesis
#17
Takamichi Inoue, Tadashi Kitamura, Shinzo Torii, Mitsuhiro Hirata, Toshiaki Mishima, Koichi Sughimoto, Hirotoki Ohkubo, Kensuke Kobayashi, Mamika Motokawa, Miyuki Shibata, Takuya Matsushiro, Yuta Tsuchida, Yurie Miyata, Minoru Ono, Kagami Miyaji
Patients with mechanical aortic valves are generally contraindicated for left ventricular assist device (LVAD) insertion because the prosthetic valve often becomes fixed in closed position. A 41-year-old woman with mechanical aortic valve prosthesis experienced sudden chest pain and developed cardiogenic shock. A paracorporeal pulsatile LVAD and a monopivot centrifugal pump as a right VAD (RVAD) were implanted. The mechanical aortic valve was intentionally left in place. Soon after the operation, LVAD support was discontinued daily for few seconds to allow the mechanical aortic valve to open and to avoid thrombus formation...
May 9, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28453794/blood-flow-competition-after-aortic-valve-bypass-an-evaluation-using-computational-fluid-dynamics
#18
Koji Kawahito, Naoyuki Kimura, Kenji Komiya, Masanori Nakamura, Yoshio Misawa
OBJECTIVES: Aortic valve bypass (AVB) (apico-aortic conduit) remains an effective surgical alternative for patients in whom surgical aortic valve replacement or transcatheter aortic valve implantation is not feasible. However, specific complications include thrombus formation, possibly caused by stagnation arising from flow competition between the antegrade and retrograde flow, but this has not been fully investigated. The aim of this study was to analyse flow characteristics after AVB and to elucidate mechanisms of intra-aortic thrombus using computational fluid dynamics (CFD)...
May 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28430391/analysis-of-pulmonary-embolus-size-at-the-time-of-recurrence-compared-with-presentation-a-single-centre-retrospective-study
#19
W Thomas, O Firth, M Besser, M Beveridge, T Baglin
Essentials Size of pulmonary embolus (PE) at the time of recurrence compared with first event is unstudied. In a retrospective cohort of patients we compared PE size at recurrence versus the initial PE. Rates of massive PE at recurrence were low whether the first PE was massive or unmassive. Studies to determine PE size and severity at recurrence when anticoagulation is stopped are needed. SUMMARY: Background The size of recurrent pulmonary embolus (PE) in relation to a prior event could be a factor in deciding whether to continue anticoagulation...
July 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28396990/incidence-and-outcomes-of-early-left-ventricular-thrombus-following-st-elevation-myocardial-infarction-treated-with-primary-percutaneous-coronary-intervention
#20
Shafik Khoury, Sarit Carmon, Gilad Margolis, Gad Keren, Yacov Shacham
BACKGROUND: Since the advent of primary percutaneous coronary intervention (PCI), studies have reported a declining incidence of left ventricular thrombus (LVT) following ST-elevation myocardial infarction (STEMI). We investigated the incidence and outcomes of early (pre-discharge) LVT in the contemporary era of PCI practice in a large cohort of STEMI patients. METHODS: We retrospectively studied 2071 consecutive STEMI patients who underwent successful primary PCI...
April 10, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
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