Pub Date : 2024-07-02DOI: 10.1016/j.crmic.2024.100039
Ahmad Jabri, Obadah Aqtash, Pedro Engel, Tiberio Frisoli, Mir Babar Basir
Late onset coronary occlusion post-transcatheter aortic valve replacement (TAVR) is a rare yet significant complication. We present an 85-year-old female with chest pain secondary to left main coronary artery obstruction eleven months post-TAVR. Angiography revealed a partial occlusion necessitating percutaneous coronary intervention. Despite initial challenges in engagement due to interaction with the TAVR valve, use of a dual lumen microcatheter facilitated successful stenting, resulting in resolution of the obstruction. This case underscores the diagnostic and therapeutic complexities of late coronary occlusion after TAVR, emphasizing the importance of vigilant recognition and innovative interventional strategies in optimizing patient outcomes.
{"title":"Challenging coronary access in a patient with delayed coronary obstruction following TAVR, facilitated by the use of a dual lumen microcatheter","authors":"Ahmad Jabri, Obadah Aqtash, Pedro Engel, Tiberio Frisoli, Mir Babar Basir","doi":"10.1016/j.crmic.2024.100039","DOIUrl":"https://doi.org/10.1016/j.crmic.2024.100039","url":null,"abstract":"<div><p>Late onset coronary occlusion post-transcatheter aortic valve replacement (TAVR) is a rare yet significant complication. We present an 85-year-old female with chest pain secondary to left main coronary artery obstruction eleven months post-TAVR. Angiography revealed a partial occlusion necessitating percutaneous coronary intervention. Despite initial challenges in engagement due to interaction with the TAVR valve, use of a dual lumen microcatheter facilitated successful stenting, resulting in resolution of the obstruction. This case underscores the diagnostic and therapeutic complexities of late coronary occlusion after TAVR, emphasizing the importance of vigilant recognition and innovative interventional strategies in optimizing patient outcomes.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100039"},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000352/pdfft?md5=4a8c305d4802f23c4459c7ddfa474f0e&pid=1-s2.0-S2950275624000352-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-02DOI: 10.1016/j.crmic.2024.100038
Sara Hazaveh , Zhongying Liu-An , Marian Vandyck-Acquah , Daniel Huq , Haroon Faraz
Spontaneous coronary vasospasm (SCV) can present as coronary stenosis on angiography. Undiagnosed thyrotoxicosis is a rare cause of SCV and patients with unclear history and workup presenting with unstable angina should have thyroid function tested.
{"title":"Coronary vasospasm masquerading as multivessel coronary artery disease in a patient with undiagnosed thyrotoxicosis","authors":"Sara Hazaveh , Zhongying Liu-An , Marian Vandyck-Acquah , Daniel Huq , Haroon Faraz","doi":"10.1016/j.crmic.2024.100038","DOIUrl":"https://doi.org/10.1016/j.crmic.2024.100038","url":null,"abstract":"<div><p>Spontaneous coronary vasospasm (SCV) can present as coronary stenosis on angiography. Undiagnosed thyrotoxicosis is a rare cause of SCV and patients with unclear history and workup presenting with unstable angina should have thyroid function tested.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100038"},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000340/pdfft?md5=9c57419b2728bbfc56ad67d1c39f4c21&pid=1-s2.0-S2950275624000340-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141542408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-28DOI: 10.1016/j.crmic.2024.100035
Francesco Moretti , Attilio Restivo , Irene Pescetelli , Angelina Vassileva , Luigi Fiocca , Paolo Canova
Percutaneous coronary interventions (PCI) in patients with prior coronary artery bypass grafting (CABG) could present significant challenges, especially when the navigation of arterial conduits is necessary. The selective cannulation of internal mammary artery (IMA) is the first step of these high-risk procedures, in which technical complexities and ischemic complications are frequently faced. Acknowledging the lack of pre-shaped guiding catheter alternatives, IMA cannulation is time and contrast–consuming and potentially dangerous, as both catheter probing and wiring attempts may threaten vessel integrity.
To address this unmet need we developed a novel, easy-to-use technique to achieve selective internal mammary artery (IMA) graft cannulation. Our method proposes to first engage the arterial graft by means of any diagnostic catheter, whose shape can be chosen according to the specific features of the graft. Afterwards, a 0.014-inch workhorse guidewire is advanced to the distal segment of the graft. A 5- or 6-French IM guiding catheter is finally tracked over the wire rail into the ostium to reach stable engagement, ensuring procedural success. This approach is applicable irrespective of access route (ipsilateral or contralateral, transradial or transfemoral), and ultimately reduces procedural complexities and ischemic risks associated with traditional practice. This method also promotes the adoption of smaller guide catheters, thus reducing the ischemic triggers during selective cannulation. Furthermore, it offers versatility in catheter selection and guidewire support, enhancing personalization to diverse patient anatomies and clinical scenarios.
By streamlining procedures and improving success rates, our technique represents a significant advancement in PCI via IMA grafts, promising safer and more efficient interventions for CABG patients.
对曾接受过冠状动脉旁路移植术(CABG)的患者进行经皮冠状动脉介入治疗(PCI)可能会面临巨大挑战,尤其是在需要引导动脉导管时。选择性插管乳内动脉(IMA)是这些高风险手术的第一步,其中经常面临技术复杂性和缺血性并发症。由于缺乏预成形的引导导管替代品,IMA 插管需要耗费大量时间和造影剂,而且具有潜在危险,因为导管探查和布线尝试都可能威胁血管完整性。为了满足这一尚未满足的需求,我们开发了一种新颖、易用的技术来实现选择性乳内动脉(IMA)移植插管。我们的方法建议首先通过任何诊断导管插入动脉移植物,导管的形状可根据移植物的具体特征进行选择。然后,将一根 0.014 英寸的工作导丝推进到移植物的远端。最后,一根 5 或 6 法分的 IM 导引导管穿过导线轨道进入骨膜,以达到稳定的接合,确保手术成功。这种方法适用于任何入路(同侧或对侧、经桡动脉或经股动脉),并最终降低了手术的复杂性和与传统做法相关的缺血风险。这种方法还有助于采用较小的导引导管,从而减少选择性插管时的缺血诱因。通过简化程序和提高成功率,我们的技术代表了经 IMA 移植物 PCI 的重大进步,有望为 CABG 患者提供更安全、更高效的介入治疗。
{"title":"Guiding the way: A seamless strategy for internal mammary artery cannulation","authors":"Francesco Moretti , Attilio Restivo , Irene Pescetelli , Angelina Vassileva , Luigi Fiocca , Paolo Canova","doi":"10.1016/j.crmic.2024.100035","DOIUrl":"https://doi.org/10.1016/j.crmic.2024.100035","url":null,"abstract":"<div><p>Percutaneous coronary interventions (PCI) in patients with prior coronary artery bypass grafting (CABG) could present significant challenges, especially when the navigation of arterial conduits is necessary. The selective cannulation of internal mammary artery (IMA) is the first step of these high-risk procedures, in which technical complexities and ischemic complications are frequently faced. Acknowledging the lack of pre-shaped guiding catheter alternatives, IMA cannulation is time and contrast–consuming and potentially dangerous, as both catheter probing and wiring attempts may threaten vessel integrity.</p><p>To address this unmet need we developed a novel, easy-to-use technique to achieve selective internal mammary artery (IMA) graft cannulation. Our method proposes to first engage the arterial graft by means of any diagnostic catheter, whose shape can be chosen according to the specific features of the graft. Afterwards, a 0.014-inch workhorse guidewire is advanced to the distal segment of the graft. A 5- or 6-French IM guiding catheter is finally tracked over the wire rail into the ostium to reach stable engagement, ensuring procedural success. This approach is applicable irrespective of access route (ipsilateral or contralateral, transradial or transfemoral), and ultimately reduces procedural complexities and ischemic risks associated with traditional practice. This method also promotes the adoption of smaller guide catheters, thus reducing the ischemic triggers during selective cannulation. Furthermore, it offers versatility in catheter selection and guidewire support, enhancing personalization to diverse patient anatomies and clinical scenarios.</p><p>By streamlining procedures and improving success rates, our technique represents a significant advancement in PCI via IMA grafts, promising safer and more efficient interventions for CABG patients.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100035"},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000315/pdfft?md5=22fba253b2ed2fbc9b4565c6e285211d&pid=1-s2.0-S2950275624000315-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141595478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-28DOI: 10.1016/j.crmic.2024.100037
Hannah Lee , Sudhi Tyagi , Paul Pearson , Peter Mason
Procedure-related stroke represents a major complication of transcatheter aortic valve replacement (TAVR). The Sentinel Cerebral Protection System is the only FDA-approved embolic protection device for TAVR and is intended for use via right radial access. As TAVR has become the preferred modality for aortic valve replacement, protection devices like Sentinel have been developed to reduce procedural complications; however, its use in aberrant aortic arch anatomy has not been previously reported. We present a case of successful Sentinel deployment and embolic protection via alternative left radial artery access in a patient with an aberrant right subclavian artery.
{"title":"Sentinel cerebral embolic protection device deployment in aberrant right subclavian artery via left radial artery access","authors":"Hannah Lee , Sudhi Tyagi , Paul Pearson , Peter Mason","doi":"10.1016/j.crmic.2024.100037","DOIUrl":"https://doi.org/10.1016/j.crmic.2024.100037","url":null,"abstract":"<div><p>Procedure-related stroke represents a major complication of transcatheter aortic valve replacement (TAVR). The Sentinel Cerebral Protection System is the only FDA-approved embolic protection device for TAVR and is intended for use via right radial access. As TAVR has become the preferred modality for aortic valve replacement, protection devices like Sentinel have been developed to reduce procedural complications; however, its use in aberrant aortic arch anatomy has not been previously reported. We present a case of successful Sentinel deployment and embolic protection via alternative left radial artery access in a patient with an aberrant right subclavian artery.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100037"},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000339/pdfft?md5=25f8b9af4ba72b3a2df62d738a796e71&pid=1-s2.0-S2950275624000339-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141542407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-26DOI: 10.1016/j.crmic.2024.100034
Saliha Erdem , Joe Aoun , Gerald Lawrie , Masroor Khan , Donnell K. Bowen , Nadeen Faza , Stephen H. Little , Sachin S. Goel
Hemolytic anemia following surgical mitral valve repair is rare, and the role of mitral transcatheter edge-to-edge repair (TEER) in its treatment is unknown. We present three cases of hemolytic anemia following surgical mitral valve repair treated with mitral TEER. All three patients experienced resolution of hemolysis after mitral TEER.
{"title":"Mitral transcatheter edge-to-edge repair as a treatment option for hemolytic anemia after surgical mitral valve repair: A report of three cases","authors":"Saliha Erdem , Joe Aoun , Gerald Lawrie , Masroor Khan , Donnell K. Bowen , Nadeen Faza , Stephen H. Little , Sachin S. Goel","doi":"10.1016/j.crmic.2024.100034","DOIUrl":"https://doi.org/10.1016/j.crmic.2024.100034","url":null,"abstract":"<div><p>Hemolytic anemia following surgical mitral valve repair is rare, and the role of mitral transcatheter edge-to-edge repair (TEER) in its treatment is unknown. We present three cases of hemolytic anemia following surgical mitral valve repair treated with mitral TEER. All three patients experienced resolution of hemolysis after mitral TEER.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100034"},"PeriodicalIF":0.0,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000303/pdfft?md5=b4a5b2856d5de8f6d6bc92632750e334&pid=1-s2.0-S2950275624000303-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141481256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-17DOI: 10.1016/j.crmic.2024.100033
Waseem Nosair , Merna Hussien , Monvadi B. Srichai , Carolina Valdiviezo , Gaby Weissman , Thomas E. MacGillivray , Lowell F. Satler , Ron Waksman , Brian C. Case , Nardos Temesgen
A 59-year-old male with incompletely treated aortic valve endocarditis from complicated methicillin-sensitive Staphylococcus aureus bacteremia presented with acute left lower-extremity osteomyelitis. He was found to have new large infected coronary artery aneurysms, which were confirmed by multimodality imaging. This case highlights key decision-making by the multidisciplinary team.
{"title":"Successful conservative management of large multivessel infected coronary artery pseudoaneurysms from complicated staphylococcal bacteremia","authors":"Waseem Nosair , Merna Hussien , Monvadi B. Srichai , Carolina Valdiviezo , Gaby Weissman , Thomas E. MacGillivray , Lowell F. Satler , Ron Waksman , Brian C. Case , Nardos Temesgen","doi":"10.1016/j.crmic.2024.100033","DOIUrl":"https://doi.org/10.1016/j.crmic.2024.100033","url":null,"abstract":"<div><p>A 59-year-old male with incompletely treated aortic valve endocarditis from complicated methicillin-sensitive Staphylococcus aureus bacteremia presented with acute left lower-extremity osteomyelitis. He was found to have new large infected coronary artery aneurysms, which were confirmed by multimodality imaging. This case highlights key decision-making by the multidisciplinary team.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"3 ","pages":"Article 100033"},"PeriodicalIF":0.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000297/pdfft?md5=1441521589f3ef981a569ca7b2d7cd16&pid=1-s2.0-S2950275624000297-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.crmic.2024.100030
Selcuk Ozturk, Ibrahim Halil Inanc, Huseyin Kandemir
Coronary stent dislodgement (CSD) during percutaneous coronary intervention is a rare complication nowadays, thanks to equipment design and stent technology improvements. Coronary calcification, inadequate lesion preparation and suboptimal stent expansion are some of the risk factors for the occurrence of CSD. On the other hand, complete dislodgement of a deployed coronary stent is extraordinarily rare and infrequently reported in the literature. Herein, we describe a complete CSD case after deployment in a severely calcified right coronary artery lesion and discuss strategies to prevent this severe complication.
{"title":"Complete dislodgement of a deployed coronary stent in a severely calcified lesion","authors":"Selcuk Ozturk, Ibrahim Halil Inanc, Huseyin Kandemir","doi":"10.1016/j.crmic.2024.100030","DOIUrl":"https://doi.org/10.1016/j.crmic.2024.100030","url":null,"abstract":"<div><p>Coronary stent dislodgement (CSD) during percutaneous coronary intervention is a rare complication nowadays, thanks to equipment design and stent technology improvements. Coronary calcification, inadequate lesion preparation and suboptimal stent expansion are some of the risk factors for the occurrence of CSD. On the other hand, complete dislodgement of a deployed coronary stent is extraordinarily rare and infrequently reported in the literature. Herein, we describe a complete CSD case after deployment in a severely calcified right coronary artery lesion and discuss strategies to prevent this severe complication.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"2 ","pages":"Article 100030"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000261/pdfft?md5=a58a951526befc22a623489bddad60f9&pid=1-s2.0-S2950275624000261-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141243412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.crmic.2024.100031
Juan Ignacio Damonte , Ignacio Miguel Seropian , Jose Gaspar Chas , Mariano Falconi , Marcio José Montenegro da Costa , Carla Romina Agatiello
Transcatheter valve-in-valve implantation has emerged as a viable alternative for treating degenerated bioprosthetic tricuspid valves. However, patients with Ebstein's anomaly, characterized by an enlarged right atrium, pose challenges due to difficulties in correct positioning and deployment of transcatheter valves, stemming from inadequate support and coaxial alignment. In our presented case report, we describe a tricuspid valve-in-valve procedure performed on a patient with Ebstein's anomaly and a significantly enlarged right atrium. A novel technique was employed to facilitate the advancement of the transcatheter heart valve within the degenerated bioprosthesis, ultimately ensuring the success of the intervention.
{"title":"Balloon occlusion of the inferior cava vein to prevent valve prolapse for transjugular tricuspid valve-in-valve","authors":"Juan Ignacio Damonte , Ignacio Miguel Seropian , Jose Gaspar Chas , Mariano Falconi , Marcio José Montenegro da Costa , Carla Romina Agatiello","doi":"10.1016/j.crmic.2024.100031","DOIUrl":"https://doi.org/10.1016/j.crmic.2024.100031","url":null,"abstract":"<div><p>Transcatheter valve-in-valve implantation has emerged as a viable alternative for treating degenerated bioprosthetic tricuspid valves. However, patients with Ebstein's anomaly, characterized by an enlarged right atrium, pose challenges due to difficulties in correct positioning and deployment of transcatheter valves, stemming from inadequate support and coaxial alignment. In our presented case report, we describe a tricuspid valve-in-valve procedure performed on a patient with Ebstein's anomaly and a significantly enlarged right atrium. A novel technique was employed to facilitate the advancement of the transcatheter heart valve within the degenerated bioprosthesis, ultimately ensuring the success of the intervention.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"2 ","pages":"Article 100031"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000273/pdfft?md5=5f369bdb87333002118c7b98b6ac6859&pid=1-s2.0-S2950275624000273-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141244915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.crmic.2024.100029
Veronica Speranza Vitiello , Cristiano Salvatore Zaccaria , Brunetto Alterini , Fabio Mori , Federico Mecacci , Pierluigi Stefàno , Carlo Di Mario , Daniela Poli
Background
Pregnancy in women with mechanical valves has a high risk of both valve thrombosis and bleeding.
Case summary
We describe the case of a pregnant woman developing thrombosis of a mechanical aortic valve causing severe aortic stenosis without heart failure symptoms. The pregnancy was managed with heparin, and a high dose of warfarin was restarted soon after delivery. One month later transesophageal echocardiogram showed dissolution of the thrombosis, with restoration of the transvalvular gradients present after implantation.
Conclusion
The management of pregnant patients with mechanical valves is complex and a multidisciplinary approach is essential.
{"title":"Case report: Management of mechanical aortic valve thrombosis during pregnancy","authors":"Veronica Speranza Vitiello , Cristiano Salvatore Zaccaria , Brunetto Alterini , Fabio Mori , Federico Mecacci , Pierluigi Stefàno , Carlo Di Mario , Daniela Poli","doi":"10.1016/j.crmic.2024.100029","DOIUrl":"https://doi.org/10.1016/j.crmic.2024.100029","url":null,"abstract":"<div><h3>Background</h3><p>Pregnancy in women with mechanical valves has a high risk of both valve thrombosis and bleeding.</p></div><div><h3>Case summary</h3><p>We describe the case of a pregnant woman developing thrombosis of a mechanical aortic valve causing severe aortic stenosis without heart failure symptoms. The pregnancy was managed with heparin, and a high dose of warfarin was restarted soon after delivery. One month later transesophageal echocardiogram showed dissolution of the thrombosis, with restoration of the transvalvular gradients present after implantation.</p></div><div><h3>Conclusion</h3><p>The management of pregnant patients with mechanical valves is complex and a multidisciplinary approach is essential.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"2 ","pages":"Article 100029"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S295027562400025X/pdfft?md5=a9c1c233931ed6f1570ead66cf0f8aa5&pid=1-s2.0-S295027562400025X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141243411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-21DOI: 10.1016/j.crmic.2024.100028
Gabriel Maluenda , Daniel Aguirre , Cristian Baeza
Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart disease due to the abnormal origin of the left coronary artery from the pulmonary artery. When this condition is not diagnosed nor surgically corrected on time, most patients do not survive childhood. We report a 58-year-old woman who presented with angina and new-onset atrial fibrillation as a delayed manifestation of ALCAPA syndrome. Following surgical intervention, the patient has experienced a satisfactory long-term survival.
{"title":"New onset atrial fibrillation and angina pectoris as late manifestation of anomalous origin of left coronary artery from pulmonary artery (ALCAPA)","authors":"Gabriel Maluenda , Daniel Aguirre , Cristian Baeza","doi":"10.1016/j.crmic.2024.100028","DOIUrl":"https://doi.org/10.1016/j.crmic.2024.100028","url":null,"abstract":"<div><p>Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart disease due to the abnormal origin of the left coronary artery from the pulmonary artery. When this condition is not diagnosed nor surgically corrected on time, most patients do not survive childhood. We report a 58-year-old woman who presented with angina and new-onset atrial fibrillation as a delayed manifestation of ALCAPA syndrome. Following surgical intervention, the patient has experienced a satisfactory long-term survival.</p></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"2 ","pages":"Article 100028"},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950275624000248/pdfft?md5=a49730003e23383ed6da4e8b21f21af6&pid=1-s2.0-S2950275624000248-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}