IHJ Cardiovascular Case Reports (CVCR)最新文献

Transcatheter aortic valve replacement (TAVR) is now the standard of therapy for elderly population with severe aortic stenosis. Several studies have established that the outcomes of TAVR are superior when compared with Surgical aortic valve replacement (SAVR), especially when the access route is transfemoral arterial approach. In the elderly population with advanced age and numerous comorbidities, iliofemoral arterial disease (IAD) is not uncommon and it precludes the use of this route for TAVR. Peripheral Intravascular lithotripsy (IVL) has been previously established as an excellent safe and efficient modality to treat symptomatic occlusive calcific iliofemoral artery disease. The same principle of IVL has been recently used successfully to modify the vascular compliance of heavily calcified iliofemoral arteries thereby enabling large bore sheath advancement and safe passage of TAVR delivery catheter systems.

We report the first case of Intravascular lithotripsy facilitated Transfemoral TAVR (TF-TAVR) in India. This case was done in December 2020 by the “femoral route” in order to keep the TAVR procedure simple straightforward and discharge the patient back home quickly in Covid times. The use of Intravascular Lithotripsy (IVL)was based on evidence of good outcomes in trials of peripheral vascular disease of lower limbs as well as from the good outcomes of few registries on IVL facilitated TAVR.^{1,2,3,4,5,6,8} The second case was done in August 2021 by us for another patient successfully.

Left main coronary artery atresia (LMCAA) is a rare coronary anomaly. Usually they present with myocardial ischemia/infarction, heart failure, syncope due to ventricular arrhythmias or sudden death. Diagnosis is confirmed by CT or invasive coronary angiography. We are presenting two cases of LMCAA, who underwent off-pump coronary artery bypass surgery.

Drug induced pericarditis is a well described entity, most commonly described secondary to hydralazine, procainamide and isoniazid. Cardiac involvement after systemic retinoic acid therapy is exceedingly rare. Here we describe a case of myopericarditis secondary to isotretinoin intake, with prompt resolution after drug discontinuation.

Ruptured sinus of Valsalva aneurysm (RSVA) is a rare entity. Its association with severe coarctation of aorta (CoA) in the setting of bicuspid aortic valve is very rare. We hereby report simultaneous transcatheter device closure of RSVA and coarctoplasty with stent implantation in adult male with bicuspid aortic valve with intermediate follow-up.

The aim was to study the feasibility and real-world experience of the use of rotating mechanical cutting tool for extraction of infected or externalized device leads. A total of 13 leads in 7 patients were extracted using this tool. The resistance was found at different levels: subclavian-superior vena cava junction, tricuspid annulus and lead tip. Two patients needed 2 incisions. Wound closure with drain was done in same sitting in 5 patients while delayed closure was done in 2 patients. No peri or post procedure complications were encountered in this series of patients.

Transcatheter closure of sinus venous Atrial Septal Defect (SVASD) was proving to be safe and effective with accumulating evidence. We report 3 cases of successful transcatheter closure of SVASD with indigenous reproducible technique without need for advanced imagining techniques with favourable outcomes. Three patients aged 27,42 and 44 years underwent successful closure of SVASD using self-expandable Endurant™ II stent graft (Medtronic) after undergoing pre-procedure successful balloon occlusion of Superior Vena Cava (SVC) without obstructing right upper pulmonary vein (RUPV) drainage. We used fluoroscopy, Trans-esophageal echocardiography (TEE) and marker pigtail for guiding measurements to choose appropriate stent size. One patient developed cardiac tamponade requiring surgical removal of stent with surgical closure of the defect.

Stent thrombosis following percutaneous trans-luminal renal angioplasty [PTRA] for renal artery involvement secondary to Takayasu's arteritis is a serious medical emergency, requiring early detection and urgent intervention to prevent permanent kidney injury. The incidence of renal artery involvement in Takayasu's arteritis is 8–38%. The involvement of the renal artery is identified as a poor prognostic factor as it leads to renal artery stenosis, renovascular hypertension that is often highly resistant to antihypertensive therapy and subsequent, hypertensive emergency and renal failure.

We report a case of a young woman who had the complete thrombotic occlusion of the renal artery secondary to stent thrombosis which required an emergency PTRA and the implantation of a drug-eluting stent to restore the flow in a single functioning kidney in the setting of Takayasu's arteritis induced renal artery stenosis.

Right ventricular outflow tract tachycardia is a type of monomorphic VT which originates from the outflow tract of the right ventricle or occasionally from the tricuspid annulus. It usually occurs in structurally normal heart but can also occur in patients with structural heart disease. A 45 year old male was referred to our hospital for EP study and RF ablation. Patient had multiple episodes of palpitations in the past 1 month and these were diagnosed as episode of ventricular tachycardia which were reverted each time with Direct Current Cardioversion in another hospital. Patient was diagnosed as case of RVOT VT, Double Chamber Right Ventricle, outlet VSD (restrictive) with RVOT aneurysm. He was managed conservatively and advised surgical repair.