Pub Date : 2023-04-07DOI: 10.3897/bgcardio.29.e100372
D. Kyuchukov
Percutaneous coronary revascularization of the „culprit“ lesion is the most contemporary method of treating patients with acute coronary syndrome (ACS) of all forms. In the management of acute ST-elevation myocardial infarction (STEMI), cardiac surgery remains, in most cases, a third option following PCI and thrombolysis, nevertheless serves an important role in a select subgroups of patients. This review will discuss current indications and potentiality of cardiac surgery in the treatment of patients with STEMI.
{"title":"The role of cardiac surgery in the treatment of acute coronary syndrome with stelevation","authors":"D. Kyuchukov","doi":"10.3897/bgcardio.29.e100372","DOIUrl":"https://doi.org/10.3897/bgcardio.29.e100372","url":null,"abstract":"Percutaneous coronary revascularization of the „culprit“ lesion is the most contemporary method of treating patients with acute coronary syndrome (ACS) of all forms. In the management of acute ST-elevation myocardial infarction (STEMI), cardiac surgery remains, in most cases, a third option following PCI and thrombolysis, nevertheless serves an important role in a select subgroups of patients. This review will discuss current indications and potentiality of cardiac surgery in the treatment of patients with STEMI.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41476012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-07DOI: 10.3897/bgcardio.29.e100441
I. Bayraktarova, G. Vladimirov, H. Mateev, A. Alexandrov, E. Trendafilova
Anaemia at admission is a known predictor of death in patients with myocardial infarction with ST-elevation (STEMI). Data on the effect of anaemia on the prognosis in patients with non-ST-elevation myocardial infarction (NSTEMI) is less readily available. Purpose: We aimed to evaluate the frequency of anaemia in a Bulgarian tertiary centre NSTEMI patient population, and its effect on the immediate and extended prognosis of the patients. Methods: We performed ambispective analysis of 138 consecutive patients with NSTEMI, and anaemia was defi ned as haemoglobin at admission below 120 g/L for females and below 130 g/L for males. Results: There was no signifi cant difference in the frequencies of standard risk factors between patients with and without anaemia. Anaemic patients tended to be older, with lower body mass index and worse kidney function. Patients with baseline anaemia tended to have higher GRACE risk scores and a larger size of the realised myocardial infarction as judged by maximal reached troponin I. There was no signifi cant difference in interventional treatment in both groups. Median hospital stay was signifi cantly longer in anaemic patients and was marked by more complications. Despite a lack of increase in inhospital bleeding and no difference in treatment with oral antiaggregants, patients with anaemia received haemotransfusion treatment more often. Mortality rate was higher in anaemic patients both during the index hospitalization and during the follow up. Conclusion: Anaemia at admission is associated with an increased risk of both in hospital cardiovascular complications and after dehospitalisation all-cause mortality in patients with NSTEMI and should be considered as an additional risk factor in the global risk assessment of patients.
{"title":"Impact of baseline anemia on the short- and long-term prognosis of patients presenting with non-ST-elevation myocardial infarction","authors":"I. Bayraktarova, G. Vladimirov, H. Mateev, A. Alexandrov, E. Trendafilova","doi":"10.3897/bgcardio.29.e100441","DOIUrl":"https://doi.org/10.3897/bgcardio.29.e100441","url":null,"abstract":"Anaemia at admission is a known predictor of death in patients with myocardial infarction with ST-elevation (STEMI). Data on the effect of anaemia on the prognosis in patients with non-ST-elevation myocardial infarction (NSTEMI) is less readily available. Purpose: We aimed to evaluate the frequency of anaemia in a Bulgarian tertiary centre NSTEMI patient population, and its effect on the immediate and extended prognosis of the patients. Methods: We performed ambispective analysis of 138 consecutive patients with NSTEMI, and anaemia was defi ned as haemoglobin at admission below 120 g/L for females and below 130 g/L for males. Results: There was no signifi cant difference in the frequencies of standard risk factors between patients with and without anaemia. Anaemic patients tended to be older, with lower body mass index and worse kidney function. Patients with baseline anaemia tended to have higher GRACE risk scores and a larger size of the realised myocardial infarction as judged by maximal reached troponin I. There was no signifi cant difference in interventional treatment in both groups. Median hospital stay was signifi cantly longer in anaemic patients and was marked by more complications. Despite a lack of increase in inhospital bleeding and no difference in treatment with oral antiaggregants, patients with anaemia received haemotransfusion treatment more often. Mortality rate was higher in anaemic patients both during the index hospitalization and during the follow up. Conclusion: Anaemia at admission is associated with an increased risk of both in hospital cardiovascular complications and after dehospitalisation all-cause mortality in patients with NSTEMI and should be considered as an additional risk factor in the global risk assessment of patients.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48156019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-07DOI: 10.3897/bgcardio.29.e98397
E. Dimitrova, E. Trendafilova, S. Nateva, S. Georgieva, E. Kostova, G. Hristova, A. Alexandrov, H. Mateev, G. Vladimirov
Introduction: COVID-19 pandemic has led to a signifi cant change in the incidence and prognosis of acute myocardial infarction (AMI) by indirect and direct mechanisms. Aim: To assess the impact of the COVID-19 pandemic on the incidence and prognosis of AMI. Material and methods: We performed a retrospective analysis of consecutive patients with AMI (STEMI and NSTEMI) during two time periods – the complete lockdown in Bulgaria and one of the waves of the pandemic. We compared patients’ risk profi le, index event, investigations and treatment to a control group from the pre-pandemic period. Results: During the fi rst period we included 52 patients with AMI without COVID-19 and compared them to a control group of 66 patients. We found a decrease primarily in the number of patients with STEMI. The scores for assessing diseaseseverity (GRACE, APACHE II, SOFA) were higher in 2020 compared to the pre-pandemic period. More patients presented with acute congestive heart failure, mortality was similar. During the second period we included 83 patients, 21 of them with COVID-19 infection. System delay was increased in all patients. Disease severity scores and baseline troponin were higher especially in the COVID-19 group. In-hospital mortality was substantially higher in patients with COVID-19 compared to controls (23,8% versus 9%, р = 0,0375), probably due to increased incidence of cardiogenic shock and need for mechanical ventilation. Conclusion: During the complete lockdown there was a reduction in the number of patients admitted with AMI, higher incidence of acute congestive heart failure and similar mortality. During one of the waves of the pandemic we found a signifi cant increase in system delay, not exceeding the recommended time frame of 120 minutes, and in disease severity in all patients. Concomitant COVID-19 infection was associated with higher in-hospital mortality due to increased incidence of cardiogenic shock and need for mechanical ventilation.
{"title":"Impact of the COVID-19 pandemic on the incidence and prognosis of acute myocardial infarction - a single-center restrospective analysis","authors":"E. Dimitrova, E. Trendafilova, S. Nateva, S. Georgieva, E. Kostova, G. Hristova, A. Alexandrov, H. Mateev, G. Vladimirov","doi":"10.3897/bgcardio.29.e98397","DOIUrl":"https://doi.org/10.3897/bgcardio.29.e98397","url":null,"abstract":"Introduction: COVID-19 pandemic has led to a signifi cant change in the incidence and prognosis of acute myocardial infarction (AMI) by indirect and direct mechanisms. Aim: To assess the impact of the COVID-19 pandemic on the incidence and prognosis of AMI. Material and methods: We performed a retrospective analysis of consecutive patients with AMI (STEMI and NSTEMI) during two time periods – the complete lockdown in Bulgaria and one of the waves of the pandemic. We compared patients’ risk profi le, index event, investigations and treatment to a control group from the pre-pandemic period. Results: During the fi rst period we included 52 patients with AMI without COVID-19 and compared them to a control group of 66 patients. We found a decrease primarily in the number of patients with STEMI. The scores for assessing diseaseseverity (GRACE, APACHE II, SOFA) were higher in 2020 compared to the pre-pandemic period. More patients presented with acute congestive heart failure, mortality was similar. During the second period we included 83 patients, 21 of them with COVID-19 infection. System delay was increased in all patients. Disease severity scores and baseline troponin were higher especially in the COVID-19 group. In-hospital mortality was substantially higher in patients with COVID-19 compared to controls (23,8% versus 9%, р = 0,0375), probably due to increased incidence of cardiogenic shock and need for mechanical ventilation. Conclusion: During the complete lockdown there was a reduction in the number of patients admitted with AMI, higher incidence of acute congestive heart failure and similar mortality. During one of the waves of the pandemic we found a signifi cant increase in system delay, not exceeding the recommended time frame of 120 minutes, and in disease severity in all patients. Concomitant COVID-19 infection was associated with higher in-hospital mortality due to increased incidence of cardiogenic shock and need for mechanical ventilation.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41968314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-07DOI: 10.3897/bgcardio.29.e101955
N. Gotcheva
The last 120 years have witnessed famous physicians and pathologists connected their medical investigation to study pathophysiology, diagnostics and treatment of acute myocardial infarction (AMI). Modern treatment algorithms based on precise and refi ned new technologies have as a main target to achieve rapid reperfusion and salvage threatened myocardium in order to enhance patients’ recovery and also to decrease mortality rate. Although long-lasting and multiple studies appeared to have impressive results, there still exist unknown or disputable viewpoints/concepts concerning for example the appearance of the reperfusion injuries, left ventricular remodeling, AMI in patients with normal coronary arteries, identifi cation of vulnerable lesions or plaques which are threatened by rupture or fi ssuring. This short historical review is aimed to remind us the evolution of the AMI knowledge and also to pull out some of the forgotten but relevant milestone hypothesis, as well as to help shaping the modern management of AMI.
{"title":"Acute myocardial infarction – a historical review","authors":"N. Gotcheva","doi":"10.3897/bgcardio.29.e101955","DOIUrl":"https://doi.org/10.3897/bgcardio.29.e101955","url":null,"abstract":"The last 120 years have witnessed famous physicians and pathologists connected their medical investigation to study pathophysiology, diagnostics and treatment of acute myocardial infarction (AMI). Modern treatment algorithms based on precise and refi ned new technologies have as a main target to achieve rapid reperfusion and salvage threatened myocardium in order to enhance patients’ recovery and also to decrease mortality rate. Although long-lasting and multiple studies appeared to have impressive results, there still exist unknown or disputable viewpoints/concepts concerning for example the appearance of the reperfusion injuries, left ventricular remodeling, AMI in patients with normal coronary arteries, identifi cation of vulnerable lesions or plaques which are threatened by rupture or fi ssuring. This short historical review is aimed to remind us the evolution of the AMI knowledge and also to pull out some of the forgotten but relevant milestone hypothesis, as well as to help shaping the modern management of AMI.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48285403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-31DOI: 10.3897/bgcardio.28.e93473
B. Kunev, V. Vasilev, G. Vladimirov, V. Karabinov
We present a clinical case of a 70-year-old woman who was urgently admitted to the Department of Neurology with threatening status epilepticus from simple motor seizures in the right half of the face and right hand. Computed tomography of the head visualized a calcified extra axial round formation in the left posterofrontal, possibly a meningioma. On admission and during the symptomatic attacks, dynamic ECG changes were recorded with negative T waves precordially, as well as a dynamic increase in serum troponin. Echocardiography revealed hypokinesia involving the middle segments of the left ventricle. Coronary angiography was performed with no evidence of coronary disease. From the ventriculography hypokinesia of middle segments was found and measured EF 47%. Complex therapy with valproate, dexamethasone, mannitol and clonazepam, levetiracetam, acetizal, a statin and a beta-blocker was initiated. After controlling the epileptic seizures and diagnostic work-up of the cardiovascular status, the patient was referred for neurosurgical treatment of the tumor formation.
{"title":"Midventricular variant of Takotsubo syndrome in a patient with threatening status epilepticus from simple motor seizures","authors":"B. Kunev, V. Vasilev, G. Vladimirov, V. Karabinov","doi":"10.3897/bgcardio.28.e93473","DOIUrl":"https://doi.org/10.3897/bgcardio.28.e93473","url":null,"abstract":"We present a clinical case of a 70-year-old woman who was urgently admitted to the Department of Neurology with threatening status epilepticus from simple motor seizures in the right half of the face and right hand. Computed tomography of the head visualized a calcified extra axial round formation in the left posterofrontal, possibly a meningioma. On admission and during the symptomatic attacks, dynamic ECG changes were recorded with negative T waves precordially, as well as a dynamic increase in serum troponin. Echocardiography revealed hypokinesia involving the middle segments of the left ventricle. Coronary angiography was performed with no evidence of coronary disease. From the ventriculography hypokinesia of middle segments was found and measured EF 47%. Complex therapy with valproate, dexamethasone, mannitol and clonazepam, levetiracetam, acetizal, a statin and a beta-blocker was initiated. After controlling the epileptic seizures and diagnostic work-up of the cardiovascular status, the patient was referred for neurosurgical treatment of the tumor formation.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46610067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-31DOI: 10.3897/bgcardio.28.e93503
R. Grigorov, P. Panayotov, D. Panayotova, I. Borisov
Left ventricle pseudoaneurysm is a rare but serious complication, most often secondary to myocardial infarction. It is associated with high mortality due to a significant risk of rupture. We present a case of a patient with a large basal pseudoaneurysm of the lateral wall of the left ventricle. The pseudoaneurysm is discovered from a chest radiography performed after a COVID-19 infection. The diagnosis is confirmed by echocardiography and ventriculography. The patient underwent surgical treatment by endoventricular patch plasty – Dor procedure. The patient in our case lacked the typical symptoms and ECG features, furthermore he had no history of myocardial infarction, cardiac surgery, trauma or endocarditis.
{"title":"Basal pseudoaneurysm of the lateral wall of the left ventricle – case report","authors":"R. Grigorov, P. Panayotov, D. Panayotova, I. Borisov","doi":"10.3897/bgcardio.28.e93503","DOIUrl":"https://doi.org/10.3897/bgcardio.28.e93503","url":null,"abstract":"Left ventricle pseudoaneurysm is a rare but serious complication, most often secondary to myocardial infarction. It is associated with high mortality due to a significant risk of rupture. We present a case of a patient with a large basal pseudoaneurysm of the lateral wall of the left ventricle. The pseudoaneurysm is discovered from a chest radiography performed after a COVID-19 infection. The diagnosis is confirmed by echocardiography and ventriculography. The patient underwent surgical treatment by endoventricular patch plasty – Dor procedure. The patient in our case lacked the typical symptoms and ECG features, furthermore he had no history of myocardial infarction, cardiac surgery, trauma or endocarditis.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46748964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-31DOI: 10.3897/bgcardio.28.e97871
R. Georgiev, S. Bakalska-Georgieva, A. Angelov
A patient was admitted to our institution with a diagnosis of a cardiac tumor, most likely myxoma, in the right atrium, detected at echocardiography. The cardio-magnetic resonance examination was performed and depicts a homogeneous fatty content, fatty proliferation and hypertrophy along the wall of the right atrium and the interatrial septum, sparing the oval fossa and mimicking a tumor with a filling defect and with slight compression of the inferior and superior vena cava. With the help of double and triple inversion techniques, magnetic resonance imaging can give a tissue-specific diagnosis, in this case a fat-equivalent lesion of the type of lipoma or lipomatous hypertrophy, and thus save additional studies and predetermine the therapeutic approach.
{"title":"Massive lipomatous hypertrophy of the interatrial septum and the wall of the right atrium mimicking a cardiac tumor (myxoma)","authors":"R. Georgiev, S. Bakalska-Georgieva, A. Angelov","doi":"10.3897/bgcardio.28.e97871","DOIUrl":"https://doi.org/10.3897/bgcardio.28.e97871","url":null,"abstract":"A patient was admitted to our institution with a diagnosis of a cardiac tumor, most likely myxoma, in the right atrium, detected at echocardiography. The cardio-magnetic resonance examination was performed and depicts a homogeneous fatty content, fatty proliferation and hypertrophy along the wall of the right atrium and the interatrial septum, sparing the oval fossa and mimicking a tumor with a filling defect and with slight compression of the inferior and superior vena cava. With the help of double and triple inversion techniques, magnetic resonance imaging can give a tissue-specific diagnosis, in this case a fat-equivalent lesion of the type of lipoma or lipomatous hypertrophy, and thus save additional studies and predetermine the therapeutic approach.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45978541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-31DOI: 10.3897/bgcardio.28.e90366
B. Dobreva-Yatseva, F. Nikolov, R. Raycheva, M. Tokmakova
Infective endocarditis (IE) is a disease of the endocardium of the heart and the endocardium of the great vessels, with infection affecting heart valves (native or prosthetic) and subvalvular structures and, in the last few decades, indwelling intracardiac devices or catheters. It is a life-threatening disease with a wide distribution worldwide. IE was first described 350 years ago, but it continues to be a huge challenge for doctors for several reasons. First – IE is a changing disease. Nowadays, the profile of patients with IE has significantly changed in terms of age, predisposing factors, microbiological causative agent, clinical picture, complications, therapeutic approach. Second, despite modern imaging and microbiological methods, diagnostics often encounter serious difficulties and delays. Third, the improvement in medical and surgical treatment in recent decades has not changed the rates of mortality and severe complications. Knowing the current profile of patients with IE helps in timely and accurate diagnosis, which is key to starting adequate treatment. Early identification of high-risk patients is important for the therapeutic approach, especially when deciding on operative treatment. This is associated with a reduction in in-hospital mortality and an improvement in the long-term prognosis of patients.
{"title":"Infectious endocarditis – current profile","authors":"B. Dobreva-Yatseva, F. Nikolov, R. Raycheva, M. Tokmakova","doi":"10.3897/bgcardio.28.e90366","DOIUrl":"https://doi.org/10.3897/bgcardio.28.e90366","url":null,"abstract":"Infective endocarditis (IE) is a disease of the endocardium of the heart and the endocardium of the great vessels, with infection affecting heart valves (native or prosthetic) and subvalvular structures and, in the last few decades, indwelling intracardiac devices or catheters. It is a life-threatening disease with a wide distribution worldwide. IE was first described 350 years ago, but it continues to be a huge challenge for doctors for several reasons. First – IE is a changing disease. Nowadays, the profile of patients with IE has significantly changed in terms of age, predisposing factors, microbiological causative agent, clinical picture, complications, therapeutic approach. Second, despite modern imaging and microbiological methods, diagnostics often encounter serious difficulties and delays. Third, the improvement in medical and surgical treatment in recent decades has not changed the rates of mortality and severe complications. Knowing the current profile of patients with IE helps in timely and accurate diagnosis, which is key to starting adequate treatment. Early identification of high-risk patients is important for the therapeutic approach, especially when deciding on operative treatment. This is associated with a reduction in in-hospital mortality and an improvement in the long-term prognosis of patients.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42210269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-31DOI: 10.3897/bgcardio.28.e96612
I. Todorov
Patients with Marfan syndrome often have severe life-threatening cardiovascular complications, including aortic aneurysmal dilatation or aortic dissection. Approximately two-thirds of people who have this syndrome suffer from chest wall deformities such as pectus excavatum (cobbler's chest) or pectus carinatum (bird's chest). When a patient with cobbler's chest requires aortic root surgery, the operator may face a major clinical challenge in selecting the optimal surgical access and approach. We present a case of a patient with Marfan syndrome and severe pectus excavatum who underwent aortic valve replacement, aortic root and ascending aorta reconstruction, coronary artery reimplantation (Bentall de Bono procedure ) via upper partial L-sternotomy and anterior left thoracotomy.
{"title":"Aortic surgery in a patient with Marfan's syndrome and pectus excavatum (shoemaker's chest)","authors":"I. Todorov","doi":"10.3897/bgcardio.28.e96612","DOIUrl":"https://doi.org/10.3897/bgcardio.28.e96612","url":null,"abstract":"Patients with Marfan syndrome often have severe life-threatening cardiovascular complications, including aortic aneurysmal dilatation or aortic dissection. Approximately two-thirds of people who have this syndrome suffer from chest wall deformities such as pectus excavatum (cobbler's chest) or pectus carinatum (bird's chest). When a patient with cobbler's chest requires aortic root surgery, the operator may face a major clinical challenge in selecting the optimal surgical access and approach. We present a case of a patient with Marfan syndrome and severe pectus excavatum who underwent aortic valve replacement, aortic root and ascending aorta reconstruction, coronary artery reimplantation (Bentall de Bono procedure ) via upper partial L-sternotomy and anterior left thoracotomy.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47126357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-30DOI: 10.3897/bgcardio.28.e97338
A. Partenova, D. Kostova-Lefterova, K. Genova
In recent decades, cardiac magnetic resonance imaging (CMR) has been established as a valuable tool in the diagnosis of patients with or at risk of heart failure. With its ability to characterize tissue changes in the myocardium, CMR can provide detailed and clinically useful information about the type and severity of cardiac damage. The method is not only important for differentiation of ischemic from non-ischemic cardiomyopathy, but also contributes to the correct diagnosis of non-ischemic cardiomyopathy subtypes. It is also widely accepted as a reference standard for the quantification of myocardial mass, volumes and ejection fraction. The purpose of this article is to review the role of CMR in the diagnosis and treatment of non-ischemic cardiomyopathies.
{"title":"Role of cardiac magnetic resonance imaging in the diagnosis of nonischemic cardiomyopathies","authors":"A. Partenova, D. Kostova-Lefterova, K. Genova","doi":"10.3897/bgcardio.28.e97338","DOIUrl":"https://doi.org/10.3897/bgcardio.28.e97338","url":null,"abstract":"In recent decades, cardiac magnetic resonance imaging (CMR) has been established as a valuable tool in the diagnosis of patients with or at risk of heart failure. With its ability to characterize tissue changes in the myocardium, CMR can provide detailed and clinically useful information about the type and severity of cardiac damage. The method is not only important for differentiation of ischemic from non-ischemic cardiomyopathy, but also contributes to the correct diagnosis of non-ischemic cardiomyopathy subtypes. It is also widely accepted as a reference standard for the quantification of myocardial mass, volumes and ejection fraction. The purpose of this article is to review the role of CMR in the diagnosis and treatment of non-ischemic cardiomyopathies.","PeriodicalId":33976,"journal":{"name":"B''lgarska kardiologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43289891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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