To our knowledge, this is the largest unresected anterolateral papillary muscle lipoma, in an asymptomatic patient, followed up for three years since diagnosis.
据我们所知，这是最大的未切除的前外侧乳头状肌脂肪瘤，患者无症状，自诊断后随访三年。
{"title":"Three-year Follow-up of Unresected Large Anterolateral Papillary Muscle Lipoma","authors":"Faye Miranda, Richie Pilapil, Simonette Kristine Sawit","doi":"10.31762/ahj2231.0202","DOIUrl":"https://doi.org/10.31762/ahj2231.0202","url":null,"abstract":"To our knowledge, this is the largest unresected anterolateral papillary muscle lipoma, in an asymptomatic patient, followed up for three years since diagnosis.","PeriodicalId":72307,"journal":{"name":"ASEAN heart journal : Official journal of the ASEAN Federation of Cardiology","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82302122","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}
Rainier John S. Buensalida, N. Pecache, Kristina Marie Michelle O. Rivera, V. Lazaro, S. Sawit
A 76-year-old female was admitted for new onset angina and diagnosed with a rare single coronary anomaly detected by coronary computed tomography angiography. Coronary computed tomography angiography also revealed mild coronary atherosclerosis with no significant stenoses. The patient was managed conservatively with beta blocker, ACE inhibitor and statins. She was discharged improved and remains asymptomatic on follow up. Keywords coronary artery anomaly; single coronary artery; CCTA
{"title":"Single Coronary Anomaly detected by Coronary Computed Tomography Angiography in an Elderly Female with Angina","authors":"Rainier John S. Buensalida, N. Pecache, Kristina Marie Michelle O. Rivera, V. Lazaro, S. Sawit","doi":"10.31762/ahj2231.0203","DOIUrl":"https://doi.org/10.31762/ahj2231.0203","url":null,"abstract":"A 76-year-old female was admitted for new onset angina and diagnosed with a rare single coronary anomaly detected by coronary computed tomography angiography. Coronary computed tomography angiography also revealed mild coronary atherosclerosis with no significant stenoses. The patient was managed conservatively with beta blocker, ACE inhibitor and statins. She was discharged improved and remains asymptomatic on follow up. Keywords coronary artery anomaly; single coronary artery; CCTA","PeriodicalId":72307,"journal":{"name":"ASEAN heart journal : Official journal of the ASEAN Federation of Cardiology","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84849023","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}
Selvaratnam Veena, Bee Sun Lee, S. Jameela, K. Pau
The management of acute coronary syndromes (ACSs) among adult patients with severe hemophilia A remains a clinical challenge, due to the use of anti-platelet, anti-thrombotic agents and/or revascularization procedures in them. We report here a case of severe hemophilia A presented with acute non-ST elevation myocardial infarction (NSTEMI), with incidental finding of coronary artery aneurysms (CAA), requiring an open-heart surgery. He successfully underwent a combined coronary artery bypass grafting (CABG) and closure of right coronary artery giant aneurysm with factor VIII (FVIII) replacement therapy, without bleeding complications nor requiring blood product transfusion. His FVIII activity level was maintained above 100% during the operation and 72 hours post-operatively. Thereafter, the FVIII coverage was reduced to maintain a trough level above 50% for another 1-week before switching back to his prophylactic dose. No inhibitor was detected. He was put on dual anti-platelets for 6 months, in which was reduced to single anti-platelet until today with no occurrence of chest pain. This case highlighted the occurrence of NSTEMI as a consequence of underlying CAA and its management challenge during the open-heart surgery.
{"title":"Giant Coronary Artery Aneurysm in a Severe Hemophilia A with Acute Coronary Syndrome: A Case Report and Brief Literature Review","authors":"Selvaratnam Veena, Bee Sun Lee, S. Jameela, K. Pau","doi":"10.31762/ahj2231.0104","DOIUrl":"https://doi.org/10.31762/ahj2231.0104","url":null,"abstract":"The management of acute coronary syndromes (ACSs) among adult patients with severe hemophilia A remains a clinical challenge, due to the use of anti-platelet, anti-thrombotic agents and/or revascularization procedures in them. We report here a case of severe hemophilia A presented with acute non-ST elevation myocardial infarction (NSTEMI), with incidental finding of coronary artery aneurysms (CAA), requiring an open-heart surgery. He successfully underwent a combined coronary artery bypass grafting (CABG) and closure of right coronary artery giant aneurysm with factor VIII (FVIII) replacement therapy, without bleeding complications nor requiring blood product transfusion. His FVIII activity level was maintained above 100% during the operation and 72 hours post-operatively. Thereafter, the FVIII coverage was reduced to maintain a trough level above 50% for another 1-week before switching back to his prophylactic dose. No inhibitor was detected. He was put on dual anti-platelets for 6 months, in which was reduced to single anti-platelet until today with no occurrence of chest pain. This case highlighted the occurrence of NSTEMI as a consequence of underlying CAA and its management challenge during the open-heart surgery.","PeriodicalId":72307,"journal":{"name":"ASEAN heart journal : Official journal of the ASEAN Federation of Cardiology","volume":"43 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87681893","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}
I. D. Nugraha, Tao Fan, R. Dewangga, S. Adiarto, S. Indriani
BACKGROUND Dengue infection has become a major public health problem with significant socioeconomic burden to the increasing geographical extension, number of cases, and severity of the disease. One of the neglected complications in dengue is venous thromboembolism (VTE) which could also be as fatal is often overlooked in the overall management of dengue. OBJECTIVE This study aimed to provide a perspective on the incidence of thromboembolism in patients with dengue infection. METHODS The search strategy was conducted through PubMed and LinkSpringer. About 182 articles were retrieved using ‘vein thrombosis’ and ‘dengue’ keywords. Further, screening was carried out and resulted in 15 articles. In the end, five articles were included. To be eligible, the articles should be published from 2011-2121 and published in English. RESULTS This review found that VTE can occur in dengue patients of all ages, genders, and severities. VTE is more common in dengue shock syndrome patient rather than dengue haemorrhagic fever or least likely in dengue fever. Administering Anticoagulants is still the preferred option in managing VTE in dengue patients with caution of the thrombocyte count of patients. CONCLUSIONS The likeliness of VTE occurrence is linear with the severity of the dengue infection and the patient’s length of stay in hospitals. Preventive measures could be taken to prevent VTE in high-risk dengue patients, thus it is important to do risk scoring in high-risk patients. Thrombocytopenia must be taken into account when realizing said preventive measure, i.e., administering anticoagulant as prophylaxis.
{"title":"The Incidence of Venous Thromboembolism in Dengue Viral Infections: A Systematic Review","authors":"I. D. Nugraha, Tao Fan, R. Dewangga, S. Adiarto, S. Indriani","doi":"10.31762/ahj2231.0103","DOIUrl":"https://doi.org/10.31762/ahj2231.0103","url":null,"abstract":"BACKGROUND Dengue infection has become a major public health problem with significant socioeconomic burden to the increasing geographical extension, number of cases, and severity of the disease. One of the neglected complications in dengue is venous thromboembolism (VTE) which could also be as fatal is often overlooked in the overall management of dengue. OBJECTIVE This study aimed to provide a perspective on the incidence of thromboembolism in patients with dengue infection. METHODS The search strategy was conducted through PubMed and LinkSpringer. About 182 articles were retrieved using ‘vein thrombosis’ and ‘dengue’ keywords. Further, screening was carried out and resulted in 15 articles. In the end, five articles were included. To be eligible, the articles should be published from 2011-2121 and published in English. RESULTS This review found that VTE can occur in dengue patients of all ages, genders, and severities. VTE is more common in dengue shock syndrome patient rather than dengue haemorrhagic fever or least likely in dengue fever. Administering Anticoagulants is still the preferred option in managing VTE in dengue patients with caution of the thrombocyte count of patients. CONCLUSIONS The likeliness of VTE occurrence is linear with the severity of the dengue infection and the patient’s length of stay in hospitals. Preventive measures could be taken to prevent VTE in high-risk dengue patients, thus it is important to do risk scoring in high-risk patients. Thrombocytopenia must be taken into account when realizing said preventive measure, i.e., administering anticoagulant as prophylaxis.","PeriodicalId":72307,"journal":{"name":"ASEAN heart journal : Official journal of the ASEAN Federation of Cardiology","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74742760","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}
Philippe Ryan K. Chung, Emma Y. Gaspar-Trinidad, T. Razon-Cuenza, L. Cuenza
Midventricular obstruction (MVO) is a rare phenotypic subvariant of hypertrophic cardiomyopathy (HCM). It occurs in 1-10% of patients and due to its rarity, its clinical progression and natural history has not yet been extensively studied. However, the available data has shown it to have worse clinical outcomes and prognosis. While reports on hypertrophic cardiomyopathy has been published in the Philippines, there has been no data on this particular variant in the local literature. We identified 3 cases of hypertrophic cardiomyopathy with midventricular obstruction. 2 cases were initially managed as a case of ischemic heart disease who were ruled out after undergoing cardiac magnetic resonance. One case was initially admitted due to a stroke however, an incidental finding on 2D Echo noted the presence of HCM. He also underwent cardiac magnetic resonance which revealed the full extent of his disease. All 3 patients were also found to have apical aneurysms due to ischemia from the pressure coming from the obstruction. Hypertrophic cardiomyopathy is the most common genetic cardiovascular disease but its subvariants are rare and difficult to diagnose. Apical aneurysms are also often missed on 2D Echo. However, cardiac magnetic resonance provides increased detection of the disease with better detailing of the extent and severity. It could also provide information regarding prognostication with regards to arrhythmias and sudden cardiac death. More data however is needed so new avenues for research are open on its application.
{"title":"A Case Series on Hypertrophic Cardiomyopathy with Midventricular Obstruction and Apical Aneurysm","authors":"Philippe Ryan K. Chung, Emma Y. Gaspar-Trinidad, T. Razon-Cuenza, L. Cuenza","doi":"10.31762/ahj2231.0102","DOIUrl":"https://doi.org/10.31762/ahj2231.0102","url":null,"abstract":"Midventricular obstruction (MVO) is a rare phenotypic subvariant of hypertrophic cardiomyopathy (HCM). It occurs in 1-10% of patients and due to its rarity, its clinical progression and natural history has not yet been extensively studied. However, the available data has shown it to have worse clinical outcomes and prognosis. While reports on hypertrophic cardiomyopathy has been published in the Philippines, there has been no data on this particular variant in the local literature. We identified 3 cases of hypertrophic cardiomyopathy with midventricular obstruction. 2 cases were initially managed as a case of ischemic heart disease who were ruled out after undergoing cardiac magnetic resonance. One case was initially admitted due to a stroke however, an incidental finding on 2D Echo noted the presence of HCM. He also underwent cardiac magnetic resonance which revealed the full extent of his disease. All 3 patients were also found to have apical aneurysms due to ischemia from the pressure coming from the obstruction. Hypertrophic cardiomyopathy is the most common genetic cardiovascular disease but its subvariants are rare and difficult to diagnose. Apical aneurysms are also often missed on 2D Echo. However, cardiac magnetic resonance provides increased detection of the disease with better detailing of the extent and severity. It could also provide information regarding prognostication with regards to arrhythmias and sudden cardiac death. More data however is needed so new avenues for research are open on its application.","PeriodicalId":72307,"journal":{"name":"ASEAN heart journal : Official journal of the ASEAN Federation of Cardiology","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82508045","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}
Herawati Isnanijah, Chyntia Monica, I. Trisnawaty, Y. B. Juwana, D. Firman
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV‑2) causing coronavirus disease 2019 (COVID-19) has reached pandemic levels by March 2020. Patients with cardiovascular disease, particularly with cardiac injury represent a vulnerable population and increased risk of mortality and morbidity. There is still no guidelines for management of cardiovascular disease during the COVID-19 pandemic. CASE ILLUSTRATION An unconscious 52-year-old male brought to ER with complaints of abdominal discomfort and nausea. The patient had a cardiac arrest in ER and ROSC was obtained. The patient was intubated ECG showed anterior STEMI and primary PCI was performed. The endotracheal tube was changed due to blockage of excessive and thick slime. Tracheostomy was performed. Bronchoscopy was performed and found tracheal mucosal edema, hyperemic and easily bleed; mucous plug and blood clots in the tip of tracheostomy cannula. Thoracic CT-Scan showed ground-glass appearance and fibrosis of the 6th thoracic dextra segment. PCR SARS-CoV-2 showed reactive. The patient was discharged from our hospital after three weeks with clinically stable and referred to COVID-19 center hospital nearby his home for another two weeks. After PCR SARS CoV-2 was performed twice showed negative results, the patient was discharged. CONCLUSION SARS-CoV‑2 infection may lead to acute myocardial injury through viral systemic inflammation, although specific mechanism remained uncertain. A thick mucus plaque and stool cell may be a specific clinical features in COVID-19 patients. Tracheostomy has a continuing role in managing weaning from extended periods of mechanical ventilation during the COVID-19 pandemic.
{"title":"Case Report: Stemi With Covid-19","authors":"Herawati Isnanijah, Chyntia Monica, I. Trisnawaty, Y. B. Juwana, D. Firman","doi":"10.31762/ahj2130.0204","DOIUrl":"https://doi.org/10.31762/ahj2130.0204","url":null,"abstract":"BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV‑2) causing coronavirus disease 2019 (COVID-19) has reached pandemic levels by March 2020. Patients with cardiovascular disease, particularly with cardiac injury represent a vulnerable population and increased risk of mortality and morbidity. There is still no guidelines for management of cardiovascular disease during the COVID-19 pandemic. CASE ILLUSTRATION An unconscious 52-year-old male brought to ER with complaints of abdominal discomfort and nausea. The patient had a cardiac arrest in ER and ROSC was obtained. The patient was intubated ECG showed anterior STEMI and primary PCI was performed. The endotracheal tube was changed due to blockage of excessive and thick slime. Tracheostomy was performed. Bronchoscopy was performed and found tracheal mucosal edema, hyperemic and easily bleed; mucous plug and blood clots in the tip of tracheostomy cannula. Thoracic CT-Scan showed ground-glass appearance and fibrosis of the 6th thoracic dextra segment. PCR SARS-CoV-2 showed reactive. The patient was discharged from our hospital after three weeks with clinically stable and referred to COVID-19 center hospital nearby his home for another two weeks. After PCR SARS CoV-2 was performed twice showed negative results, the patient was discharged. CONCLUSION SARS-CoV‑2 infection may lead to acute myocardial injury through viral systemic inflammation, although specific mechanism remained uncertain. A thick mucus plaque and stool cell may be a specific clinical features in COVID-19 patients. Tracheostomy has a continuing role in managing weaning from extended periods of mechanical ventilation during the COVID-19 pandemic.","PeriodicalId":72307,"journal":{"name":"ASEAN heart journal : Official journal of the ASEAN Federation of Cardiology","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80736872","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}
R. Ong, Maria Stephanie Alessa R. Sales-Florentino, Frederick H. Verano, R. Castro, Jillian Mae L. Tabora-Lacdao, R. Lapitan
We report the first VA-VAV-VV ECMO conversion in a 57-year-old Filipino female with persistent coronary insufficiency from toxic shock syndrome due to Streptococcus pyogenes bacteremia, acute respiratory distress syndrome, and Harlequin syndrome with progressive acute limb ischemia from cone snail venom poisoning. The patient came in via air ambulance transport because deteriorating clinical status after having stepped on a cone snail 3 days prior and developing severe dehydration from vomiting and passage of voluminous watery stools after eating a local delicacy. The patient was admitted at the ICU where after 3 days of treatment, the patient developed cardiac tamponade and underwent stat pleuropericardial windowing with pericardiocentesis. Due to increasing pressor requirements from the combined shock, Swan-Ganz catheterization was inserted and a VA-ECMO system was set up. There was gradual improvement in cardiac hemodynamics, however oxygen requirement was increasing and both lower extremities became progressively violaceous with decreasing pulses. Harlequin syndrome was ruled in, the multidisciplinary team decided to convert to VAV hybrid circuit by adding a venous access by way of the right internal jugular vein. Improvement in oxygenation lead to eventual conversion from VAV to purely VV dedicated circuit. Ultrafiltration via ECMO was likewise done because of worsening azotemia and oliguria. The patient was then gradually weaned off from ECMO and was successfully decannulated after 8 days. Below knee amputation was done to address the progressive acute limb ischemia. The patient was nutritionally built up and physically rehabilitated and was eventually discharged improved on the 28th hospital day.
{"title":"Successful Decannulation of Hybrid ECMO Circuitry: The First Philippine Experience","authors":"R. Ong, Maria Stephanie Alessa R. Sales-Florentino, Frederick H. Verano, R. Castro, Jillian Mae L. Tabora-Lacdao, R. Lapitan","doi":"10.31762/ahj2130.0201","DOIUrl":"https://doi.org/10.31762/ahj2130.0201","url":null,"abstract":"We report the first VA-VAV-VV ECMO conversion in a 57-year-old Filipino female with persistent coronary insufficiency from toxic shock syndrome due to Streptococcus pyogenes bacteremia, acute respiratory distress syndrome, and Harlequin syndrome with progressive acute limb ischemia from cone snail venom poisoning. The patient came in via air ambulance transport because deteriorating clinical status after having stepped on a cone snail 3 days prior and developing severe dehydration from vomiting and passage of voluminous watery stools after eating a local delicacy. The patient was admitted at the ICU where after 3 days of treatment, the patient developed cardiac tamponade and underwent stat pleuropericardial windowing with pericardiocentesis. Due to increasing pressor requirements from the combined shock, Swan-Ganz catheterization was inserted and a VA-ECMO system was set up. There was gradual improvement in cardiac hemodynamics, however oxygen requirement was increasing and both lower extremities became progressively violaceous with decreasing pulses. Harlequin syndrome was ruled in, the multidisciplinary team decided to convert to VAV hybrid circuit by adding a venous access by way of the right internal jugular vein. Improvement in oxygenation lead to eventual conversion from VAV to purely VV dedicated circuit. Ultrafiltration via ECMO was likewise done because of worsening azotemia and oliguria. The patient was then gradually weaned off from ECMO and was successfully decannulated after 8 days. Below knee amputation was done to address the progressive acute limb ischemia. The patient was nutritionally built up and physically rehabilitated and was eventually discharged improved on the 28th hospital day.","PeriodicalId":72307,"journal":{"name":"ASEAN heart journal : Official journal of the ASEAN Federation of Cardiology","volume":"318 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81458128","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}
B. Toledano, Maria Johanna Jaluage-Villanueva, S. Lacson
PURPOSE The gap in evidence in the management of multivalvular lesions can be addressed by providing more data on clinical and echocardiographic outcomes after Percutaneous Mitral commissurotomy (PMC). METHODS Participants were Filipinos aged >/= 19 years old, admitted due to severe mitral stenosis with moderate to severe tricuspid regurgitation (TR). The outcome of PMC was divided into 2 groups: Significant TR which included the progression of moderate to severe TR or persistence of severe TR and Insignificant TR group which included those with mild TR, regression to moderate to mild TR, severe to moderate, or persistence of moderate TR. These groups were compared from baseline, 24th hour, 1st month, and 6th month using the same echocardiographic parameters. The numerical data between significant and nonsignificant tricuspid regurgitation were compared using non-parametric Mann Whitney U test and categorical data using the Chi-Square test. RESULTS A total of 38 participants were analyzed. On the 24th-hour post- PTMC, the Significant TR group had significantly higher RAVI (42.3 vs 26.1, p=.004), RVD mid (3.81 vs 2.92, p=.001), SPAP (60.5 vs 38.5, p=.003), and RVOT (2.8 vs 2.2, p=.001) and lower MV planimetry (1.25 vs 1.58, p=.009); On the 1st-month RVD mid (3.4 vs 2.8, p=.02) and TV annulus (3.35 vs 2.76, p=0.10) were significantly higher in the Significant TR group; On the 6th month RAVI (59 vs 24.7, p=.001), RVD mid (4 vs 2.73, p=.006), and TV annulus (4.5 vs 2.67 p=.001) were significantly higher in the Significant TR group when compared to Insignificant TR group. CONCLUSION PMC improved baseline parameters of SPAP, MV planimetry, MV gradient, and functional class on short-term follow-up on both groups of TR. Majority of outcomes after the procedure had insignificant TR. However, those with significant TR had higher RVD mid and TV annulus from the 24th hour to 6 months when compared to the insignificant TR group.
目的:通过提供更多经皮二尖瓣合并术(PMC)后的临床和超声心动图结果数据，可以解决多瓣病变治疗的证据差距。方法参与者为菲律宾人，年龄bb0 /= 19岁，因严重二尖瓣狭窄合并中度至重度三尖瓣反流(TR)入院。PMC结果分为两组:显著TR组，包括中度至重度TR进展或重度TR持续;不显著TR组，包括轻度TR、回归到中度至轻度TR、重度至中度TR或中度TR持续。使用相同的超声心动图参数，从基线、24小时、1个月和6个月比较这些组。显著和非显著三尖瓣反流的数值数据采用非参数Mann Whitney U检验，分类数据采用卡方检验。结果共分析了38名参与者。PTMC后24小时，显著TR组RAVI (42.3 vs 26.1, p= 0.004)、RVD mid (3.81 vs 2.92, p= 0.001)、SPAP (60.5 vs 38.5, p= 0.003)、RVOT (2.8 vs 2.2, p= 0.003)显著升高，MV平面度(1.25 vs 1.58, p= 0.009)显著降低;在第1个月RVD中期(3.4 vs 2.8, p= 0.02)和TV环(3.35 vs 2.76, p=0.10)，显著TR组显著升高;在第6个月，显著TR组的RAVI (59 vs 24.7, p=.001)、RVD mid (4 vs 2.73, p=.006)和TV环(4.5 vs 2.67 p=.001)明显高于不显著TR组。结论PMC改善了两组TR患者短期随访的SPAP、MV平面度、MV梯度和功能分类基线参数，术后大多数TR不显著，但TR显著者在24小时至6个月的RVD中期和TV环空高于TR不显著组。
{"title":"Outcomes of Tricuspid Regurgitation after Percutaneous Mitral Commissurotomy","authors":"B. Toledano, Maria Johanna Jaluage-Villanueva, S. Lacson","doi":"10.31762/ahj2130.0203","DOIUrl":"https://doi.org/10.31762/ahj2130.0203","url":null,"abstract":"PURPOSE The gap in evidence in the management of multivalvular lesions can be addressed by providing more data on clinical and echocardiographic outcomes after Percutaneous Mitral commissurotomy (PMC). METHODS Participants were Filipinos aged >/= 19 years old, admitted due to severe mitral stenosis with moderate to severe tricuspid regurgitation (TR). The outcome of PMC was divided into 2 groups: Significant TR which included the progression of moderate to severe TR or persistence of severe TR and Insignificant TR group which included those with mild TR, regression to moderate to mild TR, severe to moderate, or persistence of moderate TR. These groups were compared from baseline, 24th hour, 1st month, and 6th month using the same echocardiographic parameters. The numerical data between significant and nonsignificant tricuspid regurgitation were compared using non-parametric Mann Whitney U test and categorical data using the Chi-Square test. RESULTS A total of 38 participants were analyzed. On the 24th-hour post- PTMC, the Significant TR group had significantly higher RAVI (42.3 vs 26.1, p=.004), RVD mid (3.81 vs 2.92, p=.001), SPAP (60.5 vs 38.5, p=.003), and RVOT (2.8 vs 2.2, p=.001) and lower MV planimetry (1.25 vs 1.58, p=.009); On the 1st-month RVD mid (3.4 vs 2.8, p=.02) and TV annulus (3.35 vs 2.76, p=0.10) were significantly higher in the Significant TR group; On the 6th month RAVI (59 vs 24.7, p=.001), RVD mid (4 vs 2.73, p=.006), and TV annulus (4.5 vs 2.67 p=.001) were significantly higher in the Significant TR group when compared to Insignificant TR group. CONCLUSION PMC improved baseline parameters of SPAP, MV planimetry, MV gradient, and functional class on short-term follow-up on both groups of TR. Majority of outcomes after the procedure had insignificant TR. However, those with significant TR had higher RVD mid and TV annulus from the 24th hour to 6 months when compared to the insignificant TR group.","PeriodicalId":72307,"journal":{"name":"ASEAN heart journal : Official journal of the ASEAN Federation of Cardiology","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87266034","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}
R. Bhardwaj, Ranjana Gupta, Sivaji Patibandla, Himanshu Tanwar, M. Ahmed, Gaurav Aggrawal
Takayasu arteritis is an inflammatory disease of large- and medium-sized arteries, with a predilection for the aorta and its branches. Advanced lesions demonstrate a panarteritis with intimal proliferation. It can affect the aorta, subclavian artery, renal artery, iliac artery, coronary artery, and other blood vessels. Pulmonary arteritis is very uncommon in TA. We describe a case of TA, who primarily presented with pulmonary hypertension.
{"title":"Takayasu Arteritis Presenting as Severe Pulmonary Hypertension","authors":"R. Bhardwaj, Ranjana Gupta, Sivaji Patibandla, Himanshu Tanwar, M. Ahmed, Gaurav Aggrawal","doi":"10.31762/ahj2130.0202","DOIUrl":"https://doi.org/10.31762/ahj2130.0202","url":null,"abstract":"Takayasu arteritis is an inflammatory disease of large- and medium-sized arteries, with a predilection for the aorta and its branches. Advanced lesions demonstrate a panarteritis with intimal proliferation. It can affect the aorta, subclavian artery, renal artery, iliac artery, coronary artery, and other blood vessels. Pulmonary arteritis is very uncommon in TA. We describe a case of TA, who primarily presented with pulmonary hypertension.","PeriodicalId":72307,"journal":{"name":"ASEAN heart journal : Official journal of the ASEAN Federation of Cardiology","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73904426","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}
This is a case of successful treatment of secondary hypertension with catheter intervention in a 62 years old gentleman who has severe aortoiliac occlusive disease, severe coronary artery disease and other comorbidities. Early recognition, diagnosis and treatment of secondary causes of hypertension lead to good clinical outcomes, possible reversal of end-organ damage and better blood pressure control. Blood pressure control is essential prior to coronary intervention in patients with resistant hypertension and concomitant coronary artery disease to prevent haemorrhagic stroke and other unwanted complications. This gentleman has triple vessels and left main stem disease which surgeons refused for coronary artery by pass graft (CABG) in view patient has severe aorto-iliac occlusive disease with resistant hypertension. We have done successful revascularization to aorto-iliac followed by coronary intervention. Keywords secondary/resistant hypertension, coronary artery disease, aortoiliac occlusive disease, catheter (endovascular) intervention
{"title":"Slaying Monster with Catheter: A Case Report","authors":"S. Yahaya, A. Omar","doi":"10.31762/ahj2130.0104","DOIUrl":"https://doi.org/10.31762/ahj2130.0104","url":null,"abstract":"This is a case of successful treatment of secondary hypertension with catheter intervention in a 62 years old gentleman who has severe aortoiliac occlusive disease, severe coronary artery disease and other comorbidities. Early recognition, diagnosis and treatment of secondary causes of hypertension lead to good clinical outcomes, possible reversal of end-organ damage and better blood pressure control. Blood pressure control is essential prior to coronary intervention in patients with resistant hypertension and concomitant coronary artery disease to prevent haemorrhagic stroke and other unwanted complications. This gentleman has triple vessels and left main stem disease which surgeons refused for coronary artery by pass graft (CABG) in view patient has severe aorto-iliac occlusive disease with resistant hypertension. We have done successful revascularization to aorto-iliac followed by coronary intervention. Keywords secondary/resistant hypertension, coronary artery disease, aortoiliac occlusive disease, catheter (endovascular) intervention","PeriodicalId":72307,"journal":{"name":"ASEAN heart journal : Official journal of the ASEAN Federation of Cardiology","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79558277","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：