Infective endocarditis, thoracic aortitis, and mycotic aneurysm formation complicating balloon angioplasty of aortic coarctation

Coarctation of the aorta is a rare congenital anomaly usually accompanying bicuspid aortic valve. Adult patients with aortic coarctation can be managed either with surgery or percutaneously. Here we present a case of percutaneously treated aortic coarctation complicated with infective endocarditis of the aortic valve, thoracic aortitis, and thoracic mycotic aneurysm

Assessment of Arterial Stiffness with Pulse Wave Velocity or Augmentation Index: Which Method is the Best?: Scientific Letter

Assesment of large arterial stiffness is increasingly used in clinal settings. Although there are several invasive and non-invasive methods such as carotid-femoral pulse wave velocity (PWV) and augmentation index (AI), researchers and clinicians still face problems in selecting the best methodology for their specific use. PWV, which is defined as the velocity of the arterial pulse for moving along the vessel wall, plays an important clinical role in defining patients under high cardiovascular risk and it is inversely correlated with arterial elasticity and relative arterial compliance. PWV along the aorta can be measured by using two ultrasound or pressure sensitive transducers fixed transcutaneously over the course of a pair of arteries separated by a known distance: the femoral and right common carotid arteries. PWV is calculated from measurements of pulse transit time and the distance, according to the following formula: PWV (m/s)= distance (m)/transit time (s). AI is defined as Dp/pp (where Dp is the difference between the late systolic peak and the mid-systolic peak and pp is the amplitude of the pulse pressure wave). Central blood pressure and pulse pressure, the AI and PWV, which are often used incorrectly as interchangeable indexes of arterial stiffness, increase with age, hypertension, diabetes mellitus and hyperlipidemia, and are associated with target organ damage such as left ventricular hypertrophy, microalbuminuria, carotid intima-media thickness and endothelial dysfunction. Althouhg the carotid-femoral (aortic) PWV is the gold standard test for assessing central arterial stiffness, the AI reflects stiffness of the systemic arterial tree. This paper summaries the advantages and disadvantages of PWV and AI in the assessment of arterial stiffness

Two adult cases of anomalous left coronary artery from the pulmonary artery

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly that presents as left-sided heart failure and mitral valve insufficiency during the first months of life. However, some cases may benefit from sufficient collateral blood supply from the right coronary artery, resulting in increased survival even to advanced ages. Herein, we report on two adult cases of ALCAPA, namely, a 52-year-old male patient that presented with angina and a 70-year-old female patient presenting with stroke, dyspnea, and pretibial edema. In both cases, ALCAPA was demonstrated by coronary angiography and multislice computed tomography angiography. The younger patient refused surgery and remained asymptomatic and event-free during a two-year follow-up with anti-ischemic medications, while the older with high surgical risk was considered for intracardiac defibrillator implantation along with medical therapy

Assessment of cardio-ankle vascular index in patients with abdominal aortic aneurysm: An observational study

KALAYCIOGLU, EZGI/0000-0003-2122-1817; Cetin, Mustafa/0000-0001-6342-436X; Aykan, Ahmet C/0000-0001-5793-7978WOS: 000556915400001PubMed: 32757746Objectives Arterial stiffness is associated with major adverse cardiovascular events. the aim of this study is to investigate arterial stiffness by cardio-ankle vascular index (CAVI) in patients with abdominal aortic aneurysm (AAA). Methods This observational and cross-sectional study involved 59 subjects with AAA and 32 healthy subjects. All subjects underwent ultrasonography examination. CAVI was measured by VaSera-1000 CAVI instrument. Results Mean abdominal aortic diameter of AAA patients and controls were 43.88 +/- 9.28 mm and 20.43 +/- 3.14 mm, consecutively. Baseline clinical characteristics of the patients and controls were similar for age, presence of hypertension, diabetes, dyslipidemia, coronary artery disease and smoking. Left ventricle ejection fraction and Left ventricle mass index (LVMI) were similar between groups. CAVI was significantly higher in patients with AAA than controls (9.74 +/- 1.50 vs. 7.60 +/- 1.07,p 8.3 had a sensitivity 89.8% and a specificity of 78.1% for predicting the presence of AAA in ROC analysis (area under curve = 0.897, 95%CI = 0.816-0.951,p < 0.001). Conclusion CAVI is increased in patients with AAA. Increased arterial stiffness may be a mechanical link between AAA, coronary artery disease and peripheral artery disease or a common mechanism effects the arterial stiffness, coronary artery disease, peripheral artery disease and AAA. Therefore, CAVI may be used as a valuable marker for risk stratification for the development of AAA in susceptible patients

Acute ST-elevation inferior myocardial infarction in a patient with a non-obstructive mechanical mitral valve thrombosis

The risk of systemic embolisation in patients with prosthetic heart valves who are receiving anticoagulation therapy is 0.5 to 1.7% per patient year and most cases present with cerebrovascular events. Here we report the case of a 42-year-old woman who was uneventfully treated with a low dose, prolonged infusion of tissue plasminogen activator because of non-obstructive prosthetic mitral valve thrombosis. It presented as coronary embolism and resulted in acute ST-elevation inferior myocardial infarction

Multimodality Imaging of the Mitral Paravalvular Abscess Cavity with Left Ventriculo-atrial Fistula

Paravalvular complications may occur in patients with infective endocarditis. Paravalvular abscess formation rarely occurs and if so it generally involves the aortic valve. Herein we present a case of left ventriculo-atrial fistula formation through mitral paravalvular abscess cavity shown by multimodality imaging including two- and real-time three-dimensional transoesophageal echocardiography (RT 3-D TEE), cardiac magnetic resonance imaging (CMRI), multislice computed tomography (MSCT) and ventriculography in a patient with a mechanical prosthetic mitral valve. This is the first case in the literature of a mechanical prosthetic mitral valve complicated by a left ventriculo-atrial fistula formation in a healed abscess cavity that is demonstrated with RT-3D TEE, cardiac MRI and MSCT. (Heart, Lung and Circulation 2012;21:284-286) (C) 2012 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier Inc. All rights reserved

Assessment of cardio-ankle vascular index in patients with cardiac syndrome-X: an observational study

Objective: Arterial stiffness is associated with major adverse cardiovascular events. Cardio-ankle vascular index (CAVI), a novel marker of arterial stiffness, which is weakly influenced by systolic blood pressure, is a sensitive marker the atherosclerosis and arteriolosclerosis. The aim of this study is to investigate arterial stiffness by CAVI in patients with cardiac syndrome X (CSX)

Assessment of cardio-ankle vascular index in patients with cardiac syndrome-X: an observational study

Objective: Arterial stiffness is associated with major adverse cardiovascular events. Cardio-ankle vascular index (CAVI), a novel marker of arterial stiffness, which is weakly influenced by systolic blood pressure, is a sensitive marker the atherosclerosis and arteriolosclerosis. The aim of this study is to investigate arterial stiffness by CAVI in patients with cardiac syndrome X (CSX)

CORONARY ARTERY VASOSPASM SECONDARY TO TYPE I VARIANT KOUNIS SYNDROME: A CASE SERIES OF MEN. IS THE GENDER DIFFERENCES IMPORTANT?

Kounis syndrome is a well-known cause of acute coronary syndrome and more than 100 cases are reported with allergic reactions to various drugs, animal and insect bites, even with drug eluting stents and endovascular devices. In this paper we report five-patients with Kounis syndrome related to different drugs. The main characteristic of patients is given in Table 1. All of them were male and their age was from 18 to 35. All patients presented with ST- elevation myocardial infarction. Coronary angiography was performed in all patients and revealed normal coronary arteries. From history of allergic exposure, electrocardiographic, laboratory (Total IgE and tryptase levels) and angiographic findings the diagnosis was Kounis syndrome type I for all patients and was treated with oral antihistamines and prednisolone. Despite Type 1 KS is not associated with atherosclerotic risk factors and CAD all patients in or report and many patients in literature are male. Gender differences in KS should be investigated in further studies

Comparison of low dose versus standard dose heparin for radial approach in elective coronary angiography?

Objective: The aim of this study is to evaluate the efficacy and safety of two doses of heparin, a low dose (2500 IU) and a standard dose (5000 IU) in patients who underwent transradial coronary angiography (TRCAG)