1/81. Calcified right atrial mass in a woman receiving long-term intravenous phosphate therapy.Right atrial masses are easily seen by 2-dimensional echocardiography and may represent primary tumors, secondary tumor invasion of the right atrium, tricuspid valve vegetations, or atrial thrombi. Calcification of right atrial masses is uncommon but easily identified by 2-dimensional echocardiography because of the high echogenicity of calcium deposits. We describe a patient with a heavily calcified right atrial thrombus caused by an indwelling central venous catheter and long-term intravenous phosphate infusion.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
2/81. Localized pericarditis with calcifications mimicking a pericardial tumor.A 62-year-old man was admitted with increasing palpitations. radiography of the chest demonstrated a calcified mass. magnetic resonance imaging revealed compression of the right ventricle by a tumor. At the time of cardiac catheterization, the coronary arteries were found not to supply blood flow of the mass, and no dip-and-plateau pattern was seen in the right ventricular pressure measurements. At the time of surgery, the mass was found to be a focal calcified thickening of the pericardium containing only pus. The thickening resembled an oval pericardial tumor. Microbiologic examination of the pus revealed propionibacterium acnes.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
3/81. String-plucking as a mechanism of chordal rupture during balloon mitral valvuloplasty using inoue balloon catheter.Percutaneous transvenous mitral commissurotomy using the Inoue technique was performed in a 59-year-old female with mitral stenosis and a severely calcified mitral leaflets. Although not entrapped in the subvalvular apparatus, the balloon catheter was deviated away from the mitral orifice-apex axis of the left ventricle during the inflation of the proximal balloon, which plucked and severed the chordae tendineae of the posterior mitral leaflet and resulted in severe mitral regurgitation.- - - - - - - - - - ranking = 5keywords = catheter (Clic here for more details about this article) |
4/81. Familial tumoral calcinosis: association with cerebral and peripheral aneurysm formation.Two siblings with histologically and radiologically proven tumoral calcinosis presented with cerebral and peripheral aneurysms. The brother died of a ruptured subclavian artery aneurysm after surgical repair of brachial, iliofemoral and coeliac axis aneurysms. Magnetic resonance and catheter angiography in the sister demonstrated marked carotid dysplasia and a left ophthalmic segment aneurysm, not amenable to treatment. We believe this is the first reported case of familial aneurysms in association with tumoral calcinosis.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
5/81. Closure of calcified patent ductus arteriosus.Patent ductus arteriosus (PDA) in adults is occasionally associated with calcification and pulmonary hypertension, for which an anterior approach through a median sternotomy with cardiopulmonary bypass is often used. sutures are placed without circulatory arrest by using a transpulmonary balloon catheter as an occluder. To secure the suture tie, we used Nelaton's catheters as tourniquets.- - - - - - - - - - ranking = 2keywords = catheter (Clic here for more details about this article) |
6/81. aortic valve replacement for the calcified ascending aorta in homozygous familial hypercholesterolemia.A 72-year-old woman who had been diagnosed as homozygous familial hypercholesterolemia was admitted for chest discomfort. Computed tomography and cardiac catheterization revealed severe calcification of the aortic root and a high grade stenosis of the proximal right coronary artery. aortic valve replacement concomitant with coronary artery bypass was done using temporary hypothermic circulatory arrest. This is preferred method when dealing the calcified aorta.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
7/81. Huge calcified aneurysm of the sinus of valsalva.Aneurysms of the sinus of valsalva often remain undiagnosed until they rupture. A 61-year-old man had a huge, heavily calcified unruptured aneurysm, originating from the right sinus of valsalva, detected incidentally on a chest radiograph taken for the diagnosis of cardiomegaly. Two-dimensional echocardiography revealed pericardial effusion with a huge calcified mass compressing the right ventricular outflow tract. The Doppler color-flow echocardiogram showed blood flow from the aortic root into the aneurysm. A chest computed tomographic scan revealed a large thrombosed aneurysm originating from the aortic root and measuring 10x10 cm. After pericardiocentesis, cardiac catheterization was performed, which showed that the right ventricular systolic pressure had elevated to 80 mmHg. Aortic root aortography demonstrated a huge unruptured calcified aneurysm in the sinus of valsalva arising from the right coronary sinus. The patient underwent surgical correction to prevent aneurysmal rupture and to relieve the right ventricular outflow obstruction.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
8/81. Severe valvular and aortic arch calcification in a patient with Gaucher's disease homozygous for the D409H mutation.Gaucher's disease is an autosomal recessive inherited defect of the lysosomal enzyme glucocerebrosidase, which leads to glucocerebroside accumulation in the reticuloendothelial system. Homozygosity for the D409H mutation has been associated with cardiovascular valvular disease. We present a case of a 17-year-old Palestinian patient who presented with severe aortic and mitral valvular calcification, as well as calcification of the ascending aorta, the aortic arch and the ostia of his coronary arteries. The patient was confirmed to be homozygous for the D409H mutation in the glucocerebrosidase gene. The patient's enzyme assay for glucocerebrosidase activity was 5 nm/h/mg protein (normal 13-22 nm/h/mg). The patient presented with symptoms of dyspnea and chest pain. He had a 6-year history of documented aortic valve calcification by echocardiogram after two of his older brothers died of congestive heart failure and severe valvular calcification. cardiac catheterization showed a severely calcified aorta with almost no motion of the aortic valve leaflets and severe calcification of the mitral valve and the mitral valvular apparatus. The patient underwent extensive cardiac surgery with aortic and mitral valve replacements and intraoperative findings confirmed calcification of the entire aortic root. Electron microscopy of the valves confirmed the presence of Gaucher's cells. enzyme therapy with imiglucerase was initiated. The patient is in stable condition, 20 months post-operatively.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
9/81. A method to minimize indwelling catheter calcification and bladder stones in individuals with spinal cord injury.Indwelling catheters are a common tool of bladder management in persons with high-level spinal cord injury who are unable to intermittently catheterize their bladders. Indwelling catheters are used to prevent bladder overdistension, which can trigger autonomic dysreflexia in those with injuries at or above T6. Unfortunately, indwelling catheters are prone to encrustation and can lead to the formation of bladder stones that can block the catheter and cause autonomic dysreflexia. We found that weekly catheter changes dramatically reduced catheter encrustation and stones in 2 individuals who had a history of recurrent stones despite various accepted interventions. We describe the clinical course and impact of this method in each case.- - - - - - - - - - ranking = 11keywords = catheter (Clic here for more details about this article) |
10/81. Pre-infarction angina secondary to calcific aortic stenosis with Bernheim's effect.Pre-infarction angina, in the absence of coronary artery disease, was found in a 62 year-old man with severe calcific aortic stenosis. After application of intraaortic balloon pump counter-pulsation, the condition was stabilized, and coronary arteriograms were safely carried out. Interestingly, an elevated right atrial and right ventricular end-diastolic pressure with an associated Bernheim's effect was demonstrated by cardiac catheterization. The hemodynamics of the right heart returned to normal after surgical correction of the aortic stenosis. The clinical indications for intra-aortic balloon pump counterpulsation in this setting are discussed.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
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