1/18. Isolated tricuspid valve regurgitation resulting from severe annular dilatation: case report.A rare case of isolated tricuspid regurgitation (TR) in a 65-year-old man is presented. echocardiography revealed enlargement of the right atrium, dilatation of the tricuspid valve annulus without thickening or prolapse of the leaflets, and an intact atrial septum. No downward displacement of the tricuspid septal leaflet was observed by echocardiography. Mild mitral regurgitation and severe TR were detected on color flow Doppler studies. cardiac catheterization indicated elevated right atrial pressure, with a pronounced V-wave. No left-to-right shunt was detected at the right atrium. At surgery, severe annular dilatation of the tricuspid valve (without organically diseased or deformed tricuspid leaflets) was observed, and tricuspid annuloplasty with a prosthetic ring performed. Postoperative echocardiography and right ventriculography showed trivial TR.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
2/18. Dilated phase of hypertrophic cardiomyopathy with mid-ventricular obstruction after 20-year follow-up.This paper reports a case of dilated phase in hypertrophic cardiomyopathy with mid-ventricular obstruction. Following the first cardiac catheterization and endomyocardial biopsy, the patient was diagnosed as having hypertrophic cardiomyopathy (HCM) with mid-ventricular obstruction. He had been first diagnosed at the age of 38 years and was subsequently followed for 20 years. Echocardiogram revealed gradually progressive dilatation of the left ventricle, associated with disappearance of the mid-ventricular obstruction. The second cardiac catheterization and endomyocardial biopsy performed at the age of 58 disclosed that the patient was in the dilated phase of HCM with a dip-and-plateau pattern diastolic pressure trace.- - - - - - - - - - ranking = 2keywords = catheterization (Clic here for more details about this article) |
3/18. Clinical significance of coronary arterial ectasia.In a study group of 2,457 consecutive patients undergoing cardiac catheterization, 30 patients had coronary arterial ectasia, an irregular dilatation of major vessels up to seven times the diameter of branch vessels. The frequency of hypertension, abnormal electrocardiogram and history of myocardial infarction was greater than that in a control group with obstructive coronary artery disease. patients with ectasia did not differ from patients with obstructive disease in sex, age, prevalence of angina or presence of metabolic abnormalities. Six deaths occurred in the group with ectasia during a mean follow-up period of 24 months (annual rate of 15 percent). Extensive destruction of the musculoelastic elements was evident, resulting in marked attenuation of the vessel wall. The short-term prognosis in this group is the same as in medically treated patients with three vessel obstructive coronary artery disease.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
4/18. Total occlusion of left main coronary artery by dilated main pulmonary artery in a patient with severe pulmonary hypertension.A 34-year-old woman was admitted to the hospital because of recently aggravated right heart failure without angina for 5 months. When she was 25 years old, patch repair with polytetrafluoroethylene (PTFE) was performed for the secondum type of atrial septal defect (ASD) with moderate pulmonary hypertension. The chest PA, echocardiography and cardiac catheterization at current admission revealed Eisenmenger syndrome without intracardiac shunt. Chest CT scan with contrast revealed markedly dilated pulmonary trunk, both pulmonary arteries and concave disfigurement of the left side of the ascending aorta suggesting extrinsic compression, as well as total occlusion of the ostium of the left main coronary artery that was retrogradly filled with collateral circulation from the right coronary artery. The coronary angiography showed normal right coronary artery and the collaterals that come out from the conus branch to the mid-left anterior descending artery (LAD) and that from distal right coronary artery to the left circumflex artery (LCX) and to the distal LAD, respectively. On aortography, the left main coronary artery was not visualized with no stump, suggestive of total occlusion of the ostium of the left main coronary artery. From our experience, it is possible to say that the occlusion of the ostium of the left main coronary can be induced by the dilated pulmonary artery trunk due to ASD with pulmonary hypertension and that, if the ASD closure was too late, the narrowing or obstruction of the left coronary artery could not be resolved even after operation owing to irreversible pulmonary hypertension.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
5/18. Neoaortic root dilation associated with left coronary artery stenosis following arterial switch procedure.We describe a patient who was diagnosed with d-transposition of the great arteries, with intact ventricular septum, who underwent arterial switch procedure on day 5 of life. Over the subsequent years, he developed progressive neoaortic root dilation with a Z score of up to 7.2. At 5 years of age, he presented with myocardial infarction. cardiac catheterization demonstrated a markedly dilated aortic root with kinking and stenosis of the left main coronary artery into the left anterior descending coronary artery. He underwent emergency left internal mammary artery bypass grafting to the left anterior descending coronary artery. Although he required left ventricular assist device (LVAD) support in the early post-operative period, he recovered with a left ventricular ejection fraction of 52% on the most recent follow-up.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
6/18. Left main coronary artery compression by dilated pulmonary trunk in a patient with atrial septal defect.A 52-year-old man, presenting with exertional chest pain was investigated to explain his chest pain. Echocardiographic examination revealed he had the ostium secundum type of atrial septal defect, dilated right heart chambers, dilated pulmonary artery, and pulmonary artery systolic pressure of 65 mm Hg calculated from tricuspid regurgitation, but his chest pain could not be explained with these findings. Therefore, cardiac catheterization and coronary angiograph were performed. coronary angiography revealed severe stenosis of the left main coronary artery and otherwise normal vessels. Angiographic images made us think that there might be an external compressing structure on the left main coronary artery. For further evaluation, contrast-enhanced magnetic resonance images of the heart were taken. These images showed that the markedly dilated pulmonary artery was compressing the left main coronary artery.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
7/18. Successful surgical repair of a giant left main coronary artery aneurysm with arteriovenous fistula draining into a persistent left superior vena cava and coronary sinus: role of intraoperative transesophageal echocardiography.We report the case of a 74-year-old woman with a history of hypertension, hypercholesterolemia, and pacemaker who presented to the hospital with new onset new york Heart association class IV congestive heart failure. Transthoracic echocardiography revealed a markedly dilated right ventricle with normal right ventricular systolic function. There was moderate pulmonary hypertension with an estimated pulmonary artery systolic pressure of 60 mm Hg. Her echocardiogram 1 year earlier had demonstrated normal right ventricular size and systolic function, and no pulmonary hypertension. Additional transthoracic imaging with saline contrast study through a left peripheral vein demonstrated the presence of a dilated coronary sinus with a persistent left superior vena cava. color Doppler demonstrated turbulent flow within the coronary sinus with evidence of significant left-to-right shunting. cardiac catheterization revealed a massively dilated left main coronary artery aneurysm with an arteriovenous fistula into the left superior vena cava and coronary sinus. The calculated Qp/Qs was 2:1. The patient underwent 2 unsuccessful attempts at percutaneous intervention to occlude the arteriovenous fistula. She then underwent successful surgical closure of the coronary arteriovenous fistula. The important role of intraoperative transesophageal echocardiography in guiding this technically challenging surgical case is discussed.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
8/18. Myocardial reinfarction in a patient with coronary ectasia.A 47-year-old male patient was admitted to our Emergency Hospital's coronary unit with an acute myocardial infarction, localized inferolaterally. He had been hospitalized 2 months before this occurrence because of persistent chest pain accompanied by elevation of the ST segment in precordial and inferior leads, for which he received thrombolytic therapy. Selective cardiac catheterization was then also effected, and showed diffuse ectasia of coronary arteries with no significant stenoses. Since streptokinase had been applied recently, the patient was given standard therapy as well as electroshocks because of chamber fibrillation. Two hours after admission, the infarct pain ceased and rapid ECG improvement occurred. Repeated coronarography showed a situation identical to the previous one. The patient was sent home to proceed with drug therapy.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
9/18. Coaxial technique for catheterization of the coronary arteries with a very dilated ascending aorta.This article describes a simple yet effective method to catheterize the coronary arteries when the ascending aorta is very dilated. Two catheters are used in a coaxial fashion. It was possible to catheterize a patient with a 9 cm wide ascending aorta.- - - - - - - - - - ranking = 4keywords = catheterization (Clic here for more details about this article) |
10/18. femoral vein occlusion and spontaneous collateral ectasia presenting as recurrent hernia of the groin: a case report.femoral vein occlusion is not a common complication even after repeated hernia repair. We describe a case of a 14-year-old boy with a visible and soft, yet irreducible, mass below the inguinal ligament after 3 previous inguinal hernia repairs and heart catheterization in infancy. Further examination showed dilated venous collaterals, bypassing an occluded common femoral vein via the testicular sheaths and across the pelvic floor. We discuss etiology, diagnostic pitfalls, therapeutic options, and possible future complications, with a literature review.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
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