1/13. Ruptured aneurysm of the sinus of valsalva in association with persistent left superior vena cava--a case report.A 58-year-old man presenting with chest pain and dyspnea was diagnosed by transesophageal echocardiography and cardiac catheterization to have the rare combination of ruptured aneurysm of noncoronary sinus of valsalva into the right ventricle in association with persistent left superior vena cava. These defects were confirmed at cardiac surgery. This case shows the importance of complementary use of invasive and noninvasive methods together in the diagnosis of rare combinations of lesions.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
2/13. magnetic resonance imaging of unroofed coronary sinus: three cases.Unroofed coronary sinus is a rare cardiac anomaly in which communication occurs between the coronary sinus and the left atrium due to the partial or complete absence of the roof of the coronary sinus. It is usually associated with other cardiovascular anomalies, especially persistent left superior vena cava. It is often not discovered during cardiac catheterization without clinical suspicion. We report three cases of unroofed coronary sinus which were incidentally detected by magnetic resonance imaging.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
3/13. Massive thrombosis after central venous catheterization in a patient with previously undiagnosed Behcet's disease.Thrombosis is an important complication of central venous catheterization. Among the many intrinsic and extrinsic factors, the patient's medical disease can play a role in thrombogenesis. Behcet's disease (BD), classified as a vasculitis, is a multisystem disease involving the small blood vessels. It is often difficult to recognize and diagnose the disease. A 24-yr-old female patient showed massive central venous thrombosis which caused superior vena cava syndrome after subclavian vein catheterization. Twenty days after catheterization, the patient exhibited swelling of the face, neck, and both upper extremities. Despite thrombectomy and continuous anticoagulation therapy, her facial and upper extremity swelling reappeared and follow-up chest computed tomography (CT) showed the recurrent thrombosis in the same central veins previously affected. A diagnosis of BD was then made. Following steroid therapy, neither clinical symptoms nor CT findings suggestive of central venous thrombosis were observed during the subsequent 6-months of follow-up period. This case emphasizes that central venous catheterization in a patient with BD should be performed with great caution.- - - - - - - - - - ranking = 8keywords = catheterization (Clic here for more details about this article) |
4/13. Haemoptysis as a late complication of a Mustard operation treated by balloon dilation of a superior caval venous obstruction.Haemoptysis was the presenting symptom in a 27-year-old male. He had undergone a Mustard operation for connection of complete transposition at the age of 2 years. For 6 months prior to admission, he had complained of dyspnoea without chestpain, and swelling of the fingers during hard physical work. Chest radiography and computer tomographic scans showed normal features of the pulmonary parenchyma, and no sign of cardiomegaly or vascular stasis. Fiberoptic bronchoscopy demonstrated a blood clot in the upper right bronchus, without any associated abnormalities of the bronchial tree. Doppler echocardiography showed obstruction of the superior caval vein, which was verified by cardiac catheterization. Balloon dilation at the site of obstruction increased the diameter of the vein from 0.5 to 1.7 cm, and the mean pressure in the superior caval vein was reduced significantly from 18 to 10 mmHg. The haemoptysis did not recur, and no complaints of dyspnoea or swelling of fingers during physical activity was reported 2 years later. Transthoracic echocardiography undertaken at this time revealed no obstruction of the superior caval vein. We conclude that hemoptysis is a rare complication of increased venous pressure in the upper body of patients with superior caval venous obstruction, which can be treated by balloon dilation or stenting.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
5/13. Carotid cavernous fistula: embolization via a bilateral superior ophthalmic vein approach.We report the case of a 74-year-old woman with a complex indirect (Barrow D) carotid cavernous sinus fistula. The patient was treated incrementally and finally cured by a rarely reported bilateral retrograde direct transvenous approach via the superior ophthalmic vein. The treatment of the complex carotid cavernous fistula with multiple bilateral fistula points showed additional complexity due to a partially thrombosed left superior ophthalmic vein, which required a combined microsurgical and endovascular treatment, showing that treatment can be achieved, if necessary, by catheterization of a thrombosed orbital vein.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
6/13. Azygos tip placement for hemodialysis catheters in patients with superior vena cava occlusion.Chronic central venous access is necessary for numerous life-saving therapies. Repeated access is complicated by thrombosis and occlusion of the major veins, such as the superior vena cava (SVC), which then require novel vascular approaches if therapy is to be continued. We present two cases of catheterization of the azygos system in the presence of an SVC obstruction. We conclude that the azygos vein may be used for long-term vascular access when other conduits are unavailable and that imaging studies such as magnetic resonance venography, contrast-enhanced computed tomography or conventional venography can be employed prior to the procedure to aid with planning and prevent unforeseen complications.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
7/13. Vena cava superior syndrome developing in a dialysis patient with antithrombin iii deficiency following temporary catheterization.Despite being widely reported in patients with neoplasms, vena cava superior (VCS) syndrome linked to thrombosis is a major catheter complication that can be encountered during the use of the hemodialysis catheter. Antithrombin III (AT-III), responsible for a large part of thrombin inactivation capacity in plasma, is the most powerful inhibitor of the thrombosis process. This report describes a case of VCS syndrome developing two weeks following the extraction of a right-sided subclavian catheter in a patient transferred from peritoneal dialysis to hemodialysis for one week due to leakage. The patient presented complaining of swelling and pain in the right arm. At Doppler examination, total thrombosis was observed in the subclavian and internal jugular vein. At advanced examinations due to lack of response to heparin and clinical worsening, VCS and AT-III deficiency were determined. Following thrombolytic therapy with streptokinase, AT-III levels were raised by the administration of plasma, and clinical and radiological stabilization was established by continuing heparin and continuous oral anticoagulant therapy.- - - - - - - - - - ranking = 4keywords = catheterization (Clic here for more details about this article) |
8/13. Resolution of protein-losing enteropathy after radiofrequency perforation and subsequent stent implantation for relief of complete occlusion of a redirected left superior vena cava.The application of radiofrequency (RF) technologies in the treatment of congenital heart defects has provided a safe and effective alternative to conventional therapies in the restoration of vascular patency for a variety of arterial and venous occlusions. This report concerns an 8-year old girl that developed protein-losing enteropathy and elevated central venous pressure after occlusion of a surgically redirected anomalous draining left superior vena cava (SVC). cardiac catheterization revealed complete obstruction of the anastomosis of the SVC into the coronary sinus. Transcatheter recanalization by RF perforation and subsequent stent implantation led to the restoration of upper venous blood flow and the resolution of her symptoms.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
9/13. Accuracy of two-dimensional echocardiography in diagnosing left superior vena cava.Seventy-three consecutive patients with a left superior vena cava evaluated at the Mayo Clinic, Rochester, minnesota, between 1983 and 1987 underwent cardiac catheterization and two-dimensional echocardiography. Bilateral superior venae cavae were present in 89%. Entry of the left superior venae cavae was into the coronary sinus in 62% (4% were unroofed), a pulmonary venous atrium in 21%, and a common atrium in 17%. Catheterization successfully identified the left superior vena cava in all patients; two-dimensional echocardiography was successful in 68% (group 1) and unsuccessful in 32% (group 2). There was no significant difference between groups with regard to age, sex, diagnosis, or site of drainage. In group 1, 43% had a dilated coronary sinus; in group 2, the coronary sinus was present in 61% but was of normal size. Cineangiograms revealed smaller caliber left superior venae cavae in group 2 than in group 1 (means 7.4 and 11.3 mm, respectively). Thus two-dimensional echocardiography is not totally reliable for the detection of small but possibly significant left superior venae cavae.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
10/13. superior vena cava syndrome as a complication of permanent cardiac pacemaker in a patient with Chagas' heart disease.A 51-year-old man with Chagas' heart disease wearing a cardiac pacemaker developed a superior vena cava syndrome. Right-sided heart catheterization showed a Superior Vena Cava obstruction with extensive collateral flow via the azygous vein. The superior vena cava syndrome can be another complication of cardiac pacemaker implantation in patients with Chagas' heart disease.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
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