- A man with severe rheumatic trivalvular disease was treated with surgical implantation of mechanical aortic and mitral prostheses at the age of 30 years and tricuspid bioprosthesis at the age of 50 years. At 61 years of age, he developed severe symptomatic tricuspid regurgitation due to bioprosthesis degeneration and was judged at very high risk for a third surgical approach. The investigators describe the successful transfemoral positioning of a 29-mm Edwards SAPIEN XT percutaneous valve inside the degenerated tricuspid prosthesis, with excellent acute results and no major complications.
- A 40-year-old woman from El Salvador presented with 3 months of abdominal pain and diarrhea followed by 2 weeks of atypical chest pain and exertional dyspnea and was diagnosed with eosinophilic endocarditis secondary to Strongyloides stercoralis infection. Transthoracic echocardiogram revealed apical masses in the left and right ventricles and a thickened posterior mitral valve leaflet and cardiac magnetic resonance imaging confirmed the presence of a left ventricular apical mass with diffuse subendocardial delayed enhancement consistent with endocardial fibrosis.
- The “Crush” procedure is a 2-stent technique for the treatment of bifurcation lesions with greater rates of in-stent restenosis than the Culotte technique. In conclusion, we report a possible mechanism for this discrepancy in the case of severe Crush stent fracture with associated focal restenosis identified by postmortem microcomputed tomography and histologic examination.
- The investigators describe 35-year-old monozygotic twins who presented 6 months apart with heart failure. In conclusion, this is the first report of adult monozygotic twins with isolated left ventricular noncompaction who presented with similar clinical and echocardiographic features and abnormal twist mechanics.
- A male who were implanted bare metal stent 11 years ago were admitted for acute coronay syndrome. Optical coherence tomography showed a neointimal disruption and integrated backscatter intravascular ultrasound revealed a lipid pool around the disrupted neointima, suggesting newly formed atherosclerotic neointima developed after bare metal stent implantation. The disruption of atherosclerotic neointima may represent a new potential mechanism of very late stent thrombosis after bare metal stent implantation.
- The investigators report similar phenotypes of hypertrophic cardiomyopathy with left ventricular apical aneurysm and thrombus in 2 brothers aged 8 years apart. This report highlights the genetic predisposition for this unique, high-risk phenotype, the issue of prophylactic anticoagulation, and the importance of nonstandard echocardiographic imaging views in the assessment of these patients.
- This report describes a variant of transient regional left ventricular dysfunction in which isolated basal left ventricular akinesia with normal mid-ventricular (papillary-level) wall motion and apical hypercontractility were noted in young women (mean age 31 years). This finding was demonstrated in 3 consecutive patients; the first patient was experiencing emotional life-altering events, and the second presented with an acute flare of multiple sclerosis. The third patient presented <24 hours after methamphetamine use.
- Forty-four patients in sinus rhythm with suspected coronary artery disease underwent 16-row multislice computed tomography coronary angiography and conventional coronary angiography. Two protocols for image analysis were applied to the multislice computed tomographic images: standard projections versus interactive postprocessing. The diagnostic accuracy of both methods for the detection of significant lesions (>50% lumen reduction) was compared with quantitative coronary angiography. Sensitivity and specificity were 58% and 96% and 96% and 97%, for standard projections and interactive postprocessing protocol, respectively.