Cardiovascular revascularization medicine : including molecular interventions
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Cardiovasc Revasc Med · Jan 2018
Case ReportsNeurological recovery from multiple cardiac arrests due to acute massive pulmonary embolism managed by cardiopulmonary resuscitation and extracorporeal membrane oxygenation.
Cardiac arrest is one of the leading causes of death worldwide. Anoxic-ischemic encephalopathy resulting from cardiac arrest is the third leading cause of coma requiring admission to the intensive care unit (following trauma and drug overdose). ⋯ The use of ECMO in such case is believed to reduce the mortality rate and increase the likelihood of survival with good neurological outcomes. Given the potential for success and the lifesaving results, ECMO should be considered in all cases of massive pulmonary embolism with cardiopulmonary compromise.
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Cardiovasc Revasc Med · Jan 2018
Comparative StudyST segment elevation myocardial infarction in patients hospitalized for non-cardiac conditions.
Timely use of primary percutaneous coronary intervention (PCI) is the standard of care for patients with ST segment elevation myocardial infarction (STEMI). Most patients with STEMI present via emergency medical services or self-transport to the emergency department (ED) and relatively little is known about the minority of patients that develop STEMI while hospitalized for non-cardiac conditions. The objective of this study was to analyze treatment times and clinical outcome for in-hospital STEMI patients. ⋯ In-hospital STEMI patients have significant treatment delays and worse clinical outcome compared to STEMI patients that present via the emergency department. Additional efforts are required to promptly identify in-hospital patients that develop STEMI.
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Cardiovasc Revasc Med · Jan 2018
Case ReportsBioprosthesis leaflet thrombosis following self-expanding valve-in-valve transcatheter aortic valve replacement in patient taking factor Xa inhibitor and warfarin: A case report.
An 87-year-old female with symptomatic severe aortic stenosis underwent transcatheter valve replacement (TAVR) via the transfemoral approach with a 29mm self-expanding device. Moderate to severe paravalvular regurgitation led to the development of congestive heart failure and hospital readmission 1 month following TAVR. A second 29mm valve was placed to abolish the paravalvular regurgitation. ⋯ Transthoracic echocardiogram revealed normal transaortic valve gradients. The patient was transitioned to a vitamin K antagonist and repeat imaging 3months later demonstrated progression of thrombosis to an additional leaflet. The case illustrates the potential increased risk of leaflet thrombosis in patients receiving valve-in-valve TAVR procedures, the superiority of multidetector computed tomography to image subclinical leaflet thrombosis, and highlights the need for further investigation in this area.
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Cardiovasc Revasc Med · Oct 2017
Observational StudyFirst experience with the Watchman FLX occluder for percutaneous left atrial appendage closure.
We aimed to evaluate efficacy and safety of left atrial appendage (LAA) closure with the new Watchman FLX and analyze procedural features in a consecutive series of high risk non-valvular atrial fibrillation patients. ⋯ We evaluated the efficacy and safety of left atrial appendage (LAA) closure with the new Watchman FLX and analyzed procedural features in a consecutive series of high risk non-valvular atrial fibrillation patients. This is a first observational study demonstrating procedural safety, complete sealing of the LAA and simple technique for repositioning. There was no stroke within a 6month follow-up.