Journal of cardiovascular medicine
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Mitral valve aneurysm is defined as a localized, thin-walled, saccular bulge of the mitral leaflet toward the left atrium. In this study, we report a case of mitral aneurysm of the posterior leaflet (scallop P3) secondary to primary mitral endocarditis in a patient who underwent prosthetic aortic valve replacement and coronary artery bypass graft.
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J Cardiovasc Med (Hagerstown) · Mar 2009
Randomized Controlled Trial Comparative StudyPositive end-expiratory pressure during infrarenal aortic clamping limits hemodynamic impairment risk.
Aortic clamping and unclamping abruptly impact hemodynamic assessment. First, vascular resistance and venous blood return increase, causing a cardiac stress; second, when the clamp has been replaced, vascular resistance falls and hypotension with low perfusion pressure risk occurs. We hypothesized that positive end-expiratory pressure (PEEP) during clamping could limit hemodynamic alterations, then its zeroing just before unclamping could guarantee a more stable blood pressure after restoring total circulation. ⋯ PEEP-mechanical ventilation during the clamping phase of infrarenal aortic aneurismectomy can limit blood pressure variation due to clamping and unclamping.
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J Cardiovasc Med (Hagerstown) · Mar 2009
Case ReportsUnexplained syncope, Brugada-like ECG and minimal structural right ventricular abnormalities: which is the right diagnosis?
We describe a 65-year-old man with unexplained syncope, Brugada ECG pattern and right ventricular abnormalities. To reach a diagnosis of Brugada syndrome, a variety of diseases have to be excluded. This case report shows how difficult the differential diagnosis is, particularly with arrhythmogenic right ventricular cardiomyopathy, after documentation of minimal structural RV abnormalities; invasive examination may be required. In this case, three-dimensional electroanatomical bipolar voltage mapping revealed a scar area in the right ventricle in the absence of clear-cut kinetic abnormalities, but the sensitivity of this method and specificity in patients without confirmed arrhythmogenic right ventricular cardiomyopathy have not been defined.