Journal of cardiovascular medicine
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J Cardiovasc Med (Hagerstown) · Jun 2009
Case ReportsLevosimendan is not effective in reducing pulmonary pressures in patients with idiopathic pulmonary arterial hypertension: report of two cases.
Currently, prostacyclin, endothelin receptor antagonists and phosphodiesterase inhibitors are recommended therapy in idiopathic pulmonary arterial hypertension. However, each of these drugs has limited efficacy in the improvement of clinical symptoms, pulmonary hemodynamics and long-term survival. ⋯ However, the potential pulmonary vasodilating effect of levosimendan in patients with idiopathic pulmonary arterial hypertension remains unclear. Levosimendan administered in two patients with nonvasoreactive idiopathic pulmonary arterial hypertension exhibited deterioration in clinical status, and, contrary to what was expected, levosimendan was found to increase pulmonary pressures and did not lead to a substantial improvement of the patient's condition.
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J Cardiovasc Med (Hagerstown) · Jun 2009
Comparative StudyMultislice computed tomography for the evaluation of coronary bypass grafts and native coronary arteries: comparison with traditional angiography.
Multislice computed tomography (CT) is a promising new noninvasive technique for the detection of atherosclerotic disease within a vessel's wall. The present study was designed to assess the diagnostic accuracy of 64-slice CT in detecting graft disease and in the evaluation of native vessels distally to the grafts. ⋯ The 64-slice CT detected with very high accuracy the presence of diseased arterial and vein grafts. Moreover, an optimal diagnostic accuracy was also documented in the appraisal of native vessels distal to the graft anastomoses. On the basis of these results, 64-slice CT can be proposed for the study of patients after coronary artery bypass and may represent an effective screening technique to select those patients with indications of new revascularization.
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J Cardiovasc Med (Hagerstown) · Jun 2009
Case ReportsUnexpected long durability of a low-profile porcine Liotta bioprosthesis in mitral position.
We report a case in which replacement of a low-profile porcine Liotta bioprosthesis was required 21 years after initial implantation. The patient underwent mitral valve replacement with a 28-mm Liotta bioprosthesis in 1985 for mitral stenosis. ⋯ Focal perforation of two cusps with consequent intravalvular leak on bioprosthesis was found. This is the longest durability report for a Liotta bioprosthesis in mitral position.