Methodist DeBakey cardiovascular journal
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Methodist Debakey Cardiovasc J · Apr 2012
Cytomegalovirus localization in atherosclerotic plaques is associated with acute coronary syndromes: report of 105 patients.
It has been shown that cytomegalovirus (CMV) is present in coronary atherosclerotic plaques, but the clinical relevance of this presence remains to be elucidated. In this study we sought to examine CMV infection in atherosclerosis patients defined by different methods and to identify the clinical significance of CMV replication in the atherosclerotic plaques. The study included 105 consecutive patients who were admitted to our department and underwent coronary artery bypass grafting (CABG) surgical interventions. ⋯ They were also more likely to have a positive family history for cardiovascular diseases (CVD). This study confirms previous evidence about the replication of CMV virus in the atherosclerotic plaques of coronary arteries and brings clinical significance to this observation by showing a higher prevalence of acute coronary syndromes in those patients with CMV-infected plaques. Our study also suggests a familial vulnerability to CMV replication in the coronary artery walls.
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While transcatheter aortic valve replacement is considered a viable alternative to traditional surgery for patients with critical aortic stenosis, it is still a cardiac surgical procedure with a steep learning curve. Space consideration is a key aspect of the procedure's success. A TAVR program requires the commitment from and investment of institutional resources, the outfitting of an appropriate procedure room, and meticulous training of a multidisciplinary TAVR team. Careful integration of the various imaging modalities, medical specialties, and equipment is necessary to ensure the safety and efficacy of the procedure and to treat complications that may arise.