International journal of cardiology
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Preoperative risk analysis for Fontan candidates is still less than optimal in that patients with apparently low risks may have a poor outcome, such as prolonged pleural drainage, protein-losing enteropathy, pulmonary thromboembolism and death. We hypothesized that low pulmonary vascular compliance (PVC) is a risk factor for persistent pleural effusion after the Fontan operation. ⋯ Low pulmonary vascular compliance is an important risk factor for prolonged pleural effusion drainage after the extracardiac Fontan procedure.
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Letter Case Reports
Asymptomatic double site of left ventricular outflow tract obstruction: subvalvular aortic stenosis associated with valvular aortic stenosis.
Left ventricular outflow tract obstruction can occur at the supravalvular, valvular, or subvalvular level. Each level of obstruction is associated with distinct symptomatology, natural history, and operative approach. We describe a case of asymptomatic double site of left ventricular outflow tract obstruction: subvalvular aortic stenosis associated with valvular aortic stenosis.
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We evaluated correlates of prolonged use of evidence-based therapies in patients discharged after non-ST-segment elevation acute coronary syndrome (NSTE ACS). ⋯ After NSTE ACS, implementation of recommendations on long-term use of evidence-based therapies depends largely on in-hospital management. A variety of clinical characteristics are also predictive of long-term use.
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Letter Case Reports
Obstruction of the right coronary artery ostium due to acute aortic dissection.
Acute aortic dissection presents with a wide range of manifestations and it is frequently confused with acute coronary syndrome, leading to delayed diagnosis and inappropriate treatment. A high clinical index of suspicion is necessary. ⋯ We present a case of acute aortic dissection in a 68-year-old Italian woman with longstanding arterial hypertension, unknown ascending aortic aneurysm, normal D-dimer levels, new onset atypical chest pain and electrocardiographic images mimicking acute coronary syndrome. Also this case focuses attention on the importance of a correct evaluation of new onset chest pain.
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Given its linearity throughout exercise, oxygen uptake efficiency slope (OUES) obtained with a sub-maximal exercise is considered a reliable predictor of exercise capacity. We sought to assess the linearity of OUES across different exercise stages in adults with various forms of congenital heart disease. ⋯ In cyanotic Fontan patients, OUES(50) differs substantially from OUES(50-100) and OUES. Therefore, OUES(50) is unable to predict maximal exercise capacity in this population.