Heart and vessels
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Comparative Study
Chlamydia pneumoniae seropositivity predicts the risk of restenosis after percutaneous transluminal coronary angioplasty.
This study was done to evaluate whether anti-Chlamydia pneumoniae seropositivity can be a predictor of restenosis after coronary intervention. Recent studies indicate that latent infection with C. pneumoniae is associated with and could possibly cause atherosclerosis. However, it is unknown whether chronic infection with this microorganism is involved in the mechanism of restenosis after percutaneous transluminal coronary angioplasty. ⋯ Lesions in the seropositive patients had a greater mean loss index (mean +/- SD 0.75 +/- 0.45 vs 0.35 +/- 0.41, P < 0.001), which was defined as late loss (luminal diameter reduction at follow-up angiography) divided by acute gain (luminal diameter gain by angioplasty), in late loss (1.07 +/- 0.64mm vs 0.65 +/- 0.79mm, P = 0.019), in percentage of diameter stenosis (57% +/- 20% vs 41% +/- 21%, P = 0.003) and a lesser mean in minimal luminal diameter (1.18 +/- 0.58 mm vs 1.67 +/- 0.63 mm, P = 0.002) at follow-up angiography. In a multivariate logistic regression model, anti-C. pneumoniae IgG seropositivity was a strong independent predictor of restenosis compared to the other risk factors (odds ratio = 6.2, P = 0.01). C. pneumoniae could play an important role in the mechanism of restenosis and evaluation of the IgG seropositivity, and may help to identify patients at high risk for restenosis.
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Case Reports
Extracorporeal membrane oxygenation and left ventricular assist device: a case of double mechanical bridge.
A 14-year-old boy with dilated cardiomyopathy with cardiac arrest was successfully implanted with a left ventricular assist device (LVAD) after 6-day extracorporeal membrane oxygenation (ECMO). He had multiple organ failure at the initiation of ECMO, but the failed organs recovered during assisted circulation, leading to LVAD implantation. This case showed the advantages of the "double bridge" such as: (1) quick and easy installation for acute cardiogenic shock, (2) providing intervention time for complications refractory to LVAD implantation, and (3) providing evaluation time for potential LVAD implantation and transplant candidates.