The Journal of invasive cardiology
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We describe the diagnostic and management dilemmas faced in the case of a thirty-year-old woman without a prior cardiac history, who after a motor vehicle accident, was found to have persistent EKG changes in the inferior leads consistent with an acute injury pattern. The patient was ultimately thought to have trauma and subsequent occlusion of the right coronary artery.
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Case Reports
Transient obstruction of the mitral valve by a massive thrombus complicating percutaneous valvuloplasty.
Percutaneous transseptal mitral valvuloplasty was attempted in a patient with severe rheumatic mitral stenosis. Introduction of the balloon into the left atrium resulted in thrombotic occlusion of the mitral valve. ⋯ The thrombus was disrupted during cardiopulmonary resuscitation. Thrombolysis was administered and the patient recovered uneventfully.
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Little research exists on the outcome of smaller patients who undergo coronary artery bypass graft surgery. The purpose of this study was to evaluate the outcomes of cardiac surgery in smaller patients (males with body surface area of 1.6 square meters or less, and women with 1.5 meters or less). A consecutive series of 4,358 patients undergoing bypass surgery was evaluated. ⋯ The results of this study indicate that smaller patients do have poorer outcomes associated with coronary artery bypass surgery. However, 90% of the smaller patients did have an event-free surgery. Surgeons may need to monitor these patients more closely and anticipate the increased risk and cost that is associated with this group.