The Journal of invasive cardiology
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A 75-year-old man presented with infective endocarditis. Transesophageal echocardiogram (TEE) revealed mild-moderate mitral regurgitation (MR). After 4 weeks of antibiotics, he presented with New York Heart Association class III dyspnea. ⋯ After consultation with Infectious Diseases, it was determined the infection risk was low and transcatheter mitral valve repair (TMVR) was offered. Deployment of two MitraClip devices (Abbott Vascular) resulted in symptom relief. This case demonstrates a potential role of TMVR in treating acute severe MR due to endocarditis.
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To compare procedural success and safety of pericardiocentesis using continuous ultrasonographic visualization of a long (7 cm) micropuncture needle to standard access with an 18 gauge needle without continuous ultrasound guidance. ⋯ This study suggests that an ultrasound-mounted micropuncture needle allows for safe and effective pericardiocentesis. This technique may provide a safer alternative to the standard use of an 18 gauge needle.
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Ventricular interdependence is a salient hemodynamic feature of cardiac tamponade that manifests as discordance between the left and right ventricles in filling and ejection on hemodynamic assessment. Ventricular interdependence can manifest as arterial discordance at the level of the great arteries.
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Surgical femoral cutdown for decannulation after veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is considered standard practice. However, access-site complications with this technique are not rare. The objective of this study is to evaluate feasibility, safety, and efficacy of a complete percutaneous decannulation procedure after VA-ECMO compared with the conventional surgical cutdown approach. ⋯ Complete percutaneous closure of the femoral access site after VA-ECMO is feasible, effective, and safe when compared with conventional surgical closure and performed by experienced operators.
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Percutaneous repair of the mitral valve has been widely adopted for the treatment of primary, symptomatic severe mitral regurgitation in patients at prohibitive risk for surgical intervention. We present a case of an elderly female patient with moderate-to-severe mitral regurgitation who underwent MitraClip procedure, with postprocedural course remarkable for the development of right-to-left shunting and hypoxia, for which the patient underwent a percutaneous repair of the atrial septal defect with immediate recovery of oxygen saturation.