Kardiol Pol
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Leads used for low-voltage and high-voltage therapy delivered by implantable cardioverter-defibrillators (ICD) differ from low-voltage pacemaker (PM) leads in their diameter and complexity of structure. Although there are reports showing that the extraction of ICD leads may be hazardous, due to firm adhesions to the vascular and chamber walls of high-voltage therapy coils, clinical evidence suggests that such procedures are safe. ⋯ 1. Extraction of ICD and PM leads is associated with a similar risk for developing major complications, however minor complications are more often during extraction of ICD leads. 2. A larger number of double coil leads may be the cause of complications despite a shorter time period elapsing from ICD implantation. 3. A probable cause of complications during ICD lead extraction is the pronounced growth of the connective tissue around the coils. However, further studies are required to clarify this phenomenon. 4. The success rate of ICD leads extraction using our own surgical technique is similar to that reported by other investigators using laser systems.
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Aneurysm of the anterior mitral leaflet is a rare complication of infective aortic valve endocarditis. The natural history of which is generally its rupture, with subsequent acute and severe mitral regurgitation. We describe a 78 years-old man without history of endocarditis, in whom transthoracic echocardiography was sufficient and transesophageal echocardiography was essential for the diagnosis of this lesion.
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It has been shown that hyperglycaemia is associated with increased in-hospital and long-term mortality in patients with myocardial infarction (MI). There are only a few reports on the relationship between glycaemia in the acute phase of MI complicated by cardiogenic shock (CS) and prognosis. ⋯ Elevated blood glucose level on admission, regardless of the diagnosis of diabetes mellitus, results in increased in-hospital and long-term mortality in patients with STEMI complicated by CS and treated with PCI.