Kardiol Pol
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Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease affecting young women and is associated with increased frequency of atherosclerotic vascular diseases. Pulse wave velocity (PWV) is an index of arterial stiffness and a marker of cardiovascular events. This study aimed to investigate arterial distensibility using carotid-femoral (aortic) PWV measurements in premenopausal women with SLE. ⋯ Arterial distensibility is decreased in premenopausal women with SLE.
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New therapies for pulmonary arterial hypertension have prolonged survival but simultaneously increased the number of hospital admissions because of decompensated right heart failure (DRHF). The optimal approach in DRHF has not been established yet. ⋯ Mortality in patients with pulmonary hypertension and DRHF remains very high and seems to be related to haemodynamic profile on admission. The newly introduced therapy with parenteral prostanoids may be more beneficial than dopamine infusion.
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Case Reports
[Subintimal recanalisation of chronic superficial femoral artery occlusion with the use of a re-entry system].
We present a case of a 59-year-old man with symptomatic long-segment occlusion of the superficial femoral artery. Subintimal recanalization was initially unsuccessful due to the inability to re-enter the true lumen after crossing the occlusion in the subintimal space. ⋯ We indicate that the Outback catheter can be used safely in case of an unsuccessful conventional re-entry to the true lumen artery. This catheter can allow reduction the time of the procedure and minimize potential complications.
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Permanent atrial fibrillation (AF) is present before operation and persists after surgery in 30-40% of patients undergoing mitral valve surgery. Using the maze procedure, 75-82% of patients can be cured of AF, but the procedure is difficult and long lasting. Percutaneous radiofrequency (RF) ablation has emerged as an effective therapy for AF in recent years. ⋯ Intra-operative RF ablation performed in the left atrium in patients with chronic AF undergoing mitral valve replacement significantly improves sinus rhythm restoration rate. Advanced heart failure (NYHA class IV) and left atrial diameter >6 cm are negative prognostic factors for sinus rhythm maintenance.
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Perimembranous ventricular septal defect (VSD) is the most common congenital heart defect. Percutaneous transcatheter closure of VSD is one of the greatest challenges in interventional cardiology. ⋯ Percutaneous perimembranous VSD closure is an interesting alternative to surgical treatment. In selected cases closure of the defect with muscular VSD implant is effective and safe.