Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Nov 2011
Case ReportsNovel application of Angiojet rheolytic thrombectomy for massive thrombosis of the native aortic valve and Jarvick 2000 ventricular assist device in a patient with end-stage heart failure.
With the diffusion of implantable ventricular assist pumps in heart failure patients refractory to treatments or ineligible to transplantation, acute aortic valve and device thrombosis is an unusual but potentially increasing complication. We report a novel application of Angiojet rheolytic thrombectomy for acute and massive thrombosis of the native aortic valve and of the left ventricular assist device in a heart failure patient. The technical execution and clinical experience with this technique is described.
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Catheter Cardiovasc Interv · Nov 2011
Case ReportsMinimally invasive transradial intervention using sheathless standard guiding catheters.
We evaluated a sheathless transradial technique for interventions using standard five and six French nonhydrophilic guiding catheters. ⋯ Sheathless transradial intervention using standard 5 and 6 Fr guiding catheters is a safe and effective method for treatment of coronary and peripheral vascular lesions.
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Catheter Cardiovasc Interv · Nov 2011
Case ReportsThrombus formation after left atrial appendage exclusion using an Amplatzer cardiac plug device.
The feasibility and safety of left atrial appendage closure with the Amplatzer cardiac plug (AGA Medical Corp., Minneapolis, MN) have been recently published; no thrombus formation on the device surface has been reported previously. We describe a case of a 66-year-old man with permanent atrial fibrillation, previous stroke, and contraindication for long-term oral anticoagulant therapy. A 22-mm ACP device was deployed successfully without complications. ⋯ A 3-month follow-up echocardiogram confirmed the exclusion of the LAA but it demonstrated the presence of a thrombus on the atrial surface of the device. It was decided to keep the patient on acetyl salicylic acid 100 mg with the addition of enoxaparin 60 mg bid. Transesophageal echocardiogram demonstrated total resolution of the thrombus after 2 months.
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Catheter Cardiovasc Interv · Nov 2011
Case ReportsTrans-pleural pericardiocentesis: revisiting an old technique.
Percutaneous access to the pericardial space serves both diagnostic and therapeutic purposes. Multiple approaches have been described, which include the apical, sub-xiphoid, trans-atrial, and trans-bronchial techniques. ⋯ Here we revisit the use of this technique in a patient. Future development of this technique, using a noncompliant balloon to expand the pleuropericardial interface, may avoid the need for a pericardial window in oncology and rheumatology patients with recurrent pericardial effusions.