Heart, lung & circulation
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Heart, lung & circulation · Dec 2012
Case ReportsTransjugular and transseptal treatment of a degenerated mitral valve prosthesis with a balloon-expandable biological valve.
In selected high-risk patients, trans-catheter valve implantation is an emerging therapy for a degenerated bioprosthesis in need of repeated valve replacement. During the last two years, valve-in-valve implantations have mainly been performed in the aortic position and only rarely in the mitral position. Here we describe for the first time the case of a 62 year-old female with severe mitral regurgitation of a degenerated Carpentier Edwards bioprosthesis treated by transjugular, transseptal implantation of a SAPIEN-XT valve. In conclusion this case, together with previous reports, show the feasibility and safety of percutaneous valve-in-valve implantations to treat a degenerated bioprosthesis.
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Heart, lung & circulation · Dec 2012
Case ReportsExtracorporeal membrane oxygenation support in a situation of diagnostic dilemma.
Severe acute respiratory distress syndrome (ARDS) in children carries a high morbidity and mortality. High frequency ventilation and extracorporeal membrane oxygenation (ECMO) are used as rescue modes of support in difficult situations. Malignancy may be considered to be a relative contraindication to ECMO support. We report a case where the decision was made to support the patient with ECMO for fulminant Epstein-Barr (EBV) infection while investigations were being done to exclude an underlying malignancy.
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Heart, lung & circulation · Dec 2012
Case ReportsNeurocardiogenic pulmonary oedema: initial presentation of multiple sclerosis.
A previously healthy 20 year-old male presented with headache, acute pulmonary oedema and left ventricular dysfunction requiring intensive care admission. Cardiorespiratory symptoms resolved within three days; however, the patient complained of persistent headache and had gait unsteadiness. ⋯ The patient was subsequently diagnosed with multiple sclerosis. This case describes a rare initial presentation of multiple sclerosis with acute pulmonary oedema and cardiac dysfunction secondary to a lower brainstem lesion.