Atrial fibrillation is highly prevalent, and affected patients carry an increased risk of a number of complications, including heart failure and thrombo-embolism. Over the past years there has been increasing interest in the role of inflammatory processes in atrial fibrillation, from the first occurrence of the arrhythmia to dreaded complications ...

Introduction: Management of complications in long-term LVAD support like aortic regurgitation, progressive decline of right ventricular function, or pump thrombosis are challenging.
Methods and Results: After 2.5 years on a HeartMate II left ventricular assist device (LVAD) a 59-year-old patient was admitted to hospital due to severe hemolysis caused by a ...

Treatment options for advanced stages of congestive heart failure remain limited. Left ventricular assist devices (LVADs) have emerged as a means to support failing circulation. However, these devices are not without significant risk such as major open chest surgery. We utilized a novel approach for device placement at the aorto-left ...

Coronary artery disease was considered a male disease for many years. However, nowadays, coronary artery disease constitutes the leading cause of death in women, although there are a lot of gender-related differences regarding the presentation of acute myocardial infarction, its diagnosis, its treatment, short- and long-term mortality rates, and post-acute ...

PURPOSE: Catheter ablation of ventricular tachycardia (VT) often requires a combined epicardial and endocardial approach. An open irrigated catheter for epicardial ablation of ventricular tachycardia is commonly used. However, this can be associated with problems of fluid accumulation in the pericardial space necessitating repeated aspirations and interfering with catheter-tissue contact. ...

OBJECTIVE:: Instrumental variable analysis can estimate treatment effects in the presence of residual or unmeasured confounding. We compared ordinary least squares regression versus instrumental variable estimates of the effects of selective cyclooxygenase-2 inhibitors (COX-2s) relative to nonselective nonsteroidal anti-inflammatory drug (NSAID) prescriptions on incidence of upper gastrointestinal complications and myocardial ...

Aims: To assess the immediate and long-term outcomes of transcatheter closure of ventricular septal defect (VSD) in combination with percutaneous coronary intervention (PCI) in patients with VSD complicating acute myocardial infarction (AMI). Methods and results: Data were prospectively collected from 35 AMI patients who underwent attempted transcatheter VSD closure and ...

EXPANDED ABSTRACT: CITATION: Thiele H, Zeymer U, Neumann FJ, Ferenc M, Olbrich HG, Hausleiter J, Richardt G, Hennersdorf M, Empen K, Fuernau G, Desch S, Eitel I, Hambrecht R, Fuhrmann J, Böhm M, Ebelt H, Schneider S, Schuler G, Werdan K; IABP-SHOCK II Trial Investigators: Intraaortic balloon support for myocardial ...

Aims: To establish success and complication rates of excimer laser coronary atherectomy (ELCA) in a contemporary series of patients with balloon failure during percutaneous coronary intervention (PCI) of both chronic total occlusions (CTO) and lesions with distal TIMI 3 flow. Methods and results: We identified 58 cases of balloon failure ...

Patent foramen ovale (PFO) may complicate left ventricular assist device (LVAD) therapy. We report a 70-year-old male with a HeartMate II LVAD at increased risk for thromboembolic stroke secondary to a PFO with right-to-left shunting and a large mobile thrombus on his right atrial pacing lead. Via percutaneous intervention, a ...

The purpose of this study was to find risk factors that are associated with complications of cerebral infarction in patients with atrial fibrillation (AF) and to discover useful association rules among these factors. The risk factors with respect to cerebral infarction were selected using logistic regression analysis with the Wald's ...

Unfractionated heparin is the most commonly used anticoagulant in ST-elevation myocardial infarction (STEMI) and its effect can be monitored with activated partial thromboplastin time (aPTT). However, the optimal aPTT range during heparin therapy after primary percutaneous coronary intervention (PCI) is yet to be defined. A mean aPTT was calculated of ...

Bronchoscopy is a procedure that is widely performed and is generally considered to be safe. Cardiac complications occurring during bronchoscopy are uncommon, and usually occur in elderly patients with co-existent coronary artery disease, hypertension or severely impaired pulmonary function with resting hypoxemia. We report an unusual patient who developed sudden ...

Surgical repair of a left ventricular pseudoaneurysm is challenging. Percutaneous closure with an AMPLATZER Septal Occluder (AGA Medical Corporation, Golden Valley, MN) has evolved to be an effective alternative to conventional surgery with less complication. We report a case of severe hemolytic hyperbilirubinemia and acute renal failure after percutaneous left ...

Thrombolysis in myocardial infarction (TIMI) is a prognostic score developed for managing the high risk of cardiac events immediately after unstable angina and non-ST elevation myocardial infarction (UA/NSTEMI). In Asian populations that have a higher rate of bleeding complications, data about TIMI score are lacking. Using a Japanese multicenter registry, ...

Transient left ventricular apical ballooning or takotsubo syndrome is characterized by transient left ventricular dysfunction, electrocardiographic changes that mimic acute myocardial infarction, and minimal release of myocardial enzymes, with no evidence of obstructive coronary artery disease. Although prognosis and outcome are relatively good, reported complications include intraventricular thrombi and embolic ...

OBJECTIVES: Endovascular treatment for peripheral arterial disease (PAD) is increasingly used and also continuously applied to more severe vascular pathology. Only few studies report on systemic complications during these procedures, but it is important to address these risks. We report the results of a recent national audit on cardio- and ...

AIMS: Despite the increasing number of device implants worldwide, little is known about the early and late complications of cardiac resynchronisation therapy (CRT) or the incidence of these complications in patients with different heart failure aetiologies. We aim to determine procedural success and early and late complications in CRT patients.METHODS ...

Temporary transcoronary unipolar pacing is a validated simple, effective, and safe alternative to temporary transvenous pacing of the right ventricle for the treatment of relevant bradyarrhythmias complicating percutaneous coronary intervention. We describe the use of rapid transcoronary pacing to aid precise placement of a stent in the left main coronary ...

Cocaine is a frequently used recreational drug which imposes important health problems with even life-threatening cardiotoxicity. The therapeutic use of cocaine is nowadays restricted to topical anesthesia in ophthalmological and nasal surgery but the possible hazards of this local anesthesia are not always fully appreciated. A 51-year old male patient ...

We report the case of a patient with an extensive anterior myocardial infarction complicated by left ventricular systolic dysfunction, left ventricular apical thrombus and an apical left ventricular aneurysm following failed thrombolysis. We obtained serial two-dimensional echocardiograms at short intervals in the acute phase and also during the months of ...

A 58-year-old male patient, suffering from an acute anterior ST-elevated myocardial infarction, developed cardiogenic shock, despite an optimal revascularization and hemodynamic support through the use of an intra-aortic balloon pump and inotropic pharmacological agents. Additional support was provided by a left ventricular assistance device Impella LP 5.0 (Abiomed, Europe GmbH). ...

This study aimed to explore the mechanism of membranous ventricular septal defect complicated with tricuspid regurgitation and the significance of ventricular septal defect occlusion by echocardiography. A total of 43 patients with membranous ventricular septal defect complicated with tricuspid regurgitation were observed by echocardiography and the changes in length, area ...

Antiplatelet therapy could prevent stent thrombosis, but may be associated with an increased risk of bleeding. Recent studies have revealed that bleeding complications are relatively frequent in patients with acute coronary syndromes. Our aim was to describe the current status of antiplatelet therapy for Japanese patients with acute myocardial infarction ...

The randomized TRial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet InhibitioN with Prasugrel-Thrombolysis In Myocardial Infarction (TRITON-TIMI) 38 trial compared prasugrel and clopidogrel in patients with acute coronary syndrome undergoing percutaneous coronary intervention (PCI). Patients treated with prasugrel had fewer ischemic events but more procedure-related bleeding. In the ...

Perioperative myocardial ischemia is rare but serious complication of CABG. Graft dysfunction, coronary artery thrombosis and incomplete revascularization are main causes. Pharmacological treatment, intra aortic counter pulsation and immediate additional grafting have limited results. Treatment strategy based on coronary angiography findings could lessen the burden of high mortality rate in ...

Left ventricular lead misplacement is an infrequent complication of pacemaker or defibrillator lead insertion. It most commonly occurs through defects in the interatrial septum. Although patients may remain asymptomatic, the most common clinical complication is a thromboembolic event. Percutaneous technology has been described to safely remove misplaced leads. We present ...

We describe a 41-year-old woman who presented with acute ST-segment elevation myocardial infarction. Emergent percutaneous intervention was performed with aspiration thrombectomy followed by coronary artery stenting. White material was extracted from the aspiration catheter. Reperfusion therapy after stenting was successful. After undergoing a cardiac rehabilitation program, she was discharged from ...

AIMS: Catheter ablation is a potentially curative treatment for atrial fibrillation (AF). However, complications such as ischaemic stroke are more frequent and more severe compared with ablation procedures for other arrhythmias. Irrigated-tip catheters have been reported to reduce the risk of stroke. The present study aimed to evaluate predictors of ...

Epicardial ablation has lately become a necessary tool to approach some ventricular tachycardias in different types of cardiomyopathy. Its diffusion is now limited to a few high volume centers not because of the difficulty of the pericardial puncture but since it requires high competence not only in the VT ablation ...

One of the greatest challenges in medicine consists of arriving at a correct diagnosis despite different presentations of the disease. We present a case in which, notwithstanding the initial diagnosis, the search for the etiology was essential for clinical guidance. Left ventricular non-compaction (LVNC) was first described by Chin et ...

Percutaneous coronary intervention for acute coronary syndrome or non-ST-elevation myocardial infarction requires the use of potent oral and intravenous anti-platelet and antithrombin medications. Although these potent antithrombotic agents and regimens may increase the effectiveness of percutaneous coronary intervention, they are also generally associated with an increased risk of vascular access ...

Stent thrombosis (ST) is the most dramatic complication of coronary stenting. Mechanisms of ST are multiple, including procedural and patient-related factors. A considerable burden of metal inside the coronary has been associated with ST as suggested by the higher rate of ST in case of multiple overlapping or complex two ...

INTRODUCTION: More than four decades have passed since the first clinical use of an (IABP) to improve the clinical scenario for patients with chronic left ventricular failure. The original IAB catheter size was 15 French (Fr), requiring an open surgical insertion and removal. This therapy has now become the most ...

Cerebral complications after snake bites-particularly ischemic complications-are rare. Very few cases of cerebral infarction resulting from a viper bite have been reported, and we call attention to this uncommon etiology. We discuss 3 authenticated reports of acute ischemic cerebrovascular accidents after 3 typical severe envenomations by Cerastes cerastes vipers. The ...

Intracoronary dehiscence of the radiopaque ring of a guiding catheter is a rare complication, which could lead to myocardial infarction, emergency surgery, or even death. We describe the percutaneous retrieval of the catheter material from the right coronary artery, thus avoiding surgery and related complications.

Abstract  Introduction: Left ventricular assist device (LVAD) support is associated with many complications, but relatively few studies have examined the full spectrum of complications beyond infectious and bleeding events. Methods: We conducted a retrospective review of patients receiving either a pulsatile-flow Heartmate XVE (HM1; Thoratec Corp., Pleasanton, CA, USA) or ...

The goal of this analysis was to determine the association between intraprocedural complications and clinical outcomes among patients with high-risk non-ST-segment elevation acute coronary syndrome (NSTEACS) undergoing percutaneous coronary intervention (PCI). Among patients undergoing PCI for NSTEACS, the relationship between intraprocedural complications and clinical outcomes, independent of epicardial and myocardial ...

Dual antiplatelet therapy (DAPT) with a thienopyridine and aspirin has been the standard of care post coronary stent implantation. DAPT has been shown to reduce the risk of stent thrombosis (ST) and complications of myocardial infarction and death after placement of a drug-eluting stent (DES) and bare-metal stent (BMS).This article ...

Cardiogenic shock complicating acute myocardial infarction continues to be a devastating event associated with extremely high mortality. The results of the Intraaortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial,(1) now reported in the Journal, show that in patients with acute myocardial infarction and hemodynamic compromise who undergo revascularization, ...

PURPOSE: Angiographic vasospasm (CVS) has been accused to be the main cause of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (SAH). However, treatment success including endovascular treatment remains to be improved. We performed a pattern analysis of ischemic lesions in SAH patients in the absence of angiographic cerebral vasospasm ...

ABSTRACT: We emphasize the role of Tc-99m-3,3-diphosphono-1,2-propanodicarboxylicacid (DPD) scintigraphy as a noninvasive tool to distinguish transthyretin (TTR)-related cardiac amyloidosis from other forms of cardiac amyloidosis. We report the case of a 76-year-old male patient suffering from congestive heart failure in whom imaging investigation by DPD scintigraphy showed a strong cardiac ...

Although stent entrapment is a rare event during percutaneous coronary intervention, stent entrapment can cause stent breakage or loss, which results in fatal complications such as stent embolism or acute myocardial infarction. We report one case of stent entrapment that was successfully treated by a snare via a contralateral transfemoral ...

The incidence of cardiac events in patients with variant angina pectoris without significant coronary stenosis and ST-segment elevation was analyzed during a 12-year follow-up period in 273 consecutive patients (82% men) admitted from 1986 through 2010. Among the 252 patients who underwent electrocardiography during pain, 205 had ST-segment elevation (82%) ...

BACKGROUND:: Differentiation of ST-segment elevation on electrocardiogram (ECG) from acute pericarditis (AP), normal variant early repolarization (ER) and early repolarization of left ventricular hypertrophy (ERLVH) can be problematic. Hence, the authors evaluated the accuracy of the ST/T ratio in ECG to more optimally differentiate between AP, ST-segment elevation, ER and ...

Older individuals (especially women) enduring an inciting emotional or physical event are prone to developing left ventricular ballooning syndrome. Ballooning of apical distribution is the most common type. However, a midventricular variant is increasingly reported. As this variant becomes further delineated, we describe a case series in which various morphological ...

About 4% of African Americans possess the isoleucine 122 (V122I) variant of transthyretin, associated with cardiac amyloidosis beyond ages of 55 to 60 years. Transthyretin amyloidosis associated with variant V122I (ATTR V122I) is likely to be an important cause of heart failure in Afro-Caribbean populations, but the high prevalence of ...

Due to the ageing population and raised life expectancy, elderly patients are increasingly referred for percutaneous coronary intervention (PCI) during acute coronary syndromes (ACS). Bleeding complications are not infrequent during ACS, occurring in 2-5% of patients with prognostic and economic consequences. In particular, periprocedural bleeding and vascular complications are associated ...

Thromboembolic events are known complications of left atrial ablation therapy. We describe a complication which may also lead to systemic thromboembolism that has not been reported so far: the formation of a moving structure attached to the fossa ovalis after an attempted transseptal puncture in a 66-year old patient with ...

BACKGROUND: Left ventricular dysfunction (LVD) is a condition resulting from clustered structural or functional cardiac disorder that reduces the ability of the ventricle to fill with or eject blood. The impaired ventricular function can be attributed to unfavorable ventricular remodeling. Among the pathways that contribute to remodeling process, matrix metalloproteinases ...