It is well established that high plasma von Willebrand factor (VWF) levels are associated with an increased risk of arterial thrombosis, including myocardial infarction and ischemic stroke. As plasma VWF levels are, to a large extent, genetically determined, numerous association studies have been performed to assess the effect of genetic ...

We report a case of syphilitic aortitis complicated by multiple aortic aneurysms in a 50-year-old man with elevated rapid plasma reagin titer of 1:128 and positive Treponema pallidum particle agglutination test. 256-slice MDCT depicted two saccular aneurysms in the descending thoracic aorta with a markedly thick mural thrombus causing the ...

This study was intended to investigate changes in cardiac biomarkers and pulmonary hemodynamic effects of invasive treatment in patients with intermediate-risk (hemodynamic stability with evidence of right ventricle dysfunction and/or myocardial injury) pulmonary embolism. Also, to also evaluate if natriuretic peptide type-B (NT-proBNP) plasma levels are associated with right ventricle ...

Objective: Circulating endothelial progenitor cells (EPCs) are a specialized subset of stem/progenitor cells found in bone marrow. They participate in neo-vascularization of injured vessels and predict cardiovascular outcome in patient at risk. Several factors influence their migration and proliferation, among which is the widely studied stromal-derived factor-1α (SDF-1α). In cardiovascular ...

Implantation of bare metal stents (BMS) induces the release not only of particulate debris, but also of soluble vasoconstrictors which contribute to microvascular impairment. So this study aimed at addressing the potential attenuation of such vasoconstriction using paclitaxel eluting stents (PES). Using a distal protection/aspiration device, coronary arterial blood was ...

This prospective study was performed on 311 consecutive knees in 227 patients for total knee arthroplasty. The aim was to assess the recent incidence of deep vein thrombosis (DVT) after total knee arthroplasty without chemoprophylaxis in Koreans, the efficacy of plasma d-dimer levels as a screening test, and the associated ...

There is evidence supporting the role of matrix metalloproteinases (MMPs) and their inhibitors (TIMPs) in aortic and abdominal wall connective tissue degeneration, resulting in aneurysm and hernia formation. Furthermore, clinical association studies have demonstrated increased prevalence of abdominal wall hernias in patients with aortic aneurysms. Our objective was to estimate ...

The mechanisms by which dietary sodium modulates cardiovascular risk are not fully understood. This study investigated whether sodium intake is related to carotid structure and hemodynamics and to plasma matrix metalloproteinase (MMP) activity in hypertensive adults. One hundred thirty-four participants were cross-sectionally evaluated by clinical history, anthropometry, carotid ultrasound, and ...

Osteopontin (OPN) has emerged as a key factor in inflammatory activation and cardiovascular remodelling. The aim of the present study was to investigate the involvement of OPN in fluoxetine amelioration of monocrotaline (MCT)-induced pulmonary inflammation and vascular remodelling in rats. Wistar rats were divided into control, MCT and two fluoxetine-treated ...

PURPOSE: To evaluate the pharmacokinetics and safety of the Zilver PTX Drug-Eluting Stent (Cook Medical, Bloomington, Indiana) in a normal porcine artery model. MATERIALS AND METHODS: Pharmacokinetic analyses were performed using 18 pigs, each implanted with four paclitaxel-coated stents. Paclitaxel remaining on the stents, delivered locally (to artery wall), regionally ...

The term pulmonary arterial hypertension (PAH) describes a rare group of diseases characterized by raised pulmonary vascular resistance, resulting from vascular remodelling in the pre-capillary resistance arterioles (<100mM). Left untreated, patients die from right heart failure, with a mortality approaching most serious cancers. Endothelin-1(ET-1) is not only a potent vasoconstrictor, ...

OBJECTIVES: (i) To validate two new image-based methods for finding the plasma arterial input function (AIF) and evaluate the performance of these and two similar techniques against arterial sampling. (ii) To evaluate the performance of all four image-derived AIF (IDAIF) methods against arterial sampling for measuring the F plasma clearance ...

BACKGROUND AND PURPOSE: The pathophysiology of cerebral aneurysms (CA) is linked to chronic inflammation.Endothelial damage is one of the first changes in CA walls resulted from inflammation.It has been shown that increase in plasma homocysteine (Hcy) impairs vascular endothelium and correlates with the development of atherosclerosis.However,the effect of hyperhomocysteinemia (HHcy) ...

OBJECTIVE: To evaluate an association between plasma concentration of total homocysteine (tHcy) and pulsatility indexes (PIs) of cerebral arteries in patients with lacunar infarction (LI), comparing control subjects. METHODS: Consecutive patients referred to a neurovascular ultrasound laboratory were evaluated from March 2007 to February 2008. LI was determined by high ...

Epidemiologic studies have correlated elevated plasma fibrinogen (hyperfibrinogenemia) with risk of cardiovascular disease and arterial and venous thrombosis. However, it is unknown whether hyperfibrinogenemia is merely a biomarker of the pro-inflammatory disease state or is a causative mechanism in the etiology. We raised plasma fibrinogen levels in mice via intravenous ...

BACKGROUND:: Tourniquet has been considered as a recognized cause of lower limb ischemia-reperfusion injury in the orthopedic field. This study investigates pulmonary function after tourniquet deflation and the protective effect of Shenmai injection (SMI), a traditional Chinese medicine. METHODS:: Twenty-eight patients undergoing lower extremity surgery were randomized into a control ...

Pulmonary arterial hypertension (PAH) is characterized by increasing pulmonary pressure, right ventricular failure, and death. The typical pathological changes include medial hypertrophy, intimal fibrosis and in situ thrombosis. Serotonin (5-HT) and other factors contribute to the development of pathologic lesions. Aspirin (ASA), a platelet aggregation inhibitor, inhibits 5-HT release from ...

Abstract Arterial stiffness is a prominent feature of vascular ageing and strongly predicts cardiovascular and total mortality. The β2-microglobulin, (β2M) a newly identified biomarker of peripheral arterial disease (PAD), is related to renal insufficiency, inflammatory and neoplastic diseases, but may also play a role in vascular dysfunction. However, the relationship ...

OBJECTIVE: To verify the existence of association between plasma levels of pro- or anti-inflammatory mediators and atherosclerotic burden at coronary and carotid arteries in individuals aged of 80 or more years old. METHODS: Healthy individuals aged between 80 and 102 years old (n=178) underwent evaluation of plasma cytokines and acute ...

BACKGROUND AND PURPOSE: Carotid artery stenosis is an important etiologic factor of stroke related to coronary artery bypass surgery. We evaluated clinical and laboratory factors to identify biomarkers for pre-existing carotid artery stenosis in patients undergoing coronary artery bypass surgery. METHODS: Between June 2006 and September 2008, 811 patients aged ...

Multidetector row computed tomography (MDCT) enables the accurate noninvasive assessment of coronary artery stenosis and plaque imaging. The characteristics of patients who have coronary artery disease (CAD) as assessed by MDCT coronary computed tomography (CT) are not well known. Participants consisted of 513 consecutive patients with suspected CAD who underwent ...

Rationale: Stent implantation into atherosclerotic plaques releases, apart from particulate debris, soluble substances that contribute to impaired microvascular perfusion. Objective: To quantify the release of vasoconstrictors and to determine the efficacy of coronary dilators to attenuate their action. Methods and Results: Using a distal protection/aspiration device, coronary arterial blood was ...

A 3-year-old, spayed female miniature dachshund was presented for vomiting and anorexia. Thoracic radiographs and CT scan revealed abnormal pulmonary opacities at bilateral caudal lobe. Cytological analysis of the pulmonary mass revealed the presence of large lymphohistiocytic cells and small lymphocytes with occasional neutrophils and plasma cells. An open lung ...

A rare case of a 54-year-old woman with absence of congenital posterior mitral leaflet, moderate mitral insufficiency, and large secundum-type atrial septal defect is reported. Two-dimensional color Doppler and transesophageal echocardiography revealed complete absence of the posterior mitral leaflet, a thick muscular formation replacing the posterior leaflet, a 3.3-cm secundum ...

We tried L-arginine for the treatment of pulmonary hypertension secondary to pulmonary embolism. The plasma brain natriuretic peptide (BNP) level inversely correlated with the plasma concentration of L-arginine. After oral supplementation of L-arginine, patient's symptoms (shortness of breath and general malaise), state of congestive heart failure, and exercise capacity all ...

Transposition of the great arteries with a ventricular septal defect and an associated aortopulmonary window is a rare anatomic combination having a high risk for pulmonary hypertension. Arterial switch with closure of the ventricular septal defect and repair of the aortopulmonary window is the procedure of choice, but a postoperative ...

Endothelin-1 (ET-1) and B-type natriuretic peptide (BNP) have been reported to be involved in numerous cardiovascular diseases. The study aim was to monitor the circulating plasma levels of these peptides in patients affected by aortic disease, and to identify any changes in such levels after surgical treatment. A total of ...

Percutaneous closure of secundum atrial septal defect (ASD II) is considered the treatment of choice in the majority of cases. Interrupted inferior vena cava with azygos continuation can make delivery of the occluder difficult or not possible. Transjugular, transhepatic approach or surgery can be the alternative. We present the case ...

Patients with coronary artery disease and atrial septal defect may have unique clinical characters. We describe an off-pump combined approach for intraoperative device closure of atrial septal defect during coronary artery bypass grafting.

Objective:  Alcohol septal ablation (ASA) has been shown to be an effective treatment in patients with hypertrophic obstructive cardiomyopathy (HOCM) who are refractory to medical treatment. We describe an alternative approach for septal ablation with glue (cyanoacrylate), which is particularly useful in patients with the collateral formation to the right ...

Microcatheters are often used for percutaneous coronary intervention via the retrograde approach through a collateral channel for chronic total occlusion lesions. Recently, we encountered an alarming case in which a septal collateral artery was dilated after the removal of a microcatheter. This dilated septal artery ruptured spontaneously and resulted in ...

Adults with congenital heart disease (CHD) and coronary artery disease (CAD) have unique clinical manifestation due to the coexistence of intracardiac anomalies and CAD. Case reports are rare in surgical management of CHD combined with CAD. Our goal is to study the outcome of surgical intervention of CHD and CAD ...

A 5-month-old boy was presented for surgical repair of scimitar syndrome associated with right lung hyperplasia, severe pulmonary hypertension, ventricular septal defect (VSD), and atrial septal defect. The calculated shunt fraction (Qp/Qs) was 3.1:1.0, pulmonary vascular resistance was 4.6, and the perfusion lung scan showed a marked decrease (11%) in ...

We present a case of a 65-year-old man who presented with atrial flutter and dilation of right heart was noted on transthoracic echocardiography. Transesophageal echocardiography revealed a large sinus venosus atrial septal defect close to superior vena cava and anomalous connection of right superior pulmonary vein. Additionally, real time three-dimensional ...

We present a 10-month-old boy with cyanosis. This is a rare case of pulmonary atresia, ventricular septal defect (VSD), major aorto-pulmonary collateral arteries (MAPCAs) to the right lung with absent native right pulmonary artery (RPA) in association with anomalous left pulmonary artery (LPA) from the ascending aorta (AAo). Echocardiography was ...

OBJECTIVES: Identification of variables influencing surgical outcome in patients treated for pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries. METHODS: A total of 90 consecutive patients (median age, 12 months; range, 20 days to 35 years), who had primarily undergone either 1-stage unifocalization (n = 69) or palliation to ...

To assess the immediate and mid-term outcome of transcatheter closure (TCC) using the first-generation Amplatzer duct occluder (ADO) in patients with ruptured sinus of Valsalva aneurysm (SOVA). Ruptured SOVA is a rare cardiac shunt lesion, with scant data about its TCC. Twenty patients (8 females and 12 males) aged 17-52 ...

Closure of ventricular septal defect (VSD) in children with elevated pulmonary vascular resistance (PVR) is associated with significant morbidity and mortality with pulmonary hypertensive (PH) episodes being a major postoperative problem. Flap valved closure of VSD is reported to decrease morbidity and mortality. We report our experience of closure of ...

A 26-year-old woman presented with acute hemolysis 1 month after percutaneous closure of an atrial septal defect. Three-dimensional transesophageal echocardiography was used to establish the diagnosis of a fistula from the aorta, toward the device and both atria. The patient required urgent surgical correction. Transcatheter closure of atrial septal defects ...

BACKGROUND: An additional malformation of the atrioventricular valve is occasionally encountered in patients with complete atrioventricular septal defect, and this may compromise accurate correction. METHODS: We reviewed 138 patients undergoing complete repair with two-patch technique between 1992 and 2008. The mean age was 7.1 + or - 8.3 months, and ...

We report the case of a 38-year-old man with a long-standing history of a small ventricular septal defect presented with chest pain. Electrocardiography revealed sinus rhythm, ST-segment elevation in leads V1-6. The chest X-ray showed mild cardiomegaly. He underwent cardiac catheterisation laboratory to primary coronary angioplasty. Coronary angiography showed normal ...

Right pulmonary artery-left atrial communication is a rare anomaly and is characterized by significant cyanosis and normal auscultation of the heart. Interventional closure of the fistula using occluder devices and coils have been rarely reported. We report an easy method of closure of the communication through trans-septal approach using an ...

OBJECTIVES: To perform surgical closure of a clinically significant arterial duct on children in a third world country. BACKGROUND: An arterial duct is one of the most common congenital cardiac defects. Large arterial ducts can cause significant pulmonary overcirculation, causing symptoms of congestive cardiac failure, ultimately resulting in premature death. ...

OBJECTIVE: Correction of tetralogy of Fallot has excellent long-term results. The present retrospective study investigates the indications for reoperation late after corrective surgery. METHODS: Data from 914 consecutive cases who underwent correction of tetralogy of Fallot in our department between 1960 and 2002 were retrospectively reviewed and analysed. In 91 ...

BACKGROUND: Biventricular repair of double-outlet right ventricle (DORV) with noncommitted ventricular septal defect (VSD) or subpulmonary VSD, associated with pulmonary stenosis, remains controversial. The usual technique, Rastelli or r?paration ? l'?tage ventriculaire (REV) procedure, may not meet a perfect biventricular outflow tract reconstruction in terms of hemodynamic performance and long-term ...

Ruptured sinus of Valsalva aneurysm (SOVA) is a rare albeit well-described entity and coexisting defects like ventricular septal defect, aortic regurgitation and, infrequently, atrial septal defect (ASD) have been reported. Until recently, open surgical closure with cardiopulmonary bypass was the mainstay of treatment. However, transcatheter closure of isolated ruptured SOVA ...

We report a woman with atrial septal defect and severe pulmonary hypertension with 25.0 Wood unit.m(2) of indexed total pulmonary vascular resistance. She underwent successful corrective repair of atrial septal defect after 2 years of treatment with sildenafil, and has been monitored for 4 years after repair. This case supports ...

Although surgery is the gold standard, percutaneous closure of an atrial septal defect (ASD) is gaining popularity. Nonoperative device closure is applicable only to secundum defects with appropriate anatomic characteristics. A 27-year-old man was referred for closure of a symptomatic secundum type ASD and suffered from a dramatic change in ...

Little is known about residual abnormalities after pulmonary embolism (PE). To assess risk factors and the clinical significance of perfusion defects in patients with PE. Consecutive patients receiving at least 3 months of anticoagulant for an acute PE were included in a prospective cohort study. Ventilation/perfusion lung scan, echocardiography, 6-min ...

We report a successful endovascular repair of a type B aortic dissection (TB-AD) with a ventricular septal defect (VSD) occluder. In a 39-year-old male patient with TB-AD, the proximal entry tear was 5 mm distal to the orifice of the left subclavian artery (LSA). Ascending aorta-left common carotid artery (LCCA)-LSA ...