BACKGROUND AND PURPOSE:Stenosis of the carotid artery may cause reduced hemodynamic and neural function that may be ameliorated with CAS. The goal of this study was to evaluate short- and long-term hemodynamic and clinical effects after CAS.MATERIALS AND METHODS:Hemodynamic parameters were acquired by PCT within 1 week before CAS and ...

BACKGROUND: Pulmonary vein stenosis (PVS) is a rare condition that can lead to worsening pulmonary hypertension and cardiac failure in children, and it is frequently lethal. Surgical and transcatheter approaches are acutely successful but restenosis is common and rapid. METHODS AND RESULTS: We reviewed outcomes among patients who underwent transcatheter ...

ABSTRACT: INTRODUCTION: We report a rare coronary anomaly presenting with aborted sudden death in an octogenarian. An anomalous left coronary artery from the pulmonary artery is a rare coronary anomaly which usually presents in the first year of life. Survival into adulthood and the elderly years is extremely rare. CASE ...

ABSTRACT: Copeptin is a peptide derived from pre-provasospression along with arginine vasospressin. In the setting of aneurysmal subarachnoid hemorrhage (SAH), elevated serum copeptin levels correlate with vasospasm, inpatient mortality, mortality at 1 year, and poor functional outcome at 1 year. The potential role of serum copeptin levels in the management ...

A 62-year-old African American woman presented to her primary care physician with binocular photopsias increasing in frequency over 1 year. Magnetic resonance angiography of the brain revealed bilateral 3-mm internal carotid artery aneurysms. She was referred to vascular medicine for further work-up. Her physical examination was unremarkable except for a ...

BACKGROUND AND PURPOSE: The present study aimed to investigate the endovascular indication with close monitoring of both endovascularly treated and untreated unruptured vertebrobasilar aneurysms. MATERIALS AND METHODS: In the past 2 years, 36 patients [7 women and 29 men with a mean age of 48.5 years (range, 13-75 years)] who ...

OBJECTIVE: We report a retrospective analysis of our experience in bypass vein graft surgery to lateral tarsal, medial plantar, and lateral plantar arteries for treatment of critical limb ischemia (CLI). METHODS: Between January 1991 and February 2010, we performed 137 inframalleolar bypass graft surgeries; of these, 25 (18%) were conducted ...

BACKGROUND: Unicommissural aortic valves (UAVs) are rare anomalies in which adjacent cusps of two commissures are congenitally fused. Currently, features of UAVs are poorly characterized. METHODS: Fifty-two surgical and autopsy cases of UAV at Mayo Clinic were evaluated for various clinicopathologic features. Histology and immunohistochemistry (IHC) were used in 30 ...

The recent American College of Cardiology/American Heart Association guideline recommended carotid artery stenting (CAS) as an alternative to carotid endarterectomy (CEA) for symptomatic patients. This and the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) form the basis for seeking more liberalized indications and reimbursement for CAS. For the years 2005-2007, ...

BACKGROUND:sICAM-1 is associated with endothelial dysfunction and clinical cardiovascular disease. We investigated the relationship of subclinical atherosclerosis with sICAM-1 concentration.METHODS:sICAM-1 concentration was assayed at year 15 of the CARDIA Study (black and white men and women, average age 40 years). We assessed progression of coronary artery calcification (CAC) through year ...

A 60-year-old man was admitted to our hospital because of aortic stenosis with a peak pressure gradient of 61 mmHg, moderate aortic regurgitation, and a dilatation of the ascending aorta of 50 mm in diameter, which had grown 5 mm in 2 years. Because of severe aortic stenosis with a ...

OBJECTIVE: We sought to identify predictors of structural valve deterioration after pulmonary valve replacement in patients with tetralogy of Fallot. METHODS: A retrospective review of 227 patients with tetralogy of Fallot who underwent stented bioprosthetic pulmonary valve replacement at Children's Hospital Boston between 1994 and 2009 was performed. Patient and ...

Common arterial trunk is a congenital malformation that is relatively uncommon, representing 0.21-0.34% of congenital heart disease. Natural history, if not treated, leads to early death. Cardiac surgery has been modifying its natural course during the last 30 years by prolonging the lifespan of patients affected. Despite surgical mortality improvements ...

Stroke is the third most common cause of death in North America and ever year approximately 700,000 new strokes are reported in the United States. Seventy-five percent of these occur in the distribution of the carotid arteries. Among strokes of a thromboembolic etiology, carotid occlusive disease is the most common ...

A rare case requiring replacement of an intact Smeloff-Cutter ball prosthesis in the mitral position 40 years after implantation is presented. The Smeloff-Cutter ball valve prosthesis was designed to have two open cages. It has two potential advantages: a relatively large, effective orifice area and its self-washing effect that prevents ...

OBJECTIVES: The primary objective of this study was to measure the width and depth of peripheral veins using bedside ultrasound in children younger than 3 years. Secondary objectives included the evaluation of other vein and patient characteristics that may affect intravenous (IV) site selection. Assessment of nursing preferences for peripheral ...

BACKGROUND: The ideal technique for addressing partial anomalous pulmonary venous drainage into the superior vena cava (SVC), with or without sinus venosus atrial septal defect (ASD), is debated. The risk of sinus node dysfunction, systemic, or pulmonary venous channels obstruction has led to different techniques being developed. We present our ...

Background: We hypothesized that chronic atrial fibrillation (AF) originated from the pulmonary veins, and was maintained by irregular activations of the posterior left atrium. We had performed the box pulmonary vein isolation procedure for the elimination of chronic AF associated with solitary mitral valve disease from 1999 to 2004. This ...

Acute traumatic transection of the aorta (ATAT) is a devastating event. Transluminal endovascular aortic repair (TEVAR) has meanwhile become an excellent alternative for such lesions. A 27-year-old woman sustained a multiple trauma in a car accident including ATAT which was treated by aortic stent graft placement. Six years after the ...

We report on the spontaneous healing of a posttraumatic focal coronary aneurysm in a previously healthy 61-year-old man after his involvement in a motor vehicle accident, resulting in blunt chest trauma that injured the anterior wall of his left ventricle. Left-sided cardiac catheterization and selective coronary angiography 1 month after ...

Neointimal hyperplasia mainly develops within several months of coronary stent deployment, after which it stabilizes. Although it was widely accepted, particularly during the bare-metal stent (BMS) era, that in-stent restenosis (ISR) generally does not present as an acute coronary syndrome (ACS), but rather as a gradual recurrence of angina symptoms, ...

ObjectiveTo examine whether a 10-year change in occupational standing is related to carotid artery intima-media thickness (IMT) 5 years later.MethodsData were obtained from 2350 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Occupational standing was measured at the Year 5 and 15 CARDIA follow-up examinations when ...

Intercoronary continuity refers to a bidirectional flow in patients with normal coronary arteries. Although such connections have been proposed to have a protective role against potential obstructive coronary artery disease, their functional significance is unclear. We report on a 53-year-old woman who presented with typical chest pain. Exercise myocardial perfusion ...

We used cardiovascular magnetic resonance (CMR) to demonstrate cardio-vascular anatomy and function in a 42 year-old man with a D-Transposition of the great arteries who survived a sudden cardiac arrest.

Abstract  Valve deterioration following aortic valve replacement using the Freestyle stentless bioprosthesis is related to cusp tear, operative injury, or infection. We report a patient with aortic regurgitation due to perforation of the right coronary cusp 10 years after implantation of a Freestyle stentless bioprosthesis in the absence of endocarditis. ...

BACKGROUND: Vascular calcification independently predicts cardiovascular disease, the major cause of death in kidney transplant recipients (KTRs). Longitudinal studies of vascular calcification in KTRs are few and small and have short follow-up. We assessed the evolution of coronary artery (CAC) and thoracic aorta calcification and their determinants in a cohort ...

BACKGROUND: The UK Multicentre Aneurysm Screening Study (MASS) demonstrated reduced mortality from screening for abdominal aortic aneurysm (AAA). As a result, the National Health Service AAA Screening Programme was introduced in England. This study reports the results from an early-implementation screening centre. METHODS: Men aged 65 years were invited to ...

Inferior vena cava (IVC) thrombosis at its hepatic portion (also known as obliterative hepatocavopathy [OH]), in the absence of systemic or local diseases such as vasculitis, coagulopathy, infection and malignancy, is a rare event. We report the case of a 25-year-old woman with progressive abdominal pain and leg edema after ...

AimsThe time course of atherosclerosis burden in distinct vascular territories remains poorly understood. We longitudinally evaluated the natural history of atherosclerotic progression in two different arterial territories using high spatial resolution magnetic resonance imaging (HR-MRI), a powerful, safe, and non-invasive tool.Methods and resultsWe prospectively studied a cohort of 30 patients ...

A 14-year-old boy presented with an unusual bulging chest noted to be increasing slowly over the last few years. He had no other complaints. Cardiac echocardiography and cardiac magnetic resonance imaging (MRI) showed aneurysmal dilation of the ascending aorta with moderate aortic valve insufficiency and moderate pericardial effusion. The boy ...

Porcine bioprosthesis (bioroots) are an attractive surgical strategy for ascending aorta and arch replacement. This study evaluated the perioperative and late outcomes using this strategy for proximal aortic aneurysmal disease. Between March 1998 and November 2009, 170 patients (40% women; median age, 70 years) underwent proximal thoracic aortic replacement using ...

The orthopedic metallic pins and wires migration for the chest cavity is uncommon and rarely reported in medical literature although it is potentially lethal, especially when they reach the heart or mediastinum great vessels. We reported a case of Kirschner wire withdrawal, for right postero-lateral thoracotomy, which were transfixanting ascendent ...

ABSTRACT: BACKGROUND: the ergotamine tartrate associated with certain categories of drugs can lead to critical ischemia of the extremities. Discontinuation of taking ergotamine is usually sufficient for the total regression of ischemia, however, in some cases it could be necessary thrombolytic and anticoagulant therapy to avoid amputation. Case report: A ...

We report an extremely rare case of deformity of the pulmonary sinus of Valsalva with pulmonary valvular stenosis 42 years after a pulmonary annular-sparing operation for tetralogy of Fallot. Aortic regurgitation with deformity of the sinus is also noted. At the previous operation, the right ventricular outflow tract was augmented ...

Purpose:To investigate the prevalence and severity of subclinical coronary atherosclerosis and plaque characteristics in asymptomatic subjects according to the presence or absence of metabolic syndrome (MS) with multidetector computed tomography (CT).Materials and Methods:This study was approved and the requirement for informed patient consent was waived by the local institutional review ...

BACKGROUND: The appropriate role for surgery and endovascular therapy for severe intermittent claudication (IC) remains controversial. We present our results after infrainguinal autogenous bypass for severe IC more than 10 years ago giving a reasoned argument to perform vein bypass as the primary procedure for severe IC. METHODS: Our prospectively designed ...

OBJECTIVE: Technical controversies exist in valve-preserving aortic root replacement. We sought to determine predictors of long-term stability of the aortic valve. METHODS: A total of 430 patients (aged 57 ± 15 years, 323 male) underwent valve-preserving aortic root surgery (remodeling in 401, reimplantation in 29) between 1995 and 2009 and ...

BACKGROUND AND PURPOSE: To evaluate the factors predictive of contralateral progression in children and adolescents with unilateral moyamoya disease (MMD), the authors retrospectively analyzed clinicoradiological findings. METHODS: The records of 394 consecutive patients with MMD aged 0 to17 years were reviewed. Unilateral MMD was defined based on the typical angiographic ...

PURPOSE: This study was designed to assess the long-term outcome of selected patients with aortic, aortoiliac, and isolated common iliac aneurysms treated with the GORE EXCLUDER(®) stent-graft. METHODS: Between December 1998 and June 2010, 121 nonconsecutive patients underwent insertion of a GORE EXCLUDER(®) stent-graft to treat an aortic (n = 80; 66%), ...

We compared arterial elasticity in American Indian and Caucasian children, adolescents, and young adults, and we assessed whether demographic, body composition, and ambulatory activity measures were predictive of arterial elasticity within each group. Fifty-one American Indians and 66 Caucasians between the ages of 8 and 30 years were assessed on ...

This is the case of 28 year-old adult with suspected congenital heart disease since birth, not treated in childhood at the his family's choice. At 27 years old, he was diagnosed with pulmonary atresia with ventricular septal defect and systemic-pulmonary collaterals, where surgery was contraindicated. A new review in our ...

An 8 year old girl presents with cyanosis, exertional dyspnoea, and palpitation only. X-ray displayed a typical coeur en sabot heart and auscultsation revealed a harsh ejection systolic murmur. Echocardiography confirmed Tetralogy of Fallot (McGoon ratio 1.3) and computed tomography was requested for further investigation of pulmonary stenosis. A vascular ...

We present a case of multiple interventions to treat symptomatic stenosis of the superior vena cava in a child, with end-stage renal disease and a history of long-term hemodialysis, who had required indwelling central venous catheters for several years. The stenosis was successfully treated with an Edwards Valeo Lifestent, but ...

A 12-year-old girl with hypoplastic right heart, double inlet left ventricle, and transposition of the great arteries had a lateral tunnel Fontan operation 8 years previously. She developed symptoms related to a combination of stenosis in the inferior caval venous pathway, a fenestration, and leak in the lateral tunnel. These ...

Object In recent years, the authors have noticed a growing number of programmable valve defects at their institution. Therefore, they conducted this study to evaluate the increased incidence of malfunctioning valves. Methods They investigated all revisions that had been performed at their institution between 1994 and 2010 for dislodgement of ...

Intracranial stenosis as late sequela after cerebral radiation therapy for medulloblastoma is an exceptionally rare finding. We report for the first time a case of 31-year-old patient with a history of medulloblastoma 25 years ago and now presenting with radiation-induced high-grade basilar stenosis and recurrent ischemic symptoms despite best medical ...

Porcine valves are generally known to have a limited durability. The case is reported of a 35-year-old male patient who underwent mitral valve replacement with a 28 mm Liotta porcine bioprosthesis. At reoperation 21 years later, the bioprosthesis was replaced (uneventfully) with a second porcine bioprosthesis. Pathological and X-radiographic examinations ...

We herein describe a rare case of a concurrent submitral left ventricular (LV) aneurysm and an aneurysm of the sinus of Valsalva in a 65-year-old Japanese woman. The patient had a history of mitral valve replacement (MVR) for mitral regurgitation caused by a submitral LV aneurysm at the age of ...

Aseptic endocarditis is an uncommon complication of Behçet's disease (BD). We describe a rare case of a 39-year-old female who had BD with aseptic endocarditis of the tricuspid valve (TV) presenting as tricuspid stenosis. She was diagnosed with BD four years ago. The mucocutaneous lesions were well-controlled with colchicine and ...

The right internal thoracic artery (RITA) is biologically identical to the left ITA, yet is rarely used in coronary artery bypass graft surgery (CABG). We examined the results and long-term patency of RITA grafts. Between 1986 and 2008, 991 consecutive RITA graft angiograms for postoperative cardiac symptoms were evaluated by ...