BACKGROUND: Management of patients with co-existent coronary and carotid disease is a controversial and challenging issue. The risk for stroke after coronary artery bypass grafting (CABG) in patients with hemodynamically significant carotid stenosis is up to 30%. In these patients a common practice is to proceed first with the restoration ...

A communicating vein between the left renal vein and the left ascending lumbar vein has only rarely been reported in the imaging literature. There are very few reports of varicosity of this communicating vein. Nonetheless, awareness about this communicating vein is of utmost importance for surgeons performing aortoiliac surgeries and ...

We report a case of an anomalous course of the right coronary artery (RCA) through the right atrium, which was evaluated using dual-source CT angiography. There have been a few cases described previously in literature, but most of them were found either during surgery or at autopsy. Although this variant ...

Early diagnosis of pulmonary hypertension (PH) can potentially improve survival and quality of life. Detecting PH using echocardiography is often insensitive in subjects with lung fibrosis or hyperinflation. Right heart catheterization (RHC) for the diagnosis of PH adds risk and expense due to its invasive nature. Pre-defined measurements utilizing computed ...

An 8-year-old girl was admitted for a simple closure of echocardiographically diagnosed Atrial Septal Defect (ASD). During the operation the right pulmonary veins orifices were not detected in the left atrium and attempt to localize them led to the discovery of three additional anomalies, namely Interrupted Inferior Vena Cava (IIVC), ...

Rationale: The atrial septal defect is one of the most common congenital anomalies in adults, but it is rarely diagnosed. It is characterized by a defect in the interatrial septum that allows pulmonary venous return to pass from the left to the right atrium. A case of a 75-year-old female ...

In this paper, we propose a Minimum Average-cost Path (MACP) model for segmenting 3D coronary arteries by minimizing the average edge cost along path in discrete 4D graph constructed by image voxels and associated radii. Prim's Minimum Spanning Tree method is used for efficient optimization of the MACP model. The ...

Aortic stenosis (AS) is the most commonly acquired valvular heart disease in the Western world (2-7% of the population aged > 65 years) and the mortality for untreated symptomatic severe AS is up to 50-60% at 2 years in high-risk patients. This review summarizes laboratory and recent clinical investigations concerning ...

In a few studies, huge anatomical variability of coronary venous system (CVS) has been documented without analysis of its variants. The aim of the present study was to evaluate anatomical variants of CVS in multislice computed tomography (MSCT). In 199 patients (114 males, age 56.6±11.5 years), a 64-slice computed tomography ...

There is only limited data on coronary artery aneurysms (CAA) after drug-eluting stent (DES) implantation. Two hundred-fifty one patients who had 2 angiographic follow-ups at 8 months and 28-36 months, respectively, after the index procedure with DES from 2003 to 2007 were enrolled. A CAA was defined as a localized ...

SUMMARY AT A GLANCE: Coronary artery disease is known to be prevalent in IPF. When and how to screen for this comorbidity remains uncertain. We report on the utility and predictive characteristics of coronary calcification, assessed on routine chest CT, for underlying coronary artery disease in a cohort of patients ...

We explored the association of noncoronary cardiac abnormalities with coronary artery dilation and with laboratory inflammatory markers early after Kawasaki disease (KD) diagnosis. Left ventricular (LV) dysfunction, mitral regurgitation (MR), and aortic root dilation occur early after diagnosis; their associations with coronary artery dilation and inflammatory markers have not been ...

BACKGROUND: It has recently been shown that systemic endothelial dysfunction is associated with airflow limitation in COPD. We conducted this ex vivo study to assess whether endothelial dysfunction of pulmonary arteries of former smokers was associated with modifications of airway functions. METHODS: Pharmacological experiments were conducted on arterial and bronchial ...

Ginsenosides, the active components found in Panax ginseng, have been reported to inhibit the cardiac hypertrophy in rats. This study aims to observe the potential effect of total ginsenosides (TG) on the hypertrophic vascular diseases. The model of vascular neointimal hyperplasia was established by rubbing the endothelia of the common ...

Aortic involvement is a potential life-threatening complication of ankylosing spondylitis, usually occurring late in the course of this frequent disease. Inflammatory lesions evolving to fibrosis are primarily localized in the aortic root causing regurgitation, but this process can extend into the left atrium (subaortic bump) involving the mitral valve and ...

We present the case of a 54-year-old female with a previous history of lung fibrosis secondary to methotrexate used for rheumatoid arthritis who was referred to cardiology evaluation due to precordial pain. Echocardiography showed biatrial enlargement with an enlarged coronary sinus and tubular image posterior to the heart. On the ...

The aim of the present study was to assess the clinical and prognostic significance of right ventricular (RV) dilation and RV hypertrophy at echocardiography in patients with idiopathic pulmonary arterial hypertension. Echocardiography and right heart catheterization were performed in 72 consecutive patients with idiopathic pulmonary arterial hypertension admitted to our ...

The use of pulmonary artery catheters has diminished so that other technologies are emerging. Central venous oxygen saturation measurement, SCVo2, as a surrogate for mixed venous oxygen saturation measurement, SVo2, is simple and clinically accessible. In order to maximize the clinical utility of SCVo2 (or SVo2) measurement it is useful ...

BACKGROUND: Types II and III pleuropulmonary blastoma (PPB) are aggressive sarcomas of lung and pleura in young children. Similar to cavoatrial extension of Wilms tumor, PPB may extend into thoracic great vessels and the heart and may involve both venous and arterial circulations and right and left cardiac chambers. Serious ...

Clopidogrel should be initiated as soon as possible in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) except those who urgently require coronary artery bypass grafting (CABG). The present study assessed the ability to predict severe left main coronary artery and/or 3-vessel disease (LM/3VD) that would most likely require urgent ...

Types II and III pleuropulmonary blastoma (PPB) are aggressive sarcomas of lung and pleura in young children. Similar to cavoatrial extension of Wilms tumor, PPB may extend into thoracic great vessels and the heart and may involve both venous and arterial circulations and right and left cardiac chambers. Serious embolic ...

BACKGROUND: /st> Cardiovascular disease is one of the major causes of death in systemic lupus erythematosus (SLE). A study was undertaken to investigate whether treatment with statins would reduce subclinical measures of atherosclerosis over a 2-year period. METHODS: /st> 200 patients with SLE without clinical cardiovascular disease were randomised to ...

Norwood I operation, including placement of a shunt from the right ventricle to the pulmonary arteries, has been adopted by many surgeons for neonates with hypoplastic left heart syndrome. A three-year-old male who had undergone the Norwood I operation, and the Glenn operation, presented with a cervical pulsating tumor prior ...

We performed the present systematic review and meta-analysis of randomized and nonrandomized comparative studies in an attempt to compare the safety and efficacy of drug-eluting stents with coronary artery bypass grafting for patients with coronary artery disease. Twenty-five eligible comparative studies (1 randomized and 24 nonrandomized) were assessed. Two reviewers ...

Abstract  Patent ductus arteriosus is one of the most common congenital cardiac pathologies, besides patency of ductus may be somewhat vital for various congenital cardiac defects, otherwise death is inevitable. Anatomically, ductus is single and located between the descending aorta and the pulmonary artery. The review of the literature reveals ...

The current use of arterial punctures, when obtaining arterial blood gas and acid-base status of patients, are associated with a risk of side effects such as pain and hematoma, and a small risk of more severe complications. This analysis investigated the cost-effectiveness of a new method, where less painful venous-converted ...

INTRODUCTION: Certain outflow tract tachyarrhythmias require ablation above the semilunar valves. Understanding of the regional anatomy of these arrhythmogenic sites is required to avoid complications. METHODS AND RESULTS: We examined 603 formalin-fixed autopsy hearts from October 1998 to July 2003. Three hundred forty-two of 603 (57%) had myocardial extensions above ...

Objective: The goal of our study was to report our experience of using half rotation of the truncus arteriosus plus arterial switch, as a modification of the Nikaidoh procedure, for anatomic repair of transposition of the great arteries (TGA) with ventricular septal defect (VSD) and pulmonary outflow tract obstruction (pulmonary ...

Abstract  Transapical transcatheter aortic valve implantation is an emerging technique for high-risk patients with symptomatic aortic valve stenosis, peripheral vascular disease, and severe concomitant comorbidities. However, a previous major surgical intervention involving the left hemithorax and the lung has always been considered a technical surgical challenge or even a potential ...

A 52-year-old woman presented to a community hospital with atypical chest pain. Her low-density lipoprotein cholesterol and high-sensitivity C-reactive protein levels were not elevated. She underwent cardiac computed tomography angiography, which showed both calcified and noncalcified coronary plaques in several locations. Her physicians subsequently performed coronary angiography, which was complicated ...

The best approach to the management of concomitant severe carotid and coronary artery disease remains unanswered. The American College of Cardiology/American Heart Association (ACC/AHA) guidelines recommend carotid endarterectomy (CEA) in asymptomatic carotid stenosis of ≥ 80% either prior to or combined with coronary artery bypass surgery (CABG). Currently, there is ...

OBJECTIVE: Matrix metalloproteinases participate in remodeling of extracellular matrix, which is central to the development of aortic stenosis. Synthesis of certain matrix metalloproteinases is induced by the glycoprotein extracellular matrix metalloproteinase inducer. We investigated whether extracellular matrix metalloproteinase inducer and membrane-type 1 matrix metalloproteinase are abundant in calcific aortic valve ...

A 55-year-old female noticed worsening exertional dyspnoea for two years. She was born with cleft palate and profound deafness. Significant physical findings included dysmorphism with micrognathia and acrocephaly and congenital deafness. Transthoracic echocardiogram revealed aneurysms involving the right and the non-coronary sinuses of Valsalva. Despite that, the native aortic valve ...

BACKGROUND: Intra-cardiac repair of congenital cardiac diseases in children with left-right shunt is often associated with acute elevation of pulmonary artery pressure following cardiopulmonary bypass. We studied the correlation between the Glu298Asp polymorphism of the endothelial nitric oxide synthase gene and pulmonary hypertension in children with congenital cardiac diseases.Methods and ...

The outcomes of reduction ascending aortoplasty (RAA) performed with aortic valve surgery were evaluated and the results of RAA in patients with bicuspid aortic valve (BAV) were compared with those in patients with tricuspid valve. From October 1994 to April 2009, 88 patients underwent RAA. Aortic valve was bicuspid in ...

Traumatic aortic-left ventricle tunnel through interventricular septum was particularly a rare event that has never previously been described. A 58-year-old male, with a history of blunt thoracic trauma caused by falling from height, was admitted to our institute for effort dyspnea. Chest computed tomography scan showed subaortic interventricular septal lumen ...

OBJECTIVE: Cardioscopy is a novel imaging method that allows closed-chest, real-time fiberoptic imaging of intracardiac structures. This study tested the feasibility and safety of cardioscopy as a platform for mitral and tricuspid valve surgery in the beating heart. METHODS: Through a median sternotomy, cardiopulmonary bypass was established in 10 calves. ...

late mortality after repair of total anomalous pulmonary venous connection is frequently associated with pulmonary venous obstruction (PVO). We aimed to describe the morphological spectrum of total anomalous pulmonary venous connection and identify risk factors for death and postoperative PVO. we conducted a retrospective, international, collaborative, population-based study involving all ...

Historically, multiple arterial access sites have been used for cerebral, peripheral or coronary angiography prior to the widespread utilization of the safer transbrachial and, more recently, transfemoral or transradial approaches. Additionally, alternative sites for arterial access such as the carotid artery are often used in complex pediatric invasive procedures. We ...

Aortic annular erosion is a serious complication of aortic valve endocarditis or previous aortic valve replacement without endocarditis, and its surgical management is challenging. We present the early and midterm results of a technique for left ventricular outflow tract and aortic root reconstruction with a polyester tube graft and translocation ...

A pseudoaneurysm with compression of the left main coronary artery causing significant ischaemia was successfully treated with a covered stent. We report this rare complication of cardiac surgery for infective endocarditis with a large root abscess. The patient developed a pseudoaneurysm arising from the body of the left main and ...

Transcatheter aortic valve implantation (TAVI) has nowadays replaced open heart surgery as an alternative therapeutic tool in selected patients. Thirty-five percent of patients with severe degenerative aortic valve stenosis (AS) remain untreated because of the existing comorbidities that increase their perioperative risk. TAVI is a relatively new technique that has ...

Transcatheter aortic valve implantation (TAVI) has nowadays replaced open heart surgery as an alternative therapeutic tool in selected patients. Thirty-five percent of patients with severe degenerative aortic valve stenosis (AS) remain untreated because of the existing comorbidities that increase their perioperative risk. TAVI is a relatively new technique that has ...

Optimizing cardiovascular function to ensure adequate tissue oxygen delivery is a key objective in the care of critically ill burn patients. In recent years several less invasive hemodynamic monitoring techniques (arterial waveform analysis techniques) have become available in clinical practice. These alternative techniques provide beat-to-beat cardiac output measurement and permit ...

Previous studies have shown that the right radial approach encounters more tortuosity than the left radial approach during transradial coronary angiography. The objective of this study was to compare the procedural difficulty of the right and left radial approaches in the modern era with dedicated transradial catheters. One hundred ninety-three ...

In the normal heart, the right and left coronary arteries arise from the aortic valvar sinuses adjacent to the pulmonary trunk. The right coronary artery then directly enters the right atrioventricular groove, whereas the main stem of the left coronary artery runs a short course before dividing to become the ...

Unilateral pulmonary vein atresia is a rare abnormality that usually presents in infants with recurrent hemoptysis and pneumonia. Presentation in adulthood without additional congenital heart disease is rare but does occur. Anatomic variations in the pulmonary vessels that supply and drain the affected lung can explain the mildly symptomatic process. ...

A 57-year-old male was brought to the Emergency Department because of acute alteration of consciousness. He had hypertension and diabetes mellitus with regular control for years. On admission, he was comatose without verbal output. His bilateral pupils measured 5mm and did not constrict to light. Eyeballs were fixed in neutral ...

The authors report the 8-year follow-up of a patient previously described in the literature who originally presented in high-output cardiac failure secondary to a complex neonatal intracranial dural arteriovenous fistula (DAVF). The earlier case report described palliative treatment with a combination of extracorporeal membrane oxygenation (ECMO) and endovascular embolization for ...

Robotic technology enables "port only" totally endoscopic coronary artery bypass grafting (TECAB). During early procedure development only single bypass grafts were feasible. Because current referral practice for coronary bypass surgery mostly includes multivessel disease, performance of multiple endoscopic bypass grafts is desirable. We report a case in which a patient ...