BACKGROUND: Pulmonary vein electrical isolation is the main goal of atrial fibrillation ablation. To ensure electrical isolation of the pulmonary veins, entrance and exit block should be demonstrated. However, this is sometimes challenging due to the complex anatomy of the pulmonary vein area and the anatomical variations that may preclude ...

A 9-year-old boy died of rabies complications. We report the unusual combination between rabies, coronary dilatation on echocardiography and coronary vasculitis documented upon autopsy. In the search for the etiological agent of Kawasaki disease, we suggest that a viral infection with potential antigenic similarities to rabies virus should be entertained.

Context:Adiposity, bone mineral density (BMD), and calcified atherosclerotic plaque (CP) exhibit complex interrelationships that are not well understood. Adipokines vary in relation to changes in body composition and may play roles in regulation of BMD and risk of cardiovascular disease.Objective:Our objective was to examine the relationship between serum adiponectin and ...

We report a male with a coronary bifurcation lesion in the mid circumflex artery (CX). After predilatation, the lesion was treated with two drug-coated balloons (DCB). Primary success in the posterolateral branch was good; however the CX lesion had a residual stenosis including a non-flow-limiting type A dissection. After 6 months, ...

Most catheter-based vascular medical devices today have hydrophilic lubricious coatings. This study was designed to perform a territory-based downstream analysis of end organs subsequent to angioplasty with coated balloon catheters to better understand the potential in vivo physiological consequence of coating wear materials. Coronary angioplasty was performed on swine using balloon ...

Aims: We report the intravascular ultrasound (IVUS) analysis of plaque distribution in left anterior descending (LAD) artery/first diagonal (D1) and distal left main coronary artery (LMCA) bifurcation lesion location. Methods and results: We reviewed 58 angiograms of LAD/D1 bifurcation lesions with pre-intervention IVUS of both the LAD and D1 and ...

Ultra-weak photon emission (UPE) is a general feature of living -biological systems. To gain further insights into the origin of UPE and its physiological significance, the aim of the present study was to investigate the connection between hemodynamics (HD), oxygenation (OX), and UPE. Therefore, during venous and arterial occlusion (VO, ...

The most important vein segment to thrombolyse after deep venous thrombosis (DVT) is the outflow tract meaning the iliofemoral vein. Iliofemoral DVT is defined as DVT in the iliac vein and the common femoral vein. Spontaneous recanalization is less than 50%, particularly on the left side. The compression from adjacent ...

It is well established that family members of those individuals with intracranial aneurysm are at high risk of intracranial aneurysms. In the past several years, more information on the heritability of location, familial susceptibility to cigarette smoking, and whether "anticipation" of aneurysm formation has been published. We review these three ...

Bone mineral density (BMD) and atherosclerotic arterial calcified plaque (CP) demonstrate inverse relationships through unknown mechanisms. Dickkopf-1 (DKK1) is an endogenous inhibitor of bone formation, and serum DKK1 has been associated with impaired osteoblast activation and susceptibility to bone loss. Plasma DKK1, BMD in the spine, and CP in three ...

Stent-based delivery of sirolimus has been shown to reduce neointimal hyperplasia significantly. However, the long-term effect of the polymer is thought to initiate and sustain an inflammatory response and contribute to the occurrence of late complications. Our study aimed to evaluate the efficacy and safety of the BuMA biodegradable drug-coated ...

Deep hypothermic circulatory arrest or low-flow bypass are commonly used in primary repair of total anomalous pulmonary venous connection, or individual veins may be dissected to allow clamp or snare application, in order to provide a bloodless field for anastomosis by the direct or sutureless marsupialization technique. In the described ...

Microscopic indocyanine green videoangiography (mICG-VA) has gained wide acceptance during intracranial aneurysm surgery by lowering rates of incomplete clipping and occlusion of surrounding vessels. However, mICG-VA images are limited to the microscopic view and some deeper areas, including the aneurysm sac/neck posterior side, cannot be efficiently assessed as they are ...

The aortic valve exhibits complex three-dimensional (3D) anatomy and heterogeneity essential for the long-term efficient biomechanical function. These are, however, challenging to mimic in de novo engineered living tissue valve strategies. We present a novel simultaneous 3D printing/photocrosslinking technique for rapidly engineering complex, heterogeneous aortic valve scaffolds. Native anatomic and ...

Computational fluid dynamics (CFD) simulations quantifying thoracic aortic flow patterns have not included disturbances from the aortic valve (AoV). 80% of patients with aortic coarctation (CoA) have a bicuspid aortic valve (BAV) which may cause adverse flow patterns contributing to morbidity. Our objectives were to develop a method to account ...

The purpose of this anatomical study is to illustrate the microscopic and endoscopic anatomy of the anterior communicating artery complex as viewed through three keyhole approaches (keyhole pterional, lateral supraorbital and supraorbital) and to compare them. Each approach was carried out once on each side in five glutaraldehyde-fixed human cadaveric ...

An alveolar-pleural fistula is a communication between the pulmonary parenchyma distal to a segmental bronchus and the pleural space. A postoperative pulmonary expiratory air leak after an anatomic pulmonary resection is usually managed conservatively. The use of endobronchial valves is a minimal invasive method that may be effective for the ...

Spontaneous intrahepatic portal-systemic shunts are rare and can lead to significant encephalopathy. If intervention is recommended, transcatheter embolization is preferred. Various embolization techniques have been described using a wide range of embolization materials. In this report, the authors describe a useful embolization technique for managing a complex, large type 3 ...

PURPOSE OF REVIEW: A recent development within pediatric cardiology is percutaneous pulmonary valve implantation (PPVI). This has extended the life of surgical conduits and decreased the number of surgical procedures required. Early reports focused on feasibility and safety of the technique; recent literature has focused on avoidance of complications such ...

Total anomalous systemic venous drainage is a rare form of congenital heart disease. All the systemic venous flow from the body (i.e., from the superior vena cava, inferior vena cava, and coronary sinus) drains abnormally into the left atrium. This condition requires the presence of a left-to-right shunt (atrial septal ...

The precise venous anatomy of the glabellar to the forehead region remains unknown. This study aimed to detail the venous architecture of the glabellar region to the forehead in conjunction with that of the supratrochlear artery to reduce the risk of venous congestion of flaps in this area. Fifteen fresh ...

This study is a step towards a new biomechanical-based measurement of the patient specific risk of rupture of cerebral aneurysms. Following a previous experimental investigation suggesting a correlation between the risk of rupture and the material properties of cerebral aneurysms, fluid-structure interaction simulations are performed to compare the deformations of ...

We report a case of a 2 year-old boy with Joubert Syndrome and Related Disorders (JSRD), severe congenital aortic stenosis, bicuspid aortic valve and an atrial septal defect. JSRD is one of a group of conditions known as 'ciliopathies', whose multi-organ involvement results from primary cilia dysfunction. To date, there ...

Superior ophthalmic vein thrombosis (SOVT) is a rare condition of multiple etiologies that generally presents with proptosis, ophthalmoplegia, periorbital edema, and occasionally decreased visual acuity. We describe a unique case of a two-year-old child presenting with extensive superior forniceal chemosis obstructing the visual axis after trauma in a motor vehicle ...

Congenital portosystemic shunts are developmental abnormalities of the portal venous system resulting in the diversion of portal blood away from the liver to the systemic venous system. Such malformations are believed to come from an insult occurring between the fourth and eighth week of gestation during the development of hepatic ...

Structural parameters of the common carotid artery (CCA) have shown to correlate with the risk of cardiovascular disease, but their precise measurement is challenging. We developed an automatic detection system with manual interaction capabilities that can reliably analyze B-mode ultrasound sequences of the CCA over several heart cycles. We evaluated ...

Thoracic aortic stent grafts have been widely used. We report two cases of proximal misaligned deployment of the Valiant Captivia stent graft after hybrid treatment of thoracic aneurysms. This complication has, to our knowledge, never been previously reported in the literature with this stent graft. We discuss the various factors ...

Herein we describe a case of perforated mitral valve annular abscess/phlegmon that presented as a new pan-systolic murmur in the setting of hallux osteomyelitis requiring amputation. We discuss the investigations, imaging and complex management challenges arising from this rare condition and the importance of considering a diagnosis of infective endocarditis ...

PURPOSE: Balloon expandable stents may on occasion be deployed in close proximity to the anchoring barbs of endovascular grafts. The aim of this study was to determine the risk and effect of balloon perforation by anchoring barbs and to assess whether these risks are different if the balloon is protected ...

Flow diverter (FD) is an emerging neurovascular device based on self-expandable braided stent for treating intracranial aneurysms. Variability in FD outcome has underscored a need for investigating the hemodynamic effect of fully deployed FD in patient-specific aneurysms. Image-based computational fluid dynamics, which can provide important hemodynamic insight, requires accurate representation ...

The role of microcalcifications (μCalcs) in the biomechanics of vulnerable plaque rupture is examined. Our laboratory previously proposed (Ref. 44), using a very limited tissue sample, that μCalcs embedded in the fibrous cap proper could significantly increase cap instability. This study has been greatly expanded. Ninety-two human coronary arteries containing ...

The presence of foramina in the transverse processes of thoracic vertebrae is not a common feature while they are the characteristic feature of cervical vertebrae. Foramina present in the transverse process of cervical vertebrae give passage to the vertebral artery-an important artery supplying the brain and spinal cord. Thoracic vertebrae ...

We present three novel techniques for creation of (1) a steerable sheath (2) a 4F snare device, and (3) dual anterograde and retrograde double-wire percutaneous transluminal angioplasty access technique using a single femoral puncture. These techniques were conceived and bench-tested in our institution, allowing the utilization of inexpensive equipment for ...

Abstract  In transcatheter aortic valve implantation procedures using balloon-expandable valves, the valve is deployed by rapid balloon inflation within a short period of rapid ventricular pacing. This system and deployment technique is generally considered to be nonrepositionable. We illustrate with two cases (transapical and transfemoral) the possibility to partially reposition ...

The ideal location of air bubble detector (ABD) placement on the cardiopulmonary bypass (CPB) circuit is debatable. There is, however, very little data characterizing the prevalence of specific ABD placement preferences by perfusionists. Therefore, the purpose of this study was to survey the perfusion community to collect data describing the ...

Ostial lesions, including aorta-ostial lesions and Medina 001 bifurcation lesions, are known to create difficulty in precise stent placement. There are many techniques used to help in precise ostial stent placement; these include using multiple angiographic views to assist in placement, the use of the Ostial Pro device, the aorta ...

Bilateral cleft lip and palate may occasionally be associated with complex congenital cyanotic heart disease. An infant with common atrium and single ventricle with infundibular pulmonary stenosis (Blalock-Taussig shunt done recently) presented for lip repair surgery. Balanced general anesthesia was administered using sevoflurane along with a regional nerve block to ...

Mitral isthmus ablation forms part of the electrophysiologist's armoury in the catheter ablation treatment of atrial fibrillation. It is well recognised however, that mitral isthmus ablation is technically challenging and incomplete ablation may be pro-arrhythmic, leading some to question its role. This article first reviews the evidence for the use ...

Transaortic replacement of the mitral valve at the time of aortic valve or root replacement is a rarely used technique that offers many possible advantages in the setting of multivalve replacement. Reports in the literature are few and dated. The purpose of this brief communication is to describe technical and ...

Flow diverters (FD), a new generation of intracranial stents with a low porosity mesh, have been applied as an alternative treatment for intracranial aneurysms. However, their efficacy varies among aneurysms of different morphology. In this study, computational fluid dynamic simulations were performed to examine the influence of an FD on ...

Aneurysms involving the venous system are a rare entity. We report the case of a 37-year-old woman who presented to us with activity-limiting left gluteal pain and who on consequent workup was found to have a left external iliac vein aneurysm in a setting of iliocavomegaly. She underwent successful treatment ...

Object Some totally occluded intracranial aneurysms may recur. The role of hemodynamic mechanisms in this process remains to be elucidated. The authors used computational fluid dynamic analysis and investigated the local hemodynamic characteristics at the aneurysm neck before and after total embolization, attempting to identify hemodynamic risk factors leading to ...

True brachial artery aneurysms (BAAs) are uncommon peripheral vessel aneurysms that typically occur in the setting of injury. While its relationship with trauma and infectious etiologies are well defined, the association between arteriovenous fistulas (AVFs) and BAA is less well understood. We present a case of a giant true BAA ...

There has been a resurgence of atherectomy as a strategy to treat peripheral atherosclerosis. Distal embolization occurs frequently during peripheral endovascular interventions but is of particular concern during atherectomy. We describe a case of distal embolization following atherectomy with the Pathway JetStream system successfully managed with aspiration thrombectomy and infrapopliteal ...

Thoracic endovascular aortic repair (TEVAR) has evolved as an alternative to open repair for a range of aortic pathology. The earliest endovascular repairs were limited to descending thoracic aortic pathology, but growing experience has resulted in the use of stents in the ascending aorta and aortic arch. This review presents ...

The rapidly emerging technique of cardiac computed tomography angiography (CTA) has enabled the anatomical assessment of coronary artery disease. CTA has very good diagnostic accuracy with the ability to detect nonobstructive from obstructive coronary artery disease and provides information on the presence of coronary artery calcification as well as on ...

The importance of the epicardium covering the heart and the intrapericardial part of the great arteries has reached a new summit. It has evolved as a major cellular component with impact both in development, disease and more recently also repair potential. The role of the epicardium in development, its differentiation ...

Total anomalous systemic venous drainage is an extremely rare congenital heart defect. In this study we describe an 11-year-old girl who presented with a history of fatigue and central cyanosis that she had had since early childhood with unremarkable precordial examination results. Investigations revealed left heterotaxy with all systemic venous ...

Although isomerism of the bronchial tree is an integral part of hetrotaxy syndrome, the association of congenital tracheal stenosis is rare in this group of disorders, and it has not yet been thoroughly described in the literature. This condition is potentially life-threatening and precludes single ventricle palliation. This report presents ...

Infection of endovascular abdominal aneurysm stent grafts is an uncommon but known complication. Inoculation with bacteria of the endovascular abdominal aneurysm stent graft during the actual implantation, in the periprocedural hospitalization or later due to an aortoenteric fistula, has been described in the literature. We report a case of endovascular ...