A 63-year-old female presented late with anterior ST-elevation myocardial infarction and cardiogenic shock. This was complicated by acute ventricular septal defect with large left-to-right shunt. An Impella CP was inserted on day seven with rapid haemodynamic improvement.
View Article and Find Full Text PDFAims: Calcified coronary stenoses are a serious impediment to optimal stent expansion and can lead to stent failure and catastrophic adverse outcomes. We hereby present early Australian experience with intravascular lithotripsy for the treatment of calcific lesions in acute and chronic coronary syndromes.
Methods And Results: This was a single-centre retrospective study of all patients treated with intravascular lithotripsy (IVL) between October 2019 and June 2021.
Objective: This study sought to determine the contractile reserve (CR) response to exercise stress echocardiography (ESE) quantified by the novel parameter, non-invasive myocardial work (MW), in subjects with angiographically proven coronary artery disease (CAD).
Methods: CR was measured by the relative change in ejection fraction (EF), global longitudinal strain (GLS) and MW indices from rest to peak exercise in 304 patients referred for clinically indicated ESE. Positive ESE patients proceeded to coronary angiography and further risk stratified based on either percutaneous or surgical intervention.
Background: Three-dimensional (3D) printing of cardiac fistulae allows for immediate understanding of their complex courses and anatomical relations. Models can be used to improve patient understanding, enhance the consenting process, facilitate communication between multidisciplinary staff at heart team meetings, and help plan surgical or percutaneous interventions.
Case Summary: We report four cases where 3D printed models were used as an adjunct with traditional measures in treating patients with complex cardiac fistulae.
Transcatheter aortic valve implantation (TAVI) is an effective therapeutic option for severe symptomatic aortic valve stenosis (AS) with intermediate or high surgical risk. The purpose of this study was to examine the effects of TAVI on left ventricular (LV) mechanics using multilayer global longitudinal strain (GLS) by 2D speckle-tracking echocardiography. A total of 119 patients (mean age 83 ± 7.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
December 2018
We present the case of a 21-year-old female with a complex right coronary sinus of valsalva to right atrial fistulae. 3D printing of the fistulae and surrounding anatomy was beneficial in assessment of the anatomy and perioperative planning. Successful percutaneous closure was achieved.
View Article and Find Full Text PDFLeft atrial (LA) strain is an emerging technique with potential applications including arrhythmia prediction in atrial fibrillation and early identification of atrial dysfunction. The aim of this study was to evaluate reproducibility of LA strain and strain rate (SR) using multi-vendor analysis software between novice and expert. For LA strain to be a reliable tool, the technique must be reproducible by observers with variable experience.
View Article and Find Full Text PDFIn patients with a degenerative mitral bioprosthesis and prohibitive surgical risk there is emerging evidence for the feasibility of valve-in-valve procedures via a percutaneous transvenous transseptal approach. This paper describes the first time this procedure has been performed in Australia.
View Article and Find Full Text PDFThe limited durability of prosthetic cardiac valves together with an aging population will present ongoing management challenges. This paper describes the case of an 82 year-old male with symptomatic severe regurgitation in an aortic homograft which remains successfully treated with Transcatheter Aortic Valve Replacement (TAVR) at two-year follow-up.
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