Direct Measurement of Left Atrial Pressure during Routine Transradial Catheterization.

Left atrial pressure indicates the left ventricular filling pressure in patients who have systolic or diastolic left ventricular dysfunction or valvular heart disease. The use of indirect surrogate methods to determine left atrial pressure has been essential in the modern evaluation and treatment of cardiovascular disease because of the difficulty and inherent risks associated with direct methods (typically the transseptal approach). One method that has been widely used to determine left atrial pressure indirectly is Swan-Ganz catheterization, in which a balloon-flotation technique is applied to measure pulmonary capillary wedge pressure; however, this approach has been associated with several limitations and potential risks.

Complex endovascular repair of a large dissection of the ascending aorta in a 70-year-old man.

We report the case of a 70-year-old man who presented with a large dissection of the ascending aorta related to coronary artery bypass grafting 3 years earlier. One graft was patent; however, a reverse venous graft to the right coronary artery was occluded, and that artery was substantially stenotic. The patient was a high-risk surgical candidate, so we treated a large dissection successfully by endovascular means with a thoracic endograft.

Spontaneous celiac artery dissection case report and literature review.

Symptomatic spontaneous celiac artery dissection is a rare condition that is being detected more often with the use of advanced imaging techniques. There is no consensus as to whether surgical or endovascular treatment is more appropriate.We describe the case of a 41-year-old hypertensive woman who presented with the sudden onset of sharp, persistent, right-upper-quadrant abdominal and epigastric pain.

Papillary fibroelastoma involving the left ventricular wall.

A 71-year-old white woman presented to her primary care physician for a routine visit and was found to have a new, previously undocumented cardiac murmur. A subsequent transthoracic echocardiogram revealed a 1 cm mobile mass arising from the lateral free wall of the left ventricle. Transesophageal echocardiography later confirmed these findings.