Thrombosed massive portal vein aneurysm in an adolescent boy.

Portal vein aneurysm is a rare vascular disorder, particularly in the pediatric population, with relatively few cases reported in the literature. The most frequent complication of portal vein aneurysm is thrombosis, which may lead to diagnostic uncertainty as it can resemble a tumor. Therefore, it is important to recognize this entity and its imaging features for accurate diagnosis.

Myositis Ossificans: A Mimicker of an Intramuscular Tumour.

Myositis ossificans is a do not touch lesion of which the radiological findings can be misleading in the early stages due to possible features mimicking a malignant process.

Spectrum of bowel wall thickening on ultrasound with pathological correlation in children.

Applications for bowel US in children have been well described; however, less focus has been placed on patterns of bowel wall architectural change in specific disease states. This pictorial essay reviews normal bowel wall architecture and covers a variety of inflammatory, infectious, vascular and neoplastic disorders outside the neonatal period as seen on US, with illustrative pathological correlation. A thorough understanding of normal and abnormal bowel wall architecture can enrich sonographic interpretation and provide a valuable adjunct to appropriate clinical investigation.

Cardioversion of persistent atrial fibrillation is associated with a 24-hour relapse gap: Observations from prolonged postcardioversion rhythm monitoring.

Background: Many recurrences occur after electrical cardioversion (ECV) of atrial fibrillation (AF). Assessment of extent of remodeling and continuous prolonged rhythm monitoring might reveal actionable recurrence mechanisms.

Hypothesis: After ECV of AF specific patterns of arrhythmia recurrence can be distinguished.

The electrocardiogram as a predictor of successful pharmacological cardioversion and progression of atrial fibrillation.

Aims: Non-invasive characterization of atrial fibrillation (AF) substrate complexity based on the electrocardiogram (ECG) may improve outcome prediction in patients receiving rhythm control therapies for AF. Multiple parameters to assess AF complexity and predict treatment outcome have been suggested. A comparative study of the predictive performance of complexity parameters on response to therapy and progression of AF in a large patient population is needed to standardize non-invasive analysis of AF.

Poor anticoagulation relates to extended access times for cardioversion and is associated with long-term major cardiac and cerebrovascular events.

Background: Patients undergoing elective electrical cardioversion (ECV) for atrial fibrillation have a temporarily increased risk of thromboembolism. Current guidelines recommend adequate anticoagulation for ≥3 consecutive weeks precardioversion, i.e.

Systematic analysis of ECG predictors of sinus rhythm maintenance after electrical cardioversion for persistent atrial fibrillation.

Background: Electrical cardioversion (ECV) is one of the rhythm control strategies in patients with persistent atrial fibrillation (AF). Unfortunately, recurrences of AF are common after ECV, which significantly limits the practical benefit of this treatment in patients with AF.

Objectives: The objectives of this study were to identify noninvasive complexity or frequency parameters obtained from the surface electrocardiogram (ECG) to predict sinus rhythm (SR) maintenance after ECV and to compare these ECG parameters with clinical predictors.

The mechanical fibrillation pattern of the atrial myocardium is associated with acute and long-term success of electrical cardioversion in patients with persistent atrial fibrillation.

Background: Electrophysiological studies demonstrate that a short atrial fibrillation cycle length (AFCL) is related with poor outcome of electrical cardioversion (ECV) of atrial fibrillation (AF). We found previously that the mechanical AFCL (AFCL-tvi) and atrial fibrillatory velocity (AFV-tvi) may be determined noninvasively using color tissue velocity imaging (TVI) and closely relates to the electrophysiological AFCL.

Objective: To evaluate the relation between AFCL-tvi, AFV-tvi, and success of ECV in patients with AF.

Clinical correlates of echocardiographic tissue velocity imaging abnormalities of the left atrial wall during atrial fibrillation.

Aims: In patients with atrial fibrillation (AF), echocardiographic tissue velocity imaging (TVI) enables assessment of electrical and structural remodelling by measuring, respectively, the AF cycle length (AFCL-TVI) and the atrial fibrillatory wall motion velocity (AFV-TVI). We investigated the clinical and echocardiographic correlates of atrial remodelling assessed by TVI.

Methods And Results: We studied 215 patients presenting with AF.

Tissue velocity imaging of the left atrium predicts response to flecainide in patients with acute atrial fibrillation.

Background: Acute atrial fibrillation (AF) is often treated with the administration of intravenous flecainide; however, this treatment may not always be successful and is potentially hazardous. Previous studies suggest that electro-echocardiographic tissue velocity imaging (TVI) of the atrial wall may reflect atrial remodeling.

Objective: To study whether atrial TVI can be used to identify nonresponders of flecainide administered intravenously in patients with acute AF.

Laparoscopic liver resection in the Netherlands: how far are we?

Background: The objective of this study was to provide a systematic review on the introduction of laparoscopic liver surgery in the Netherlands, to investigate the initial experience with laparoscopic liver resections and to report on the current status of laparoscopic liver surgery in the Netherlands.

Methods: A systematic literature search of laparoscopic liver resections in the Netherlands was conducted using PubMed/MEDLINE. Analysis of initial experience with laparoscopic liver surgery was performed by case-control comparison of patients undergoing laparoscopic left lateral sectionectomy matched with patients undergoing the open procedure in the Netherlands between the years 2000 and 2008.

Idiopathic atrial fibrillation revisited in a large longitudinal clinical cohort.

Aims: An age of 60 years is often used as cut-off for the diagnosis of idiopathic atrial fibrillation (AF). We investigated the importance of age and atrial size in patients with idiopathic AF and AF patients with isolated hypertension.

Methods And Results: Out of 3978 AF patients in the Euro Heart Survey on AF with known follow-up, 119 (3%) patients had idiopathic AF.