Successful multi-vessel percutaneous coronary intervention with bivalirudin in a patient with severe hemophilia A: a case report and review of literature.

We describe a 64-year-old male with severe hemophilia A (factor VIII-dependent), acute myocardial infarction (MI) and congestive heart failure (CHF) who underwent successful multi-vessel percutaneous coronary intervention (PCI). The patient was administered factor VIII transfusion to maintain activity levels between 60-80%. Anticoagulation during the PCI procedure was maintained with the direct thrombin inhibitor, bivalirudin.

Optimal noninvasive assessment of left ventricular filling pressures: a comparison of tissue Doppler echocardiography and B-type natriuretic peptide in patients with pulmonary artery catheters.

Background: Early transmitral velocity/tissue Doppler mitral annular early diastolic velocity (E/Ea) and B-type natriuretic peptide (BNP) have been correlated with left ventricular filling pressures, yet there are no data on how these 2 estimates of left ventricular filling pressures compare.

Methods And Results: Patients admitted to intensive care underwent simultaneous tissue Doppler echocardiography, BNP measurement, and pulmonary capillary wedge pressure (PCWP) determination. The ability of mitral E/Ea and BNP to predict PCWP >15 mm Hg was assessed.

The role of echocardiography in the diagnosis and prognosis of patients with heart failure.

The number of patients with congestive heart failure has increased in epidemic proportions. Echocardiography plays an important role in the diagnosis and management of these patients. Recent studies have also confirmed the independent prognostic information of the echocardiographic findings.

Echocardiography and prognosis of heart failure.

Echocardiography plays an important role in the diagnosis of patients with congestive heart failure (CHF). It determines the cause and readily provides a reliable noninvasive assessment of left and right ventricular function and filling pressures. This technique also has a tremendous potential in guiding therapy and tracking the clinical response.