Thrombus vs Tumor: Use of AngioVac in a RV Mass.

This paper present a challenging case of a right ventricular mass in a patient who was at high surgical risk for open removal. The minimally invasive AngioVac device has been used with a successful 50% reduction in mass burden. This report illustrates AngioVac as a safe alternative to invasive surgery.

In-hospital complications after MitraClip in patients with heart failure and preserved versus reduced ejection fraction in the United States.

Background: The clinical benefits of transcatheter edge to edge mitral valve repair have been well established in patients with heart failure and severe mitral regurgitation (MR) who have prohibitive surgical risk. In March of 2019, the FDA approved the MitraClip for treatment of selected patients with HF and severe secondary MR. However, the relative outcomes of patients with HFrEF and HFpEF treated with MitraClip are largely unknown.

A novel technique for invasive aortic valve pressure gradient measurement using a 6 Fr Swan-Ganz catheter: a case series.

Background: Simultaneous left ventricular (LV) and aortic (Ao) pressure gradient assessment has been rendered challenging since the recall of the Langston catheter. Here we describe a simple method for simultaneous LV and Ao pressure gradient assessment using a Swan-Ganz catheter.

Case Summary: We describe two cases where assessment of simultaneous left ventricle and Ao valve gradients was done using a Swan-Ganz catheter to assess the degree of Ao stenosis and dynamic LV outflow obstruction.

Nasogastric Tube: A Novel Way to Prevent Iatrogenic Bleeding in Emergent Coronary Artery Bypass Graft.

Patients with indications for emergent cardiac surgery procedures who have previously received a P2Y12 inhibitor loading dose are at extremely high risk for bleeding. We present a successful example of lateral thinking in solving a controversial clinical scenario.

More bullets for PISTOL: linear and cyclic siloxane reporter probes for quantitative H MR oximetry.

Tissue oximetry can assist in diagnosis and prognosis of many diseases and enable personalized therapy. Previously, we reported the ability of hexamethyldisiloxane (HMDSO) for accurate measurements of tissue oxygen tension (pO) using Proton Imaging of Siloxanes to map Tissue Oxygenation Levels (PISTOL) magnetic resonance imaging. Here we report the feasibility of several commercially available linear and cyclic siloxanes (molecular weight 162-410 g/mol) as PISTOL-based oxygen reporters by characterizing their calibration constants.

Predictors of In-Hospital Mortality after Transcatheter Aortic Valve Implantation.

The development of aortic valve stenosis is strongly associated with older adults. Patients who undergo transcatheter aortic valve implantation (TAVI) for severe aortic stenosis frequently have heart failure (HF). We investigated the predictors of mortality after TAVI according to the presence of HF, and specifically HF with preserved ejection fraction (HFpEF) versus HF with reduced ejection fraction (HFrEF).

Recurrence of eosinophilic granulomatosis with polyangitis after orthotopic heart transplant.

Eosinophilic granulomatosis with polyangitis (EGPA), previously referred to as Churg-Strauss syndrome, is a necrotizing small vessel vasculitis associated with eosinophilic infiltrates and extravascular granulomas. We report a case of a Caucasian woman successfully bridged to heart transplantation with a continuous flow left ventricular assist device (LVAD) who survived recurrence of EGPA in the allograft.

Late Incomplete stent apposition is associated with late/very late stent thrombosis: A meta-analysis.

Background: There is a lingering controversy in the current literature about the impact of late incomplete stent apposition (LISA) on clinical outcomes, especially stent thrombosis (ST). Therefore, we aimed to synthesize the available evidence evaluating the association between LISA and adverse clinical outcomes.

Methods: We systematically searched electronic databases for studies reporting clinical outcomes in patients with and without LISA.

Lyme Arrhythmia in an Avid Golfer: A Diagnostic Challenge and a Therapeutic Dilemma.

Lyme disease is a multisystem disorder affecting dermatologic, cardiac, nervous and musculoskeletal systems. Cardiac manifestations occur in about 5% of Lyme infections and stem from the involvement of the cardiac conduction system, resulting in varying degrees of sino-atrioventricular block. Occasionally, Lyme infection may also present with myopericarditis.

Quantification of Tumor Burden in a Genetically Engineered Mouse Model of Lung Cancer by Micro-CT and Automated Analysis.

Genetically engineered mouse models (GEMMs) of lung cancer closely recapitulate the human disease but suffer from the difficulty of evaluating tumor growth by conventional methods. Herein, a novel automated image analysis method for estimating the lung tumor burden from in vivo micro-computed tomography (micro-CT) data is described. The proposed tumor burden metric is the segmented soft tissue volume contained within a chest space region of interest, excluding an estimate of the heart volume.

Newer Pharmaceutical Agents for STEMI Interventions.

ST-elevation myocardial infarction (STEMI) causes 12.6% of deaths worldwide. Treatment strategies involve early revascularization by percutaneous coronary intervention and/or fibrinolytics, with adjunctive pharmacologic therapy.

Pharmacokinetic evaluation of rivaroxaban for the treatment of acute coronary syndromes.

Introduction: Arterial and venous thrombotic states, including myocardial infarction (MI), stroke and deep vein thrombosis with subsequent pulmonary embolism, are a significant cause of cardiovascular mortality and morbidity. Factor Xa (FXa) plays a pivotal role in thrombus formation. Its inhibition following acute coronary syndromes (ACS) blocks amplification of thrombin generation and subsequent clot formation, resulting in a risk reduction in recurrent MI, stroke and death.

Neurological deficit as the first manifestation of vesical transitional cell carcinoma.

Transitional cell carcinoma of urinary bladder (TCCUB) usually presents with hematuria. Cerebral and leptomeningeal metastases as a first manifestation of TCCUB have been occasionally reported in the medical literature. Hence, we report a case of an elderly man who presented with localizing neurological signs and whose magnetic resonance imaging brain showed multifocal cerebral and leptomeningeal lesions suspected to be metastatic deposits.

Hexamethyldisiloxane-based nanoprobes for (1) H MRI oximetry.

Quantitative in vivo oximetry has been reported using (19) F MRI in conjunction with reporter molecules, such as perfluorocarbons, for tissue oxygenation (pO(2) ). Recently, hexamethyldisiloxane (HMDSO) has been proposed as a promising alternative reporter molecule for (1) H MRI-based measurement of pO(2) . To aid biocompatibility for potential systemic administration, we prepared various nanoemulsion formulations using a wide range of HMDSO volume fractions and HMDSO to surfactant ratios.

Aortic dissection and moyamoya disease in Turner syndrome.

Aortic dilation and dissection are well-recognized cardiac abnormalities in women with Turner syndrome (TS), although the underlying pathophysiology is not fully understood. We report on a 46-year-old Hispanic woman who was previously diagnosed with moyamoya disease on magnetic resonance imaging after a presentation with stroke-like symptoms. Her features were consistent with TS and chromosome analysis revealed mosaicism in which 17% of the cells showed a pseudoisodicentric Y chromosome: 45,X (25)/46,X psu idic (Y)(11.

Renal lymphangiectasia associated with chronic myeloid leukemia.

Renal lymphangiectasia is a rare disorder characterized by dilatation of peripelvic, renal and perirenal lymphatic ducts. The exact etiology is not known. Congenital forms and ac-quired forms have been described.

Pachydermoperiostosis or primary hypertrophic osteoarthropathy: A rare clinicoradiologic case.

Pachydermoperiostosis (PDP) or primary hypertrophic osteoarthropathy is a rare syndrome with diverse radiological and clinical features. Though the diagnosis can be made on the basis of the classic clinical and radiological features, it is often missed due to variable presentations. A case of PDP that presented with dental complaints and had almost all the clinical and radiological features described in literature is reported.

Gall bladder carcinoma presenting as multiple cavitary pulmonary metastases - a rare event.

Carcinoma of the gall bladder is the commonest malignancy of the biliary tract. It is either detected incidentally during routine imaging or presents as lump in right hypochondrium or with signs of jaundice. Rarely, it may present with multiple cavitary metastatic lesions in the pulmonary parenchyma.