Middle Aortic Syndrome in a Child-Bearing Age Patient.

We report a rare case of a 30-year-old female who had a long-standing history of middle aortic syndrome that was being managed nonsurgically. She presented with hypertension and buttock pain with plans to become pregnant. She underwent an aortoiliac bypass.

Food as Medicine for Secondary Prevention of Cardiovascular Events Following an Acute Coronary Syndrome.

Cardiovascular disease is the leading cause of death in men and women in the USA. Once a patient experiences an acute coronary syndrome (ACS), they are at increased risk for hospital readmission within 30 days and 6 months after discharge and more importantly, they have worse survival. Hospital readmissions lead to poor clinical outcomes for the patient and also significantly increase healthcare costs due to repeat diagnostic evaluation, imaging, and coronary interventions.

Is intra-procedure three-dimensional transesophageal echocardiogram an alternative to preprocedure multidetector computed tomography for the measurement of the aortic annulus in patients undergoing transcatheter aortic valve replacement?

Background: The role of three-dimensional transesophageal echocardiography (3DTEE) vs multidetector computed tomography (MDCT) in aortic annular sizing has been poorly defined in patients undergoing transcatheter aortic valve replacements (TAVR). We set to determine the correlation between 3DTEE and MDCT in measuring the aortic annulus prior to TAVR.

Methods: In an observational, retrospective study, we compared aortic annular areas measured by MDCT and 3DTEE in TAVR patients.

Prognostic Value of Late Gadolinium Enhancement in Nonischemic Cardiomyopathy.

The purpose of this study was to determine the prognostic value of late gadolinium enhancement seen on cardiac magnetic resonance (CMR) imaging in patients with nonischemic cardiomyopathy (NICMP). Patients with NICMP are at increased risk for cardiovascular events and death. The presence of late gadolinium enhancement (LGE) in CMR may be associated with a poor prognosis, but its significance is still under investigation.

Thrombolytics for late superior caval vein thrombus in a patient with tricuspid atresia and single-lung Glenn anastomosis.

Background: Those with cyanotic heart disease have an elevated bleeding risk but also are hypercoaguable. Treating haemodynamically significant thrombi in this unique cohort poses a monumental challenge. Case A 29-year-old women with tricuspid atresia and left pulmonary artery atresia presented with superior caval vein syndrome.

Aortic Size Distribution in the General Population: Explaining the Size Paradox in Aortic Dissection.

Background: Current guidelines recommend a diameter of 5-5.5 cm as the threshold for surgery on the ascending aorta. However, a study from the International Registry of Acute Aortic Dissection showed that nearly 60% occurred at <5.

Indications and imaging for aortic surgery: size and other matters.

Objectives: To review the current general concepts and understanding of the natural history of thoracic aortic aneurysm and their clinical implications.

Methods: Data on the the normal thoracic aortas were derived from the database of the Multi-Ethnic Study of Atherosclerosis (n = 3573), representative of the general population. Data on diseased thoracic aorta were derived from the database of the Aortic Institute at Yale-New Haven Hospital (n = 3263), representative of patients with thoracic aortic aneurysm and dissection.

Spontaneous baroreflex sensitivity: prospective validation trial of a novel technique in survivors of acute myocardial infarction.

Background: Low baroreflex sensitivity (BRS) indicates poor prognosis after acute myocardial infarction. Noninvasive BRS assessment is complicated by nonstationarities and noise in electrocardiogram and pressure signals. Phase-rectified signal averaging is a novel signal processing technology overcoming these problems.

Clinical utility of a novel wireless implantable loop recorder in the evaluation of patients with unexplained syncope.

Background: The implantable loop recorder (ILR) is particularly useful for monitoring patients with syncope, given the episodic nature and unpredictable pattern of recurrent episodes. Current practice guidelines advocate ILR implantation in select patients with unexplained syncope.

Objective: The purpose of this study was to evaluate the clinical utility and potential advantages of a novel wireless ILR in a consecutive cohort of patients with unexplained syncope.

How to Learn Epicardial Intervention Techniques in Electrophysiology.

This article outlines an approach to begin an epicardial ablation program in the electrophysiology laboratory. There are some logistical hurdles in getting this program up and running, so this is a good opportunity to review the indications, the risks that are inherent in the procedure, and the infrastructure necessary in the electrophysiology laboratory and institution to perform the procedure safely and effectively.