A new endoscopic method of retrieval of a migrated and transmurally embedded intrauterine contraceptive device in the rectum.

A 45-year-old lady presented with left lower quadrant abdominal pain and hematochezia of 1 month duration. She had Copper-T, an intrauterine contraceptive device (IUCD) inserted in the immediate post-partum period 25 years ago elsewhere and was lost to follow up. CT abdomen done 2 weeks earlier before reporting to us revealed a migrated and translocated IUCD embedded in the right lateral wall of the rectum.

Feasibility and efficacy of the 2.5 L and 3.8 L impella percutaneous left ventricular support device during high-risk, percutaneous coronary intervention in patients with severe aortic stenosis.

Objective: Assessment of the feasibility and outcomes of the 2.5 L and 3.8 L Impella cardiac pump in patients with severe aortic stenosis (AS) and left ventricular impairment undergoing percutaneous revascularization (PCI) with or without balloon aortic valvuloplasty (BAV).

Intramural hemotoma presenting as acute coronary syndrome: the importance of intravascular ultrasound.

Intramural hematoma in major coronary epicardial vessels is a rare cause of chest pain. Afflicted individuals may present with acute coronary syndrome (ACS) or even sudden cardiac death. Spontaneous, isolated intramural hematoma may occur in the absence of associated intimal dissection.

Acquired left ventricular to left atrial fistula--not mitral regurgitation! Transcutaneous closure with amplatzer device.

Acquired left ventricle (LV) to left atrial (LA) fistula is a very rare complication following aortic valve replacement (AVR). This can usually be surgically repaired but the risk of re-operation is high due to repeat sternotomy and also due to other comorbidities usually seen in this population. We report a case presenting with recurrent episodes of left ventricular failure 10 years following bioprosthetic aortic valve replacement and who was diagnosed to have a communication between the LV and the LA on transesophageal echocardiography (TEE).

Kissing drug eluting balloons for in-stent restenosis complicating bifurcations treated with drug-eluting stents.

The management of in-stent restenosis (ISR) complicating bifurcation lesions is technically challenging and implant of further stents may not be feasible. The use of drug-eluting balloons provides an attractive option for treatment of such lesions allowing a technically simple procedure without the need for further complex stenting. The SeQuent Please paclitaxel-eluting balloon (B.

Successful implantation of the Edwards Sapien THV via direct aortic access in a patient with previous pneumonectomy and no other access.

The Edwards Sapien transcatheter heart valve (THV) is available for treatment of severe symptomatic aortic stenosis via transfemoral access or trans-apical access when ilio-femoral vessels are considered unsuitable. Some patients, however, may be unsuitable for access via either of these routes. We describe successful implantation of an Edwards Sapien THV via direct access of the ascending aorta in a patient with previous right pneumonectomy and pulmonary disease who was considered unsuitable for implantation via femoral vessels or via trans-apical approach.

Coronary stenting for iatrogenic stenosis of the left main coronary artery post-aortic valve replacement: an alternative treatment?

Iatrogenic coronary ostial stenosis after aortic valve replacement is a rare, life-threatening complication, which may follow implantation of either a mechanical or a biological prosthesis. Historically, this condition has been treated by urgent coronary bypass surgery but is associated with high morbidity and mortality, due to the hazards of early repeat sternotomy. We report a case of iatrogenic coronary ostial stenosis successfully treated with stenting and discuss the advantages of percutaneous intervention over coronary bypass surgery.

A noncompliant, high pressure balloon to manage undilatable coronary lesions.

Undilatable coronary lesions, due to coronary calcification, are encountered with increasing frequency. Percutaneous intervention of such lesions comes with the risk of stent underexpansion, which increases the risk of stent thrombosis and restenosis. A variety of techniques and devices are available to assist the interventionist in the treatment of calcified lesions.

Don't rule out retroperitoneal bleeding just because the angiogram was done from the radial artery.

The use of radial artery for vascular access for cardiac catheterization and intervention has gained increasing acceptance over the last few years as result of the lower risk of vascular complications compared to use of the femoral artery. The strong evidence showing that major bleeding (commonly access site related) is an independent predictor of mortality in acute coronary syndrome patients undergoing intervention has only accelerated this change. This case highlights that although the risk of access site complications is reduced with the radial approach there remains a risk of spontaneous bleeding elsewhere due to the use of multiple potent antiplatelet and anticoagulant therapy in the treatment of acute coronary syndromes.

Lipomatous hypertrophy of the interatrial septum.

Lipomatous hypertrophy of the interatrial septum is a rare condition and it does not require any specific treatment. We present the transoesophageal echocardiogram findings of a 70-year-old lady demonstrating the appearances that were typical of lipomatous hypertrophy of the interatrial septum.