An active 68-year-old man with asymptomatic severe aortic stenosis and normal functional capacity on a conventional bicycle exercise test underwent a haemodynamic stress test with simultaneous invasive haemodynamic monitoring and echocardiography during supine bicycle testing as part of a research project. With exercise, the patient developed pulmonary venous hypertension and mild regional wall motion abnormalities on echocardiography. The patient terminated the test due to exhaustion. In the recovery period, he developed sustained ventricular tachycardia and became unconscious. No symptoms were present during exercise or prior to cardiac arrest. The following coronary angiogram revealed significant 2-vessel disease, and the patient subsequently underwent successful aortic valve replacement and coronary-artery bypass graft surgery.
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http://dx.doi.org/10.1136/bcr-2015-211473 | DOI Listing |
Eur J Cardiothorac Surg
January 2025
Department of Cardiac Surgery, University Hospital Quironsalud Madrid, Spain.
Objectives: The Ross procedure for aortic regurgitation (AR) and abnormal aortic valve morphologies is associated with an increased risk of autograft dilatation. Autograft support may ameliorate this problem. We analyzed the results for all haemodynamic lesions and the effect of autograft support.
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
The Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194, Japan.
Background: Self-expanding valves used in transcatheter aortic valve implantation (TAVI) are designed to allow recapture and repositioning, facilitating optimal placement and mitigating conduction disturbances and paravalvular leakage. Here, we present a rare case in which the Navitor (Abbott Structural Heart, Santa Clara, CA, USA) could not be recaptured.
Case Summary: An 81-year-old Japanese woman with very severe aortic stenosis and a massively calcified nodule at the non-coronary cusp (NCC) underwent TAVI with a 25 mm Navitor valve.
Exp Physiol
January 2025
Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK.
Fenestrated/branched endovascular aortic repair emerges as the primary therapeutic modality for intricate aortic pathologies encompassing the paravisceral and thoracoabdominal segments, where bridging stent grafts (BSGs) play a vital role in linking the primary aortic endograft with target vessels. Bridging stent grafts can be categorized mainly into self-expanding stent grafts (SESGs) and balloon-expandable stent grafts (BESGs). Physiological factors significantly influence post-complex endovascular aortic repair BSG behaviour, impacting clinical outcomes of SESGs and BESGs in different but overlapping ways.
View Article and Find Full Text PDFJ Vasc Surg Cases Innov Tech
April 2025
Vascular Surgery Unit, S. Chiara Hospital, APSS Trento, Trento, Italy.
This case report presents the use of intravascular lithotripsy (IVL) in a 68-year-old woman with disabling bilateral claudication owing to a heavily calcified subocclusive stenosis of the infrarenal aorta. The patient had a history of tobacco use, dyslipidemia, and chronic obstructive pulmonary disease, with absent femoral pulses and severe arterial calcification. A 12-mm Shockwave L6 lithotripsy catheter was employed to treat the aortic lesion, resulting in a significant decrease in the aortic pressure gradient without the need for stenting.
View Article and Find Full Text PDFInt J Cardiol Heart Vasc
February 2025
Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
Background: Epicardial fat tissue (EFT) is an active organ that can affect cardiac function and structure through endocrine, paracrine, and proinflammatory mechanisms. We hypothesized that greater thickness of EFT may harm the recovery of left ventricular (LV) systolic function in patients with severe aortic stenosis (AS) and reduced LV ejection fraction (EF ≤ 50 %) undergoing transcatheter aortic valve implantation (TAVI).
Methods: A sixty six patients with severe AS and 20 % ≥ LVEF ≤ 50 % who underwent TAVI were included.
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