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Interventricular septal dissection secondary to acute inferior myocardial infarction: case series and literature review.

J Cardiothorac Surg

January 2025

Echocardiography and Vascular Ultrasound Center, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China.

Background: Interventricular septal dissection is a critical disease characterized by the separation of the intraventricular septum into two layers, forming an intermediate layer with a cystic cavity that communicates with the root of the aorta or ventricle. It has low morbidity and high mortality rates.

Case Presentation: Case 1: A 58-year-old male with a history of hypertension and smoking presented to a local hospital due to chest tightness and pain for 4 days.

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Subendocardial ischemia: does CMD really exist?

Cardiovasc Revasc Med

January 2025

Weatherhead PET Imaging Center, Division of Cardiology, Department of Medicine, McGovern Medical School at UTHealth and Memorial Hermann Hospital, Houston, TX, United States of America.

Patients with angina but without obstructive epicardial coronary disease still require a specific mechanistic diagnosis to enable targeted treatment. The overarching term "coronary microvascular dysfunction" (CMD) has been applied broadly - but is it correct? We present a series of case examples culminating a systematic exploration of our large clinical database to distinguish among four categories of coronary pathophysiology. First, by far the largest group of "no stenosis angina" patients exhibits subendocardial ischemia during intact flow through diffuse epicardial disease during dipyridamole vasodilator stress.

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Computational modeling of cardiac hemodynamics including chordae tendineae, papillaries, and valves dynamics.

Comput Biol Med

January 2025

LaBS, Dipartimento di Chimica, Materiali e Ingegneria Chimica "Giulio Natta", Politecnico di Milano, Piazza Leonardo da Vinci 32, Milan, 20133, Italy. Electronic address:

In the context of dynamic image-based computational fluid dynamics (DIB-CFD) modeling of cardiac system, the role of sub-valvular apparatus (chordae tendineae and papillary muscles) and the effects of different mitral valve (MV) opening/closure dynamics, have not been systemically determined. To provide a partial filling of this gap, in this study we performed DIB-CFD numerical experiments in the left ventricle, left atrium and aortic root, with the aim of highlighting the influence on the numerical results of two specific modeling scenarios: (i) the presence of the sub-valvular apparatus, consisting of chordae tendineae and papillary muscles; (ii) different MV dynamics models accounting for different use of leaflet reconstruction from imaging. This is performed for one healthy subject and one patient with mitral valve regurgitation.

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This study employed large eddy simulation (LES) with the wall-adapting local eddy-viscosity (WALE) model to investigate transitional flow characteristics in an idealized model of a healthy thoracic aorta. The OpenFOAM solver pimpleFoam was used to simulate blood flow as an incompressible Newtonian fluid, with the aortic walls treated as rigid boundaries. Simulations were conducted for 30 cardiac cycles and ensemble averaging was employed to ensure statistically reliable results.

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Background: Nonocclusive mesenteric ischemia (NOMI), a subtype of acute mesenteric ischemia, is primarily caused by mesenteric arterial vasoconstriction and decreased vascular resistance, leading to impaired intestinal perfusion.Commonly observed after cardiac surgery, NOMI affects older patients with cardiovascular or systemic diseases, accounting for 20-30% of acute mesenteric ischemia cases with a mortality rate of ∼50%. This review explores NOMI's pathophysiology, clinical implications in aortic dissection, and the unmet needs in diagnosis and management, emphasizing its prognostic significance.

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