A 68-year-old woman had a transvenous pacemaker implanted 6 years ago. One year after the procedure the pulse generator was removed due to generator site infection. Efforts to remove the lead resulted in fracture of the tip, which was abandoned in the right cardiac cavities. After this the patient suffered intermittent episodes of fever and chills, which responded to antibiotic therapy. At her recent admission, transesophageal echocardiography revealed a large mass attached to the free end of the fractured lead suggestive of the existence of a vegetation on the pacing lead. The diagnosis was confirmed at surgery.
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http://dx.doi.org/10.1111/j.1540-8159.1998.tb00165.x | DOI Listing |
J Am Coll Cardiol
March 2025
Cedars Sinai Medical Center, Los Angeles, California, USA. Electronic address:
This updated Heart Valve Collaboratory framework addresses the growing concern for transcatheter valve failure (TVF) following transcatheter aortic valve replacement (TAVR). With the increasing volume of redo-TAV and surgical TAV explantation, there is a critical need for standardized pathways and protocols for evaluating TVF using echocardiography and cardiac computed tomography (CT) angiography. This document clarifies prior definitions of bioprosthetic valve deterioration and bioprosthetic valve failure in a practical, imaging directed context for TAVR.
View Article and Find Full Text PDFJACC Case Rep
January 2025
Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. Electronic address:
Background: Although rare, embolization of left atrial appendage occlusion (LAAO) devices carries a significant morbidity and mortality burden.
Case Summary: An asymptomatic 77-year-old woman with inability to tolerate anticoagulation due to gastrointestinal bleeding presented for 45-day transesophageal echocardiography following LAAO with a Watchman device, which demonstrated incidental device migration to the left ventricular outflow tract (LVOT). Percutaneous extraction was performed using a novel technique with rat tooth/alligator forceps to successfully retrieve the Watchman from the LVOT using a transaortic approach.
Front Neurol
February 2025
Catholic Health Initiatives (CHI) Memorial Neuroscience Institute, Morehouse School of Medicine, Chattanooga, TN, United States.
Background: Stroke is the leading cause of adult disability worldwide, with approximately 30% of strokes remaining cryptogenic. One potential important etiology is a patent foramen ovale (PFO), which may contribute to stroke through paradoxical thromboembolism or thromboembolus formation. Recent advancements in robot-assisted transcranial Doppler (raTCD) have shown increased sensitivity in detecting right-to-left shunt (RLS) compared to transthoracic echocardiography (TTE), particularly in detecting the large shunts which are associated with higher stroke risk.
View Article and Find Full Text PDFEchocardiography
March 2025
Coronary Unit, Ignacio Chávez National Institute of Cardiology, Mexico City, Mexico.
Take home messages 1. Despite being considered a benign tumor, the high reported incidence of embolic events increasingly warrants surgical resection, regardless of size, especially in patients with a history of cardiovascular risk factors. 2.
View Article and Find Full Text PDFCureus
March 2025
Department of Cardiovascular Surgery, Japanese Red Cross Society Kyoto Daiichi Hospital, Kyoto, JPN.
Pheochromocytomas present with paroxysmal hypertension due to a sudden release of catecholamines stimulated by radiological contrast media, surgery, or anesthetic agents. This often complicates the maintenance of patient hemodynamics during surgery. A 55-year-old man with a high fever was admitted to a hospital.
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