Early Thrombosis of a Mitral Annuloplasty Ring in a Patient with MTHFR and Factor V Leiden Mutations.

Mitral annuloplasty ring thrombosis is an extremely infrequent pathology, for which no evidence-based antithrombotic management has yet been described. Herein is presented a case of heterozygous Factor V Leiden (FVL) and hyperhomocysteinemia with homozygous methylenetetrahydrofolate reductase (MTHFR) mutations that caused early thrombosis of the mitral annuloplasty ring. The clinical management and antithrombotic treatment of the patient, and the implications of hyperhomocysteinemia, are discussed.

Brachial embolism from mechanical mitral valve thrombosis: multimodality imaging-guided successful thrombolysis.

: We report the administration of low-dose (25 mg) prolonged infusion (25 h) of tissue-typed plasminogen activator (t-PA) in the treatment of brachial arterial thromboembolism (BAT) secondary to prosthetic valve thrombosis (PVT), under the guidance of multimodality imaging. BAT is a rare disorder with serious consequences. The case of BAT secondary to mitral PVT was successfully treated with low-dose prolonged infusion of t-PA under the guidance of multimodality imaging with upper extremity duplex Doppler ultrasonography, multislice computerized tomographic angiography, coventional angiography and advanced transesophageal echocardiography.

Left ventricular twist in hypertrophic cardiomyopathy : Predictor of nonsustained ventricular tachycardia.

Background: We investigated the efficacy of clinical and classic echocardiographic parameters in predicting the occurrence of nonsustained ventricular tachycardia (NsVT) in patients with hypertrophic cardiomyopathy (HCM).

Methods: The study comprised 59 patients with HCM (47 male, [80%]; mean age, 48.48 ± 14.

Enlargement Ratio May Predict Device Size in Elderly Patients with Atrial Septal Defect.

Background And Objectives: Balloon sizing remains the main technique for determining occluder device size for atrial septal defects (ASDs). New evidence has proposed that accurate estimation of device size could be possible without using the balloon technique. Operators have predicted the amount of possible enlargement depending on their experiences.

Single-center experience with percutaneous mitral valve repair using the MitraClip in a high-risk series in Turkey.

Objective: Mitral valve regurgitation (MR) is the second most common heart valve disease in Europe. Without intervention, prognosis of severe symptomatic MR is poor. Percutaneous edge-to-edge mitral valve repair with MitraClip is a promising mitral regurgitation treatment technique in select, high-surgical-risk patients.

Saphenous vein graft aneurysm: A case report.

Background: Saphenous vein graft aneurysms (SVGAs) are rare seen issues after coronary artery bypass graft (CABG) operation which may lead to major complications including compression of adjacent structure, myocardial ischemia, rupture, and even death.

Case Report: We report a patient with recurrent SVGA and its treatment by percutaneous intervention with a covered stent, the diagnostic and treatment procedure were based on contrast enhanced computed tomography and myocardial perfusion scintigraphy (MPS).

Conclusion: Multimodality imaging is required to demonstrate the true size and complications of the SVGA, the relationship among the adjacent structure, and to assess ischemia and size of myocardial territory supplied by the aneurysmal graft to decide treatment strategy.

Rationale, design and methodology of the RAMSES Study: ReAl-life Multicenter Survey Evaluating Stroke Prevention Strategies.

Objective: Atrial fibrillation is the most common arrhythmia and is associated with a five- fold increased risk of thromboembolic events. Vitamin K antagonists (VKAs) have been the mainstay of oral anticoagulant prophylaxis and the data on stroke prevention strategies are limited to VKA era. The purpose of this study is to evaluate the use of VKA, non-Vitamin K antagonist oral anticoagulants (NOAC), and antiplatelet agents in patients with non-valvular atrial fibrillation (NVAF).

Real-time three-dimensional left ventricular contraction in patients with diastolic dysfunction.

Purpose: Systolic alterations in left ventricular (LV) myocardial function have been reported previously in patients with diastolic dysfunction (DD). Recent advances in real-time three-dimensional echocardiography (3DE) enable the measurement of a set of parameters previously difficult to obtain with standard two-dimensional echocardiography (2DE). The aim of this study was to evaluate global 3DE LV contraction in patients with and without DD who had normal ejection fraction (EF).

Predictive role of left atrial and ventricular mechanical function in postoperative atrial fibrillation: a two-dimensional speckle-tracking echocardiography study.

Objective: The aim of this study was to determine the role of left-sided mechanical parameters in postoperative atrial fibrillation (POAF) in patients undergoing coronary artery bypass grafting (CABG).

Methods: Ninety patients with coronary artery disease and normal left ventricular (LV) function in sinus rhythm were enrolled in the study. Preoperative LV and left atrial (LA) mechanics were evaluated by two-dimensional (2D) speckle-tracking echocardiography (STE), including strain and rotation parameters, and volume indices.

Intracardiac Thrombus in Behçet's Disease.

Behçet's disease (BD) is a chronic multisystem disease that presents with recurrent oral and genital ulceration and recurrent uveitis. The patients are often diagnosed in the range of 20-30 years of age and BD are more common in men.[1] BD has a worldwide distribution, but it is mainly observed in Mediterranean areas and Japan.

Peripheral self-expandable stent catheter fracture: Retrieval of two different components with two different modalities.

A 58-year-old man whose right superficial femoral artery had been stented 2 weeks previously presented at the emergency service complaining of right leg pain of 2 days' duration. Angiography revealed a radiopaque foreign body distal to the stent. It was removed with a snare.

Multimodality imaging of a recurrent case of right-sided cardiac leiomyosarcoma with an unusual clinical course.

Primary cardiac sarcoma is an uncommon entity and is related with poor long-term survival. Presented here is an unusual case of right atrial leiomyosarcoma which almost completely occluded both the right atrium and ventricle and destroyed the tricuspid valve. Multimodality imaging was used to characterize the mass and guide surgical management.

Early Detection of Bi-ventricular and Atrial Mechanical Dysfunction Using Two-Dimensional Speckle Tracking Echocardiography in Patients with Sarcoidosis.

Purpose: Sarcoidosis is a systemic inflammatory disease with unknown etiology involving several organs. Myocardial involvement, pericarditis, severe rhythm abnormalities, and heart valve disease due to papillary muscle dysfunction are some of the cardiac manifestations. Conventional echocardiographic methods remain insufficient for the determination of subclinical myocardial dysfunction in patients with sarcoidosis.

Prediction of elevated left ventricular filling pressures in patients with preserved ejection fraction using longitudinal deformation indices of the left ventricle.

Aims: Estimation of left ventricular (LV) filling pressures is a clinical challenge in patients with preserved ejection fraction (EF). In the present study, we investigated whether LV and atrial longitudinal strain and strain rate (SR) parameters derived by speckle tracking echocardiography (STE) could be used to predict invasively measured LV end-diastolic pressure (LVEDP) in this patient population.

Methods And Results: LVEDP was measured before coronary angiography was performed in 65 patients with preserved EF (≥50%) referred to elective cardiac catheterization; besides, patients enrolled underwent comprehensive echocardiographic examination before the procedure.

The relationship between rheumatoid factor levels and coronary artery lesion complexity and severity in patients with stable coronary artery disease.

Introduction: The relation between serum rheumatoid factor levels and the extent, severity, and complexity of coronary artery disease has not been adequately studied.

Aim: Therefore, we assessed the relationship between the severity of coronary artery disease assessed by SYNTAX score and serum rheumatoid factor levels in patients with stable coronary artery disease.

Material And Methods: We enrolled 268 consecutive patients who underwent coronary angiography.

Incidental finding of complete interruption of the aorta in a septuagenarian.

Adult survivors of aortic interruption is extremely rare. Diagnosis mostly depends on additional imaging with CT and MRI. We present a rare case of acquired complete interruption of the aorta that was found incidentally at the time of coronary angiography.

Complexity of lower extremity peripheral artery disease reflects the complexity of coronary artery disease.

We investigated the relationship between peripheral artery disease complexity and coronary artery disease complexity in patients with peripheral artery disease. A total of 449 patients were enrolled. SYNTAX score, a marker of coronary artery disease complexity, was assessed by dedicated computer software and complexity of peripheral artery disease was determined by Trans Atlantic Inter-Society Consensus II classification.

Assessment of the influence of radiofrequency catheter ablation of the slow pathway of the atrioventricular node on cardiac function in patients with atrioventricular nodal reentrant tachycardia: a speckle tracking echocardiography study.

Objectives: Typical atrioventricular nodal reentrant tachycardia (AVNRT) can be cured with slow pathway ablation. This study was designed to assess the alterations in atrial and ventricular functioning using speckle tracking echocardiography in consecutive patients with typical AVNRT who underwent slow pathway radiofrequency (RF) ablation.

Study Design: Included in this study were 23 consecutive patients with symptomatic drug-resistant typical (slow-fast) AVNRT, all of whom underwent an invasive electrophysiology study and RF ablation.

Percutaneous treatment of huge congenital coronary-cameral fistula.

An 11-year-old girl was admitted to our hospital with a history of fatigue, effort dyspnea, and chest pain. On transthoracic echocardiography, the parasternal short-axis and apical four-chamber color Doppler flow imaging showed a structure matching the level of the coronary sinus and pouring into the right ventricle. On multi-slice computed tomography, the circumflex artery became immediately narrowed just before draining in to the base of the right ventricle, close to the septal leaflet of the tricuspid leaflet, and the Qp/Qs was 1.

Clinical outcomes and effectiveness of renal artery stenting in patients with critical atherosclerotic renal artery stenosis: does it improve blood pressure control and renal function assessed by estimated glomerular filtration rate?

Introduction: Atherosclerotic renal artery stenosis (ARAS) is associated with uncontrolled hypertension and chronic renal failure.

Aim: To evaluate the influence of gender and presence of chronic renal failure on the outcomes of percutaneous transluminal renal artery stenting (PTRAS) due to atherosclerosis.

Material And Methods: A total of 28 ARAS patients underwent PTRAS and 36 stents were placed.

Mitral valve with a single leaflet.

Congenital anomalies of the mitral valve apparatus are rare. Of such cases, congenital mitral stenosis, atresia, accessory valvular tissue, and cleft mitral valve are more common. Descriptions of unileaflet mitral valves (either partial or complete leaflet agenesis/hypoplasia) are extremely rare and largely limited to a few case reports.

Alternative causes of bioreaction to prosthetic heart valves: three cases with pannus formation.

Pannus formation is an infrequent but serious complication of prosthetic heart valve surgery. The cause of pannus is recognized as a bioreaction to the prostheses; histological investigations have shown that pannus comprises collagen and elastic tissues containing endothelial cells, chronic inflammatory cells, and myofibroblasts. However, the detailed mechanism of its formation has not been fully demonstrated.