Surgical anesthesia in a patient with a pheochromocytoma crisis supported by ECMO: a case report.

Pheochromocytoma is rare in clinical practice, with patients typically presenting with headache, high blood pressure and sweating. Patients who develop a pheochromocytoma crisis are particularly rare. This report describes the case of a patient in a pheochromocytoma crisis who presented with severe cardiogenic shock, acute respiratory failure, and acute coronary syndrome.

Hemodynamic Characteristics and Prognostic Implication of Modified Society for Cardiovascular Angiography and Interventions Shock Classification in Comatose Patients With Out-of-Hospital Cardiac Arrest.

Background: Cardiogenic shock complicating acute myocardial infarction is associated with a high mortality rate. Cardiogenic shock after out-of-hospital cardiac arrest (OHCA) can be due to transient myocardial stunning but also reflect the increasing severity of ongoing heart failure. The Society for Cardiovascular Angiography and Interventions (SCAI) proposed a division of cardiogenic shock into 5 phenotypes, with cardiac arrest being a modifier.

Impact of Sex on Outcomes With Femoral Artery Closure Devices Versus Manual Compression in Patients Undergoing Percutaneous Coronary Intervention.

Background And Aims: Femoral artery access is widely used despite recent increase in radial access for percutaneous coronary interventions (PCI). Femoral artery closure devices are used to shorten vascular closure time and reduce bleeding. We sought to examine sex-based outcomes of femoral artery vascular closure devices (VCD) in patients undergoing PCI.

Endocarditis and ascending aortic aneurysm with aortic valve insufficiency secondary to late syphilis: Case report.

Venereal syphilis, caused by Treponema pallidum, is a major global health problem. Untreated latent syphilis can progress to tertiary syphilis, often leading to severe complications such as cardiac involvement, particularly syphilitic aortitis, which may manifest decades after the initial infection. We present a case of a 46-year-old woman who developed an ascending aortic aneurysm and severe aortic valve insufficiency due to late-stage syphilis.

Acute kidney injury and in-hospital outcomes after transcatheter aortic valve replacement in patients without chronic kidney disease: insights from the national inpatient sample.

Background: Acute kidney injury (AKI) complicates transcatheter aortic valve replacement (TAVR), leading to higher mortality. The incidence and effects of AKI on clinical outcomes in patients undergoing TAVR without chronic kidney disease (CKD) are unclear. We aimed to determine the association between AKI and in-hospital outcomes in patients with TAVR using propensity score matching (PSM).

Shear stress-induced restoration of pulmonary microvascular endothelial barrier function following ischaemia reperfusion injury requires VEGFR2 signalling.

Normal shear stress produced by blood flow is sensed by the vascular endothelium and required for maintenance of the homeostatic functions of the endothelium in systemic conduit and resistance vessels. Many critical illnesses are characterised by periods of abnormally reduced or absent shear stress in the lung (e.g.

NSTEMI and Ischemic Mitral Regurgitation: Incidence and Long-Term Clinical Outcomes with Respect to Management Strategy.

Background: The optimal treatment for ischemic mitral regurgitation (IMR) in patients of non-ST elevation myocardial infarction (NSTEMI) is a debated topic.

Objective: To evaluate the long term outcome on patients with NSTEMI and IMR, particularly emphasizing the comparison of treatments in those with moderate to severe MR.

Methods: We enrolled patients with NSTEMI and classified non/trivial to mild regurgitation as insignificant IMR and moderate to severe regurgitation as significant IMR.

Inserting a VA-ECMO cannula through an inferior vena cava filter during extracorporeal cardiopulmonary resuscitation.

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been utilized to treat massive pulmonary embolism (PE) accompanied by cardiac arrest or refractory cardiogenic shock. Our team opted for a femoral-femoral approach for vascular cannulation, using drainage and return cannulas in the common femoral vein and artery, respectively. However, femoral venous cannulation can be limited or challenging due to the presence of thrombus in the inferior vena cava (IVC), making the insertion of the drainage cannula via the femoral vein difficult.

Comparison of outcomes of Impella-assisted high-risk percutaneous coronary intervention in patients with and without prior coronary artery bypass graft.

Background: Limited data is available regarding in-hospital outcomes of patients undergoing high-risk percutaneous coronary intervention (HR-PCI) with Impella with and without a prior history of coronary artery bypass grafting (CABG).

Methods: We performed a retrospective study from the Nationwide Inpatient Sample from year 2016 to 2020. We identified patients who underwent Impella and percutaneous coronary intervention on the same day and excluded those with cardiogenic shock.

Causes of mortality following PCI: the University of New Mexico hospital experience.

Background: Mortality after percutaneous coronary intervention (PCI) remains a problem. Clinical databases such as the American College of Cardiology National Cardiovascular Data CathPCI Registry do not contain enough information to determine the specific cause of death after PCI, and thus are not able to identify opportunities for improvement (OFIs) that might have prevented the death of specific patients. We reviewed cases of death after coronary intervention to identify specific OFIs.

Left Ventricular Unloading With Surgically Implanted Microaxial Flow Pump in Patients on Venoarterial Membrane Oxygenation.

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is applied for the treatment of cardiogenic shock. Concomitant left ventricular unloading (LVU) with a microaxial flow pump (mAFP) enables myocardial and pulmonary recovery and may overcome some of the limitations of VA-ECMO. The study included 145 cardiogenic shock patients, 89 (61.

Giant Cell Myocarditis vs Cardiac Sarcoidosis: Reconsidering the Diagnosis With FDG PET Imaging.

Giant cell myocarditis (GCM) and cardiac sarcoidosis share clinical and histologic features, but whether they represent separate processes or lie on an inflammatory cardiomyopathy spectrum is unclear. We present a case of cardiogenic shock thought to be secondary to biopsy-proven GCM with a subsequent post-transplant diagnosis of sarcoidosis through 18-fluorodeoxyglucose positron emission tomography and biopsy.

Rapidly Worsening Infective Endocarditis With Severe Mitral Stenosis.

Infective endocarditis (IE) rarely results in mitral stenosis (MS), but MS in patients with IE can be life-threatening. We present a case of prosthetic MS secondary to IE. A 69-year-old Japanese man underwent mitral valve replacement with a bioprosthetic valve 2 years previously.

Preemptive Use of a Left Microaxial Flow Pump in Peripartum Cardiomyopathy.

Management of peripartum cardiomyopathy and cardiogenic shock often presents a significant clinical challenge. These patients are frequently best served at a specialized center with access to cardiac anesthesia, maternal-fetal medicine, and cardiac intensivists. Planning for delivery involves a plan for anesthesia and management of hemodynamic changes during the postoperative period.

Impact of ECPELLA support on 1-year outcomes and myocardial damage in patients with acute myocardial infarction and refractory cardiogenic shock: A single-center retrospective observational study.

Background: Venoarterial-extracorporeal membrane oxygenation (VA-ECMO) is a vital mechanical circulatory support for treating patients with refractory cardiogenic shock (CS). VA-ECMO can improve end-organ perfusion; however, it increases left ventricular (LV) afterload, resulting in further myocardial damage. ECPELLA, a combination of VA-ECMO and Impella (Abiomed Inc.

Clinical outcomes of cardiogenic shock among critically ill patients admitted to intensive care units in Australia and New Zealand from 2003 to 2022.

Purpose: Patients with Cardiogenic shock (CS) admitted to intensive care units (ICUs) have high mortality rates. We aimed to investigate the changes patient characteristics and outcomes over time among patients admitted to the ICU with CS.

Methods: Retrospective study utilizing a large bi-national ICU database from 2003 to 2022.

Closed-Loop Automated Control System of Extracorporeal Membrane Oxygenation and Left Ventricular Assist Device Support in Cardiogenic Shock.

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) benefits patients with cardiogenic shock (CS) but can increase left ventricular afterload and exacerbate pulmonary edema. Adding a percutaneous left ventricular assist device (LVAD) to VA-ECMO can optimize the hemodynamics. Because managing VA-ECMO and LVAD simultaneously is complex and labor-intensive, we developed a closed-loop automated control system for VA-ECMO and LVAD.

Brugada phenocopy in fulminant eosinophilic myocarditis: a case series.

Background: Brugada phenocopy (BrP) is a condition that induces reversible Brugada-like electrocardiographic (ECG) changes in patients without true Brugada syndrome. We present two cases of fulminant eosinophilic myocarditis that showed Type 1 Brugada ECG changes in the early phase of the clinical course.

Case Summary: Case 1 was a 76-year-old man who developed fulminant eosinophilic myocarditis with ventricular tachycardia while hospitalized for heart failure.

Percutaneous Atrial Septostomy in Adult Patients on Veno-Arterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock: A Canadian Single-Center Experience.

Patients with cardiogenic shock on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) frequently develop left ventricular (LV) distension and pulmonary edema due to an increased LV afterload. A balloon atrial septostomy (BAS) is a technique used to alleviate LV pressure and facilitate left atrial decompression. While primarily performed in pediatric populations, this procedure's feasibility in adult patients is less studied.

Multiple Arterial Grafting During Coronary Artery Bypass Graft Surgery in Diabetic and Non-Diabetic Patients: A Short- and Long-Term Analysis at a Single Center.

: Coronary artery bypass surgery (CABG) with multiple arterial grafting (MAG) has shown potential to improve patient survival compared to single arterial bypass grafting. Whether this superiority in survival also exists in diabetics is uncertain. We therefore aimed to compare short and long-term outcomes of MAG in diabetic versus non-diabetic patients.

Utility of an Echocardiographic Machine Learning Model to Predict Outcomes in ICCU Patients.

Introduction: The risk stratification at admission in ICCU (intensive cardiac care unit) is crucial and remains challenging.

Objectives: We aimed to investigate the accuracy of a machine learning (ML)-model based on initial transthoracic echocardiography (TTE) to predict in-hospital major adverse events (MAEs) in a broad spectrum of patients admitted to ICCU.

Methods: All consecutive patients hospitalised in ICCUs with a complete TTE performed within the first 24 hours of admission were included in this prospective multicenter study (39 centers).

Survival after extracorporeal cardiopulmonary resuscitation for adolescent arrhythmogenic arrest: ECPella (extracorporeal membrane oxygenation with Impella)-a case report.

Background: The combined therapy with venoarterial extracorporeal membrane oxygenation and Impella (ECPella) has been shown to improve survival in acute cardiogenic shock (CS) in adult patient. Only three paediatric cases have been reported in a multicentre study.

Case Summary: We present our case, the first described to our knowledge in the UK, of a 15-year-old adolescent of Afro-Caribbean descent, weight 75 kg, who received extracorporeal cardiopulmonary resuscitation (E-CPR) and ECPella implantation.