Cardiovascular Medicine

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Open AccessCommunication

Verleihung der Ehrenmitgliedschaft bei der Schweizerischen Gesellschaft für Kardiologie

by Thomas F. Lüscher

Cardiovasc. Med. 2010, 13(4), 143; https://doi.org/10.4414/cvm.2010.01493 - 28 Apr 2010

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Anlässlich der letztjährigen Jahrestagung der Schweizerischen Gesellschaft für Kardiologie wurden bekannte Persönlichkeiten der Kardiologie mit der Ehrenmitgliedschaft unserer Gesellschaft ausgezeichnet [...] Full article

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1 pages, 329 KB

Open AccessCommunication

15th Cardiovascular Biology and Clinical Implications Meeting

by Marijke Brink, Brenda R. Kwak and Christian M. Matter

Cardiovasc. Med. 2010, 13(4), 142; https://doi.org/10.4414/cvm.2010.01489 - 28 Apr 2010

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Abstract

The Annual Swiss Cardiovascular Biology and Clinical Implications Meeting, organised by the Swiss Society of Cardiology Working Group of Cardiovascular Biology, took place from October 1–2, 2009 in Muntelier. The meeting highlighted recent progress on the following topics [...] Full article

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Neonatal Bradycardia

by Susanne Navarini, Mladen Pavlovic, Nicola Schwick and Jean-Pierre Pfammatter

Cardiovasc. Med. 2010, 13(4), 141; https://doi.org/10.4414/cvm.2010.01495 - 28 Apr 2010

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Abstract

A 34-year-old primigravida was referred for foetal ultrasound due to irregular heart beat at 31 weeks’ gestation [...] Full article

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Open AccessInteresting Images

Unity in Diversity: The Varied Manifestations of WPW Syndrome

by Andrew De Nazareth, Venkata M. Alla and Claire Hunter

Cardiovasc. Med. 2010, 13(4), 138; https://doi.org/10.4414/cvm.2010.01492 - 28 Apr 2010

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Abstract

A 24-year-old Caucasian male presented to the emergency room with palpitations [...] Full article

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3 pages, 409 KB

Open AccessCase Report

Gut Feelings

by Martin Schlaepfer and Nils Kucher

Cardiovasc. Med. 2010, 13(4), 135; https://doi.org/10.4414/cvm.2010.01490 - 28 Apr 2010

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Abstract

We report the case of a 69-year-old man with known atherosclerosis and a typical history of abdominal angina. Angiography of his splanchnic arteries revealed severe stenosis of two of the three main splanchnic arteries. The patient was completely cured of his symptoms by [...] Read more.

We report the case of a 69-year-old man with known atherosclerosis and a typical history of abdominal angina. Angiography of his splanchnic arteries revealed severe stenosis of two of the three main splanchnic arteries. The patient was completely cured of his symptoms by percutaneous balloon angioplasty (PTA) and bare metal stent implantation in the stenotic celiac and superior mesenteric artery. Full article

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5 pages, 743 KB

Open AccessEditorial

Transcatheter Devices for Left Atrial Appendage Occlusion

by Ahmed A. Khattab and Bernhard Meier

Cardiovasc. Med. 2010, 13(4), 130; https://doi.org/10.4414/cvm.2010.01488 - 28 Apr 2010

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Abstract

Atrial fibrillation (AF) patients are at inherent risk for thromboembolic stroke. Since the left atrial appendage (LAA) is known to be the primary site for thrombus formation in nonvalvular AF, its exclusion may offer an attractive alternative to long-term oral anticoagulation therapy in [...] Read more.

Atrial fibrillation (AF) patients are at inherent risk for thromboembolic stroke. Since the left atrial appendage (LAA) is known to be the primary site for thrombus formation in nonvalvular AF, its exclusion may offer an attractive alternative to long-term oral anticoagulation therapy in such patients. Accordingly, simultaneous LAA closure became common practice during cardiac surgery and was recently adopted by surgical guidelines. Alternatively, while thoracoscopic epicardial occlusion under general anaesthesia has been successfully performed, the actual breakthrough came with the introduction of transcatheter LAA exclusion in 2001. Although this device technology was beset with initial difficulties which even led to withdrawal of the original device line, several events in the recent past have revived interest in this catheter-based technology as a valid and safe option for stroke prevention in AF patients. This review discusses the relation of the LAA to the development of AF-related stroke and provides detailed insight into different transcatheter devices for LAA occlusion. Full article

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8 pages, 574 KB

Open AccessArticle

Perkutane Katheter-Basierte Behandlung der Schweren Mitralinsuffizienz

by Giovanni Pedrazzini, Daniel Sürder, Marco Moccetti, David Hürlimann, Franco Faletra, Christian Felix, Dominique Bettex, Elena Pasotti, Ines Bühler, Julija Klimusina, Thomas F. Lüscher, Tiziano Moccetti, Jürg Grünenfelder and Roberto Corti

Cardiovasc. Med. 2010, 13(4), 122; https://doi.org/10.4414/cvm.2010.01491 - 28 Apr 2010

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Abstract

Many patients with severe mitral regurgitation and a high operative risk are treated conservatively despite their high morbidity and mortality. Here we report the first Swiss experience of a new technique for transvenous mitral valve reconstruction using the Mitraclip^® system and performed [...] Read more.

Many patients with severe mitral regurgitation and a high operative risk are treated conservatively despite their high morbidity and mortality. Here we report the first Swiss experience of a new technique for transvenous mitral valve reconstruction using the Mitraclip^® system and performed in high-risk patients. Methods: Retrospective analysis of the clinical, echocardiographic and periprocedural data of the first patients treated by Mitraclip^® in Switzerland. Patient selection: Patients with severe mitral regurgitation (3+/4+) either presenting a high operative risk (log Euroscore or STS-Score) or classified as inoperable by a cardiological-cardiosurgical panel. Results: Since February 2009, 25 patients with an average age of 69 ± 9.8 years have been treated (60% male, log Euroscore 15 ± 20%, STS score 7 ± 9%; median ± STDEV). The median left ventricular ejection fraction was 36 ± 16%. The origin of mitral regurgitation was functionalischaemic in 11 patients (44%). In 3 patients (12%) the cause was functional-non-ischaemic and in 7 patients (28%) degenerative. In 4 patients the cause was mixed. Implantation of one or two clips was successful in 22 of the 25 patients (88%). In 8 patients (32%) implantation of a second clip was performed during the index intervention, in two cases (8%) a second clip was successfully implanted during a subsequent intervention. Before the intervention the severity degree of mitral regurgitation was at least 3+ in all patients. Successful implantation (n = 22) was followed by a fall of at least one degree in the severity of MI in all patients, in 20 patients (91%) to 1+/2+. Clinically this was reflected in improvement of NYHA class from an average of 3.2 ± 0.5 to 2.1 ± 0.7. The 30-day major adverse cardiovascular event (MACE) rate in these high-risk patients was 20% (5 patients). Conclusion: In Switzerland, the first 25 patients with severe mitral regurgitation have been treated percutaneously (for the most part successfully) by the Mitraclip® system. This new intervention has a major future potential, especially in patients unsuitable for surgical treatment due to a high operative risk. The future role of this technique in patients with severe heart failure is currently under investigation. Full article

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7 pages, 1069 KB

Open AccessArticle

A Head-to-Head Comparison of Echocardiography and Radionuclide Ventriculography for Diagnosis of Ventricular Dyssynchrony

by Haran Burri, Hajo Müller, Ines Foulkes, Eric Fleury, Carine Stettler, Thomas Schindler, René Lerch and Osman Ratib

Cardiovasc. Med. 2010, 13(4), 115; https://doi.org/10.4414/cvm.2010.01496 - 28 Apr 2010

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Abstract

Background: Diagnosis of ventricular dyssynchrony may play a role in patient selection for cardiac resynchronisation therapy. Various imaging techniques are available for diagnosis of dyssynchrony, including echocardiography and radionuclide imaging. Whether these techniques yield concordant results is not known. Methods: We [...] Read more.

Background: Diagnosis of ventricular dyssynchrony may play a role in patient selection for cardiac resynchronisation therapy. Various imaging techniques are available for diagnosis of dyssynchrony, including echocardiography and radionuclide imaging. Whether these techniques yield concordant results is not known. Methods: We studied 31 patients with left ventricular systolic dysfunction. Dyssynchrony was evaluated by echocardiography using interventricular mechanical delay (IVMD) and pulsed-wave tissue Doppler imaging (TDI). Dyssynchrony was also measured in the same patients using radionuclide angiography with nuclear phase analysis (NPA). Control subjects with normal systolic function were studied to determine cutoff values for each technique. Results: NPA was more likely to diagnose interventricular dyssynchrony than IVMD (68% vs 26% of patients, p = 0.001). Intraventricular dyssynchrony was more often diagnosed by NPA than TDI (84% vs 42%, p = 0.002). Agreement between echocardiography and NPA was poor in diagnosing inter- and intraventricular dyssynchrony (k <0.22 for all comparisons). Conclusion: Poor agreement between echocardiography and NPA in diagnosing dyssynchrony may be explained by the inherent differences between these techniques, which are therefore non-interchangeable. Recent data suggest that echocardiography has limited value in predicting response to CRT. As NPA evaluates dyssynchrony differently, it should be evaluated for this application. Full article

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4 pages, 108 KB

Open AccessArticle

Prevalence of Thrombophilia in Patients Undergoing Closure of Patent Foramen Ovale

by Philipp Wagdi, Manfred Ritter and Frank Salzer

Cardiovasc. Med. 2010, 13(4), 111; https://doi.org/10.4414/cvm.2010.01494 - 28 Apr 2010

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Abstract

Objectives: One of the less controversial indications for percutaneous closure (C) of a patent foramen ovale (PFO) may be reduction of recurrent cerebral thromboembolic events, although these may sometimes recur after PFO-C. Hypercoagulable states are among the less well understood causes of [...] Read more.

Objectives: One of the less controversial indications for percutaneous closure (C) of a patent foramen ovale (PFO) may be reduction of recurrent cerebral thromboembolic events, although these may sometimes recur after PFO-C. Hypercoagulable states are among the less well understood causes of cryptogenic stroke (CS). The reported prevalence of coagulopathies in patients with PFO varies widely and there is no consensus concerning their role. Methods and results: This single centre observational study examined the prevalence of coagulopathies in 49 consecutive patients below 65 years of age in whom PFO-C was performed. Heterozygous mutation of factor V (Leiden) gene was detected in 6 patients (12%), prothrombin gene mutation in 3 patients (6%), protein S deficiency in 1 (2%), antiphospholipid antibodies in 1 (2%), and antithrombin III deficiency in 1 (2%). In all, a coagulopathy was detected in 11 patients (22.5%). During the follow-up period of 13 ± 5.5 months no cerebrovascular or other thromboembolic event occurred. Conclusion: Heterozygous forms of inherited coagulopathies may be more frequent in patients with PFO and CS than in the general population, thus potentially contributing to the original event of paradoxical embolisation. Data from larger centres and metaanalysis of existing data may help to clarify the role of coagulopathies further. Full article

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Cardiovasc. Med., Volume 13, Issue 4 (04 2010) – 9 articles

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