Cardiovascular Medicine

3 pages, 1007 KB

Open AccessCase Report

Typical Signs of Secundum Atrial Septal Defect in a Young Man

by Marcello Di Valentino, Augusto Gallino, Julija Klimusina, Stephanos Demertzis and Andrea Menafoglio

Cardiovasc. Med. 2011, 14(3), 98; https://doi.org/10.4414/cvm.2011.01577 - 23 Mar 2011

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Abstract

We report the case of a 22-year-old man with dyspnea during a long-distance military march. The ECG showed signs of right ventricular overload. The chest X-ray showed an enlargement of central pulmonary arteries, pulmonary plethora and a small aortic knuckle. Atrial septal defect [...] Read more.

We report the case of a 22-year-old man with dyspnea during a long-distance military march. The ECG showed signs of right ventricular overload. The chest X-ray showed an enlargement of central pulmonary arteries, pulmonary plethora and a small aortic knuckle. Atrial septal defect (ASD) was suspected and transthoracic echocardiography (TTE) subsequently confirmed the presence of a large ostium secundum ASD. A surgical closure with an equine pericardium patch was performed. Two months after the surgical repair, the ECG and TTE showed the regression of signs of right ventricular overload. Full article

3 pages, 269 KB

Open AccessCase Report

Acute Myocardial Infarction in a 19 Year-Old Woman: Sometimes Hoofbeats are Zebras

by Diego Arroyo, Tobias Rutz and Jean-Christophe Stauffer

Cardiovasc. Med. 2011, 14(3), 95; https://doi.org/10.4414/cvm.2011.01576 - 23 Mar 2011

Cited by 1 | Viewed by 14

Abstract

We report the case of a 19 year-old woman who presented with chest pain at the emergency department. Cardiac risk factors were obesity, dyslipidemia, cigarette smoking and a sedentary lifestyle. Investigations revealed an acute myocardial infarction with ST-segment elevation. A thrombotic occlusion of [...] Read more.

We report the case of a 19 year-old woman who presented with chest pain at the emergency department. Cardiac risk factors were obesity, dyslipidemia, cigarette smoking and a sedentary lifestyle. Investigations revealed an acute myocardial infarction with ST-segment elevation. A thrombotic occlusion of the mid left anterior descending artery was visualised on coronary angiography, the cause of which remains unknown. Full article

3 pages, 268 KB

Open AccessArticle

Routine Robotic and Video-Assisted Mitral Valve Repair in Everyday Surgery

by Aristotelis Panos and Patrick O. Myers

Cardiovasc. Med. 2011, 14(3), 92; https://doi.org/10.4414/cvm.2011.01573 - 23 Mar 2011

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Abstract

Objectives: We report our experience with video-assisted minithoracotomy and robotic-enhanced cardiac surgery in the setting of mitral valve repair.
Methods: Patients undergoing video-assisted minithoracotomy (n = 74) and robotic-enhanced (n = 15) cardiac surgery were prospectively included between December 2008 and [...] Read more.

Objectives: We report our experience with video-assisted minithoracotomy and robotic-enhanced cardiac surgery in the setting of mitral valve repair.
Methods: Patients undergoing video-assisted minithoracotomy (n = 74) and robotic-enhanced (n = 15) cardiac surgery were prospectively included between December 2008 and October 2010. The feasibility, safety and echocardiographic follow-up were evaluated.
Results: 89 patients with a median age of 48 years (range 24–75) underwent video-assisted or robotic-enhanced cardiac surgery. 74 were operated on through a small anterolateral thoracotomy and fifteen with the da Vinci S robotic system. The procedures performed were lone mitral valve repair in 79 patients, associated with tricuspid valve repair in 10 patients, and mitral valve repair and atrial fibrillation ablation in 20 patients. Two patients required conversion to sternotomy (2.2%). There was no operative mortality. Mean blood transfusion was 1.6 packages/patient. No neurological, vascular or wound complication was observed. Mean CPB and aortic cross clamping were 138 ± 28 min and 114 ± 28 min respectively. Mean ICU stay was 1.5 ± 0.4 days. All the patients had a fast-track extubation (ranging from 3–12 hours postoperatively) and 15 patients were extubated in the operating theatre. Bleeding was evaluated to 350 ± 186 ml. Hospital stay was 5 ± 1.3 days. No patient required reoperation. Three patients required reexploration for bleeding and in all of them haemostasis was achieved through the same incision. Follow-up ranged from 2–24 months, during which all of the patients remained with no or trace mitral valve regurgitation in all the mitral repair patients and mild tricuspid valve regurgitation in all the tricuspid repair patients. All the atrial fibrillation ablation patients had a conversion success rate of 45% at 2 years.
Conclusion: Minimally invasive mitral valve repair can be safely performed, with excellent and durable results in a wide range of patients in routine surgical settings. Low blood transfusion rate, short hospital stay and avoidance of wound complications are the main advantages of this approach. Full article

6 pages, 121 KB

Open AccessGuidelines

Richtlinien 2011 zur Herzschrittmacherund Defibrillatortherapie und perkutanen Katheterablation

by Jürg Schläpfer, Istvan Babotai, Urs Bauersfeld, Haran Burri, Jürg Fuhrer, Hans Gloor, Christian Sticherling and Peter Zwicky

Cardiovasc. Med. 2011, 14(3), 86; https://doi.org/10.4414/cvm.2011.01575 - 23 Mar 2011

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Abstract

Guidelines 2011 on the treatment by cardiac pacing, defibrillation and percutaneous catheter ablation. In 2000 the Working Group on Cardiac Pacing and Electrophysiology of the Swiss Society of Cardiology published guidelines on the diagnosis and treatment of arrhythmias by cardiac pacing, internal defibrillation [...] Read more.

Guidelines 2011 on the treatment by cardiac pacing, defibrillation and percutaneous catheter ablation. In 2000 the Working Group on Cardiac Pacing and Electrophysiology of the Swiss Society of Cardiology published guidelines on the diagnosis and treatment of arrhythmias by cardiac pacing, internal defibrillation and catheter ablation. These fields have evolved significantly in the last few years, and new recommendations on the proficiency of physicians involved in this domain have been published by European and North American societies. For these reasons, and with a view to maintaining quality of care, the recommendations are updated in the present document. Full article

11 pages, 1069 KB

Open AccessReview

Kardiale Hybrid-Bildgebung in der Diagnostik der koronaren Herzerkrankung

by Oliver Gaemperli and Philipp A. Kaufmann

Cardiovasc. Med. 2011, 14(3), 75; https://doi.org/10.4414/cvm.2011.01572 - 23 Mar 2011

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Abstract

CT coronary angiography and myocardial perfusion scintigraphy are both established non-invasive techniques for the diagnosis of coronary artery disease (CAD). Cardiac hybrid imaging consists of the combination (or “fusion”) of both modalities and allows obtaining complementary morphological (coronary anatomy, stenoses) and functional (myocardial [...] Read more.

CT coronary angiography and myocardial perfusion scintigraphy are both established non-invasive techniques for the diagnosis of coronary artery disease (CAD). Cardiac hybrid imaging consists of the combination (or “fusion”) of both modalities and allows obtaining complementary morphological (coronary anatomy, stenoses) and functional (myocardial perfusion) information in a single image. The appropriate clinical use of hybrid imaging requires its integration into joint clinical diagnostic services where experts in all fields (cardiology, radiology, nuclear medicine) collaborate and colleagues with clinical and technical expertise together can exploit the potential of the new technique. The feasibility and clinical value of hybrid imaging has been documented in small cohort studies and selected series of patients. The incremental value of the hybrid technique arises from the spatial coregistration of perfusion defects with coronary stenoses. This allows to assess the haemodynamic relevance of coronary stenoses and determine the need for revascularisation procedures in each individual artery. The combination of the (native) coronary artery calcium score scan with MP-SPECT can also be helpful in different clinical scenarios. Thus, it can be anticipated, that the ongoing efforts to reduce radiation exposure and the increasing clinical interest will further pave the way for an ever increasing use of cardiac hybrid imaging in clinical practice. Full article

2 pages, 332 KB

Open AccessInteresting Images

Transcatheter Closure of a Large Right Coronary Artery Fistula in a Patient with Bacterial Endocarditis

by Stefan Toggweiler, Jonathon Leipsic, Namal Wijesinghe and Ronald G. Carere

Cardiovasc. Med. 2011, 14(3), 105; https://doi.org/10.4414/cvm.2011.01574 - 23 Mar 2011

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Abstract

This 45-year-old male, generally healthy patient was hospitalised with sepsis, due to endocarditis with a right atrial vegetation [...] Full article

4 pages, 434 KB

Open AccessCase Report

Iatrogenic Left Main Stem Stenosis After Surgical Aortic Valve Replacement

by Jens Robert, David Tüller and Stephan Windecker

Cardiovasc. Med. 2011, 14(3), 101; https://doi.org/10.4414/cvm.2011.01578 - 23 Mar 2011

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Abstract

Surgical aortic valve replacement (SAVR) represents the gold standard in the treatment of symptomatic severe aortic valve stenosis as reflected by the class I indication assigned in the ACC/AHA and ESC guidelines. SAVR effectively relieves symptoms, improves quality of life as well as [...] Read more.

Surgical aortic valve replacement (SAVR) represents the gold standard in the treatment of symptomatic severe aortic valve stenosis as reflected by the class I indication assigned in the ACC/AHA and ESC guidelines. SAVR effectively relieves symptoms, improves quality of life as well as prognosis of affected patients. As with any therapeutic intervention, SAVR is associated with some short and long term adverse events including death, stroke, myocardial infarction, renal failure, bleeding, as well as structural and non-structural valve deterioration. We present two cases of iatrogenic left main stemstenosis within less than one year after SAVR, describe the management and discuss the literature. Full article

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Cardiovasc. Med., Volume 14, Issue 3 (03 2011) – 7 articles

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