Cardiovascular Medicine

2 pages, 249 KB

Open AccessInteresting Images

by Eléonore Marchon, Jean-Christophe Stauffer, Cedric Lehner and Jean-Jacques Goy

Cardiovasc. Med. 2012, 15(12), 371; https://doi.org/10.4414/cvm.2012.00113 - 19 Dec 2012

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A 25-year-old woman presented at our out-patient clinic for exclusion of cardiac disease as Steinert muscular dystrophy was part of her family history. [...] Full article

3 pages, 335 KB

Open AccessInteresting Images

Unexplained Aneurysm Involving Both Ventricles

by Julija Klimusina, Marcello Di Valentino, Andrea Menafoglio, Giovanni Pedrazzini, Francesco Faletra, Ludwig von Segesser and Augusto Gallino

Cardiovasc. Med. 2012, 15(12), 368; https://doi.org/10.4414/cvm.2012.00121 - 19 Dec 2012

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Abstract

A 62-year-old woman, without previous history of cardiovascular diseases, was admitted to our institution due to episodes of monomorphic non-sustained ventricular tachycardia (VT) associated with dizziness.[...] Full article

3 pages, 227 KB

Open AccessCase Report

Coronary Steal Phenomenon Due to Ipsilateral Upper Extremity Arteriovenous Fistula in a Patient with Internal Thoracic Artery Bypass Graft—An Alternative Treatment Strategy

by Sergio Musto D’Amore, Manuel Zipponi, Christian Hagne and Giovanni B. Pedrazzini

Cardiovasc. Med. 2012, 15(12), 365; https://doi.org/10.4414/cvm.2012.00111 - 19 Dec 2012

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Abstract

We report the case of a 69-year old woman with an internal thoracic artery bypass, undergoing chronic dialysis through an ipsilateral upper extremity arteriovenous fistula, who experienced typical angina pectoris at rest, with transitory ST segment elevation and angiographic evidence of a coronary [...] Read more.

We report the case of a 69-year old woman with an internal thoracic artery bypass, undergoing chronic dialysis through an ipsilateral upper extremity arteriovenous fistula, who experienced typical angina pectoris at rest, with transitory ST segment elevation and angiographic evidence of a coronary steal phenomenon. For this kind of situation, the approach most commonly described in the literature is the closure of the existing fistula. However, the haemodynamic effects in such situations are incompletely understood. In our case, we proceded to revascularisation of the proximal left anterior descendent artery by percutaneous coronary intervention and stent implantation, after which a steal phenomenon was no longer observed and the patient remained asymptomatic. We hence suggest this approach as a possible alternative strategy in patients with internal thoracic artery steal from ipsilateral upper extremity arteriovenous fistula and feasable proximal native vessel revascularisation. Full article

3 pages, 377 KB

Open AccessCase Report

Blocking Bug–Complete Atrioventricular Block in Chronic Chagas Disease

by Stephan Keusch, Simon F. Stämpfli, Urs Hufschmid, Jürg H. Beer and Bernhard C. Friedli

Cardiovasc. Med. 2012, 15(12), 362; https://doi.org/10.4414/cvm.2012.00130 - 19 Dec 2012

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Abstract

We report the case of a Bolivian woman with a complete atrioventricular block due to Chagas cardiomyopathy. Diagnosis was established by echocardiography and highly positive serological results for Trypanosoma cruzi americanum. Treatment included initiation of an ACE inhibitor and implantation of a dual-chamber [...] Read more.

We report the case of a Bolivian woman with a complete atrioventricular block due to Chagas cardiomyopathy. Diagnosis was established by echocardiography and highly positive serological results for Trypanosoma cruzi americanum. Treatment included initiation of an ACE inhibitor and implantation of a dual-chamber pacemaker, as well as an anti-parasitic medication with benznidazole. A follow-up after one year exhibited improved left ventricular function and intermittent sinus rhythm. Full article

8 pages, 286 KB

Open AccessArticle

Balloon Angioplasty Using the “GRIP™” Scoring Balloon for Treatment of Coronary In-Stent Restenosis—Immediate and 12-Month Clinical Outcomes

by Serban Puricel, Linus Schoepke, Mario Togni, Markus Oberhänsli, Aris Moschovitis, Bernhard Meier, Stephan Windecker and Stéphane Cook

Cardiovasc. Med. 2012, 15(12), 354; https://doi.org/10.4414/cvm.2012.00128 - 19 Dec 2012

Cited by 2 | Viewed by 15

Abstract

Objectives: We sought to determine the efficacy and safety of a scoring balloon for the treatment of in-stent restenosis (ISR). Background: The optimal therapy for ISR is not yet properly established and subject to many discussions. The GRIP™ Balloon (Acrostak, Switzerland) [...] Read more.

Objectives: We sought to determine the efficacy and safety of a scoring balloon for the treatment of in-stent restenosis (ISR). Background: The optimal therapy for ISR is not yet properly established and subject to many discussions. The GRIP™ Balloon (Acrostak, Switzerland) might be of interest for the treatment of certain types of ISR. Methods: Between 2003 and 2009, 157 patients who were treated for ISR (182 lesions, 164 interventions) with the GRIP™ balloon were retrieved from our database and followed clinically. The safety endpoint was the occurrence of immediate coronary complication (such as perforation or dissection). The efficacy endpoint was freedom from major adverse cardiac events (MACE: cardiac death, myocardial infarction, and target lesion revascularisation) at 12-month clinical follow-up. Results: Mean age was 65 ± 11 years and 82% were men. A focal ISR was found in 54% (n = 93) of lesions. Additional stenting was performed in 22% of lesions after angioplasty with the GRIP™ balloon. There was no perforation as immediate coronary complication whereas localised dissection was identified in five patients (3%). Survival was 98% at 12 months. MACE occurred in 13% of patients (n = 21). Target lesion revascularisation (TLR) needed to be performed in 17 (11%). Myocardial infarction occurred in 2 (1%), and stent thrombosis occurred in 1 (1%) patient. MACE rates were higher in patients with diffuse ISR (20%) compared with focal ISR (7%) (p = 0.02). Conclusions: Balloon angioplasty with the GRIP™ balloon for ISR can be safely and successfully performed, and leads to good clinical outcome in patients presenting with focal ISR. Full article

9 pages, 608 KB

Open AccessReview

Practical Aspects and Challenges in the Echocardiographic Assessment of Right Ventricle and Its Function

by Ina Bluzaitė, Jolanta Vaskelytė, Jolanta Marcinkevicienė, Hans Rickli and Philipp K. Haager

Cardiovasc. Med. 2012, 15(12), 345; https://doi.org/10.4414/cvm.2012.00127 - 19 Dec 2012

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Abstract

The aim of the present review article is to provide an overview of the evaluation of the right ventricle and its function using conventional measurements and newer echocardiographic modalities. Because of the complex geometry of the right ventricle calculation of volumes and ejection [...] Read more.

The aim of the present review article is to provide an overview of the evaluation of the right ventricle and its function using conventional measurements and newer echocardiographic modalities. Because of the complex geometry of the right ventricle calculation of volumes and ejection fraction using 2D measurements is not useful in clinical practice. Echocardiographic assessment of systolic right ventricular function using 2D guided M-mode measurements of systolic long axis motion of the tricuspid annulus (tricuspid annular plane systolic motion, TAPSE) is a simple and established tool also providing prognostic information in a number of settings. The main limitation of this method is that it only represents the inflow free wall segments but not outflow tract and the septum which also contribute to the overall function of the right ventricle. Additional measurements of the right ventricular outflow tract fractional shortening and fractional area change add great value in the assessment of the right ventricle function. Doppler tissue imaging is a relatively new echocardiographic tool for the assessment of right ventricular function, however, similarly to TAPSE its main caveat is its angle dependency. The most recent imaging technique is based on detecting speckles from the myocardium with 2D echocardiography analysing motion in different directions (longitudinal, radial and circumferential). One of the greatest advantages of speckle tracking compared to Doppler tissue imaging is the lack of angle dependency. Finally, 3D imaging for functional assessment and volume calculations overcomes the limitations of 2D echocardiography and has a similar accuracy as magnetic resonance imaging for the assessment of right ventricular function. Full article

6 pages, 1213 KB

Open AccessReview

Cardiovascular In Situ Tissue Engineering

by Benedikt Weber, Volkmar Falk and Simon P. Hoerstrup

Cardiovasc. Med. 2012, 15(12), 339; https://doi.org/10.4414/cvm.2012.00134 - 19 Dec 2012

Cited by 1 | Viewed by 14

Abstract

Structural cardiovascular disease is responsible for a significant disease load worldwide. Although currently used replacement procedures are efficacious and change the deadly evolution of many structural cardiovascular defects, the clinically used replacement materials are sub-optimal as they are prone to progressive calcific degeneration [...] Read more.

Structural cardiovascular disease is responsible for a significant disease load worldwide. Although currently used replacement procedures are efficacious and change the deadly evolution of many structural cardiovascular defects, the clinically used replacement materials are sub-optimal as they are prone to progressive calcific degeneration or thromboembolic complications. Therefore, the concept of cardiovascular tissue engineering has been initiated, aiming at the fabrication of autologous cell-based constructs with growth, regeneration and remodelling potential. While most attempts have focused on the in vitro fabrication of native-analogous cardiovascular constructs, more recent approaches have also focused on the fabrication of more “immature” autologous cell-seeded constructs without in vitro tissue processing–mainly aiming at full tissue development in vivo. This approach, which is also referred to as the “in situ tissue engineering” approach, has shown promising initial success in several pre-clinical as well as initial clinical investigations. Here, we review the concept of in situ cardiovascular tissue engineering and systematically compare the “in situ” technology to the “classical” in vitro tissue engineering approach. Full article

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Cardiovasc. Med., Volume 15, Issue 12 (12 2012) – 7 articles

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