Cardiovascular Medicine

1 pages, 167 KB

Open AccessEditorial

Cardiology Update 2015—Another Chapter of Postgraduate Education

by

Cardiovasc. Med. 2015, 18(4), 152; https://doi.org/10.4414/cvm.2015.00326 - 22 Apr 2015

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Shortly after the World Economic Forum, the 21st Postgraduate Course in Cardiovascular Disease, the Cardiology Update 2015 was held at the Congress Centre in Davos from February 8–12, 2015. [...] Full article

7 pages, 158 KB

Open AccessCommunication

What Is a Standard Transthoracic Echocardiogram Performed by a Cardiologist?

by Xavier Jeanrenaud, Christian Seiler, Christine Attenhofer Jost, Beat Kaufmann, Christiane Gruner, Hajo Mueller, Simon Koestner, Stefano Muzzarelli and Jean Berube

Cardiovasc. Med. 2015, 18(4), 146; https://doi.org/10.4414/cvm.2015.00306 - 22 Apr 2015

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Abstract

Introduction. The first “Guidelines for quality maintenance in echocardiography“ were published by the Working Group of Echocardiography of the Swiss Society of Cardiology in 1999, then revised in 2009 [...] Full article

3 pages, 131 KB

Open AccessCommunication

Grown-Up Congenital Heart Disease

by Judith Bouchardy, Matthias Greutmann, Markus Schwerzmann, Christine Attenhofer Jost, Gabriella De Pasquale, Angela Oxenius, Tobias Rutz, Kerstin Wustmann, Christian Balmer and Daniel Tobler

Cardiovasc. Med. 2015, 18(4), 144; https://doi.org/10.4414/cvm.2015.00317 - 22 Apr 2015

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Abstract

Grown-up congenital heart disease (GUCH) is a rapidly growing field in adult cardiology with specific needs.[...] Full article

2 pages, 142 KB

Open AccessInteresting Images

A Curious Case of “Tachy-Brady” Syndrome

by Thomas Kofler and Michael Kühne

Cardiovasc. Med. 2015, 18(4), 142; https://doi.org/10.4414/cvm.2015.00323 (registering DOI) - 22 Apr 2015

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Abstract

An 82-year-old man presented to the emergency department with severe pain and progressive blue discolouration of the left foot. [...] Full article

3 pages, 219 KB

Open AccessCase Report

A Valve-in-Valve Approach for Ebstein’s Anomaly

by Fabienne Schwitz, Peter Wenaweser, Alexander Kadner, Kerstin Wustmann, Stephan Windecker and Markus Schwerzmann

Cardiovasc. Med. 2015, 18(4), 139; https://doi.org/10.4414/cvm.2015.00331 (registering DOI) - 22 Apr 2015

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Abstract

A 41-year-old women with Ebstein’s anomaly required tricuspid valve replacement six years ago. At that time a biological prosthesis was implanted. The tricuspid valve prosthesis became severely stenotic within five years. Instead of re-do surgery, the patient underwent a percutaneous procedure. An Edwards [...] Read more.

A 41-year-old women with Ebstein’s anomaly required tricuspid valve replacement six years ago. At that time a biological prosthesis was implanted. The tricuspid valve prosthesis became severely stenotic within five years. Instead of re-do surgery, the patient underwent a percutaneous procedure. An Edwards SAPIEN 29-mm bioprosthesis was successfully implanted in the stenotic 33-mm stented Perimount bioprosthesis. A periprocedural transoesophageal echocardiography showed a residual transprothetic mean gradient of 1 mm Hg after the procedure. In conclusion, percutaneous valve replacement is an additional option for patients with a degenerated right-sided bioprostheses in atrioventriuclar position, potentially reducing the need for re-do surgery in adults with congenital heart disease. Full article

6 pages, 230 KB

Open AccessArticle

Axillary vein Puncture for Device Implantation and Use of 4F Catheter-Delivered Pacing Leads in Children

by Hania Burgan, Henri Sunthorn and Haran Burri

Cardiovasc. Med. 2015, 18(4), 134; https://doi.org/10.4414/cvm.2015.00328 (registering DOI) - 22 Apr 2015

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Abstract

Background: Contrast-guided axillary vein puncture has gained popularity for pacemaker and implantable cardioverter defibrillator (ICD) implantation in adults owing to its low risk profile, and could be an alternative to subclavian vein puncture, which is commonly performed in children. The Medtronic 3830 [...] Read more.

Background: Contrast-guided axillary vein puncture has gained popularity for pacemaker and implantable cardioverter defibrillator (ICD) implantation in adults owing to its low risk profile, and could be an alternative to subclavian vein puncture, which is commonly performed in children. The Medtronic 3830 lead is a 4.1F lumenless catheter-delivered lead which may be particularly well-suited for use in the paediatric population because of the reduction in intravascular material and possibility for selective-site lead placement in complex anatomies. Methods: Data on paediatric patients at our institution aged <15 years who underwent transvenous device implantation using contrast-guided axillary vein puncture were retrieved. Contrast-guided axillary vein puncture was performed in all patients as the primary approach under general anaesthesia. Results: We retrieved data from 15 patients (7 males), aged 7.7 ± 4.1 yr (range 2–15 yr) at the time of intervention, and weighing 23.0 ± 9.6 kg (range 11.3–38.0 kg). Axillary vein puncture was successful in all patients. We placed 9 right atrial leads, 13 right ventricular pacing leads, 1 right ventricular ICD lead and 1 coronary sinus lead. A 3830 lead was successfully implanted in all 12 patients in whom this lead was intended. There were no procedure-related complications and lead electrical parameters were within normal limits in all patients after a mean follow-up of 13 months. Conclusion: Contrast-guided axillary vein puncture is a safe and effective method for pacemaker implantation in children. Furthermore, the thin-bodied 3830 lead provides stable pacing parameters while reducing the bulk of intravascular material. Full article

7 pages, 439 KB

Open AccessReview

Cardiovascular Risk Management in Patients with Rheumatoid Arthritis

by Cem Gabay, Nicolas Buchs, Jean Dudler, Paul Hasler, Baris Gencer, Christian Matter, Beat Michel, Johannes von Kempis, Pascal Zufferey and François Mach

Cardiovasc. Med. 2015, 18(4), 127; https://doi.org/10.4414/cvm.2015.00307 - 22 Apr 2015

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Abstract

Cardiovascular diseases (CVD) and complications occur prematurely and approximately 1.5 times more frequently in patients with rheumatoid arthritis (RA) compared to the general population. The higher level of CV complications is insufficiently explained by the traditional cardiovascular (CV) risk factors. There is substantial [...] Read more.

Cardiovascular diseases (CVD) and complications occur prematurely and approximately 1.5 times more frequently in patients with rheumatoid arthritis (RA) compared to the general population. The higher level of CV complications is insufficiently explained by the traditional cardiovascular (CV) risk factors. There is substantial evidence that chronic systemic inflammation contributes to excess CVD in RA and that effective suppression of RA-associated inflammation reduces CV morbidity. CV risk assessment and management tools were developed many years ago for the general population. A Swiss expert group consisting of cardiologists and rheumatologists has elaborated the following pragmatic guidelines for the management of CV risk in patients with RA. In addition to systematic screening for and reduction of traditional individual CV risk factors based on the national risk score model, the direct link between inflammation and the development of atherosclerosis demands early and effective control of joint and systemic inflammation. Antirheumatic therapy preferably includes methotrexate, a disease modifying antirheumatic drug (DMARD) and, if necessary, tumour necrosis factor-α blockers or other biologics, because they are not only effective in the treatment of RA but might also reduce excess CV events in patients with RA. Additional treatment should be initiated according to the strategies for lowering circulating lipids and blood pressure as published by the European Society of Cardiology and European Atherosclerosis Society. Pharmacological interventions should be complemented by lifestyle changes. Full article

8 pages, 746 KB

Open AccessReview

Gastroenterologische Kontraindikationen der Transösophagealen Echokardiographie

by Dominique Criblez

Cardiovasc. Med. 2015, 18(4), 120; https://doi.org/10.4414/cvm.2015.00312 - 22 Apr 2015

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Abstract

Gastroenterological contraindications to transoesophageal echocardiography. Transoesophageal echocardiography (TEE) is considered a safe procedure. Serious or even fatal complications are rare. The most relevant gastrointestinal complication is oesophageal perforation. The reported incidence is ≤0.3% for intraoperative TEE, and <0.01% in the ambulatory setting. A [...] Read more.

Gastroenterological contraindications to transoesophageal echocardiography. Transoesophageal echocardiography (TEE) is considered a safe procedure. Serious or even fatal complications are rare. The most relevant gastrointestinal complication is oesophageal perforation. The reported incidence is ≤0.3% for intraoperative TEE, and <0.01% in the ambulatory setting. A number of gastrointestinal conditions may predispose to complications. Thus TEE guidelines have defined several absolute and relative contraindications. Whereas an absolute contraindication indicates a prohibitive risk, the presence of relative contraindications allows for an individual risk-benefit analysis that is best undertaken in collaboration with a gastroenterologist. This tutorial article comments on some of the gastroenterological diagnoses involved, in order to encourage the cardiologist to screen each patient’s file and question the patient for oesophageal symptoms (namely dysphagia and odynophagia) prior to TEE. Compliance with guidelines does not, however, completely rule out a residual risk for serious complications. Full article

5 pages, 327 KB

Open AccessReview

Assisted Reproduction: A Novel Cardiovascular Risk Factor

by Emrush Rexhaj, Stefano F. Rimoldi, Elisa Bouillet, David Cerny, Rodrigo Soria, Robert Von Arx, Yves Allemann, Claudio Sartori and Urs Scherrer

Cardiovasc. Med. 2015, 18(4), 115; https://doi.org/10.4414/cvm.2015.00311 - 22 Apr 2015

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Abstract

There is abundant evidence indicating that pathological events during early life predispose to cardiovascular and metabolic diseases later in life. Recent evidence suggests that assisted reproductive technologies (ART) represent a novel important example of this problem. Here we will review recent data in [...] Read more.

There is abundant evidence indicating that pathological events during early life predispose to cardiovascular and metabolic diseases later in life. Recent evidence suggests that assisted reproductive technologies (ART) represent a novel important example of this problem. Here we will review recent data in humans and animals demonstrating ART-induced cardiac dysfunction, premature vascular ageing and arterial hypertension that appear to be related, at least of part, to epigenetic mechanisms. Therefore, a better comprehension of mechanisms of ART-induced vascular dysfunction and long-term monitoring of the ART population is of upmost importance in order to prevent or treat the long-term cardiovascular consequences. Given the young age of the ART population, we will have to wait for 20–30 years before we will know in how many premature cardiovascular endpoints these ART-induced alterations will result, ART should be taken into account when counseling putting into place preventive strategies. Full article

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Cardiovasc. Med., Volume 18, Issue 4 (04 2015) – 9 articles

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