Cardiovascular Medicine

3 pages, 233 KB

Open AccessLetter

Cardiovascular Trials with SGLT2 Inhibitors—A Primer to Survive in the Jungle

by Mattia Arrigo and Lars C. Huber

Cardiovasc. Med. 2022, 25(5), 6; https://doi.org/10.4414/cvm.2022.02228 (registering DOI) - 1 Sep 2022

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We read with interest the review article by Maeder, Rickli, and Buser on the role of sodi um-glucose co-transporter 2 (SGLT2) inhibi tors in heart failure [1]. [...] Full article

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6 pages, 417 KB

Open AccessArticle

Impact of a Structured Institutional Lead Management Programme at a High Volume Centre for Transvenous Lead Extractions in Switzerland

by Andreas Haeberlina, Alexander Holz, Jens Seiler, Samuel H. Baldinger, Hildegard Tanner, Laurent Roten, Antonio Madaffari, Helge Servatius, Hansjörg Jenni, Alexander Kadner, Gabor Erdoes, Tobias Reichlin and Fabian Noti

Cardiovasc. Med. 2022, 25(5), 28; https://doi.org/10.4414/cvm.2022.02224 (registering DOI) - 1 Sep 2022

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Abstract

BACKGROUND: Transvenous lead extraction (TLE) is the recommended management strategy for a variety of cardiac implantable electronic device (CIED) infections, malfunctions and other conditions. Large registries have established the safety and efficacy of TLE per se but temporal outcome data after the introduction [...] Read more.

BACKGROUND: Transvenous lead extraction (TLE) is the recommended management strategy for a variety of cardiac implantable electronic device (CIED) infections, malfunctions and other conditions. Large registries have established the safety and efficacy of TLE per se but temporal outcome data after the introduction of an institutional lead management programme remain scarce. OBJECTIVE: To investigate the impact of a structured institutional lead management programme on TLE outcomes. METHODS: All patients who underwent TLE at our institution between January 2013 and Decem ber 2020 were included. We assessed procedural outcomes after TLE for two separate time pe riods: from January 2013 to December 2018 and January 2019 to December 2020 (after introduc tion of a structured institutional lead management programme). RESULTS: In 2013–2018, the median number of TLE procedures per year at our centre was 14 (range 10–19, total 84). In 2019/2020, the median number of interventions per year increased to 46 (range 41–51, total 92). Noninfectious indications for TLE became more frequent (p <0.001), and the proportion of TLEs due to infections decreased. Median lead dwell time was not different (4.3 years [2013–2018] vs 4.4 years [2019–2020], p = 0.43). Clinical success rates improved from 90% to 98% (p = 0.020) and complete procedural success increased from 85% to 95% (p = 0.027). There was a trend towards a lower number of TLE-associated complications (p = 0.07). CONCLUSION: A structured institutional lead management programme and increasing experi ence significantly improve TLE outcomes. TLE can be safely performed in high-volume centres, allowing for a more liberal extraction policy, including in the case of non-infectious TLE indica tions. Full article

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14 pages, 1024 KB

Open AccessCase Report

A Case of Acute Coronary Syndrome Featuring a Forgotten and Disguised Intruder

by Andreas Y. Andreou

Cardiovasc. Med. 2022, 25(5), 225; https://doi.org/10.4414/cvm.2022.02225 - 1 Sep 2022

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Abstract

An infrequently diagnosed case of atrial infarction (AI) which occurred in conjunction with left ventricular myocardial infarction is presented. Atrial infarction was recognized by the presence of PR-segment depression in conjunction with premature atrial complexes. Spatial vector analysis of premature atrial complexes, is [...] Read more.

An infrequently diagnosed case of atrial infarction (AI) which occurred in conjunction with left ventricular myocardial infarction is presented. Atrial infarction was recognized by the presence of PR-segment depression in conjunction with premature atrial complexes. Spatial vector analysis of premature atrial complexes, is highlighted as a means to localize AI. Full article

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3 pages, 418 KB

Open AccessCase Report

Atrial Fibrillation Ablation from Above

by Antonio Madaffari, Nicolas Brugger, Christoph Gräni, Stefano F. Rimoldi, Laurent Roten and Tobias Reichlin

Cardiovasc. Med. 2022, 25(5), 2205; https://doi.org/10.4414/cvm.2022.02205 - 1 Sep 2022

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Abstract

Pulmonary vein isolation is a well-established therapy for symptomatic atrial fibrillation. The standard access for left atrial procedures is a transfemoral approach. Rarely, access to the heart from an inferior approach is not feasible due to congenital or acquired interruption of the inferior [...] Read more.

Pulmonary vein isolation is a well-established therapy for symptomatic atrial fibrillation. The standard access for left atrial procedures is a transfemoral approach. Rarely, access to the heart from an inferior approach is not feasible due to congenital or acquired interruption of the inferior vena cava. In the present case, we discuss relevant aspects and technical issues related to the superior approach for pulmonary vein isolation. Full article

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2 pages, 3359 KB

Open AccessCase Report

Takotsubo Syndrome After COVID-19 Vaccination with the Pfizer/Biontech or Moderna Vaccines

by Burbuqe Ibrahimi, Hanane Hireche and Igal Moarof

Cardiovasc. Med. 2022, 25(5), 188; https://doi.org/10.4414/cvm.2022.02227 - 1 Sep 2022

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Abstract

A 68-year-old female patient with history of arterial hypertension, renal failure KDIGO grade 3a and urothelial carcinoma was admitted to the emergency room with chest pain and high blood pressure (195/86 mm Hg) [...] Full article

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3 pages, 2489 KB

Open AccessCase Report

Monitoring of Apixaban in a Super-Obese Patient: Impact of Renal Failure and Topical Application of Econazole

by Olivier Cadart, Christine Mouton, Marie Michelet, Laurène Bosc, Emilie Pupier, Maud Monsaingeon-Henry and Blandine Cherifi

Cardiovasc. Med. 2022, 25(5), 182; https://doi.org/10.4414/cvm.2022.02204 - 1 Sep 2022

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Abstract

Direct oral anticoagulants (DOACs) are considered advantageous compared with vitamin K antagonists in eligible atrial fibrillation patients, but the efficacy and the safety of DOACs are not well defined in the morbidly obese population. We report the case of a 59-year-old woman (160 [...] Read more.

Direct oral anticoagulants (DOACs) are considered advantageous compared with vitamin K antagonists in eligible atrial fibrillation patients, but the efficacy and the safety of DOACs are not well defined in the morbidly obese population. We report the case of a 59-year-old woman (160 cm, 188 kg, body mass index 73.5 kg/m²) with multiple comorbidities including non-valvular atrial fibrillation, who was anticoagulated with apixaban 5 mg twice a day and who was admitted to our hospital because of acute renal failure. We report changes in apixaban concentrations over the course of management. Apixaban concentrations were quantified using Liquid Anti-Xa HemosIL^® Werfen. The table and figure show apixaban concentrations according to therapeutic modifications and renal function. This case illustrates the importance of occasionally measuring the DOAC concentration in the case of intercurrent pathology, in particular acute renal insufficiency, or in the case of topical use of drugs known to interact with DOACs by the oral route. Plasma DOAC measurement would be also interesting in the case of co-medications with an unknown potential for drug interactions. This case also shows an effective and safe anticoagulation by DOAC in a super-obese patient. Full article

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7 pages, 6112 KB

Open AccessReview

Update in Antilipidaemic Management of Atherosclerotic Cardiovascular Disease: Emerging Concepts, New Risk Assessment, and Risk-Related Management

by Augusto Gallino, David Nanchen and Walter Riesen

Cardiovasc. Med. 2022, 25(5), 171; https://doi.org/10.4414/cvm.2022.02208 - 1 Sep 2022

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Abstract

The first publication by WB Kannel et al. from the Framingham study on the causal role of hypercholesterolaemia in myocardial infarction dates back exactly 60 years [...] Full article

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6 pages, 2907 KB

Open AccessReview

Stress Echocardiography for Assessment of Native Valvular Heart Disease

by Beshoy Gabra and Beat A. Kaufmann

Cardiovasc. Med. 2022, 25(5), 148; https://doi.org/10.4414/cvm.2022.02218 (registering DOI) - 1 Sep 2022

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Abstract

Stress echocardiography (SE) plays an important role along with resting transthoracic (TTE) and transesophageal echocardiography (TEE) with respect to evaluation and management of valvular heart disease [...] Full article

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3 pages, 708 KB

Open AccessCase Report

A Rare Cause of Dyspnoea and Its Surgical Treatment

by Thierry Carrel, Matthias Greutmann and Paul Vogt

Cardiovasc. Med. 2022, 25(5), 143; https://doi.org/10.4414/cvm.2022.02200 - 1 Sep 2022

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Abstract

Diagnosis of vascular anomalies of the aortic arch is often delayed in adolescents and adult patients. In the presence of dyspnea that cannot be explained through a pulmonary and/or cardiac disease, and sudden dysphagia in children and younger adult patients, a cross-sectional imaging [...] Read more.

Diagnosis of vascular anomalies of the aortic arch is often delayed in adolescents and adult patients. In the presence of dyspnea that cannot be explained through a pulmonary and/or cardiac disease, and sudden dysphagia in children and younger adult patients, a cross-sectional imaging examination of the chest is mandatory to exclude or confirm malformation or malposition of the aortic arch and/or aberrant supra-aortic vessels. Full article

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3 pages, 718 KB

Open AccessCase Report

Challenges in Primary PCI: Congenital Anomalous Origin of the Left Main Coronary Artery from the Right Coronary Sinus of Valsalva

by Telmo Silva dos Santos, Sophie Degrauwe and Juan F. Iglesias

Cardiovasc. Med. 2022, 25(5), 140; https://doi.org/10.4414/cvm.2022.02239 (registering DOI) - 1 Sep 2022

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Abstract

BACKGROUND: The anomalous origin of the left main coronary artery (LMCA) from the right coronary sinus (RCS) of Valsalva is a rare congenital cardiac anomaly that has been associated with myocardial ischaemia and sudden cardiac death in young patients. ST-segment elevation myocardial (STEMI) [...] Read more.

BACKGROUND: The anomalous origin of the left main coronary artery (LMCA) from the right coronary sinus (RCS) of Valsalva is a rare congenital cardiac anomaly that has been associated with myocardial ischaemia and sudden cardiac death in young patients. ST-segment elevation myocardial (STEMI) as the first clinical presentation in previously asymptomatic elderly patients is extremely rare with only a few cases reported in the literature to date. Prompt identification of the culprit lesion and primary percutaneous coronary intervention (PCI) may represent a technical challenge in this patient subset. We report the case of a patient with congenital anomalous origin of the LCMA from the RCS who presented with an acute STEMI and underwent successful primary PCI. CASE DESCRIPTION: A 75-year-old man, an active smoker, was admitted to the emergency department after an episode of de novo typical chest pain at rest. The 12-lead ECG showed an anterolateral STEMI. Urgent coronary angiography demonstrated an unobstructed right coronary artery. After use of several different diagnostic catheters, selective engagement of the LMCA was finally achieved and demonstrated an anomalous origin of the LMCA originating from the RCS of Valsalva. LMCA angiography showed an acute thrombotic occlusion of the proximal left anterior descending (LAD) and severe stenoses of the mid-LAD and proximal left circumflex artery. The patient was successfully treated by primary PCI with four drug-eluting stents. Coronary computed tomography angiography confirmed an anomalous origin of the LMCA arising from the RCS and a retro aortic course of the LMCA. CONCLUSION: Congenital anomalous origin of the LMCA from the RCS of Valsalva may present as acute STEMI in elderly, previously asymptomatic patients, and constitutes a technical challenge during primary PCI. Full article

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2 pages, 158 KB

Open AccessEditorial

Artificial Intelligence und Deep Learning: Wittgenstein schlägt Platon

by Thomas F. Lüscher

Cardiovasc. Med. 2022, 25(5), 132; https://doi.org/10.4414/cvm.2022.02240 - 1 Sep 2022

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Abstract

Im siebten Buch der Politeia lässt Platon seinen Lehrer Sokrates das Höhleingleichnis erzählen. Der sagte: [...] Full article

1 pages, 94 KB

Open AccessEditorial

Schweizer Preis für Angiologie 2022/Prix Suisse d’Angiologie 2022

by Marc Righini

Cardiovasc. Med. 2022, 25(5), 128; https://doi.org/10.4414/cvm.2022.02241 - 1 Sep 2022

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Abstract

Die Schweizerische Gesellschaft für Angiologie schreibt jedes Jahr einen Preis in Höhe von CHF 10 000 [...] Full article

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Cardiovasc. Med., Volume 25, Issue 5 (09 2022) – 12 articles

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