ABSTRACT The finding of ST segment elevation in the electrocardiogram identifies many patients with acute myocardial infarction, but presents low sensibility. Recently, some new electrocardiogram patterns have been described for the early identification of myocardial infarction. We report a case of a 53-year-old male patient who presented with an anterior myocardial infarction and an unusual electrocardiographic pattern. The electrocardiogram presented a slightly widened QRS complex, slow progression of the R wave in the anterior wall, and an ascending ST segment […]
ABSTRACT Coronary artery anomalies are congenital changes in their origin, course, and/or structure. Intercoronary communication is a very rare subset with uni- or bidirectional blood flow between two or more coronary arteries. We present the case of a 70-year-old male patient with acute coronary syndrome, and his coronary angiography incidentally showed a surprising and very rare communication between the left circumflex and right coronary arteries.
ABSTRACT Percutaneous left atrial appendage closure is an invasive option for cardioembolic event prevention and it is indicated for patients presenting non-valvular atrial fibrillation and oral anticoagulation therapy failure or contraindication. There is limited data addressing the technical success of percutaneous left atrial appendage closure in patients with complex anatomy and history of previous atrial septal defect repair surgery. We report a case of left atrial appendage closure performed with the LAmbre™ device (LifeTech Scientific, Shenzhen, China) in a patient […]
ABSTRACT A 62-year-old female patient with hypertension and a 4-month history of angina pectoris, triggered by emotional stress. The electrocardiogram showed left ventricular hypertrophy and changes in ventricular repolarization. The coronary angiography showed a significant left ventricular hypertrophy with no intracavitary gradient, and the presence of a myocardial bridge over the middle third of the left anterior descending artery and the right coronary artery in its posterior descending branch. Myocardial bridge almost exclusively occurs in the left anterior descending artery. […]
ABSTRACT Valve-in-valve procedures are likely to become increasingly frequent with the aging of the population and the increasing number of surgical bioprostheses implanted. More than 50% of these implanted valves have small diameters, which hinders the good expansion of transcatheter devices, leading to higher final gradients. Therefore, post-dilation is required to optimize implantation of the new device. Compliant balloons have limitations and a higher potential to rupture when used for this purpose. We describe a case of a valve-in-valve procedure […]
ABSTRACT Mitral valve surgery has become an increasingly common procedure for patients with mitral valve disease. Iatrogenic coronary artery lesion has been reported as an uncommon and potentially fatal complication of mitral valve surgery. Its diagnosis must be considered during perioperative care, and coronary angiography helps in deciding the best therapeutic strategy. In the present clinical report, we describe a patient with iatrogenic occlusion of the left circumflex artery after surgery for mitral valve replacement due to rheumatic disease.
ABSTRACT Risk awareness of no-reflow is mandatory, especially in patients with cardiovascular risk factors, long door-to-balloon time, and in the presence of angiographic evidence of a large thrombus burden. Some preventive strategies have been described. Nevertheless, in clinical practice, is difficult to avoid no-reflow. Interventional cardiologists have no guidelines or recommendations for this situation. We suggest that a conservative management with dual antiplatelet therapy and slow intravenous infusion of nitroglycerine over 12 to 24 hours and abciximab, followed by deferred […]
ABSTRACT The authors report on two patients whose congenital sinus of Valsalva aneurysms had ruptured into the right ventricle and were successfully occluded percutaneously. Three different devices were implanted using two different approaches. Percutaneous closure warranted that one patent ductus arteriosus occluder through a transvenous antegrade approach and that one coil plus one ventricular septal defect occluder were implanted through an arterial retrograde approach. The procedures were accomplished without complications, the devices were well positioned at angiography and echocardiography views […]
ABSTRACT Anomalous coronary arteries are rare. The origin of the left main coronary artery from the right sinus of Valsalva is related to some events, such as syncope, arrhythmias, angina, among others. By and large, its diagnosis is incidentally made by coronary angiography. The presence of this type of anomaly may hinder percutaneous approach of the coronary lesions. The authors describe a case of left main coronary artery originating from the right sinus of Valsalva, associated to disease of multiple […]
ABSTRACT Direct oral anticoagulants have been presented as a novel option for prevention and treatment of nonvalvular atrial fibrillation. However, significant hemorrhagic side effects have been observed with the use of these medications in recent years. The use of dabigatran in combination with p-glycoprotein inhibitors have been discussed due to its interactive effects. We present the case of a 74-year old female who developed spontaneous hemopericardium and cardiac tamponade induced by dabigatran combined with a p-glycoprotein inhibitor.