RESUMEN
In this case report, we present 31-year-old twin sisters diagnosed with severe Barlow mitral valve prolapse, mitral annular disjunction and presence of lateral mid-wall fibrosis diagnosed on MRI as well as ventricular arrhythmias, and a very rare variant of Loeys-Dietz syndrome, being referred to our center for surgical repair. Genetic testing detected pathogenic variants of clinical significance in SMAD3 and KCNH2 genes that are associated with autosomal dominant disease of Loeys-Dietz syndrome. Due to the presence of severe mitral valve regurgitation, the first patient was referred for minimally invasive mitral valve repair that was performed successfully. Before discharge, a subcutaneous ICD implantation was performed as primary prevention against malignant ventricular arrhythmias and sudden cardiac death. Her twin sister presented with the identical diagnosis and underwent the same surgical procedure with S-ICD implantation a few months later.
RESUMEN
Dysphagia is a common clinical symptom in older people that can be attributed to a wide range of diseases, extending from neoplasm to gastroesophageal reflux diseases such as stroke or achalasia. We are presenting a case of a 78-year-old male with a history of heart failure with preserved ejection fraction and progressive dysphagia, due to a rare case, namely, dysphagia megalatriensis. Even though left ventricular ejection fraction was preserved, the patient improved, when we provided him with optimal medical heart failure with reduced ejection fraction treatment. In our case report, we intend to highlight the benefits of optimized medical therapy in a patient with heart failure with preserved ejection fraction, due to mitral valve regurgitation leading to a hugely dilated left atrium.
Asunto(s)
Trastornos de Deglución , Insuficiencia Cardíaca , Disfunción Ventricular Izquierda , Humanos , Masculino , Anciano , Volumen Sistólico , Función Ventricular Izquierda , Trastornos de Deglución/diagnóstico , Trastornos de Deglución/etiología , Insuficiencia Cardíaca/complicaciones , Insuficiencia Cardíaca/diagnósticoRESUMEN
We describe a 58-year-old Caucasian male weightlifter who presented with acute shortness of breath after finishing his extensive exercise routine. Acute aortic valve regurgitation, due to spontaneous rupture of a bicuspid aortic valve, was diagnosed. Urgent surgical intervention was carried out, during which the bicuspid aortic valve was resected and replaced with an On-X bileaflet mechanical valve. The patient remains asymptomatic and is treated with warfarin, being in excellent physical condition 4 years after aortic valve replacement. LEARNING POINTS: Spontaneous rupture of a bicuspid aortic valve, after heavy weightlifting, is a very rare cause of acute aortic valve regurgitation.Echocardiography is of vital importance to distinguish the reason for this medical emergency from other possible causes.Prompt diagnosis and surgical treatment can achieve excellent long-term results.
Asunto(s)
Cardiomiopatías/complicaciones , Enfermedad de la Arteria Coronaria/complicaciones , Embolia Pulmonar/complicaciones , Trombosis de la Vena/complicaciones , Anciano , Cardiomiopatías/diagnóstico por imagen , Cardiomiopatías/fisiopatología , Puente de Arteria Coronaria/métodos , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/cirugía , Ecocardiografía/métodos , Electrocardiografía , Heparina de Bajo-Peso-Molecular/administración & dosificación , Heparina de Bajo-Peso-Molecular/uso terapéutico , Humanos , Masculino , Embolia Pulmonar/tratamiento farmacológico , Embolia Pulmonar/fisiopatología , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento , Troponina T/sangre , Trombosis de la Vena/tratamiento farmacológicoAsunto(s)
Aneurisma de la Aorta/diagnóstico , Insuficiencia Cardíaca/etiología , Seno Aórtico/diagnóstico por imagen , Aneurisma de la Aorta/diagnóstico por imagen , Aneurisma de la Aorta/cirugía , Resultado Fatal , Femenino , Insuficiencia Cardíaca/cirugía , Humanos , Persona de Mediana Edad , Radiografía , Seno Aórtico/cirugíaRESUMEN
Despite its simplicity, device closure of atrial septal defects is still associated with rare but potentially lethal complications. In this prospective non-randomized multicenter study we investigated the safety and efficacy of the Cocoon septal occluder (CSO) for closure of atrial septal defects (ASDs) in 92 patients. Median age of the patients was 10.5 years (range 3-61 years) and median weight was 25 kg (range 13-65 kg). The device is an improved new generation double disc design made of Nitinol wire mesh that is coated with platinum using NanoFusion technology. The discs are connected by a waist with diameter ranging from 6mm to 40 mm with 2mm increments. All patients completed a 3-month follow-up. Mean ASD diameter was 21 ± 7 mm (range 10-35 mm), while the mean device diameter was 24 ± 8 mm (range 14-40 mm). The CSO was permanently implanted in all 92 patients. Complete echocardiographic closure of the defect immediately after the procedure or at the one month follow-up, was observed in all 92 patients (100%). No device-related complications were observed during the procedure or at short-term follow-up (range 3-12 months). Our preliminary results indicate that CSO is a promising device for transcatheter closure of ASDs. Further studies are required to document its efficacy, safety and long-term results in a larger patient population.