Resolution of Hypoxia and Ascites With Percutaneous Intervention of Mustard Baffle Obstruction and Leak.

A 45-year-old man with history of Mustard repair for transposition of the great arteries, cirrhosis, and chronic hypoxemic respiratory failure presented for subacute worsening of his chronic symptoms, which were found to be secondary to a previously unrecognized baffle stenosis and leak. Percutaneous intervention resolved his ascites and hypoxia. (Level of Difficulty: Intermediate.).

An uncommon case of heart failure.

A 55-year-old man evaluated for syncope had mild and gradually progressive left ventricular systolic dysfunction on initial workup. Although not identified initially, repeat cardiac magnetic resonance one year later demonstrated the presence of trabeculations in the left ventricle consistent with the diagnosis of isolated non-compaction of the left ventricular myocardium. This case highlights the need for increased awareness of this entity among primary care physicians, cardiologists, and radiologists in order to enhance its identification. This case also demonstrates the advantages of cardiac magnetic resonance for diagnosis and provides insight into this rare type of cardiomyopathy in adults.

Plasma Exchange for Urgent Apixaban Reversal in a Case of Hemorrhagic Tamponade after Pacemaker Implantation.

We report the case of an 82-year-old man in whom hemorrhagic pericardial effusion occurred one week after pacemaker implantation, while he was taking apixaban. Few therapies exist for reversing the anti-Xa effect of apixaban. To reverse anticoagulation, our patient underwent plasma exchange, which facilitated pericardiocentesis and prevented possible surgical intervention. To our knowledge, this is the first report of the use of plasmapheresis to reverse the anticoagulant effect of apixaban.