Unraveling the Trio of Interrupted Descending Aorta, Aortic Stenosis, and Bicuspid Aortic Valve: A Complex Cardiovascular Conundrum.

Interrupted descending aorta (IDA) is an extremely rare congenital heart defect characterized by a complete loss of connection between the ascending and descending aorta. This condition is typically diagnosed in infancy or early childhood, but there have been very few cases reported in adulthood. Here, we present a unique case of an IDA in a 16-year-old patient with concomitant aortic stenosis (AS) and bicuspid aortic valve (BAV), making it an extremely rare scenario. This case highlights the importance of early diagnosis and appropriate management in patients with an IDA, particularly when in association with other cardiovascular abnormalities.

An Extremely Rare Case of Isolated Aortic Valve Prolapse Causing Aortic Regurgitation in the Absence of Any Other Pre-existing Cardiovascular or Non-cardiovascular Condition.

In this case report, we present an extremely rare case of isolated aortic valve prolapse causing aortic regurgitation having no association with any comorbid conditions that are commonly seen with aortic valve prolapse. A 27-year-old female patient presented with chief complaints of dyspnea on exertion (New York Heart Association grade III) for 20 days, decreased appetite for 15 days, and a history of significant weight loss for one and a half years. Transthoracic and transesophageal echocardiography revealed a trileaflet floppy aortic valve with prolapsing non-coronary and right coronary cusps, associated with moderate aortic regurgitation. The incidence of aortic valve prolapse is roughly around 1%. Exceptionally, very few cases of isolated aortic valve prolapse with moderate-to-severe aortic regurgitation without any associated pathology have been reported to date.

Experience of Percutaneous Closure of Ventricular Septal Defects in 140 Patients With Different Duct Occluders in a Tertiary Care Rural Hospital in Central India.

Background Ventricular septal defects (VSDs) are the most common type of septal defects in early infants and are very complicated. This has paved the way for the development of new minimally invasive procedures for interventional cardiologists. This study presents our experience using duct occluders instead of conventional ventricular septal devices in the Department of Cardiology at Acharya Vinoba Bhave Rural Hospital (AVBRH) in central rural India. This study aimed to review success and complications and assess safety and its relation to age, sex, size of the VSDs, type of VSD, and types of devices used after transcatheter closure of perimembranous and muscular VSDs using various types of duct occluders. Methodology This retrospective study included patients who underwent percutaneous VSD device closure at the AVBRH between July 2017 and December 2020. We reviewed the patients' medical records to recognize imaging, clinical, and interventional data pre- and post-procedure and at the last follow-up. Results The success rate of VSD closure was 98.6%, one (0.7%) out of 81 females developed a complication due to device dislodgement, and one male aged six years (0.7%) out of 59 developed a post-procedural complication; hence, the total failure rate was 1.4%. The perimembranous type had no complication, and the muscular type had two (14.3%) unsuccessful procedures. Conclusion This study has concluded an impressive percentage of VSD closure, showing no mortality and low morbidity, using a percutaneous approach with different duct occluders. As the type of device used is not correlated with device failure and failure rate, duct occluders will be financially helpful in the closure of VSD in indicated patients.

Association of Leptin and Carotid Intima-Media Thickness in Overweight and Obese Individuals: A Cross-sectional Study.

OBJECTIVE: Leptin levels are increased in obesity and have been found to be strongly associated with obesity, increased risk of cardiovascular diseases and morbidity. While, carotid intima-media thickness (CIMT) is measured to predict atherosclerosis in early phase. Thus, the objective of this study was to evaluate the leptin levels and CIMT in overweight and obese individuals. METHODS: This cross-sectional study involving 95 subjects, was performed over a period of 1 year in the Department of Medicine, King George's Medical University, Lucknow. Anthropometric measurements included weight, height, waist circumference (WC), and BMI (Kg/m2). Baseline investigations were fasting blood glucose and lipid profile. Quantitative estimation of leptin was done by leptin ELISA, and CIMT was measured using a high-resolution B-mode ultrasound scanner with a 7 MHz linear transducer. Unpaired t-test or ANNOVA was used to compare quantitative variables, and chi-square or fisher's exact test was used to compare categorical variables. Pearson's correlation coefficient was used to test the strength of correlation. A p value of < 0.05 was considered as statistically significant. RESULTS: Based on both BMI and WC, mean leptin levels were significantly increased in overweight and obese subjects (p < 0.05) as compared to normal subjects. Similarly, based on both BMI and WC, significantly higher proportion of overweight and obese subjects had increased CIMT values (p < 0.05), as compared to normal subjects. Mean leptin levels were positively and significantly correlated with weight, WC, BMI, total cholesterol, triglyceride, LDL-cholesterol, and CIMT. Similarly, CIMT values were positively and significantly correlated with age, weight, WC, BMI, total cholesterol, triglyceride, HDL-cholesterol. CONCLUSION: Findings of this study indicates that overweight and obesity results in significant increase in both leptin levels and CIMT values. Furthermore, increased leptin levels and CIMT values are positively correlated with increase in BMI and WC.