Mycosis fungoides: A rare cause of giant cardiac mass.

Mycosis fungoides is the most common cutaneous T-cell lymphoma. Although myocardial infiltration is frequent in advanced stages, symptomatic cardiac involvement is rare. We report an unusual case of rapidly progressing acute heart failure due to cardiac affection by mycosis fungoides manifested as an intracavitary mass in the right atrium. The patient received cytoreductive surgery and adjuvant radiotherapy, presenting an excellent cardiovascular outcome during follow-up. Learning objectives: •Recognize mycosis fungoides as a potential cause of cardiac mass due to its visceral progression.•Note the role of cytoreductive surgery with adjuvant radiotherapy in order to relieve heart failure symptoms and improve the prognosis of the disease in the exceptional case of mycosis fungoides presenting as an isolated cardiac mass.

Spontaneous healing of a ruptured mycotic aneurysm of the posterior mitral leaflet: Unexpected resolution of a severe mitral regurgitation.

Mycotic mitral valve aneurysm is an uncommon complication that rarely appears in isolated mitral valve endocarditis. The weakened aneurysmal wall may rupture, causing severe mitral regurgitation. In this situation surgery is essential. We present a case of a rare complicated mycotic posterior mitral aneurysm. After completing the antibiotic course for Streptococcus agalactiae infective endocarditis, an unexpected healing process within the aneurysm led to the virtual disappearance of the mitral regurgitation and remarkably changed the patient's clinical outcome. We emphasize the key role of three-dimensional transesophageal echocardiography, as it is becoming the reference imaging technique for infective endocarditis.

Outcomes of predefined optimisation criteria for intravascular ultrasound guidance of left main stenting.

AIMS: This study sought to investigate the prognostic effect of a protocol with optimisation targets for intravascular ultrasound (IVUS)-guided left main (LM) revascularisation. METHODS AND RESULTS: A protocol was prospectively applied for IVUS-guided LM revascularisation (IVUS-PRO group) including predefined optimisation targets. Using propensity score matching, we selected as control groups patients with angiography-guided PCI (ANGIO group) and IVUS-guided PCI (IVUS group) from a large multicentre registry. The primary endpoint was a composite of cardiac death, LM-related infarction and LM revascularisation at 12 months. In each group, 124 patients with comparable characteristics were included. The incidence of the primary outcome was significantly higher in the ANGIO group compared to the IVUS-PRO group (12.9% vs 4.8%, HR 0.35, 95% CI: 0.15 to 0.82, p=0.02), but not with respect to the IVUS group (12.9% vs 8%, HR 0.51, 95% CI: 0.20 to 1.22, p=0.1), driven by a lower rate of LM revascularisation (8% in the ANGIO group, 6.4% in the IVUS group and 3.2% in the IVUS-PRO group). IVUS-PRO resulted in being an independent risk predictor (HR 0.45, 95% CI: 0.15 to 0.98; p=0.041). CONCLUSIONS: IVUS guidance of LM stenting provides prognostic benefit with respect to the use of angiography alone, particularly when following a protocol with these predefined optimisation criteria.

Fibrosis endomiocárdica: afección cardiaca en un paciente infectado por el VIH / Endomyocardial fibrosis: cardiac involvement in an HIV-infected patient

No disponible