ABSTRACT
Paragangliomas, extra-adrenal pheochromocytomas, are rare catecholamine-secreting tumor. A 34-year-old lady admitted with diagnosis of ST elevation acute myocardial infarction with cardiogenic shock. Left ventricular function, severely depressed, returned to normal after initial stabilization. Coronary angiogram was normal. A para-aortic paraganglioma was diagnosed during the patient's work-up with biochemical studies, computed tomography of abdomen and functional radioisotopes imaging and was eventually surgically resected. This case shows that acute myocardial infarction may be the initial manifestation of these neuroendocrine tumors. Hypertensive emergency, much less elevated blood pressure may not be present at time of presentation.
Subject(s)
Chest Pain/etiology , Paraganglioma, Extra-Adrenal/diagnosis , Retroperitoneal Neoplasms/diagnosis , ST Elevation Myocardial Infarction/diagnosis , Shock, Cardiogenic/diagnosis , Adult , Biopsy , Chest Pain/diagnosis , Coronary Angiography , Diagnosis, Differential , Echocardiography , Electrocardiography , Female , Humans , Paraganglioma, Extra-Adrenal/complications , Positron-Emission Tomography , Retroperitoneal Neoplasms/complications , Ultrasonography, DopplerABSTRACT
Less-invasive methods for nonsurgical closure of a patent ductus arteriosus have gained popularity as first-line therapy. An 11-year-old girl underwent percutaneous patent ductus arteriosus closure with a device. The device embolized into the descending aorta. An attempt at catheter retrieval was complicated by iliofemoral arterial injury. Subsequent device extraction was performed with repair of the arterial injury using a tube graft.
Subject(s)
Aorta, Thoracic , Cardiac Catheterization/instrumentation , Device Removal/adverse effects , Ductus Arteriosus, Patent/therapy , Femoral Artery/injuries , Foreign-Body Migration/therapy , Iliac Artery/injuries , Septal Occluder Device , Vascular System Injuries/etiology , Aorta, Thoracic/diagnostic imaging , Aortography , Blood Vessel Prosthesis Implantation , Cardiac Catheterization/adverse effects , Child , Ductus Arteriosus, Patent/diagnosis , Female , Femoral Artery/diagnostic imaging , Femoral Artery/surgery , Foreign-Body Migration/diagnosis , Foreign-Body Migration/etiology , Humans , Iliac Artery/diagnostic imaging , Iliac Artery/surgery , Prosthesis Design , Tomography, X-Ray Computed , Treatment Outcome , Vascular System Injuries/diagnosis , Vascular System Injuries/surgeryABSTRACT
Coronary-cameral fistulas are rare cardiovascular anomalies. A giant coronary artery aneurysm associated with a coronary-cameral fistula is a very rare condition, with an estimated prevalence of 0.02%. We report the case of middle-aged woman who presented with a huge extracardiac aneurysmal mass and a coronary-cameral fistula from a right coronary artery branch. It was successfully repaired by ligation and excision plus marsupialization of the aneurysm. We believe this is the first such a case reported in literature.
Subject(s)
Coronary Aneurysm/complications , Coronary Vessel Anomalies/complications , Fistula/complications , Heart Atria/abnormalities , Adult , Cardiac Surgical Procedures , Coronary Aneurysm/diagnosis , Coronary Aneurysm/surgery , Coronary Angiography/methods , Coronary Vessel Anomalies/diagnosis , Coronary Vessel Anomalies/surgery , Echocardiography, Transesophageal , Female , Fistula/diagnosis , Fistula/surgery , Heart Atria/diagnostic imaging , Heart Atria/surgery , Humans , Ligation , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
A 3-year-old girl presented with fever and acute dyspnea for 4 days. She had suffered an injury to the left lower leg 3 weeks earlier, with abscess formation. Magnetic resonance imaging showed osteomyelitis of the lower tibia. Echocardiography showed a mass in the right ventricular wall. She underwent concomitant heart surgery for removal of the right ventricular mass and limb arthrotomy. We believe this is a first reported case in which a ventricular wall abscess developed in a structurally normal heart following leg osteomyelitis.
Subject(s)
Abscess/microbiology , Heart Diseases/microbiology , Osteomyelitis/microbiology , Tibia/microbiology , Abscess/diagnostic imaging , Abscess/surgery , Anti-Bacterial Agents/therapeutic use , Child, Preschool , Echocardiography , Female , Heart Diseases/diagnostic imaging , Heart Diseases/surgery , Humans , Magnetic Resonance Imaging , Osteomyelitis/complications , Osteomyelitis/diagnostic imaging , Osteomyelitis/surgery , Tibia/diagnostic imaging , Tibia/surgery , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Renal transplantation remains a mainstay of therapy for the end-stage renal disease. Cardiac disease has a high prevalence in this patient population. Cardiovascular disease remains the leading cause of death among kidney transplantation patients. The cardiac disease accounts for 43% of all-cause mortality among dialysis patients and for ≈38% of all-cause mortality after transplantation. In this article, we review the factors and outcomes associated with valve surgeries in renal transplant recipients and evaluate the strategy for open heart surgery after renal transplantation performed.
Subject(s)
Heart Valve Diseases/surgery , Heart Valves/surgery , Kidney Transplantation , Postoperative Complications/surgery , Aged , Heart Valve Diseases/complications , Humans , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/surgery , Male , Risk Factors , Treatment OutcomeABSTRACT
Postoperative coronary artery spasm is one of the grave complications of cardiac surgery and is usually seen in patients undergoing coronary artery bypass surgery. We describe the case of a 63 year old male patient developing postoperative spasm of the entire coronary tree after aortic & mitral valve replacement, manifesting as significant electrocardiographic changes. Urgent coronary angiography was performed which revealed diffuse spasm of the entire coronary tree. It resolved completely with intracoronary injection of Nitroglycerine. The present case highlights the likelihood of postoperative coronary spasm even after valve replacement surgery, and not just coronary bypass surgery. It also illustrated the usefulness of coronary angiography for both diagnosis and treatment of this entity.
