Surgical or Percutaneous Repair of Sinus of Valsalva Rupture: Case Series and Literature Review.

The rupture of the sinus of the Valsalva aneurysm is a rare but very serious condition. Rapid and accurate diagnosis and prompt treatment are critical for these cases. We present two cases of sinus of Valsalva ruptures. One case was managed with open surgical repair and the second case was treated percutaneously. We have discussed these two therapeutic approaches available to treat sinus of Valsalva rupture.

Correlation of unipolar electrogram modification with ablation index during pulmonary vein isolation: A pilot study.

BACKGROUND: Pulmonary vein isolation (PVI) using radiofrequency catheter ablation is a widely accepted therapy for drug-refractory atrial fibrillation patients. Elimination of the negative component of the local unipolar electrogram (UEGM) during PVI is a marker of transmural lesion formation. The ablation index (AI) can predict the quality of ablation lesion. Combining these two parameters could make PVI safer and efficient. The purpose of this pilot study was to examine the correlation between UEGM modification characteristics of the different target areas of left atrium and the associated AI values during PVI. METHODS: We analyzed 10 patients who underwent PVI using radiofrequency energy. The local electrophysiological properties and ablation parameters of 15 designated areas of interest in the left atria targeted by radiofrequency catheter ablation were collected. RESULTS: Out of the 10 patients, six were men (mean age 66 years) and 80% had paroxysmal AF. The mean time to achieve the UEGM modification in the posterior wall was shorter than that of the anterior wall (8.9 seconds vs. 11.1 s, respectively). The UEGM modification for every lesion was achieved at significantly lower AI values than conventional AIs (p < .001). CONCLUSION: During PVI, the AIs deduced according to the local UEGM modification are markedly shorter than those generally recommended AIs in contemporary practice. This indicates that conventionally recommended AIs could be safely reduced while ensuring the efficacy and quality of radiofrequency ablation during PVI. This approach would probably reduce to risk of collateral thermal injuries.

The mRNA-Based Coronavirus Disease-2019 Vaccine-induced Severe Cardiomyopathy: A Rare Incident.

We are presenting a case of severe dilated cardiomyopathy (DCM) post-mRNA-based coronavirus disease-2019 (COVID-19) vaccine (Pfizer-BioNTech) in a young healthy man. After the second dose of the vaccine, his health rapidly declined, and he developed severe DCM with reduced ejection fraction. Investigations for other causes of DCM were unremarkable. Severe DCM following COVID-19 vaccine injection is a rare but serious condition. It also highlights the importance of close follow-up of pericarditis and perimyocarditis cases post-COVID-19 vaccine and we recommend clinicians have a low threshold for using echocardiography for early diagnosis and management.

Tropheryma Whipplei Endocarditis: Case Report and Literature Review.

We describe a young man who initially presented with stroke and febrile illness. He was eventually diagnosed with Tropheryma whipplei endocarditis. This is a very rare condition and to the best of our knowledge, this is the first documented case of T. whipplei endocarditis in Australia and New Zealand regions. This report aims to increase awareness of clinicians of this very rare but potentially treatable condition. It is reasonable to exclude T. whipplei endocarditis when dealing with high-risk patients who are suspected for "culture-negative" endocarditis.