RESUMEN
Pacemaker-related fungal endocarditis is an uncommon and unexpected complication. It is associated with high mortality rates. Due to nonspecific clinical symptoms, negative blood culture and delays in obtaining appropriate imaging studies; late diagnosis is common with fungal endocarditis. Hereby we are reporting a rare case of pacemaker lead endocarditis due to Trichosporon species. In literature we did not find any case of pacemaker-related endocarditis due to Trichosporon species.
Asunto(s)
Endocarditis/microbiología , Marcapaso Artificial , Infecciones Relacionadas con Prótesis/microbiología , Trichosporon/aislamiento & purificación , Tricosporonosis/microbiología , Ecocardiografía , Endocarditis/diagnóstico por imagen , Femenino , Humanos , Persona de Mediana Edad , Infecciones Relacionadas con Prótesis/diagnóstico por imagen , Tricosporonosis/diagnóstico por imagenRESUMEN
The everolimus-eluting biovascular scaffold (BVS) does not contain any metal, therefore struts are not evident angiographically. Two adjacent platinum radio-opaque markers at each end facilitate precise location of stent ends. Here we report one case of anomalous left main stenting using BVS. The BVS got accidentally distorted in left main during the procedure, which was not visible on angiography but detected on OCT.
Asunto(s)
Implantes Absorbibles , Infarto de la Pared Anterior del Miocardio/cirugía , Anomalías de los Vasos Coronarios/complicaciones , Stents Liberadores de Fármacos , Everolimus/farmacología , Intervención Coronaria Percutánea/métodos , Andamios del Tejido , Infarto de la Pared Anterior del Miocardio/diagnóstico , Infarto de la Pared Anterior del Miocardio/etiología , Angiografía Coronaria , Anomalías de los Vasos Coronarios/diagnóstico , Anomalías de los Vasos Coronarios/cirugía , Vasos Coronarios/diagnóstico por imagen , Vasos Coronarios/cirugía , Humanos , Inmunosupresores/farmacología , Masculino , Persona de Mediana Edad , Diseño de Prótesis , Tomografía de Coherencia ÓpticaRESUMEN
BACKGROUND: The capability of OCT to examine the structure of the arterial wall before or after PCI is superior to those of other imaging modalities. Therefore the application of OCT during PCI seems logical and has the potential to enhance our performance during the PCI procedures. METHODS: OCT was performed in fifty-two patients out of which, 45 patients underwent PCI. Out of these 45 patients, in 25 patients both pre and post PCI OCT assessment was done. In 20 patients only post PCI OCT assessment was done. In seven patients PCI was not done due to nonsignificant obstruction, these seven patients were not included in final analysis. RESULTS: Over all OCT leads to management changes in 65% of the time it was used. Alteration of stent length was done in 56% of the cases when evaluated pre PCI. Alteration of stent diameter was done in 36% cases when evaluated pre PCI. Treatment of malapposition was done in 24% of total cases. Further balloon dilatation for vessel expansion was done in 15% of total cases. In one case left main stenting was done after proximal edge dissection. CONCLUSION: OCT makes better visualization of plaque, thrombus, stent malapposition, dissection, plaque prolapse and helps in optimization of PCI results. More extensive, long-term studies will be needed to assess the prognostic implications of these findings.
