Aorta-to-right atrium fistula, an unusual complication of endocarditis.

Infective endocarditis (IE) remains a serious disease. Aorta-to-right atrium fistula is a rare but very serious complication of IE and predicts a higher mortality. This report describes a 50-year-old man with endocarditis, vegetation, perforation of noncoronary sinus, and formation of two aorta-to-right atrium fistulas with native valves detected by transthoracic echocardiography. This disease is lethal despite developments in cardiac imaging and antibacterial therapy. Early diagnosis, aggressive antibacterial therapy, and surgical treatment may improve the prognosis.

Verapamil-sensitive fascicular ventricular tachycardia in a patient with isolated left ventricular noncompaction.

Isolated left ventricular noncompaction (IVNC) is a rare congenital form of cardiomyopathy. Verapamil-sensitive fascicular ventricular tachycardia is a rare arrhythmogenic condition characterized by a right bundle-branch block pattern and left-axis deviation with a relatively narrow QRS complex. We herein present the case of a patient with IVNC who presented with verapamil-sensitive fascicular ventricular tachycardia.

Successful ablation of atrioventricular nodal reentrant tachycardia in a patient with coexistent congenitally corrected transposition of the great vessels and situs inversus.

Congenitally corrected transposition of the great vessels (CTGV) is a rare congenital cardiac and great vessel abnormality. The anomalous inversion of the ventricles and great vessels makes performing catheter ablation difficult. We herein report a successful case of atrioventricular node reentrant tachycardia ablation in a patient with coexistent CTGV and situs inversus.

An adult patient with isolated left ventricular noncompaction presented with atrial fibrillation and complete atrioventricular block.

Isolated left ventricular noncompaction (IVNC) is a rare congenital anomaly. The clinical manifestations include congestive heart failure, systemic thromboemboli, arrhythmias and sudden death. We report a case of IVNC in a male patient who presented with atrial fibrillation with complete heart block.

Adiponectin levels are associated with the number and activity of circulating endothelial progenitor cells in patients with coronary artery disease.

OBJECTIVE: To study the relationship between plasma adiponectin concentration and the functional activities of circulating endothelial progenitor cells (EPCs) in patients with coronary artery disease (CAD). METHODS: Circulating EPCs were enumerated as AC133(+)/KDR(+) cells via flow cytometry and identified by co-staining with DiI-acLDL and fluorescein isothiocyanate (FITC)-conjugated lectin under a fluorescent microscope. The migratory capacity of EPCs was measured by modified Boyden chamber assay. Adhesion capacity was performed to count adherent cells after replating EPCs on six-well culture dishes coated with fibronectin. RESULTS: The number of circulating EPCs (AC133(+)/KDR(+) cells) decreased significantly in CAD patients, compared with control subjects [(74.2+/-12.3) vs (83.5+/-12.9) cells/ml blood, P<0.01]. In addition, the number of EPCs also decreased in CAD patients after ex vivo cultivation [(54.4+/-8.6) vs (71.9+/-11.6) EPCs/field, P<0.01]. Both circulating EPCs and differentiated EPCs were positively correlated with plasma adiponectin concentration. The functional activities of EPCs from CAD patients, such as migratory and adherent capacities, were also impaired, compared with control subjects, and positively correlated with plasma adiponectin concentration. CONCLUSION: The study demonstrates that the impairment of the number and functional activities of EPCs in CAD patients is correlated with their lower plasma adiponectin concentrations.

Biventricular pacemaker implantation in a patient with isolated noncompaction of the right ventricular myocardium.

Isolated noncompaction of the ventricular myocardium is an unclassified cardiomyopathy and is thought to be due to arrest of myocardial morphogenesis. Fetal arrhythmias may occur in approximately half of the patients and account for the death in this disorder. We describe a patient with isolated noncompaction of the right ventricular myocardium in whom implantation of biventricular pacemaker was thought to be effective to prevent the risk of sudden cardiac death and complications.

Cerebral infarction in an adult patient with right ventricular hypertrabeculation/noncompaction.

Ventricular hypertrabeculation/noncompaction (VHT) is a rare congenital anomaly, and usually involves the left ventricle (LVHT), with the right ventricle (RVHT) being infrequently involved. Clinical manifestations are highly variable, ranging from no symptoms to disabling congestive heart failure, arrhythmias, systemic thromboemboli and sudden death. We report a case of right ventricular hypertrabeculation/noncompaction (RVHT) presenting as cerebral infarction.