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Case Report  |   Volume 2, Issue 4

Guidewire Fracture during Crossing A Chronic Coronary Total Occlusion: A Troublesome Experience

ErsanTatli, MustafaYilmaztepe, Ali Buturak and Yusuf Can
Abstract

Increased interest focusing on coronary chronic total occlusions has emerged since several studies have proven improved cardiovascular outcomes and quality of life after successful chronic total occlusion (CTO) revascularization. CTO of an epicardial coronary artery is one of the leading challenging complex lesion type when percutaneous coronary intervention (PCI) is indicated. Advanced antegrade and retrograde techniques performed with dedicated equipment have provided significant improvements in procedural success and decrease periprocedural complications leading to PCI failure.

  PDF   |    Full Text | DOI: 10.23937/2378-2951/1410047

Research Article  |   Volume 2, Issue 4

Pioglitazone Improves Endothelial Function in Patients with Paroxysmal Atrial Fibrillation and Type 2 Diabetes Mellitus Following Catheter Ablation

Jun Gu, Wei Hu, Xu Liu and Chang-Qian Wang
Abstract

Atrial Fibrillation (AF) is the most common type of sustained heart rhythm disorder confronted in clinical practice, which confers a high risk of mortality and morbidity from abnormal hemodynamics and thromboembolism. The beat-to-beat alteration of flow dynamics in AF has disadvantageous effects on cardiac haemodynamics and is associated with endothelial dysfunction. Endothelial dysfunction may contribute to a prothrombotic state in patients with AF and cardiovascular events. Besides, the presence of diabetes mellitus (DM) augments endothelial dysfunction in AF patients.

  PDF   |    Full Text | DOI: 10.23937/2378-2951/1410046

Research Article  |   Volume 2, Issue 4

Prevalence of Pulmonary Hypertension among Chronic Kidney Disease Patients and its Relation to Location and Blood Flow of Vascular Access

Osama A. Khamis, Tarek Abd El-Hamid Elzyat and Abd El-Rahman Ibrahim Mohammed Ali
Abstract

Background:Pulmonary hypertension is increasingly being recognized as a factor that can affect outcome in end stage renal disease. This study was carried out to evaluate the prevalence of pulmonary hypertension among CKD patients and it's relation to vascular access blood flow and location. Patient and Methods:30 patients on regular hemodialysis, 30 patients in predialysis and 30 healthy individuals participated in this study. Each patient underwent full clinical evaluation, chest radiography, pulmonary function tests, standard 12-lead electrocardiography, Two-dimensional and M-mode echocardiography.

  PDF   |    Full Text | DOI: 10.23937/2378-2951/1410045

Research Article  |   Volume 2, Issue 4

Randomized Trial of a Discharge Planning and Telehealth Intervention for Patients Aged 65 and older after Coronary Artery Bypass Surgery

Ruth M. Kleinpell, Boaz Avitall, Cathy Catrambone, Tricia Johnson, Louis Fogg, Shirley Moore and Nicole T. Thompson
Abstract

Despite diagnostic and treatment advances, coronary heart disease (CHD) remains the leading cause of death in Americans over the age of 65. Coronary artery bypass surgery (CABG) is the most frequently performed major surgery for CHD in the United States (U.S.). While the rates of CABG surgeries have declined in recent years due to the increased use of percutaneous coronary procedures, current treatment guidelines from the American Heart Association and the American College of Cardiology identify that CABG is recommended over angioplasty for patients with severe coronary artery disease.

  PDF   |    Full Text | DOI: 10.23937/2378-2951/1410044

Case Report  |   Volume 2, Issue 4

Hemolytic Anemia 19 Years after Mitral Valve Replacement with A Porcine Bioprosthesis

Debora Corsi, Michele Celiento, Stefano Pratali, Alberto Balbarini and Uberto Bortolotti
Abstract

A 58-year-old man had undergone mitral valve replacement with a 27 mm Carpentier-Edwards porcine bioprosthesis (Edwards Lifesciences, Irvine, USA) in 1993. Nineteen years later he presented with dark urine, fatigue and moderate dyspnea denying any history of infection. He was in atrial fibrillation with a systolic mitral regurgitant murmur. Hematologic evaluation was consistent with haemolytic anemia; particularly, reduced hemoglobin, hematocrit and haptoglobin (6.6 mg/dl), and increased total bilirubin and lactic dehydrogenase (752 U/L) with schistocytosis and reticulocytosis were observed. A 2D echocardiogram showed moderate mitral regurgitation and increased pulmonary artery pressure.

  PDF   |    Full Text | DOI: 10.23937/2378-2951/1410043

Case Report  |   Volume 2, Issue 4

Herpes Simplex Encephalitis, an Unusual Cause of Sinus Node Dysfunction: Case Report and Literature Review

Pierre-Philippe Nicol, Jean-Philippe Talarmin and Thierry Joseph
Abstract

Herpes simplex encephalitis is responsible for progressive alteration of behaviour, epilepsy, focal neurological signs, and cognitive problems, but is rarely involved in sinus node dysfunction. We describe this association in a 66-year-old woman with a complete cardiac and neurologic recovery after acyclovir treatment. Consequently, this aetiology of sinoatrial arrest should be recognized in order to systematically assess cardiac monitoring and avoid unnecessary pacemaker implantation. Moreover the literature shows that sinus node dysfunction may also result from several other neurological diseases.

  PDF   |    Full Text | DOI: 10.23937/2378-2951/1410042

Case Report  |   Volume 2, Issue 4

Origin of Right Coronary Artery from the Ascending Aorta: An Extremely Rare Anomaly

Abdulrahman M Abdulbaki and Shivang Shah
Abstract

The incidence of coronary anomalies in patients undergoing coronary angiography varies from 0.27% to 1.66%. Many of these anomalies are clinically benign; while, others are associated with serious morbidity. We describe the case of a patient undergoing coronary angiogram to evaluate her cardiomyopathy revealing an anomalous right coronary artery arising from the ascending aorta above the left sintubular junction plane. We discuss the rarity of this anomaly along with its clinical importance.

  PDF   |    Full Text | DOI: 10.23937/2378-2951/1410041

Case Report  |   Volume 2, Issue 4

Favorable Plaque Sealing Process after Implantation of Endeavor Zotarolimus-Eluting Stent into Chronic Total Occlusion of Sirolimus Eluting Stent

Minoru Ichikawa and Yoshiyuki Kijima
Abstract

We here report a case with in-stent chronic total occlusion (CTO) of sirolimus-eluting stent (SES). The SES-CTO lesion was successfully treated with additional implantation of Endeavorzotarolimus-eluting stent (E-ZES) into the lesion. During the follow up period of 50 months, coronary angioscopy and optical coherence tomography revealed the favorable plaque sealing process after E-ZES implantation into SES-CTO.

  PDF   |    Full Text | DOI: 10.23937/2378-2951/1410040

Review Article  |   Volume 2, Issue 4

Ranolazine: Beyond the Treatment of Chronic Stable Angina Pectoris

Nicola Vitulano, Pio Cialdella, Massimo Gustapane, Lorenzo Vitulano, Daniela Pedicino and Gemma Pelargonio
Abstract

The aims in the treatment of angina are relief of pain and prevention of disease progression through risk reduction. A number of patients may have contraindications or remain unrelieved from anginal discomfort with conventional drugs. Among newer alternatives, ranolazine indirectly prevents the intracellular calcium overload involved in cardiac ischemia and it is a considered as a valid addition to traditional treatments. Recent findings showed potential positive side effect of ranolazine in the treatment of arrhythmias.

  PDF   |    Full Text | DOI: 10.23937/2378-2951/1410039