Circulation journal : official journal of the Japanese Circulation Society
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Case Reports
Pulmonary artery obstruction caused by thoracic aortic dissection: a case with unique pathological findings.
Pulmonary artery obstruction is a rare complication of acute thoracic aortic dissection. A 74-year-old woman was admitted to hospital with respiratory distress. Computed tomography scan showed right pulmonary artery occlusion and a thoracic aortic dissection of the Stanford A type. ⋯ Autopsy disclosed that the right pulmonary artery was compressed by a hematoma in the adventitial space around the pulmonary artery. Such a mechanism of pulmonary artery obstruction caused by acute aortic dissection is unique, and is distinct from that caused by chronic non-dissecting aortic aneurysms, which themselves compress the pulmonary arteries. This complication inevitably follows aortic rupture; therefore, emergency operation to repair the dissected aorta must be performed to avoid the following catastrophic event.
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The present study examined whether the very low frequency (VLF) power of heart rate variability (HRV) is predictive of clinical prognosis in patients with congestive heart failure (CHF). ⋯ VLF power is an independent risk predictor in patients with CHF.
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Ventricular assist devices (VADs) have been used as a bridge to cardiac transplantation in patients with end-stage congestive heart failure. Despite adequate anticoagulation, thromboembolism is a major complication and in particular, a left ventricular (LV) thrombus associated with VADs has been reported as an important cause of thromboembolic complications. The frequency of LV thrombus formation in the patients with VAD support using LV apical cannulation is reported to be low. A 61-year-old woman supported with VAD with LV apical cannulation had a mobile LV thrombus adjacent to the inflow cannula diagnosed by transesophageal echocardiography.
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Sleep-disordered breathing may adversely affect heart function, and thereby contribute to the progression of heart failure. A study was undertaken in patients with idiopathic cardiomyopathy to document the characteristics of sleep-disordered breathing. ⋯ Sleep-disordered breathing is common in patients with idiopathic cardiomyopathy; half of DCM patients had CSAHS, which was closely associated with obesity.