Archives of cardiovascular diseases
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Arch Cardiovasc Dis · Jul 2008
Absence of recurrent stroke after percutaneous closure of patent foramen ovale despite residual right-to-left cardiac shunt assessed by transcranial Doppler.
Percutaneous transcatheter closure of patent foramen ovale has been proposed to prevent recurrent strokes in young adults. Contrast transcranial Doppler ultrasonography provides a functional, semiquantitative evaluation of right-to-left cardiac shunt. ⋯ Contrast transcranial Doppler is a useful tool in the selection of patients for percutaneous closure of patent foramen ovale. The absence of recurrent stroke events after transcatheter closure suggests that this procedure may prevent stroke by changing the foramen ovale configuration, even in cases of persisting shunt. Larger studies are needed to confirm these data.
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Arch Cardiovasc Dis · Jan 2008
Mechanical circulatory assistance in myocardial infarction with refractory cardiogenic shock: clinical experience in 10 patients at a teaching hospital in Rouen.
In patients with acute myocardial infarction (MI), cardiogenic shock (CS) remains associated with a high mortality (close to 50%) despite optimal therapeutic strategy. For those patients who are unlikely to survive, mechanical circulatory support (MCS) might be an additional life saving strategy. ⋯ Mechanical circulatory support appeared life saving in 4 out of 10 patients with acute MI and cardiogenic shock refractory to optimal treatment. In this situation, circulatory assistance deserves discussion and the choice of optimal device should be further evaluated.