The Journal of invasive cardiology
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The present study determined the utility and needle control characteristics of highly controlled vascular syringes for image-guided pericardiocentesis. ⋯ Vascular syringes improve needle control in pericardiocentesis, promote patient safety and permit one-handed aspiration and injection.
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Review Case Reports
Myopericarditis secondary to embolization of fractured inferior vena cava filter limbs.
Vena cava filters are placed for the prevention of pulmonary embolism in the setting of venous thromboembolism, especially when there is a contraindication to anticoagulation or complication secondary to anticoagulation. Here we discuss a rare complication of vena cava filters. We present the first documented case of inferior vena cava filter limb fracture presenting as myopericarditis. Six other cases of embolization of vena cava filter limbs are reviewed and a mechanism for fracture and embolization is proposed.
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Iatrogenic coronary artery stenosis (ICAS) after aortic valve replacement (AVR) is a rare but potentially fatal complication. Immediate traumatic lesions or late stenoses caused by insertion of an antegrade cardioplegia catheter during AVR mostly occur at the site of the left main trunk or right coronary ostium. ⋯ Histological examination of the specimen taken by DCA demonstrated intimal hyperplasia and no findings of atheromatous plaque with lipid core or thrombus. The patient has been asymptomatic after the procedure and the follow-up multidetector computed tomography at 1 year showed no restenosis.
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The use of thrombus aspiration during percutaneous coronary intervention (PCI) is recommended in patients with ST-elevation myocardial infarction (STEMI) undergoing mechanical revascularization. When thrombus aspiration is adopted, the standard technique includes, after mechanical thrombus extraction, angioplasty and/or stent implantation to eliminate residual stenosis. To date, no data are available concerning the use of thrombectomy alone without additional ballooning or stenting. ⋯ In selected patients with STEMI undergoing mechanical reperfusion, thrombus aspiration without additional ballooning or stenting may be successfully performed. Further studies are needed to assess the clinical relevance of this novel approach.
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Extracorporeal membrane oxygenation (ECMO) is an effective rescue method for severe respiratory and cardiac failure. Right ventricular (RV) failure with cardiogenic shock is a critical condition with generally poor prognosis unless aggressive therapeutical measures are undertaken. Authors report on their initial experience with ECMO support in severe RV failure with cardiogenic shock caused by an obstructive hemodynamic pattern. ⋯ Bleeding complications were the main complications observed. As per initial experience, veno-arterial ECMO allows bypassing of the pulmonary bed, therefore, relieves the RV pressure overload and does not cause further elevation of the pulmonary pressures in contrary to RV assist devices. This aggressive management approach requires further clinical evaluation in order to establish its definite role in critical RV failure.