improvement of myocardial function by granulocyte colony stimulating factor following acute anterior myocardial infarction: a double blind placebo controlled study

In patients with acute myocardial infarction [AMI], reperfusion of the occluded infarct-related artery significantly improves acute and late clinical outcome. There is increasing evidence that transplantation of autologous stem cells improves cardiac function after AMI. For propagation of peripheral blood stem cells, application of granulocyte-colony stimulating factor [G-CSF] has been shown to be feasible, effective, and safe. Ten patients in the treatment group and 10 patients in the control group were enrolled in this prospective, randomized controlled and double blind study. Two weeks after myocardial infarction that was followed by successful recanalization and stent implantation, the patients of the treatment group received 10 micro g/kg body weight per day [divided BID] G-CSF subcutaneously for a maximum duration of 5.0 days. In both groups, ejection fraction was evaluated with echocardiography and cardiac perfusion scans 10 days and 6 months after myocardial infarction. The Tei index was measured by echocardiography. No severe side effects of G-CSF treatment were observed. There was no significant improvement of left ventricular ejection fraction when the G-CSF treated group was compared to the control group [P=0.821 for cardiac scan and P=0.705 for echocardiography]. Changes in Tei index was not significant in the treatment group [P=0.815]; however, it was significantly deteriorated in the control group [P=0.005]. In patients with acute anterior myocardial infarction, treatment with G-CSF, is feasible and safe and seems to be effective in improving global cardiac function without affecting the ejection fraction under clinical conditions

Hydatid cyst presented as pulmonary stenosis

A 27-years-old woman, presented with progressive dyspnea on exertion and chest pain. Transthoracic echocardiography revealed severe pulmonary stenosis. Her transsophageal echocardiography [TEE] showed a single, large, well-defined thin wall cystic mass with pressure on the main pulmonary artery at the level of pulmonic valve that caused severe pulmonary stenosis. Computed tomography [CT] scan of chest and abdomen confirmed presence of hydatid cyst in mediastinum and liver. Serologic test using Eliza was positive for echinococcal infection. Albendazol was started for the patient and she was referred to surgeon for resection of cystic mass but the patient refused the operation

Mitral valve aneurysm: a rare complications of aortic valve endocarditis

A 20-year-old intravenous drug abuser man, refered to our hospital with dyspnea and orthopnea. Tranesophageal echocardiography revealed severe aortic regurgitation, healed vegetation of aortic valve and an aneurysm of the anterior leaflet of the mitral valve. The patient was discharged after aortic valve replacement and mitral valve repair