ABSTRACT
A 63-year-old man presented with delayed inferior ST-elevation myocardial infarction complicated with ventricular septal rupture (VSR). He developed cardiogenic shock and respiratory failure requiring intubation and Impella (Abiomed) support.
Subject(s)
Aortic Valve Stenosis , Heart Valve Prosthesis , Transcatheter Aortic Valve Replacement , Humans , Transcatheter Aortic Valve Replacement/adverse effects , Transcatheter Aortic Valve Replacement/methods , Predictive Value of Tests , Aortic Valve/diagnostic imaging , Aortic Valve/surgery , Aortic Valve Stenosis/diagnostic imaging , Aortic Valve Stenosis/surgery , Patient-Specific Modeling , Treatment Outcome , Risk FactorsABSTRACT
Traditionally, percutaneous mitral commissurotomy (PMC) is performed under fluoroscopy only. In difficult cases, general anesthesia with transesophageal echocardiography (TEE) guidance is needed. Intracardiac echocardiography (ICE) enables operators to perform PMC under local anesthesia while providing intra-procedural imaging guidance, as in TEE. Hereby, we describe a case of PMC guided by ICE to allow early detection of complications.
Subject(s)
Atrial Appendage , Echocardiography, Transesophageal , Humans , Treatment Outcome , Echocardiography, Transesophageal/methods , Fluoroscopy , Ultrasonography, Interventional/methods , Atrial Appendage/diagnostic imaging , Cardiac Catheterization/methodsABSTRACT
A 70-year-old man with history of transcatheter aortic valve-in-valve implantation was admitted because of suspected infective endocarditis (IE). Transesophageal echocardiogram did not reveal any vegetations, as the metallic stent frames caused significant artifacts. Position emission tomography was also negative. Intracardiac echocardiogram (ICE) was performed retrogradely through the ascending aorta, which showed clear vegetations over the stent frame of the transcatheter heart valve. Endocarditis after transcatheter aortic valve implantation was not uncommon. With increasing use of valve-in-valve procedures, echocardiographic diagnosis of IE would be more challenging. This case demonstrated the advantage of ICE over conventional echocardiography in visualizing the neo-aortic valve complex for diagnosing IE.
Subject(s)
Endocarditis, Bacterial , Endocarditis , Prosthesis-Related Infections , Transcatheter Aortic Valve Replacement , Male , Humans , Aged , Aortic Valve/diagnostic imaging , Aortic Valve/surgery , Prosthesis-Related Infections/diagnostic imaging , Prosthesis-Related Infections/etiology , Prosthesis-Related Infections/therapy , Treatment Outcome , Endocarditis, Bacterial/diagnostic imaging , Endocarditis, Bacterial/etiology , Endocarditis, Bacterial/surgery , Endocarditis/etiology , Endocarditis/complications , Transcatheter Aortic Valve Replacement/adverse effects , Echocardiography/adverse effectsABSTRACT
A 68-year old lady present with left ventricular free wall rupture and cardiac arrest post-myocardial infarction. This article illustrates a strategy combining pericardiocentesis with autologous transfusion together with VA-ECMO as a bridge to definitive surgical repair.
