[Giant coronary artery aneurysm in a patient with rheumatoid arthritis]. / Romatoit artritli bir hastada dev koroner arter anevrizmasi

A 52-year-old men with rheumatoid arthritis of 12-year history presented with severe chest pain. The electrocardiogram was consistent with acute inferior myocardial infarction. Transthoracic echocardiography showed increased left ventricular dimensions and hypokinesia in the inferolateral wall. Coronary angiography performed for percutaneous coronary intervention showed aneurysmatic dilatation (15-16 mm) and total occlusion of the right coronary artery by a large thrombus. As there was no stent available for dilated right coronary artery and due to the large thrombus burden, medical therapy was decided and tissue plasminogen activator infusion was started. The patient's chest pain progressively decreased. Coronary angiography performed on the fifth day of admission showed TIMI 3 flow in the right coronary artery. Warfarin was added to standard anti-ischemic treatment with a target INR of 2.5-3.0. Our literature search yielded no reported case of such aneurysmatic dilatation associated with rheumatoid arthritis.

[Percutaneous closure of a femoral arteriovenous fistula with an endovascular stent graft: a case report]. / Femoral arteriyovenöz fistülün endovasküler stent greft ile perkütan tedavisi: Olgu sunumu.

A 25-year-old male patient underwent primary femoral artery repair following a gunshot injury. Postoperative examination showed a thrill and bruit in the right femoral region. Peripheral angiography performed under right femoral Doppler ultrasound guidance revealed an arteriovenous fistula between the right superficial femoral artery and femoral vein. Through selective angiography from the left femoral artery, an endovascular stent was implanted in the right femoral artery. Control contrast injection showed near-total closure of the fistula and Doppler ultrasonography on the following day showed total closure.

Ruptured abdominal aortic aneurysm after resection of an infected cardiac myxoma.

A 12-year-old girl with a high fever underwent echocardiography and was found to have a myxoma that arose from the atrial side of the anterior mitral valve leaflet. The tumor was successfully excised. Histologic examination of the tumor showed myxoma cells and an organized thrombus with bacterial colonization. The patient was discharged from the hospital on antibiotic treatment. After remaining asymptomatic for 3 weeks, she was readmitted with acute abdomen. Ultrasonography and magnetic resonance angiography detected intra-abdominal hemorrhaging and a saccular aneurysm of the abdominal aorta. The patient underwent successful emergency surgery. To our knowledge, no other report has been published concerning an abdominal aortic aneurysm secondary to bacterial infection of a cardiac myxoma. Although complications this severe are rarely observed in patients who have endocarditis, early recognition and treatment can be life-saving.