ABSTRACT
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) is a common, effective and reliable treatment modality for portal hypertension. Migration of the TIPS stent into the right atrium is a rare and fatal complication. CASE PRESENTATION: We report a case of severe tricuspid regurgitation caused by a stent migrating into the right atrium in a patient hospitalized with refractory ascites due to cirrhosis. DISCUSSION: In this case, it is noteworthy that secondary stenting, which is necessary especially in cases of occlusion, significantly increases the risk of migration. CONCLUSION: Although a rare complication, intracardiac stent migration should be considered in patients with a history of TIPS in the presence of a new heart murmur and signs of arrhythmia.
Subject(s)
Portasystemic Shunt, Transjugular Intrahepatic , Tricuspid Valve Insufficiency , Humans , Tricuspid Valve Insufficiency/diagnostic imaging , Tricuspid Valve Insufficiency/etiology , Tricuspid Valve Insufficiency/surgery , Portasystemic Shunt, Transjugular Intrahepatic/adverse effects , Treatment Outcome , Stents/adverse effects , Liver Cirrhosis/complications , Heart Atria/diagnostic imagingABSTRACT
We have carefully read the article titled 'Prognostic Nutritional Index as a Predictor of No-Reflow Occurrence in Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention' and find it to be of significant interest. The no-reflow phenomenon (NRP) stands as a formidable complication of ST-segment elevation myocardial infarction (STEMI), carrying a high mortality risk. Managing NRP entails pharmacological and mechanical interventions, making its prediction a crucial aspect in the management of STEMI cases. We extend our gratitude to you and the authors for conducting this valuable and thought-provoking study. We anticipate that our insights will serve as a guide for future comprehensive studies in this dynamic area.
ABSTRACT
BACKGROUND: The function of both ventricles has been suggested to be affected in patients with mitral stenosis. In this study, it was aimed to investigate deformation properties of right (RV) and left ventricle (LV) in rheumatic mitral stenosis (MS) patients with three-dimensional speckle tracking echocardiography (3D-STE). METHODS: A total of 60 patients were included in the study (20 patients with mild MS diagnosis, 20 patients with moderate MS diagnosis, and 20 healthy volunteers). Three-dimensional echocardiography datasets were obtained for both ventricles in all patients. LV global longitudinal strain (GLS), LV torsion, RV free wall (FW) LS, and interventricular septal (IVS) LS measurements were analyzed. RESULTS: The LV ejection fraction (EF), RV fractional area change, peak systolic velocity of the tricuspit annulus, isovolumic acceleration, and tricuspid annular plane systolic excursion values were statistically similar and in the normal range. The LV GLS measurements were significantly different among the groups by being highest in the control group and least in the moderate stenosis group. Patients with MS showed higher torsional values, correlated with MS severity. IVS LS, RVFW LS values obtained by RV analysis also differed significantly among groups. The RVFW-GLS values only showed significant difference between the control group and moderate MS group. CONCLUSION: Patients with MS showed lower LV-GLS and higher LV torsion values. RV deformation indices showed significant decrease in correlation with the severity of the mitral stenosis. In conclusion, our data suggest that subclinical LV and RV systolic dysfunction is present in mild-moderate MS patients and this dysfunction can be detected by 3D-STE.
