Aggregation of BioGlue(®) presenting as a right atrial mass: a case report.

Use of biological glue during cardiovascular surgery is a common practice, rarely associated with immediate or long-term complications. We present a patient with a right atrial mass as a long-term complication associated with the use of biological glue. Surgical exploration revealed the mass to be an unabsorbed and infected aggregate of biological glue used to stop bleeding from a friable right atrium during previous surgery.

Noncompaction of ventricular myocardium associated with hypertrophic cardiomyopathy and polycystic kidney disease.

Noncompaction of ventricular myocardium (NVM), a relatively new diagnostic entity, is described as an arrest in the process of compaction of myocardial fibers, which results in a prominent trabecular network and deep intertrabecular recesses. Its coexistence with other cardiac anomalies like hypertrophic obstructive cardiomyopathy (HOCM) or polycystic kidney disease (PKD) had been reported in the past. We report the first case with all 3 different inherent conditions (NVM, HOCM, and PKD) manifesting in 1 patient. A 37-year-old man was referred for evaluation of a heart murmur. His medical history was positive for paroxysmal atrial fibrillation. Physical examination revealed a grade 3/6 systolic murmur loudest along the left sternal border accentuating on Valsalva maneuver. Echocardiography revealed HOCM. Cardiac magnetic resonance confirmed the presence of HOCM with the incidental finding of NVM and PKD. This case raises the possibility of genetic mutation common to these 3 clinical entities or 2 different gene mutations existing in the same individual.

Baseline correction of phase contrast images improves quantification of blood flow in the great vessels.

PURPOSE: Phase-contrast Cardiovascular Magnetic Resonance Imaging (CMR) generally requires the analysis of stationary tissue adjacent to a blood vessel to serve as a baseline reference for zero velocity. However, for the heart and great vessels, there is often no stationary tissue immediately adjacent to the vessel. Consequently, uncorrected velocity offsets may introduce substantial errors in flow quantification. The purpose of this study was to assess the magnitude of these flow errors and to validate a clinically applicable method for their correction. MATERIALS AND METHODS: In 10 normal volunteers, phase-contrast CMR was used to quantify blood flow in the main pulmonary artery (Qp) and the aorta (Qs). Following image acquisition, phase contrast CMR was performed on a stationary phantom using identical acquisition parameters so as to provide a baseline reference for zero velocity. Aortic and pulmonary blood flow was then corrected using the offset values from the phantom. RESULTS: The mean difference between pulmonary and aortic flow was 26 +/- 21 mL before correction and 7.1 +/- 6.6 mL after correction (p = 0.002). The measured Qp/Qs was 1.25 +/- 0.20 before correction and 1.05 +/- 0.07 after correction (p = 0.001). CONCLUSION: Phase-contrast CMR can have substantial errors in great vessel flow quantification if there is no correction for velocity offset errors. The proposed method of correction is clinically applicable and provides a more accurate measurement of blood flow.

High-density lipoprotein cholesterol: a potential therapeutic target for prevention of coronary artery disease.

High-density lipoprotein cholesterol has an important role in the pathophysiology of coronary artery disease. High-density lipoprotein cholesterol is becoming an increasingly important prognostic and therapeutic target. The purpose of this paper is to review the biochemical pathways involved in reverse cholesterol transport and to discuss potential, clinically based high-density lipoprotein therapies that may contribute to reduction in risk of atherosclerosis.