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  • 1
    In: Texas Heart Institute Journal, Texas Heart Institute Journal, Vol. 43, No. 3 ( 2016-06-01), p. 236-240
    Abstract: We discuss the case of a 38-year-old black man who presented at our hospital with his first episode of syncope, recently developed atrial arrhythmias refractory to pharmacologic therapy, and a left atrial thrombus. He was diagnosed with primary cardiac sarcoidosis characterized by predominant involvement of the epicardium that caused atrial fibrillation and atrial flutter. Histologic analysis of his epicardial lesions yielded a diagnosis of sarcoidosis. This patient's atrial arrhythmia was successfully treated with a hybrid operation that involved resection of his atrial appendage, an Epicor maze procedure, and radiofrequency ablation during a catheter-based electrophysiologic study. The cardiac sarcoidosis was successfully managed with corticosteroid therapy. Our case report shows that sarcoidosis can initially manifest itself as syncope with new-onset atrial arrhythmia. Sarcoidosis is important in the differential diagnosis because of its progressive nature and its potential for treatment with pharmacologic, surgical, and catheter-based interventions.
    Type of Medium: Online Resource
    ISSN: 0730-2347 , 1526-6702
    Language: English
    Publisher: Texas Heart Institute Journal
    Publication Date: 2016
    detail.hit.zdb_id: 2068440-X
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  • 2
    In: Texas Heart Institute Journal, Texas Heart Institute Journal, Vol. 50, No. 1 ( 2023-01-1)
    Abstract: The optimal treatment strategy for patients with severe carotid artery disease undergoing coronary artery bypass grafting is still problematic. The important question is whether it is necessary to treat significant carotid disease in patients who have undergone coronary artery bypass grafting. This study analyzed short- and midterm results after same-day carotid artery stenting and coronary artery bypass grafting. Methods From 2013 to 2020, a total of 69 patients were enrolled in the study. Same-day carotid artery stenting and coronary artery bypass grafting were performed in all patients. The study's primary end points were the evaluation rate of stroke, myocardial infarction, and death within short- and midterm periods after the procedures. Results The 30-day mortality was 0%. The occurrences of perioperative adverse events, namely stroke, myocardial infarction, and transient ischemic attack, were 1 (1.4%), 1 (1.4%), and 4 (5.8%), respectively. Mean (IQR) follow-up time was 28 (IQR, 17–43) months. Six (8.8%) patients died during this period. Fatal stroke was registered in 2 cases, and 1 patient experienced a disabling stroke with a fatal outcome. The other 3 patients died because of chronic renal disease, a traffic accident, and for an unknown reason, respectively. Midterm survival in the group was 91.2%. Conclusion The study showed that same-day carotid artery stenting and coronary artery bypass grafting for concomitant carotid and coronary disease treatment could be a promising and feasible therapeutic strategy.
    Type of Medium: Online Resource
    ISSN: 1526-6702 , 0730-2347
    Language: English
    Publisher: Texas Heart Institute Journal
    Publication Date: 2023
    detail.hit.zdb_id: 2068440-X
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  • 3
    Online Resource
    Online Resource
    Texas Heart Institute Journal ; 2016
    In:  Texas Heart Institute Journal Vol. 43, No. 5 ( 2016-10-01), p. 458-460
    In: Texas Heart Institute Journal, Texas Heart Institute Journal, Vol. 43, No. 5 ( 2016-10-01), p. 458-460
    Abstract: Ewing sarcoma is the second most prevalent malignant primary bone tumor but constitutes only a small proportion of cardiac metastases. We present a case of asymptomatic Ewing sarcoma metastatic to the right ventricle. A 36-year-old man presented for evaluation and resection of a pedunculated right ventricular cardiac tumor. Three years before, he had been diagnosed with translocation-negative Ewing sarcoma, for which he had undergone chemotherapy and amputation of the left leg below the knee. We resected the right ventricular tumor. Analysis of the resected mass supported the diagnosis of metastatic Ewing sarcoma. Postoperative transthoracic echocardiograms showed normal biventricular size and function. One year later, the patient had no recurrence of the sarcoma. In addition to discussing this case, we review the relevant medical literature.
    Type of Medium: Online Resource
    ISSN: 0730-2347 , 1526-6702
    Language: English
    Publisher: Texas Heart Institute Journal
    Publication Date: 2016
    detail.hit.zdb_id: 2068440-X
    Location Call Number Limitation Availability
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  • 4
    Online Resource
    Online Resource
    Texas Heart Institute Journal ; 2017
    In:  Texas Heart Institute Journal Vol. 44, No. 2 ( 2017-04-01), p. 127-130
    In: Texas Heart Institute Journal, Texas Heart Institute Journal, Vol. 44, No. 2 ( 2017-04-01), p. 127-130
    Abstract: Transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valves has been successfully performed, but there is a lack of published experience in percutaneous treatment of patients with unicuspid valves and severe aortic stenosis. We describe a case of TAVR in such a patient. A 31-year-old woman with Turner syndrome—who had undergone coarctation repair via subclavian flap at age 7 days and an aortic valvotomy at age 6 weeks—presented with severe symptomatic aortic stenosis. She was deemed inoperable because of her severe pulmonary hypertension and numerous comorbidities; consequently, a 20-mm Edwards Sapien 3 Transcatheter Heart Valve was offered for compassionate use. Postdeployment angiography and transesophageal echocardiography and aortography revealed no aortic insufficiency. Transcatheter aortic valve replacement for unicuspid aortic valve stenosis is technically feasible. Before implantation, particular attention should be paid to the interplay between the large single leaflet, coronary ostia, and stented valve, to select the correct size and position of the device. Some degree of intraoperative aortic migration should be anticipated.
    Type of Medium: Online Resource
    ISSN: 0730-2347 , 1526-6702
    Language: English
    Publisher: Texas Heart Institute Journal
    Publication Date: 2017
    detail.hit.zdb_id: 2068440-X
    Location Call Number Limitation Availability
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  • 5
    Online Resource
    Online Resource
    Texas Heart Institute Journal ; 2017
    In:  Texas Heart Institute Journal Vol. 44, No. 2 ( 2017-04-01), p. 135-137
    In: Texas Heart Institute Journal, Texas Heart Institute Journal, Vol. 44, No. 2 ( 2017-04-01), p. 135-137
    Abstract: Current criteria for donor hearts limit the number of hearts available for transplantation, despite an increasing number of recipients on waiting lists. We report the case of a patient with ischemic cardiomyopathy and refractory ventricular tachycardia who underwent successful orthotopic heart transplantation and concurrent aortic valve replacement with a donor heart that had displayed moderate aortic valve regurgitation. The patient was a 71-year-old man with a history of advanced heart failure, 5-vessel coronary artery bypass grafting, and paroxysmal ventricular tachycardia. He was not a candidate for repeat revascularization or myocardial ablation, so he was placed on the heart-transplant list as status 1A. On intra-aortic balloon pump support, the patient waited 51 days for a donor match to be identified. Despite the donor heart's having moderate aortic valve regurgitation, the decision was made to use that heart. We performed a back-table aortic valve replacement with a 23-mm St. Jude Epic bioprosthesis, and then performed the orthotopic heart transplantation. The patient did well and was discharged from the hospital on postoperative day 11. This case indicates that expanding donor criteria to include otherwise healthy hearts with certain aortic valve defects is feasible, if surgical experience and expertise permit.
    Type of Medium: Online Resource
    ISSN: 0730-2347 , 1526-6702
    Language: English
    Publisher: Texas Heart Institute Journal
    Publication Date: 2017
    detail.hit.zdb_id: 2068440-X
    Location Call Number Limitation Availability
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