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  • ISSN: 2333-6676
    Volume 5, Issue 3
    Case Report
    Linle Hou, Zohaib Shaikh, and Todd J. Cohen*
    Due to the use of fluoroscopy in the electrophysiology lab, long and complex procedures to diagnose and treat cardiac arrhythmias can lead to radiation exposure to both patients and the laboratory staff. In this report, we present a case in which a diagnostic electrophysiology study was conducted on a 41 year-old patient with atrial tachycardia without the use of fluoroscopy. The diagnostic component of the procedure was successfully completed exclusively utilizing a 3D nonfluoroscopic electroanatomic mapping system to guide catheters into the heart and determine the mechanism of the arrhythmia. The patient then underwent a successful mapping and ablation procedure using a robotic remote catheter system and the electroanatomic mapping system, with minimal use of fluoroscopy.
    Keyur Vora*
    We report a case of an acute inferior wall myocardial infarction as per electrocardiogram (ECG) criteria. Customarily, this represents thrombotic occlusion of right coronary artery (RCA) or left circumflex coronary artery (LCX). Contradicting, the coronary angiogram revealed total occlusion of distal left anterior descending coronary artery (LAD) and lesion free LCX & RCA. Our case report highlights the rare occurrences of dissociation of electrophysiological abnormalities and standard coronary artery perfusion zones.
    Carlo Bothner*, Julia Seeger, Wolfgang Rottbauer, Jochen Wöhrle
    Transcatheter aortic valve replacement (TAVR) for severe aortic stenosis has been proven to be a safe therapeutic and well-established option in patients at high and intermediate surgical risk. TAVR shows a comparable mid-term durability compared to surgical aortic valve replacement. Only minimal data exist in the long-term survival of dialysis patients after cardiac valve replacement. Long-term function of TAVR devices in patients requiring hemodialysis remains unknown. We are presenting a case of early deterioration of a bioprosthetic CoreValve in a patient undergoing hemodialysis. The patient was scheduled for re-TAVR, unfortunately, the patient´s course deteriorated and cardiopulmonary resuscitation was unsuccessful. The autopsy revealed a severely denaturated CoreValve prosthesis with severe calcifications. In the subset of patients with renal failure however valve performance has to be regularly monitored for early signs of degeneration. Our case shows that the long-term performance of first generation TAVR devices in a patient requiring hemodialysis was limited.
    Jean Paul Vilchez Tschischke, Javier Escaned, Nieves Gonzalo*
    Longitudinal stent deformation is a rare complication of coronary angioplasty; however, newer stents have thinner struts and fewer connectors, losing longitudinal strength, with more risk of this complication. We report a complex case of left main angioplasty that was complicated with LSD, describing the solution we applied, so it can help as an option for other interventional cardiologists in these cases.
    Mini Review
    Francesca Mastorci, Cristina Vassalle, Alessandro Pingitore*
    Cardiovascular disease (CVD) currently represents the leading cause of death, accounting for over 15 million deaths worldwide each year. The protection from susceptibility to CVD can be considered as the final result of the fine-tuning cross talk among environmental factors, gene expression modulation by environment and endogenous homeostatic regulatory systems. In this view, the evaluation of risk factors in cardiovascular prevention field is associated to a parallel transformation of medicine’s clinical goals. This shifts the focus towards implementation and definition of multidisciplinary teams of clinicians and researchers to provide integrated care, early detection and prevention of cardiovascular disease, according a complex interplay of physical, social, economic, cultural and environmental factors, with which the patient is related. In this scenario, bioethical perspective has pointed to the importance of the patient’s point of view in health care decisions through its call to respect patient autonomy according to humanistic conceptions to emphasize ‘‘patient-centeredness’’ outcomes. This integrative, holistic, and personalized perspective offers the possibility for studying patient as a person and human body as a complex adaptive system in which health and disease could be viewed in an onlinear, dynamic, and inter-active network in order to develop multiple purpose preventive and therapeutic treatments.
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