Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging, 2021
Post infarction pericarditis, Dressler's syndrome is a well-recognized condition, but its inc... more Post infarction pericarditis, Dressler's syndrome is a well-recognized condition, but its incidence has decreased in the present interventional era due to early reperfusion strategy. We encountered an unusual association of large pericardial effusion secondary to Dressler's syndrome and intractable ventricular tachycardia that reverted upon pericardiocentesis. We coined a term “electrical tamponade” to describe an electrical storm or high-grade ventricular arrhythmias secondary to pericardial effusion.
Renal-artery stenosis/occlusion is the cause of ischemic nephropathy, which is associated with hy... more Renal-artery stenosis/occlusion is the cause of ischemic nephropathy, which is associated with hypertension due to renovascular system involvement. Acute renal failure in patients with bilateral renal artery stenosis can occur for a variety of reasons, including administration of an angiotensin-converting enzyme inhibitor or spontaneous progression of renal-artery stenosis leading to bilateral total occlusion or high-grade stenosis. Rapid diagnosis and prompt treatment are the basis of kidney survival. The root cause of renal-artery occlusion must be elucidated in younger age patients after revascularization, such as Takayasu’s arteritis (TA) or fibromuscular dysplasia. We discuss the case of a preadolescent girl who had bilateral complete renal artery occlusion due to TA and acute kidney injury, needing renal replacement therapy. She had a bailout percutaneous renal intervention to the left renal artery, which resulted in remarkable clinical improvement.
Transcatheter heart valve retrograde migration after transcatheter aortic valve implantation is u... more Transcatheter heart valve retrograde migration after transcatheter aortic valve implantation is unusual. It can occur during the implantation of the aortic transcatheter heart valve, i.e., intra-procedural, or in the first few days following the intervention. Transcatheter valve embolisation and migration soon after deployment typically results from the implantation of a prothesis that was undersized for the annulus, an unreasonably low implantation, or the expulsion of the device following deployment by an excessive ventricular contraction. The presented case highlights the importance of the timing of the complication that has taken place, in this case, intra-procedural, which has become relevant to the research.
We present a rare case with simultaneous COVID-19 pneumonia and acute complicated type -B aortic ... more We present a rare case with simultaneous COVID-19 pneumonia and acute complicated type -B aortic dissection (ACTBAD). With strained health services a major procedure endovascular aortic repair (EVAR) was performed. Despite successful EVAR, patient had sudden unexplained cardiac arrest. Procedural mortality is high among COVID-19 infected patients.
Years after coronary artery bypass graft surgery, plaque formation or graft degeneration is a maj... more Years after coronary artery bypass graft surgery, plaque formation or graft degeneration is a major concern. Saphenous vein grafts (SVG) are vulnerable to degeneration and occlusion, leading to poorer long-term disease because of atherosclerotic degeneration. The main mechanism responsible for SVG failure is neointimal hyperplasia and the occluded SVG is treated with percutaneous coronary intervention, mostly with the use of additional protection devices. Graft intervention for the diffuse degeneration of SVG can be performed with the use of suitable hardware without the distal protection device being required. The authors herein report the case of a 63-year-old female who presented with degenerated SVG to the left anterior descending artery with anastomotic stenosis, 6 years after coronary artery bypass graft surgery. She was successfully treated with three ultra-thin sirolimus-eluting stents in SVG to the left anterior descending artery, without the use of any embolic protection d...
Simultaneous ST-segment elevation (SST-SE) in anterior and inferior leads in the setting of ST-se... more Simultaneous ST-segment elevation (SST-SE) in anterior and inferior leads in the setting of ST-segment elevation myocardial infarction is often confounding for a cardiologist and further more challenging is the angiographic localization of the culprit vessel. SST-SE can be fatal as it jeopardizes simultaneously a larger area of myocardium. This phenomenon could be due to “one lesion, one artery,” “two lesions, one artery,” “two lesions, two arteries,” or combinations in two different coronary arteries. We have discussed an index case where we encountered a phenomenon of SST-SE and coronary angiography demonstrated “two lesions, one artery” (proximal occlusion and distal critical diffuse stenoses of the wrap-around left anterior descending [LAD] artery) and “two lesions, two (different coronary) arteries” (previously mentioned stenoses of the LAD artery and critical stenosis of the posterolateral branch of the right coronary arteries). We have also described in brief the possible cau...
A 7-month-old girl with failure to thrive, who, on clinical and diagnostic evaluation [echocardio... more A 7-month-old girl with failure to thrive, who, on clinical and diagnostic evaluation [echocardiography & CT angiography] to rule out congenital heart disease, revealed a rare vascular anomaly called systemic artery to pulmonary venous fistula. In our case, there was dual abnormal supply to the entire left lung as(1) anomalous supply by normal systemic artery [internal mammary artery](2) and an aberrant feeder vessel from the abdominal aorta. Left Lung had normal bronchial connections and normal pulmonary vasculature. The fistula drained through the pulmonary veins to the left atrium leading to 'left-left shunt'. Percutaneous intervention in two stages was performed using Amplatzer vascular plugs and coil embolization to close them successfully. The patient gained significant weight in follow up with other normal developmental and mental milestones.
Address for Correspondence: Dr. Suresh Babu Kale, Department of Cardiovascular Thoracic Surgery, ... more Address for Correspondence: Dr. Suresh Babu Kale, Department of Cardiovascular Thoracic Surgery, The Royal Melbourne Hospital, Grattan Street, Parkville, Victoria 3050. Australia. Phone: 0061-408641172, Fax: +61-3-93475258 Email: kalebsuresh@yahoo.com Annals ...
Abstract The association of acute coronary syndrome with any immunological mediated polyradiculop... more Abstract The association of acute coronary syndrome with any immunological mediated polyradiculopathy like Guillain–Barre syndrome is very rare. We report such a rare association of acute myocardial infarction and Guillain–Barre syndrome. Our patient underwent primary angioplasty successfully, but developed respiratory failure while in hospital. While the difficulty in weaning off from ventilator a suspicion of neuromuscular disease was made. The further investigations, including nerve conduction study confirmed a diagnosis of Guillain–Barre syndrome. Despite treatment, the patient died secondary to multi-organ dysfunction. Our case is 4th reported in the literature without use of any thrombolytic agent for such association.
Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging, 2021
Post infarction pericarditis, Dressler's syndrome is a well-recognized condition, but its inc... more Post infarction pericarditis, Dressler's syndrome is a well-recognized condition, but its incidence has decreased in the present interventional era due to early reperfusion strategy. We encountered an unusual association of large pericardial effusion secondary to Dressler's syndrome and intractable ventricular tachycardia that reverted upon pericardiocentesis. We coined a term “electrical tamponade” to describe an electrical storm or high-grade ventricular arrhythmias secondary to pericardial effusion.
Renal-artery stenosis/occlusion is the cause of ischemic nephropathy, which is associated with hy... more Renal-artery stenosis/occlusion is the cause of ischemic nephropathy, which is associated with hypertension due to renovascular system involvement. Acute renal failure in patients with bilateral renal artery stenosis can occur for a variety of reasons, including administration of an angiotensin-converting enzyme inhibitor or spontaneous progression of renal-artery stenosis leading to bilateral total occlusion or high-grade stenosis. Rapid diagnosis and prompt treatment are the basis of kidney survival. The root cause of renal-artery occlusion must be elucidated in younger age patients after revascularization, such as Takayasu’s arteritis (TA) or fibromuscular dysplasia. We discuss the case of a preadolescent girl who had bilateral complete renal artery occlusion due to TA and acute kidney injury, needing renal replacement therapy. She had a bailout percutaneous renal intervention to the left renal artery, which resulted in remarkable clinical improvement.
Transcatheter heart valve retrograde migration after transcatheter aortic valve implantation is u... more Transcatheter heart valve retrograde migration after transcatheter aortic valve implantation is unusual. It can occur during the implantation of the aortic transcatheter heart valve, i.e., intra-procedural, or in the first few days following the intervention. Transcatheter valve embolisation and migration soon after deployment typically results from the implantation of a prothesis that was undersized for the annulus, an unreasonably low implantation, or the expulsion of the device following deployment by an excessive ventricular contraction. The presented case highlights the importance of the timing of the complication that has taken place, in this case, intra-procedural, which has become relevant to the research.
We present a rare case with simultaneous COVID-19 pneumonia and acute complicated type -B aortic ... more We present a rare case with simultaneous COVID-19 pneumonia and acute complicated type -B aortic dissection (ACTBAD). With strained health services a major procedure endovascular aortic repair (EVAR) was performed. Despite successful EVAR, patient had sudden unexplained cardiac arrest. Procedural mortality is high among COVID-19 infected patients.
Years after coronary artery bypass graft surgery, plaque formation or graft degeneration is a maj... more Years after coronary artery bypass graft surgery, plaque formation or graft degeneration is a major concern. Saphenous vein grafts (SVG) are vulnerable to degeneration and occlusion, leading to poorer long-term disease because of atherosclerotic degeneration. The main mechanism responsible for SVG failure is neointimal hyperplasia and the occluded SVG is treated with percutaneous coronary intervention, mostly with the use of additional protection devices. Graft intervention for the diffuse degeneration of SVG can be performed with the use of suitable hardware without the distal protection device being required. The authors herein report the case of a 63-year-old female who presented with degenerated SVG to the left anterior descending artery with anastomotic stenosis, 6 years after coronary artery bypass graft surgery. She was successfully treated with three ultra-thin sirolimus-eluting stents in SVG to the left anterior descending artery, without the use of any embolic protection d...
Simultaneous ST-segment elevation (SST-SE) in anterior and inferior leads in the setting of ST-se... more Simultaneous ST-segment elevation (SST-SE) in anterior and inferior leads in the setting of ST-segment elevation myocardial infarction is often confounding for a cardiologist and further more challenging is the angiographic localization of the culprit vessel. SST-SE can be fatal as it jeopardizes simultaneously a larger area of myocardium. This phenomenon could be due to “one lesion, one artery,” “two lesions, one artery,” “two lesions, two arteries,” or combinations in two different coronary arteries. We have discussed an index case where we encountered a phenomenon of SST-SE and coronary angiography demonstrated “two lesions, one artery” (proximal occlusion and distal critical diffuse stenoses of the wrap-around left anterior descending [LAD] artery) and “two lesions, two (different coronary) arteries” (previously mentioned stenoses of the LAD artery and critical stenosis of the posterolateral branch of the right coronary arteries). We have also described in brief the possible cau...
A 7-month-old girl with failure to thrive, who, on clinical and diagnostic evaluation [echocardio... more A 7-month-old girl with failure to thrive, who, on clinical and diagnostic evaluation [echocardiography & CT angiography] to rule out congenital heart disease, revealed a rare vascular anomaly called systemic artery to pulmonary venous fistula. In our case, there was dual abnormal supply to the entire left lung as(1) anomalous supply by normal systemic artery [internal mammary artery](2) and an aberrant feeder vessel from the abdominal aorta. Left Lung had normal bronchial connections and normal pulmonary vasculature. The fistula drained through the pulmonary veins to the left atrium leading to 'left-left shunt'. Percutaneous intervention in two stages was performed using Amplatzer vascular plugs and coil embolization to close them successfully. The patient gained significant weight in follow up with other normal developmental and mental milestones.
Address for Correspondence: Dr. Suresh Babu Kale, Department of Cardiovascular Thoracic Surgery, ... more Address for Correspondence: Dr. Suresh Babu Kale, Department of Cardiovascular Thoracic Surgery, The Royal Melbourne Hospital, Grattan Street, Parkville, Victoria 3050. Australia. Phone: 0061-408641172, Fax: +61-3-93475258 Email: kalebsuresh@yahoo.com Annals ...
Abstract The association of acute coronary syndrome with any immunological mediated polyradiculop... more Abstract The association of acute coronary syndrome with any immunological mediated polyradiculopathy like Guillain–Barre syndrome is very rare. We report such a rare association of acute myocardial infarction and Guillain–Barre syndrome. Our patient underwent primary angioplasty successfully, but developed respiratory failure while in hospital. While the difficulty in weaning off from ventilator a suspicion of neuromuscular disease was made. The further investigations, including nerve conduction study confirmed a diagnosis of Guillain–Barre syndrome. Despite treatment, the patient died secondary to multi-organ dysfunction. Our case is 4th reported in the literature without use of any thrombolytic agent for such association.
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