No abstract available.
Aortic Valve Insufficiency ; Transcatheter Aortic Valve Replacement

Aortic coarctation is a correctable hypertensive disease. For safety reasons and due to the invasiveness of surgical techniques, percutaneous interventions have become drastically more popular in recent times. In elderly patients with aortic coarctation who are at risk of an aortic wall aneurysm and rupture, covered stents are preferred but in younger patients, bare metal stenting may be sufficient for long-term safety. Herein we present a 47-year-old typical aortic coarctation patient who was successfully treated with a bare metal stent.
Adult ; Aged ; Aneurysm ; Angioplasty ; Aortic Coarctation ; Humans ; Rupture ; Stents

Percutaneous recanalization of chronic total occlusions (CTOs) in peripheral arteries, especially TASC D classification including the distal aorta and both iliac arteries is still technically challenging. The conventional technique using standard guidewires and catheters guided by computed tomography and angiography can achieve a limited initial success, depending on lesion characteristics and operator's experience. A special imaging technique using 3-dimensional rotational angiography and spatio-temporal reconstruction with endoview for a better examination of the proximal stump, exact obstruction location, and distal stump direction in a stumpless lesion can be indispensable for successful intervention. We report a successful revascularization case of stumpless distal aorta and bi-iliac CTO guided by this specialized imaging technique.
Angiography ; Angioplasty ; Aorta ; Aorta, Abdominal ; Arteries ; Catheters ; Iliac Artery ; Imaging, Three-Dimensional

Coronary artery fistulas (CAFs) are one of the most rare cardiac anomalies. Some patients with CAF may suffer from ischemic chest pain that originates from combined significant coronary artery spasm (CAS). Spontaneous regression of CAF has been reported in a few cases, almost all of which were infants. We report an adult patient who presented with ischemic chest pain due to multiple coronary arteries to pulmonary artery fistulas and combined significant CAS induced by intracoronary acetylcholine provocation test. Spontaneous regression of one of the fistulas was observed at 2-year angiography follow-up.
Acetylcholine ; Adult ; Angiography ; Arteriovenous Fistula ; Chest Pain ; Coronary Vasospasm ; Coronary Vessel Anomalies ; Coronary Vessels ; Fistula ; Follow-Up Studies ; Humans ; Infant ; Pulmonary Artery ; Spasm

BACKGROUND AND OBJECTIVES: The sinus venosus (SV) is not a well known source of atrial tachycardia (AT), but it can harbor AT during catheter ablation of atrial fibrillation (AF). SUBJECTS AND METHODS: A total of 1223 patients who underwent catheter ablation for AF were reviewed. Electrophysiological and electrocardiographic characteristics and outcomes after catheter ablation of AT originating from the SV were investigated. RESULTS: Ten patients (0.82%) demonstrated AT from the SV (7 males, 53.9+/-16.0 years, 6 persistent) during ablation of AF. The mean cycle length was 281+/-73 ms. After pulmonary vein isolation and left atrial ablation, AF converted to AT from the SV during right atrial ablation in 2 patients, by rapid atrial pacing after AF termination in 7 patients, and during isoproterenol infusion in 1 patient. Positive P-waves in inferior leads were shown in most patients (90%). The activation sequence of AT was from proximal to distal in the superior vena cava and high to low in the right atrium, which was similar to that of AT from crista terminalis. Fragmented double potentials were recorded during sinus, and a second discrete potential preceded the onset of P wave by 80+/-37 ms during AT. Using 4.4+/-2.7 radiofrequency focal applications, ATs were terminated and became no longer inducible in all. After ablation procedure, two patients showed transient right phrenic nerve palsy. After 19.9+/-14.8 months, all but 1 patient were free of atrial tachyarrhythmia without complications. CONCLUSION: The AT which develops during AF ablation is rarely originated from SV, and its electrophysiologic characteristics may be helpful in guiding effective focal ablation.
Atrial Fibrillation ; Catheter Ablation ; Catheters ; Electrocardiography ; Heart Atria ; Humans ; Isoproterenol ; Male ; Paralysis ; Phrenic Nerve ; Pulmonary Veins ; Tachycardia ; Vena Cava, Superior

We report a case about a 27-year-old healthy young male who developed syncope during exercise, which was subsequently identified to be attributable to non-sustained polymorphic ventricular tachycardia (VT). Occurrence of polymorphic VT was neither related to a prolonged QT interval nor a fixed short coupling interval. Standard examinations including echocardiography, coronary angiography, isoproterenol infusion study, and cardiac MRI showed no structural heart disease. On the electrophysiology study, activation mapping revealed that a discrete potential preceded the premature ventricular complex (PVC) triggered polymorphic VT, which was recorded just above the pulmonary valve. After radiofrequency ablation at this area, PVC and polymorphic VT disappeared and did not recur after a 2 month follow up.
Catheter Ablation ; Coronary Angiography ; Echocardiography ; Electrophysiology ; Follow-Up Studies ; Heart Diseases ; Humans ; Isoproterenol ; Male ; Pulmonary Artery ; Pulmonary Valve ; Syncope ; Tachycardia, Ventricular ; Ventricular Premature Complexes

We report a case about a 27-year-old healthy young male who developed syncope during exercise, which was subsequently identified to be attributable to non-sustained polymorphic ventricular tachycardia (VT). Occurrence of polymorphic VT was neither related to a prolonged QT interval nor a fixed short coupling interval. Standard examinations including echocardiography, coronary angiography, isoproterenol infusion study, and cardiac MRI showed no structural heart disease. On the electrophysiology study, activation mapping revealed that a discrete potential preceded the premature ventricular complex (PVC) triggered polymorphic VT, which was recorded just above the pulmonary valve. After radiofrequency ablation at this area, PVC and polymorphic VT disappeared and did not recur after a 2 month follow up.
Catheter Ablation ; Coronary Angiography ; Echocardiography ; Electrophysiology ; Follow-Up Studies ; Heart Diseases ; Humans ; Isoproterenol ; Male ; Pulmonary Artery ; Pulmonary Valve ; Syncope ; Tachycardia, Ventricular ; Ventricular Premature Complexes