Echocardiographic Assessment of the Vegetation: Are There Characteristics that Mandate Prophylactic Surgical Intervention?

2002 ◽  
pp. 203-209
Author(s):  
M. Berger
Keyword(s):  
Surgical Intervention ◽  
Echocardiographic Assessment

scholarly journals Biventricular Failure due to Stress Cardiomyopathy after Pericardiectomy for Constrictive Pericarditis

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Elliott M. Groves ◽  
Jin Kyung Kim
Keyword(s):  
Constrictive Pericarditis ◽  
Coronary Atherosclerosis ◽  
Single Ventricle ◽  
Surgical Intervention ◽  
Rare Complication ◽  
Stress Cardiomyopathy ◽  
Rare Clinical Entity ◽  
Resonance Imaging ◽  
Biventricular Failure ◽  
Echocardiographic Assessment

Importance. Constrictive pericarditis is a rare clinical entity that frequently necessitates surgical intervention. Here we present a case of biventricular failure due to stress cardiomyopathy after pericardiectomy. This is an extremely rare complication that is not well described and does not have a definitive mechanism.Observations. A 40-year-old Ecuadorian woman who was found to have constrictive pericarditis due toMycobacterium tuberculosisinfection was referred to our institution. The presence of constrictive pericarditis was confirmed by echocardiography, computed tomography, magnetic resonance imaging, and cardiac catheterization. Following pericardiectomy, the patient developed biventricular failure consistent with stress cardiomyopathy (Takotsubo cardiomyopathy), based on the echocardiographic assessment of the ventricles, which demonstrated an akinetic apex and hyperactive base in both ventricles, the absence of significant epicardial coronary atherosclerosis, and prompt normalization of the cardiac function after intensive medical therapy.Conclusions and Relevance. Biventricular failure in the form of stress cardiomyopathy after pericardiectomy in the manner presented here has not been previously described in the literature. While postulations as to the cause of single ventricle dysfunction have been described, the exact mechanism is unclear and current theories do not explain the clinical features in this case of stress cardiomyopathy after pericardiectomy.

Thrombolysis in Arterial Occlusion

1999 ◽  
Vol 82 (S 01) ◽  
pp. 109-111 ◽  
Author(s):  
Raymond Verhaeghe
Keyword(s):  
Clinical Practice ◽  
Thrombolytic Therapy ◽  
Hemorrhagic Stroke ◽  
Surgical Intervention ◽  
Bypass Graft ◽  
Surgical Techniques ◽  
Arterial Occlusion ◽  
Second Step ◽  
Severe Bleeding ◽  
Initial Management

SummaryIntra-arterial thrombolytic therapy has replaced systemic intravenous infusion of thrombolytic agents as a treatment modality for arterial occlusion in the limbs. Several catheter-guided techniques and various infusion methods and schemes have been developed. At present there is no scientific proof of definite superiority of any agent in terms of efficacy or safety but clinical practice favours the use of urokinase or alteplase. Studies which compared thrombolysis to surgical intervention suggest that thrombolytic therapy is an appropriate initial management in patients with acute occlusion of a native leg artery or a bypass graft. Underlying causative lesions are treated in a second step by endovascular or open surgical techniques. Severe bleeding is the most feared complication: the risk of hemorrhagic stroke is 1-2%.

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