Archives of Cardiovascular Imaging

Case Report

25/2/2023

Large Coronary-Cameral Fistulas in an Adult Patient: A Rare Coronary Anomaly with Concealed Clinical Findings (Case Report and Literature Review)

Hamidreza Pouraliakbar, Anita Sadeghpour, Azin Alizadehasl, Ata Firoozi, Kianoush Homightoun, Nazila Alborzi, Pravin Bayati, Masoud Movassaghi

Coronary-cameral fistulas (CCFs) constitute a rare anomaly that can be incidentally detected during angiography. CCFs are solitary, large or small assemblies that originate from coronary arteries and enter one of the cardiac chambers. We describe a 29-year-old woman, who referred to our clinic with the chief complaints of palpitation, atypical chest pain, and dyspnea on exertion (functional class II). Multimodality imaging confirmed the diagnosis of a CCF from the left main with extension to the right atrium and drainage therein. The CCF was closed percutaneously with a patent ductus arteriosus occluder successfully.

Letter

30/5/2023

Severe Isolated Rheumatic Aortic Valve Regurgitation

Azin Alizadehasl, Samaneh Pourhosseinali

Brief Report

25/5/2023

Role of Computed Tomographic Angiography in Central Venous Catheter Related Complications in Dialysis Patients

Konstantinos Spanos, Christos Karathanos, George Kouvelos, Athanasios Athanasoulas, Aikaterini Drakou, Athanasios D Giannoukas

Results: From 2012 - 2014, eight patients (mean age 59 ± 1.2 years; 6 males) with CVC related complication were treated. All complication were diagnosed and verified by a CTA (100%). Two patients presented with local hematoma, 3 with major bleeding, 2 with a retained guide-wire, and 1 with a disconnected part of a port-catheter. The direct repair of an arterial or venous wall injury was undertaken in 7 patients, with the simultaneous removal of a retained guide-wire in 2 and the removal of a misplaced CVC in 1 of them. One patient had the endovascular approach with the removal of the disconnected part. No death or major complication occurred during the procedures. During the follow-up (range =12 - 24 mon), no re-intervention, clinical episode of venous thromboembolism, or death was recorded.

Review Article

29/5/2023

Pulmonary Arterial Hypertension: A Two-Dimensional Echocardiographic Approach from Screening to Prognosis

Samir Kanti Saha

An elevated pulmonary artery pressure (PAP) from any cause is associated with increased mortality, especially in cases of primary pulmonary arterial hypertension (PAH). One of the many reasons behind a bad prognosis is the inherent difficulty in assessing right ventricular (RV) function with reproducible methods. Intensive research involving the left heart has made it relatively easy to assess left ventricular (LV) systolic and diastolic functions in many centers around the world. As for the RV, however, although increasing attention has been focused on the right-sided heart in the recent times, neither global longitudinal strain nor right ventricular ejection fraction (RVEF) has been studied well in relation to the outcome (unlike in the LV). Another issue is that the right heart functions in a circuitry involving the right atrium (RA), the RV, and the pulmonary artery. Hence, all 3 components of this circuit have important roles in unison to eject a cardiac output equivalent to the left-sided heart. In this review, we sought to discuss the ways to quantity the function of the entire circuit using both standard and advanced echocardiographic imaging modalities. As primary PAH is the classic form of pathology causing the RV to face an afterload with which it is not destined to cope, this review is mainly based on the assessment of the right heart as a circuit in idiopathic primary PAH.

Research Article

28/5/2023

Does the Post-Systolic Shortening of the Left Ventricle by Tissue Doppler Imaging Predict Coronary Artery Disease?

Hanan Radwan, Ahmed Shawky, Abd Elhakem Selem

Methods: Eighty consecutive patients (49% female) with typical ischemic chest pain but without prior myocardial infarction, coronary revascularization, arrhythmia, or heart failure, who had no regional wall motion abnormalities on resting echocardiography and who were scheduled to undergo coronary angiography, were selected. TDI was performed in each patient before coronary angiography at 2 levels (basal and mid left ventricle [LV]) in each of the 4 LV walls (i.e., septal, anterior, inferior, and lateral). Coronary angiography was performed and interpreted per standard clinical protocols.

Results: Compared to the patients with normal coronaries, those with angiographic CAD showed significantly increased myocardial isovolumic relaxation time (IVRT) velocity (P < 0.001) and significantly prolonged IVRT (P < 0.001) at the septal, anterior, inferior, and lateral LV walls. With a cutoff value > 4.0 m/sec, a positive PSS velocity had about 65% sensitivity and 85% specificity with a positive predictive value > 90% in predicting angiographic CAD.

Archives of Cardiovascular Imaging: May 2016, 4 (2), 5 articles.