Long-term outcome after percutaneous closure of persistent left superior caval vein draining into the left atrium: a contrast-enhanced CT study

2017 ◽  
Vol 27 (8) ◽  
pp. 1550-1556 ◽  
Author(s):  
Davide Marini ◽  
Matteo Castagno ◽  
Michele Millesimo ◽  
Francesca Ferroni ◽  
Gaetana Ferraro ◽  
...  
Keyword(s):  
Left Atrium ◽  
Percutaneous Closure ◽  
Caval Vein ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Superior Caval Vein ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

AbstractBackgroundData regarding long-term outcome after percutaneous closure of left superior caval vein draining into the left atrium are lacking. The aim of the present study was to report the long-term follow-up by using contrast-enhanced CT.MethodsIn all, three patients underwent percutaneous closure of left superior caval vein draining into the left atrium between 2005 and 2015. All of them were evaluated clinically and underwent contrast-enhanced CT.ResultsIn one patient, the Amplatzer® Septal Occluder was used. In two patients, the Amplatzer® Vascular Plug type-1 was preferred: the device size/LSVC diameter ratio was 1.7 in the child and 1.2 in the adult. There were no early-onset or long-term onset complications. CT was performed 1, 2, and 10 years after the procedure, respectively. Complete occlusion of the vessel was documented in all. After 10 years since the procedure, CT revealed a persistent trivial residual shunt through the accessory hemiazygos vein in one patient, in whom the device was implanted above its drainage into the left superior caval vein. When an Amplatzer® Vascular Plug type-1 is oversized compared with the venous vessel diameter, it immediately assumes a dog-bone shape that disappears early to regain its shape memory and nominal size.ConclusionsPercutaneous occlusion of left superior caval vein draining into the left atrium has excellent early and long-term outcomes. The optimal implantation of the device is below the drainage of the accessory hemiazygos vein, when present. The device might be oversized compared with the left superior caval vein diameter according to the age of the patient.

scholarly journals The volume of left atrium measured by multi-detector computed tomography can predict of long term outcome in catheter ablation of atrial fibrillation

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
YR Kim
Keyword(s):  
Computed Tomography ◽  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Left Atrium ◽  
Volume Estimation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Group 2 ◽  
Group 1

Abstract Funding Acknowledgements Type of funding sources: None. Background This study aimed to identify the volume left atrium (LA) and left atrial appendage (LAA) calculated by multidetector computed tomography (MDCT) is related to the long term out come of radiofrequency catheter ablation (RFCA) for atrial fibrillation(AF). Methods We analyzed data from 99 consecutive patients who referred for RFCA due to drug-refractory symptomatic AF (age 56 ± 10 years; 74% men; 64% paroxysmal AF). Prior to the procedure, all patients underwent ECG-gated 128 channels MDCT scan for assessment for pulmonary vein  anatomy, LA and LAA volume estimation, and electro-anatomical mapping integration.  Results The volume of LA and LAA calculated by CT was 142.6 ± 32.2 mL and 14.7 ± 6.0 mL, respectively. LA volume was smaller in paroxysmal AF(PAF) than persistent AF(PeAF) (133.9 ± 29.3 mL vs. 158.0 ± 31.4 mL, p < 0.0001) but  LAA volume was not significantly different between PAF and PeAF(13.9 ± 5.0 mL vs. 16.3 ± 7.3 mL, p = 0.09). Patients were classified into 2 groups by the LA volume of 160mL; group 1  (LA volume < 160mL,n = 73) and group 2 (LA volume ≥160mL, n = 26). After a mean follow up 12.6 ± 5.3 months, 78.8% of the patients maintained sinus rhythm after the index ablation. AF free survival was significantly greater in group  1 than group 2 (84.9% vs. 61.5% p = 0.017). No relationship was found between LAA volume and the outcome of RFCA. Multivariate analysis showed that the LA volume >160mL was an independent predictor of arrhythmia-free after ablation (Hazard ration 2.55, 95% confidential interval 1.02-6.35, p = 0.045) Conclusion Higher LA volume is independent risk factor for AF recurrence after RFCA but not LAA volume. The LA volume quickly assessed by MDCT could be a good predictor of long term recurrence after AF ablation.

Abstract 2008: Impact of Hyperglycemia on Myocardial Damage and its Prognostic Implications in Patients with Acute ST-Segment Elevation Myocardial Infarction (STEMI) Assessed by Contrast-Enhanced Cardiac Magnetic Resonance Imaging (CMR)

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Christoph J Jensen ◽  
Markus Jochims ◽  
Kai Nassenstein ◽  
Michael Bell ◽  
Thomas Schlosser ◽  
...  
Keyword(s):  
Logistic Regression Model ◽  
Microvascular Obstruction ◽  
Myocardial Damage ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Glucose Levels ◽  
Contrast Enhanced ◽  
Lv Mass ◽  
The Impact

To investigate the impact of admission glucose levels on myocardial damage and long term outcome in patients with acute STEMI using contrast-enhanced CMR. 130 consecutive patients (104 males; mean age 59.4±11.8 years) with first reperfused STEMI were included. Hyperglycemia was defined as glucose levels above 7.8mmol/l. CMR was performed within 3.9±2.2 days after admission on a 1.5 Tesla MR System. The imaging protocol included SSFP cine sequences for the calculation of LV function, volumes and mass. Total no reflow volumes (NRV) and delayed enhancement volumes (DEV) were calculated from planimetry of the IR-SSFP stacks of short axis images by disc-summation performed early / late following administration of 0.2mmol/kg/BW of gadodiamid. NRV and DEV were expressed as percent of LV Mass (NR%, DE%). Continuous variables were compared by Mann-Whitney test. Correlation of admission hyperglycemia and NR% was tested by spearman rank test. Patients were prospectively followed for 30±9 months. A stepwise logistic regression model was used to analyze the impact of hyperglycemia and CMR parameters on NR% and outcome. 55 of 130 (42%) patients had hyperglycemia on admission. Patients with admission hyperglycemia had lower LV ejection fraction (38.6±12.9% vs. 47.7±11.9%, p=0.001), greater ESV (89.2±39.2ml vs. 71.7±34.1ml, p=0.002), greater LV Mass (156.7±40.4g vs. 136.3±36.7g, p=0.003), larger DE% (19.3±13.8% vs. 9.7±8.5%, p<0.001) and larger NR% (8.1± 9.2% vs. 2.3± 4.2%, p<0.001). Admission hyperglycemia correlated moderate but significant to DE% (r=0.386, p<0.001) and NR% (r=0.421, p<0.001). In a multivariable logistic regression model admission hyperglycemia was an independent predictor (OR 6.8; CI 2.8 −16.6) of extensive (> median) microvascular obstruction, extensive delayed enhancement (OR 3.2; CI 1.5–7.1) and was associated with an increased risk for death and reinfarction (OR 4.7; CI 1.2–18.3) during follow up. Admission hyperglycemia in acute, reperfused STEMI is independently related to the extent of microvascular obstruction on early contrast-enhanced CMR and is associated with worse long-term outcome. Thus, CMR may play a major role in monitoring effects of glucose control on myocardial damage in AMI.

scholarly journals Diagnosis and Outcome of Cardiac Paragangliomas: A Retrospective Observational Cohort Study in China

2022 ◽  
Vol 8 ◽  
Author(s):  
Xueqi Dong ◽  
Xu Meng ◽  
Ting Zhang ◽  
Lin Zhao ◽  
Fang Liu ◽  
...  
Keyword(s):  
Symptom Relief ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Contrast Enhanced ◽  
Octreotide Scintigraphy ◽  
Great Vessels ◽  
Observational Cohort ◽  
Biochemical Remission ◽  
Enhanced Computed Tomography

Background: Cardiac paragangliomas (CPGLs) are rare neuroendocrine tumors that are easily overlooked and difficult to diagnose. Detailed comprehensive data regarding CPGL diagnosis and outcome are lacking.Methods: We retrospectively analyzed a cohort of 27 CPGL patients. This cohort represents the largest such cohort reported to date.Results: The prevalence of trilogy symptoms (concurrent palpitations, hyperhidrosis, and headache) was frequent (9/27, 33.3%). Sensitivity of echocardiography and contrast-enhanced computed tomography for localization of CPGL were 81.8% and 87%, respectively. Octreotide scintigraphy showed 100% sensitivity for detecting GPCLs, while sensitivity of I131-metaiodoben-zylguanidine scintigraphy was only 32.9%. Multiple tumors were found in 29.6% of patients. Most CPGLs originated from the epicardium or root of the great vessels (92.9%) and were mostly supplied by the coronary arteries and their branches (95.7%). Twenty-four patients underwent surgical treatment. Although local invasion was present in 40.0% of patients, it did not affect long-term outcome. Mean follow-up was 6.9 ± 3.6 years. Biochemical remission was achieved in 85% of patients. The recurrence rate was 15%.Conclusions: Manifestations of CPGLs are non-specific and they can be difficult to detect on imaging examinations. Octreotide scintigraphy should be performed in patients with suspected paragangliomas to screen for multiple lesions. Surgical resection of CPGLs can achieve symptom relief and biochemical remission.

Acute aortic syndromes

2020 ◽  
pp. 3674-3680
Author(s):  
James D. Newton ◽  
Andrew R.J. Mitchell ◽  
Adrian P. Banning
Keyword(s):  
Transoesophageal Echocardiography ◽  
Mri Contrast ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Acute Aortic Syndromes ◽  
Adjacent Structures ◽  
Enhanced Ct ◽  
Penetrating Ulcer ◽  
Acute Dissection

The acute aortic syndromes are acute dissection, intramural haematoma, and penetrating ulcer, and all involve disruption of the wall of the aorta with potentially devastating consequences. Although relatively uncommon, left unrecognized and untreated they can carry a mortality rate of up to 2% per hour and 50% within the first few weeks. Physical signs typically reflect the region of the aorta involved and effects of pressure on adjacent structures: evidence of new aortic regurgitation or development of pulse deficits should be actively sought. Abnormalities on the chest radiograph and ECG are common, but neither investigation is diagnostic and further imaging is always necessary by MRI, contrast-enhanced CT, or transoesophageal echocardiography, depending on local availability and the clinical condition of the patient. In the long term, strenuous efforts to control blood pressure are indicated for all patients who have survived aortic dissection, with repeat imaging at least once a year.

Laparoscopic pyeloplasty for UPJ obstruction with crossing vessels: contrast-enhanced color Doppler findings and long-term outcome

Urology ◽  
2002 ◽  
Vol 59 (4) ◽  
pp. 500-505 ◽  
Author(s):  
Ferdinand Frauscher ◽  
Guenter Janetschek ◽  
Andrea Klauser ◽  
Reinhard Peschel ◽  
Ethan J Halpern ◽  
...  
Keyword(s):  
Color Doppler ◽  
Laparoscopic Pyeloplasty ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Upj Obstruction ◽  
Contrast Enhanced ◽  
Crossing Vessels

scholarly journals Mid-term outcome of transarterial embolization of renal artery pseudoaneurysm and arteriovenous fistula after partial nephrectomy screened by early postoperative contrast-enhanced CT

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Satoru Morita ◽  
Yuka Matsuzaki ◽  
Takahiro Yamamoto ◽  
Kumi Kamoshida ◽  
Hiroshi Yamazaki ◽  
...  
Keyword(s):  
Renal Artery ◽  
Partial Nephrectomy ◽  
Transarterial Embolization ◽  
Term Outcome ◽  
Artery Pseudoaneurysm ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Renal Artery Pseudoaneurysm

Abstract Purpose To retrospectively evaluate the mid-term outcome of transarterial embolization (TAE) of renal artery pseudoaneurysm (RAP) including arteriovenous fistula (AVF) after partial nephrectomy screened by early postoperative contrast-enhanced CT (CE-CT). Materials and methods Eighty-two patients (7.0%) who underwent TAE after partial nephrectomy were reviewed, from 1166 partial nephrectomies performed over 6 years. In 18 patients (22.0%), TAE was performed emergently on the median postoperative day (POD) seven. In the remaining patients, elective TAE was performed on the median POD six for RAP detected by early postoperative CE-CT or that emerged on follow-up CE-CT. Results In one patient (1.2%), TAE was performed twice because one of two RAPs could not be embolized during the first TAE, being successfully embolized at the second TAE after readmission with hematuria. Otherwise, no bleeding recurrence or RAPs were observed during the median 1354 follow-up days. Thus, the primary and secondary success rates of TAE were 98.8% (81 of 82 patients) and 100% (82 of 82 patients), respectively. On angiography, the average number of lesions was 1.7 ± 0.9 and the average RAP size was 12.8 ± 6.0 mm. The shapes of the lesions varied: oval-round 60, oval-round + AVF 36, irregular + AVF 14, AVF 12, irregular 10, disruption 4, and extravasation 3. No major complications were observed. The median inpatient days after TAE were two. No estimated glomerular filtration rate deterioration was observed (64.6 ± 18.6 vs. 64.2 ± 18.4 mL/min/1.73 m2, p = 0.902). Conclusion TAE is largely effective and safe for treating bleedings or RAPs, including AVFs, after partial nephrectomy, as screened by early postoperative CE-CT.

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