scholarly journals Pulsation of catheter during coronary angiography: Is it a sign of severe aortic regurgitation?

2021 ◽  
Author(s):  
Muzaffer Kahyaoglu ◽  
Cetin Gecmen ◽  
Ozkan Candan
Keyword(s):  
Coronary Angiography ◽  
Aortic Regurgitation ◽  
Ascending Aorta ◽  
Severe Aortic Regurgitation ◽  
Sternal Border ◽  
Diastolic Murmur ◽  
The Right ◽  
Diagnostic Catheter ◽  
Physical Findings ◽  
Flow Reversals

AbstractA 48-year-old male patient was admitted to our outpatient clinic with complaints of shortness of breath. He also had a holo-diastolic murmur at the right sternal border and an apical impulse being displaced laterally and inferiorly. Transthoracic echocardiography showed a severe aortic regurgitation without aortic valve stenosis and a mildly dilated left ventricle accompanied by an ejection fraction of 55%. The aortic regurgitation jet was eccentric and there were significant holodiastolic flow reversals in the descending thoracic aorta. Surgical management was advised for this patient because of symptomatic severe aortic regurgitation. Then, the patient underwent preoperative coronary angiography through the right femoral artery route. The left coronary ostium could be engaged with a 6 Fr Judkins left diagnostic catheter; however, the catheter jumped through the ascending aorta. Afterwards, the catheter was engaged and again jumped through the ascending aorta. Engagement and jumping cycles observed between successive systole to diastole. In our opinion, this catheter movement is explained by wide pulse pressure, like the severe characteristic physical findings of severe aortic regurgitation. Further studies are needed to understand whether this catheter movement is angiographically evidence of severe aortic regurgitation.

The Art of the Clinician

2021 ◽  
Vol 6 (09) ◽  
pp. 612-615
Author(s):  
Rodríguez-Guerra, Miguel, MD ◽  
Pandey, Neelanjana MD ◽  
Shrestha, Elina, MD ◽  
Vittorio, Timothy J. MD
Keyword(s):  
Correct Diagnosis ◽  
Critical Time ◽  
Mitral Valve Regurgitation ◽  
Intercostal Space ◽  
Av Fistula ◽  
Severe Aortic Regurgitation ◽  
Fibrin Sheath ◽  
Diastolic Murmur ◽  
Small Perforation ◽  
The Right

Background: The promotion of clinical abilities could represent a significant factor leading the clinicians to in making the correct diagnosis in a timely matter. Case: Our patient is a 42-year-old African male with a history of Hypertension, ESRD on hemodialysis via right-sided Permcath (PC), Mastoidectomy & Right ear surgery due to trauma in childhood, AV Fistula (Needed intervention 4 times) in left upper extremity, admitted due to witnessed seizures in the setting of hypertensive emergency. The patient denied family history and toxic habits. While the patient was at the emergency room, CT head revealed stable curvilinear hyper-attenuation thought to be a thrombosed developmental vein more likely than small subarachnoid hemorrhage. He was loaded with levetiracetam, received Ativan 1mg IV and HD done as per Nephrology. The patient was transferred to the floor he was not in acute distress and was asymptomatic, the cardiovascular (CV) examination showed regular pulse, normal S1, S2, S4+ appreciated with 2/4 diastolic murmur at second right intercostal space (ICS); 2/6 pansystolic murmur at third right intercostal space left parasternal border (LPSB) radiated to the right parasternal border (RPSB) and right mid-clavicular line (MCL); 3/6 systolic murmur at 5LICS MCL radiated to the posterior axillar line (PAL). Point of maximal impulse (PMI) displaced to mid axillar line (MAL). Parasternal heave present; the neurological exam was preserved. Endocarditis was suspected and echocardiogram was expedited, it showed severe aortic regurgitation, 1.60cm x 1.68cm mass in the tip of the catheter in the right atrium, possible vegetation in the tricuspid valve with mild regurgitation, moderate mitral valve regurgitation. Later, staphylococcus epidermidis was identified in blood cultures twice, as well as the culture from the PC. The transesophageal echocardiogram found 2.41 X 0.62 cm mass appears to be a fibrin sheath, possibly remnant of a prior catheter, small perforation in the non-coronary cusp likely in the setting of healed endocarditis. Infectious disease onboard for antibiotic management. Conclusion: The art of the clinician goes beyond the available technology; it could prevent the loss of critical time as well as unnecessary studies, guiding a better assessment and treatment of our patients and potentially improving their outcomes.

scholarly journals Surgical treatment of aneurysms of the ascending aorta associated with severe aortic regurgitation.

Thorax ◽  
1984 ◽  
Vol 39 (4) ◽  
pp. 305-310 ◽  
Author(s):  
M J Antunes ◽  
A L Baptista ◽  
P R Colsen ◽  
R H Kinsley
Keyword(s):  
Surgical Treatment ◽  
Aortic Regurgitation ◽  
Ascending Aorta ◽  
Severe Aortic Regurgitation

scholarly journals SUBAORTIC MEMBRANE;

2017 ◽  
Vol 24 (12) ◽  
pp. 1801-1805
Author(s):  
Tariq Waqar ◽  
Yasir Khan ◽  
Muhammad Usman Riaz
Keyword(s):  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Aortic Insufficiency ◽  
P Value ◽  
Pressure Gradients ◽  
Severe Aortic Regurgitation ◽  
Associated Lesions ◽  
Dacron Patch ◽  
Pace Maker ◽  
The Right

Objectives: In this study, we presented our results regarding outcomes ofsurgical correction of sub-aortic membrane. Study Design: Retrospective observational study.Period: June 2012 to June 2017. Setting: CPEIC Multan, Pakistan. Methods: 51 patientsoperated for resection of sub aortic membrane. The resection of sub aortic membrane wasdone through the aorta. Evaluation of the aortic valve done in all patients. The aortic valve waseither replaced or repaired in cases of severe aortic regurgitation. Associated lesions such asventricular septal defects (VSD’s) were repaired with a dacron patch through the right atriumwhile ASD’s were repaired with a pericardial patch. Post-operative echocardiography was donebefore discharge and post-op LVOT gradients and aortic insufficiency were recorded for allthe patients. Results: There were 36 males and 15 females whose mean ages were 16.29years. On post-op echocardiography there was no residual significant LVOT gradient in anypatient. Three (3) patients developed mild to moderate aortic regurgitation post operativelybut none of them warrant any surgical intervention. There was only 1 death in the series whichwas due to VSD patch dehiscence. None of the patients developed conduction problems postoperatively needing any permanent pace maker. Mean pre-op LVOT gradient was 94.7 mmHgwhile it reduced to 20.7 post operatively (p-value <0.001). Conclusion: We concluded thatearly resection of sub aortic membrane can be safely accomplished with good results andsignificant drop in the mean LVOT pressure gradients post operatively.

Giant-Cell Arteritis Causing Severe Aortic Regurgitation Secondary to Aneurysm of the Ascending Aorta— A Case Report

Angiology ◽  
1987 ◽  
Vol 38 (9) ◽  
pp. 712-716 ◽  
Author(s):  
Niccolo Marchionni ◽  
Mauro Di Bari ◽  
Luigi Ferrucci ◽  
Guya Moschi ◽  
Roberto P. Dabizzi ◽  
...  
Keyword(s):  
Case Report ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Aortic Regurgitation ◽  
Ascending Aorta ◽  
Severe Aortic Regurgitation

Luetic Aneurysm of Ascending Aorta with Aorta-to-Right Atrial Fistula

1997 ◽  
Vol 5 (3) ◽  
pp. 186-187
Author(s):  
Shrivastava Shipra ◽  
Shrivastava Sandeep ◽  
Soman Rema Krishna Manohar
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Aortic Valve ◽  
Ascending Aorta ◽  
Patch Repair ◽  
Right Atrial ◽  
Fistulous Opening ◽  
Direct Closure ◽  
Severe Aortic Regurgitation ◽  
Pulmonary Arterial ◽  
The Right

We report a case of luetic saccular aneurysm of the ascending aorta eroding into the right atrium causing an aorta-to-right atrial fistula. The patient had severe aortic regurgitation, pulmonary arterial hypertension, and congestive cardiac failure. Patch repair of the aneurysm from the aortic side, direct closure of the fistulous opening from the right atrial side, and aortic valve replacement were performed. The patient recovered fully. This case is reported because of its extreme rarity and good surgical result.

Asymptomatic Ascending Aorta Aneurysm With Severe Aortic Regurgitation Caused by Multiple Intimal-Medial Tears Unassociated With Aortic Dissection

2018 ◽  
Vol 121 (5) ◽  
pp. 668-669
Author(s):  
Carlos E. Velasco ◽  
Helen Hashemi ◽  
Christina P. Roullard ◽  
Juan Machannaford ◽  
William C. Roberts
Keyword(s):  
Aortic Dissection ◽  
Aortic Regurgitation ◽  
Ascending Aorta ◽  
Aorta Aneurysm ◽  
Severe Aortic Regurgitation
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