Successful Surgical Salvage for a Patient with Ruptured Coronary Sinus during Percutaneous Ablation for Atrial Fibrillation: A Case Report

Herein, we describe the rare anatomy of an abnormal shunt from the left atrium to the coronary sinus, which ruptured during a percutaneous ablation for atrial fibrillation. The iatrogenic lesion was successfully repaired after emergent extracorporeal membrane oxygenation set up followed by surgical exploration. The patient’s postoperative course was uneventful, and she was regularly followed up without any complications.

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Abolishment of high-risk left lateral accessory pathway by myocardial infarction: a blessing in disguise? A case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytab050 ◽

2021 ◽

Vol 5 (2) ◽

Author(s):

Jim O’Brien ◽

Nikola Kozhuharov ◽

Shui Hao Chin ◽

Mark Hall

Keyword(s):

Atrial Fibrillation ◽

Acute Coronary Syndrome ◽

Case Report ◽

High Risk ◽

Coronary Sinus ◽

Refractory Period ◽

Accessory Pathway ◽

Coronary Syndrome ◽

Electrophysiology Study ◽

Anomalous Coronary

Abstract Background Antegradely conducting left lateral accessory pathways are a risk for supraventricular tachycardias and pre-excited atrial fibrillation. Rarely, an anomalous coronary sinus can cause difficulty in locating the pathway. The left circumflex coronary artery and obtuse marginal branches supply the posterolateral left ventricle. We describe a case report of a high-risk accessory pathway associated with an anomalous coronary sinus which, between successive electrophysiology studies, was obliterated by a felicitous acute coronary syndrome in the left circumflex territory. Case summary A 49-year-old male with palpitations and manifest pre-excitation was referred for electrophysiology study. Initial study revealed a high-risk left lateral accessory pathway with antegrade effective refractory period of 240 ms and rapidly conducting pre-excited atrial fibrillation. The coronary sinus could not be cannulated to localize the pathway. Coronary angiography and cardiac computed tomography showed an anomalous coronary sinus emptying into the right atrial free wall and patent coronaries. While awaiting repeat electrophysiology study, the patient suffered an acute coronary syndrome with immediate loss of previously visible pre-excitation on electrocardiogram, and underwent stenting of an occluded marginal branch of the circumflex. Repeat electrophysiology study demonstrated a now low-risk accessory pathway (effective refractory period 390 ms). Since infarction, the patient’s palpitations have fully settled with all subsequent electrocardiograms devoid of manifest pre-excitation. Discussion Left lateral accessory pathways, which can associate with an anomalous coronary sinus, derive from tissue similar to normal ventricular myocardium and are vulnerable to ischaemic insults in the area subtended by the circumflex artery.

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First mitral valve replacement using Edwards MITRIS RESILIA mitral valve in a patient with functional mitral regurgitation: a case report

10.22541/au.162275887.76671697/v1 ◽

2021 ◽

Author(s):

Takashi Kakuta ◽

Tomoyuki Fujita ◽

Satoshi Kainuma ◽

Naonori Kawamoto ◽

Naoki Tadokoro ◽

...

Keyword(s):

Atrial Fibrillation ◽

Case Report ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Functional Mitral Regurgitation ◽

Postoperative Course ◽

Structural Valve Deterioration ◽

History Of ◽

Mitral Surgery ◽

Mitral Bioprosthesis

RESILIA tissue expected to prevent structural valve deterioration owing to calcification on leaflets was firstly mounted in a mitral bioprosthesis, named MITRIS RESILIA mitral valve (MITRIS). MITRIS has softer cuff than Magna Mitral Ease and stent posts that deflect to prevent suture looping. A 77-year-old man, having a history of long-standing atrial fibrillation, presented with dyspnea on effort. An echocardiography suggested atrial functional MR. We successfully replaced mitral valve using a 27-mm MITRIS, and his postoperative course was uneventful with good hemodynamics. MITRIS may have advantages for implantability and durability, making it a promising prosthesis for patients requiring mitral surgery.

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Continuous renal replacement therapy and ECMO in COVID patients, a Moroccan case report experience

World Journal of Advanced Research and Reviews ◽

10.30574/wjarr.2021.9.2.0059 ◽

2021 ◽

Vol 9 (2) ◽

pp. 159-162

Author(s):

Younes Oujidi ◽

Imane Melhaoui ◽

Layla Kherroubi ◽

Houssam Bkiyar ◽

Brahim Housni

Keyword(s):

Case Report ◽

Renal Replacement Therapy ◽

Extracorporeal Membrane Oxygenation ◽

Continuous Renal Replacement Therapy ◽

Replacement Therapy ◽

Kidney Failure ◽

Effective Technique ◽

Combination Methods ◽

Refractory Hypoxemia ◽

Set Up

Introduction: Extracorporeal membrane oxygenation (ECMO) is a therapy that ameliorate the oxygenation of hypoxemia refractory patient it could be associated to a kidney failure that necessity a Continuous Renal Replacement Therapy. Case Report: We report the case of a 68-year-old patient, who presents ARDS due to covid infection, during his hospitalisation the patient presented a refractory hypoxemia with the need to set up ECMO, the case worsened with kidney failure with need for CRRT. Conclusion: The association between ECMO and CRRT might be a safe and effective technique. A variety of ECMO and CRRT combination methods can be chosen, this remains an association that should be investigated in order to improve the prognosis of kidney failure on ECMO.

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Stiff Left Atrium Syndrome After Atrial Fibrillation Ablation – A Diagnosis Not To Forget

Journal of Cardiac Arrhythmias ◽

10.24207/jca.v34i3.3457 ◽

2021 ◽

Vol 34 (3) ◽

pp. 120-127

Author(s):

Raul Valerio ◽

Rafael Thiesen Magliari ◽

Alfredo Augusto Eyer Rodrigues ◽

Cristiano de Oliveira Dietrich

Keyword(s):

Atrial Fibrillation ◽

Case Report ◽

Clinical Practice ◽

Cardiac Magnetic Resonance ◽

Pulmonary Veins ◽

Invasive Procedure ◽

Percutaneous Ablation ◽

Recurrence Rates ◽

Important Complication ◽

Consequent Increase

Atrial fibrillation is the most prevalent arrhythmia in clinical practice and has different strategies for its control. Of these strategies, the percutaneous ablation of the pulmonary veins stands out, with robust results in relation to drug treatment. It is an invasive procedure and, therefore, not free from complications, which must be properly diagnosed and treated. Among the possible complications, there is stiff atrium syndrome, characterized by reduced atrial compliance caused by post-ablation fibrosis, which, in turn, leads to atrial filling dysfunction and the consequent increase in atrial and venous capillary pulmonary pressures. The case report demonstrates this infrequent but important complication, which presents good results for clinical treatment, in addition to the contribution of cardiac magnetic resonance in its diagnosis and in the assessment of arrhythmia recurrence rates.

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Spigelian hernia case report and review of literature

International Surgery Journal ◽

10.18203/2349-2902.isj20200839 ◽

2020 ◽

Vol 7 (3) ◽

pp. 880

Author(s):

Saad Slaiki ◽

Amine Hamdane ◽

Hicham El Bouhaddouti ◽

Abdelmalek Ousadden ◽

Khalid Ait Taleb ◽

...

Keyword(s):

Case Report ◽

Literature Review ◽

Obese Patient ◽

Iliac Fossa ◽

Spigelian Hernia ◽

Review Of Literature ◽

Morphological Examination ◽

Surgical Exploration ◽

Postoperative Course ◽

The Right

Spigelian hernia is rare and accounts for less than 0.1% of abdominal wall hernias. It is often diagnosed at the complication stage. Authors report the case of a 48-year-old obese patient who had a painful swelling of the right iliac fossa. Morphological examination data were in favour of a strangled spigelian hernia and surgical exploration had shown a hernial sac with epiploic contents with a narrow collar. It was performed a resection of the retracted epiploon with simple raphy. The postoperative course was uneventful. Diagnostic and therapeutic difficulties are discussed through a literature review.

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Coronary sinus iatrogenic lesion during repeated mitral valve replacement: case report of an immediate transmitral annulus repair

Brazilian Journal of Cardiovascular Surgery ◽

10.1590/s0102-76382003000200013 ◽

2003 ◽

Vol 18 (2) ◽

Author(s):

Paulo R. B. Evora ◽

Paulo J. F. Ribeiro ◽

Antonio C. Menardi ◽

Walter V. A. Vicente ◽

Alfredo J. Rodrigues

Keyword(s):

Case Report ◽

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Coronary Sinus ◽

Iatrogenic Lesion

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Intraparenchymal Epididymal Cyst (IEC) 4 cm in Diameter in a 15-Year Old Male Patient; a Case Report and Review of the Literature

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2017.41 ◽

2016 ◽

Vol 59 (4) ◽

pp. 137-139

Author(s):

Dimitrios Patoulias ◽

Maria Kalogirou ◽

Ioannis Patoulias

Keyword(s):

Case Report ◽

Male Patient ◽

Current Literature ◽

Ultrasound Examination ◽

Outpatient Department ◽

Review Of The Literature ◽

Surgical Exploration ◽

Postoperative Course ◽

The Right

Intraparenchymal epididymal cysts (IECs) are benign cystic formations of the epididymis of unknown pathogenesis, which typically appear in adolescence or adulthood. In patients older than 14 years old their prevalence is doubled. After systematic and thorough research of the current literature, we did not find another case report of intraparenchymal epididymal cyst with similar dimensions. The male patient, 15 years old, visited our outpatient department complaining of pain in the right hemiscrotum. Diagnosis of IEC was confirmed after the conduction of ultrasound examination. Patient underwent surgical exploration of the right hemiscrotum. Resection of the IEC followed. Postoperative course was uneventful, with recession of the symptoms. In our opinion, IECs should be surgically removed, either when they are symptomatic or when they are asymptomatic, but of a diameter greater than 1 cm and without regression tendency.

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