Juniper Publishers Journal of Cardiology and Cardiovascular Therapy

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Abstract Background: Surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR) have been shown to improve symptoms and overall survival in patients with severe, symptomatic aortic stenosis (AS). However, there still remains a group of patients not considered as appropriate candidates due to comorbid conditions and/or hemodynamic instability. The purpose of this study is to evaluate the in-hospital mortality of this high risk group undergoing BAV. Methods: An institutional BAV registry was created to compare baseline clinical characteristics with treatment outcomes and its associations with in-hospital mortality. Univariate analyses for continuous variables were performed with analysis of variance and Mann Whitney tests. Univariate analyses for categorical variables were preformed with Pearson chi square and Fischer’s exact test. Multivariate logistic regre...

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY   Introduction An estimated 5.1 million Americans ≥20 years of age have heart failure. By 2030, the prevalence of HF is believed to increase by 25% [1]. The International Society for Heart and Lung Transplantation (ISHLT) registers upto 3,500-4,000 heart transplants worldwide every year. The number of transplants done annually have been quite static over last 20 years despite the growing heart failure population. The shortage of donor hearts has clearly limited the number of heart transplantations [2]. This disparity in organ (heart) demand and the ever increasing shortage of donors has led to a need to expand the donor eligibility criteria. This has led to accepting the donor organs from remote places, with the anticipated prolonged ischemic times. Although donor ischemic times up to 4-5 hours are generally acceptable, the benefits of ischemic times in excess of 240-300 minutes are sti...

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY   Introduction Fibromuscular dysplasia (FMD) is a condition predominantly affecting the renal and cervicocranial arteries. Isolated involvement of the iliac arteries is a rare manifestation of this disease. We describe a case of incidentally detected left external iliac artery fibromuscular dysplasia in a 53 year old female. Case Report A 53 year old female was referred for computed tomography (CT) angiogram of the abdomen and pelvis to evaluate the deep inferior epigastric artery perforators prior to breast reconstruction surgery. (Figure 1A & 1B). The CT angiogram revealed a beaded appearance of the left external iliac artery. There was no significant stenosis or aneurysm of the artery. The remaining major arteries of the abdomen showed normal appearance. A diagnosis of isolated left external iliac artery fibromuscular dysplasia was made. As the patient was...

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY   Abstract Acquired factor V inhibitor is a rare cause of factor V deficiency, with an overall good prognosis even if the clinical spectrum varies widely. Due to the rarity of the disease, there is scarce information on treatment that is mainly based on immunosuppressive agents. Recently, the use of the anti-CD20 monoclonal antibody rituximab has been associated with a good clinical efficacy in the few reported cases. We describe here the case of a 78 year-old woman with a mesenchimal pleural neoplasm, who developed a mild bleeding diathesis with severe prolongation of prothrombin time and activated partial thromboplastin time due to the presence of acquired factor V inhibitor. Immunosuppressive treatment with prednisone, cyclophosphamide and rituximab failed to correct coagulopathy. Notwithstanding the severe prolongation of basal coagulation tests and of Factor V deficiency, the patie...

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Abstract Acute aortic syndrome (AAS) describes emergency aortic diseases. In 80% of patients, the AAS presents itself as an Acute Dissection of Aorta (ADA). It’s worth pointing out that the traumatic etiology of this condition has great relevance regarding morbidity and mortality. This is fact that the Traumatic Thoracic Aortic Dissection (TTAD), usually occurs from a contuse injury, product of an abrupt deceleration, especially in men and individuals with overweight or obesity, which have a history of smoking and heart surgeries. Early diagnosis of ADA is indispensable, since patients who arrive alive at the hospital, have high probability of death in a short period of time if not treated properly, especially those who have been victims of some traumatic event earlier. In this context, the endovascular approach has become the treatment of choice for acute surgical emergencies involving the...