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Background: We present a case of left ventricular perforation and delayed cardiac tamponade after transcatheter aortic valve implantation (TAVI) managed percutaneously. This report describes a novel technique for management of left ventricular perforation after TAVI.
Case Summary: We performed elective transfemoral TAVI in a frail 85-year-old lady. Anatomical challenges included tortuous and horizontal aorta and a small left ventricular cavity. A 23-mm Sapien valve was implanted. She developed cardiac tamponade the next day needing emergency pericardiocentesis. Left ventricular angiogram showed perforation of the lateral wall. SURGIFLO Hemostatic Matrix was injected into the pericardial space using Agilis steerable introducer with a good outcome.
Discussion: Cardiac perforation and tamponade are serious and potentially fatal complications after TAVI. The outcomes in these patients remain poor with high mortality rate even with emergent cardiac surgery. This report describes a novel technique for management of left ventricular perforation after TAVI.
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http://dx.doi.org/10.1016/j.jaccas.2024.103193 | DOI Listing |
Ann Am Thorac Soc
September 2025
Brigham and Women's Hospital, Division of Sleep and Circadian Disorders, Boston, Massachusetts, United States.
Rationale: There are insufficient data to inform the management of central sleep apnea (CSA) in patients with heart failure (HF) with reduced ejection fraction (HFrEF). Nocturnal oxygen therapy (NOT) has been postulated to benefit CSA patients with HFrEF, but has not been rigorously studied. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.
View Article and Find Full Text PDFAm J Physiol Heart Circ Physiol
September 2025
Department of Medical Pharmacology and Physiology, School of Medicine, University of Missouri.
The sarcomeric protein cardiac myosin binding protein-C (cMyBP-C) binds myosin on thick filaments and regulates cardiac myocyte contraction. Our lab has reported that permeabilized cardiac myocytes lacking cMyBP-C generate greater power and show disproportionately fast sarcomere shortening velocities at high loads. Also, high resolution X-ray diffraction of cardiac trabeculae found that myosin cross-bridges in the cMyBP-C zone are the most active during loaded contractions.
View Article and Find Full Text PDFJAMA Cardiol
September 2025
Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, New York.
Importance: Transthyretin cardiac amyloidosis (ATTR-CA) is an underdiagnosed but treatable cause of heart failure (HF) in older individuals that occurs in the context of normal wild-type (ATTRwt-CA) or an abnormal inherited (ATTRv-CA) TTR gene variant. While the most common inherited TTR variant, V142I, occurs in 3% to 4% of self-identified Black Americans and is associated with excess morbidity and mortality, the prevalence of ATTR-CA in this at-risk population is unknown.
Objective: To define the prevalence of ATTR-CA and proportions attributable to ATTRwt-CA or ATTRv-CA among older Black and Caribbean Hispanic individuals with HF.
JACC Case Rep
September 2025
Cardiovascular Division, Department of Medicine, Froedtert and Medical College of Wisconsin, Milwaukee, Wisconsin, USA. Electronic address:
Baroreflex activation therapy (BAT) improves functional status, quality of life, and exercise capacity in patients with heart failure with reduced ejection fraction; however, its direct effects on reversing adverse cardiac remodeling as assessed by improvements in cardiac structure, function, and coupling with the arterial system remain unclear. We present 2 cases of patients who initially presented with decompensated heart failure, and despite initial medical therapy and continued outpatient follow-up, were unable to tolerate full escalation of guideline-directed medical therapy. The patients remained symptomatic, with high biomarker levels, poor functional capacity, severe heart failure symptoms, and objectively had decreased stroke volume, low left ventricular ejection fraction, and high left ventricular mass.
View Article and Find Full Text PDFExpert Rev Med Devices
September 2025
Rutgers University, New Brunswick, NJ, USA.