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A 76-year-old man presented with diaphragmatic herniation of the colon that was causing bowel obstruction with gangrene seen on a computed tomography scan and right ventricular (RV) collapse seen on a transthoracic echocardiogram. The patient's condition was successfully managed with emergency robotic colectomy and diaphragmatic hernia repair. His RV function returned to normal, and he had no sign of diaphragmatic herniation recurrence at follow-up or on imaging.
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http://dx.doi.org/10.1016/j.jaccas.2025.103513 | DOI Listing |
J Am Coll Cardiol
September 2025
Service de Médecine Intensive-Réanimation, Institut de Cardiologie, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France; Sorbonne Université, INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, Paris, France.
Background: The hemodynamic effects of femoro-femoral venoarterial (VA) extracorporeal membrane oxygenation (ECMO) on pulmonary capillary wedge pressure (PCWP) remain poorly defined. High ECMO flow is believed to increase PCWP and the risk of pulmonary edema; yet, supporting in vivo physiological data are lacking.
Objectives: The purpose of this study was to evaluate the impact of incremental femoro-femoral VA-ECMO flow variations on PCWP, hemodynamic, and echocardiographic parameters in patients with cardiogenic shock during the early phase of VA-ECMO support, after stabilization.
Eur Heart J
September 2025
Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Venusberg-Campus 1, Bonn 53127, Germany.
Background And Aims: Fulminant myocarditis (FM) is a complex clinical syndrome characterized by acute myocardial inflammation and cardiogenic shock. Evidence on long-term outcomes, mortality risk factors, and targeted treatment options remains limited.
Methods: This retrospective analysis included consecutive adult patients admitted for FM between January 2012 and November 2022 at 26 European tertiary centres.
Eur Heart J Open
September 2025
Calderdale and Huddersfield NHS Foundation Trust, Acre St, Lindley, Huddersfield HD3 3EA, UK.
Aims: Cardiogenic shock remains a significant cause of mortality despite multiple advancements in medical interventions. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides crucial circulatory support but also increases left ventricular (LV) after-load, potentially worsening outcomes. Effective LV unloading strategies can enhance patient survival during VA-ECMO treatment.
View Article and Find Full Text PDFRev Cardiovasc Med
August 2025
Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy.
Harlequin syndrome, also known as differential hypoxia (DH) or North-South syndrome, is a serious complication of femoro-femoral venoarterial extracorporeal membrane oxygenation (V-A ECMO). Moreover, Harlequin syndrome is caused by competing flows between the retrograde oxygenated ECMO output and the anterograde ejection of poorly oxygenated blood from the native heart. In the setting of impaired pulmonary gas exchange, the addition of an Impella device (ECPELLA configuration), although beneficial for ventricular unloading and hemodynamic support, may further exacerbate this competition and precipitate DH.
View Article and Find Full Text PDFJ Interv Card Electrophysiol
September 2025
Federal University of Minas Gerais, R. Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, Brazil.
Background: Chagas heart disease (ChD) is a significant public health concern in Latin America, contributing to a high incidence of sudden cardiac death (SCD). Despite advances in heart failure treatment, management of Chagas cardiomyopathy has not progressed accordingly. While ICDs are effective for primary and secondary prevention in other conditions, patients with ChD often experience more frequent episodes of ventricular tachycardia, and ICD use may provide a negative impact and increase mortality.
View Article and Find Full Text PDF