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Arora GS, Kaur Gill T. Critical insights into the diagnosis and management of post-myocardial infarction left ventricular aneurysm of the inferior wall: a case report and brief review. Arch Med Sci Atheroscler Dis 2024; 9:e147-e151. [PMID: 39086616 PMCID: PMC11289232 DOI: 10.5114/amsad/189733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 06/06/2024] [Indexed: 08/02/2024] Open
Affiliation(s)
| | - Tanveen Kaur Gill
- Sri Guru Ram Das Institute of Medical Science and Research, Amritsar, India
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2
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Rumbinaitė E, Venckus V, Mamedov A, Jakuškaitė G, Bučius P, Dobilienė O, Žaliūnas R, Jakuška P, Benetis R. Anterior basal left ventricular pseudoaneurysm in a single vessel disease. Perfusion 2024; 39:849-853. [PMID: 36855313 PMCID: PMC11083744 DOI: 10.1177/02676591231160269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
INTRODUCTION Left ventricular pseudoaneurysm is a rare but serious clinicopathologic entity. MATERIALS AND RESULTS This article describes a case report of 51-year-old man who experienced recurrence of chest pain and dyspnea 4 months later after anterior ST elevation myocardial infarction of first diagonal branch. Anterior basal left ventricular pseudoaneurysm was diagnosed and successful surgical treatment was performed. One year after operation, patient has no cardiovascular events and remains in NYHA class II. CONCLUSION Cardiac magnetic resonance should be performed, if there is a suspicion of left ventricular pseudoaneurysm from transthoracic echocardiography. Surgery is the treatment of choice in case of left ventricular pseudoaneuryms because untreated lesions carry a significantly high risk of rupture.
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Affiliation(s)
- Eglė Rumbinaitė
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vilius Venckus
- Department of Cardiac, Thoracic and Vascular Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Arslan Mamedov
- Department of Cardiac, Thoracic and Vascular Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gabrielė Jakuškaitė
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Paulius Bučius
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Olivija Dobilienė
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Remigijus Žaliūnas
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Povilas Jakuška
- Department of Cardiac, Thoracic and Vascular Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rimantas Benetis
- Department of Cardiac, Thoracic and Vascular Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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3
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Lan NS, Slimani E, O’Brien A, Dembo L, Anvardeen K, Lam K. Six-Month Progression of Massive Left Ventricular Pseudoaneurysm. CJC Open 2024; 6:670-671. [PMID: 38708048 PMCID: PMC11065739 DOI: 10.1016/j.cjco.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 01/24/2024] [Indexed: 05/07/2024] Open
Affiliation(s)
- Nick S.R. Lan
- Medical School, The University of Western Australia, Crawley, Perth, Western Australia, Australia
- Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Murdoch, Perth, Western Australia, Australia
- Department of Cardiology, Fiona Stanley Hospital, Murdoch, Perth, Western Australia, Australia
| | - Eric Slimani
- Department of Cardiothoracic Surgery and Transplantation, Fiona Stanley Hospital, Murdoch, Perth, Western Australia, Australia
| | - Aife O’Brien
- Department of Cardiology, Fiona Stanley Hospital, Murdoch, Perth, Western Australia, Australia
| | - Lawrence Dembo
- Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Murdoch, Perth, Western Australia, Australia
- Department of Cardiology, Fiona Stanley Hospital, Murdoch, Perth, Western Australia, Australia
| | - Kalilur Anvardeen
- Department of Cardiology, Fiona Stanley Hospital, Murdoch, Perth, Western Australia, Australia
| | - Kaitlyn Lam
- Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Murdoch, Perth, Western Australia, Australia
- Department of Cardiology, Fiona Stanley Hospital, Murdoch, Perth, Western Australia, Australia
- Medical School, Curtin University, Bentley, Perth, Western Australia, Australia
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Subramanian K, Mahdi R, Singh H, Sood A, Mittal BR. Perfusion defect with characteristic anterior wall indentation on myocardial perfusion imaging caused by a large left ventricular aneurysm. J Nucl Cardiol 2023; 30:2809-2812. [PMID: 36810675 DOI: 10.1007/s12350-023-03223-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 02/23/2023]
Affiliation(s)
- Karthikeyan Subramanian
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Raza Mahdi
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Harpreet Singh
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - Ashwani Sood
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bhagwant Rai Mittal
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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5
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Hu Y, Liu J, Qian J, Lu H, Ge J. Unveiling a rare case: Cardiac rupture secondary to acute occlusion of the distal left circumflex artery detected by contrast-enhanced spiral CT. Heliyon 2023; 9:e18460. [PMID: 37576269 PMCID: PMC10415615 DOI: 10.1016/j.heliyon.2023.e18460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 07/13/2023] [Accepted: 07/18/2023] [Indexed: 08/15/2023] Open
Abstract
A 79-year-old female patient was admitted to the hospital due to intense chest pain. Emergency percutaneous coronary intervention (PCI) revealed an occlusion in the distal portion of the left circumflex artery (LCx). The patient suffered from cardiac rupture, an uncommon yet extremely perilous condition, within 30 minutes following the procedure. This was verified through a computed tomography angiography (CTA) scan and bedside echocardiography. The etiology of cardiac rupture remains elusive, yet potential factors such as the patient's age, gender, initial acute myocardial infarction (AMI), and single-vessel disease without collateral circulation may be linked to this occurrence. This case report emphasizes that occluded tiny distal coronary arteries can also induce cardiac rupture and that a sufficient level of suspicion for the diagnosis of cardiac rupture should be raised when adequate fluid resuscitation fails to alleviate hypotension. Additionally, contrast-enhanced spiral computed tomography (CESCT) is highly effective in revealing certain pathological features associated with cardiac rupture.
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Affiliation(s)
- Yiqing Hu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
- Shanghai Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Junzhen Liu
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Juying Qian
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
- Shanghai Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Hao Lu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
- Shanghai Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
- Shanghai Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
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Tiruneh AG, Bekele A, Asrat Y, Tsegaye Q, Tesfaye W, Bezabih A. Successful repair of left ventricular rupture with pseudoaneurysm: a case report. J Surg Case Rep 2023; 2023:rjad444. [PMID: 37560604 PMCID: PMC10409564 DOI: 10.1093/jscr/rjad444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/18/2023] [Indexed: 08/11/2023] Open
Abstract
Ventricular rupture with pseudoaneurysm is a rare phenomenon that usually occurs after myocardial infarction, previous cardiac surgery and infectious or inflammatory conditions. To prevent rupture of the pseudoaneurysm, urgent repair is recommended. We report successful open surgical repair of a 46-year-old man, who presented with pseudoaneurysm communicating with left ventricle.
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Affiliation(s)
- Abraham G Tiruneh
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Admikew Bekele
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yidnekachew Asrat
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Qaleab Tsegaye
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Workneh Tesfaye
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abebe Bezabih
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Naseerullah FS, Pyle W, Addai T, Murthy A. Left ventricular pseudoaneurysm without antecedent myocardial infarction. J Cardiol Cases 2023. [DOI: 10.1016/j.jccase.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Muscogiuri G, Guaricci AI, Soldato N, Cau R, Saba L, Siena P, Tarsitano MG, Giannetta E, Sala D, Sganzerla P, Gatti M, Faletti R, Senatieri A, Chierchia G, Pontone G, Marra P, Rabbat MG, Sironi S. Multimodality Imaging of Sudden Cardiac Death and Acute Complications in Acute Coronary Syndrome. J Clin Med 2022; 11:jcm11195663. [PMID: 36233531 PMCID: PMC9573273 DOI: 10.3390/jcm11195663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/07/2022] [Accepted: 09/22/2022] [Indexed: 11/23/2022] Open
Abstract
Sudden cardiac death (SCD) is a potentially fatal event usually caused by a cardiac arrhythmia, which is often the result of coronary artery disease (CAD). Up to 80% of patients suffering from SCD have concomitant CAD. Arrhythmic complications may occur in patients with acute coronary syndrome (ACS) before admission, during revascularization procedures, and in hospital intensive care monitoring. In addition, about 20% of patients who survive cardiac arrest develop a transmural myocardial infarction (MI). Prevention of ACS can be evaluated in selected patients using cardiac computed tomography angiography (CCTA), while diagnosis can be depicted using electrocardiography (ECG), and complications can be evaluated with cardiac magnetic resonance (CMR) and echocardiography. CCTA can evaluate plaque, burden of disease, stenosis, and adverse plaque characteristics, in patients with chest pain. ECG and echocardiography are the first-line tests for ACS and are affordable and useful for diagnosis. CMR can evaluate function and the presence of complications after ACS, such as development of ventricular thrombus and presence of myocardial tissue characterization abnormalities that can be the substrate of ventricular arrhythmias.
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Affiliation(s)
- Giuseppe Muscogiuri
- Department of Radiology, Istituto Auxologico Italiano IRCCS, San Luca Hospital, Piazzale Brescia 20, 20149 Milan, Italy
- School of Medicine, University of Milano-Bicocca, 20126 Milan, Italy
- Correspondence:
| | - Andrea Igoren Guaricci
- University Cardiology Unit, Department of Interdisciplinary Medicine, University of Bari, 70121 Bari, Italy
| | - Nicola Soldato
- University Cardiology Unit, Department of Interdisciplinary Medicine, University of Bari, 70121 Bari, Italy
| | - Riccardo Cau
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari-Polo di Monserrato, 09124 Cagliari, Italy
| | - Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari-Polo di Monserrato, 09124 Cagliari, Italy
| | - Paola Siena
- University Cardiology Unit, Department of Interdisciplinary Medicine, University of Bari, 70121 Bari, Italy
| | - Maria Grazia Tarsitano
- Department of Medical and Surgical Science, University Magna Grecia, 88100 Catanzaro, Italy
| | - Elisa Giannetta
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy
| | - Davide Sala
- Department of Cardiac, Neurological and Metabolic Sciences, San Luca Hospital, Istituto Auxologico Italiano IRCCS, 20149 Milan, Italy
| | - Paolo Sganzerla
- Department of Cardiac, Neurological and Metabolic Sciences, San Luca Hospital, Istituto Auxologico Italiano IRCCS, 20149 Milan, Italy
| | - Marco Gatti
- Radiology Unit, Department of Surgical Sciences, University of Turin, 10124 Turin, Italy
| | - Riccardo Faletti
- Radiology Unit, Department of Surgical Sciences, University of Turin, 10124 Turin, Italy
| | - Alberto Senatieri
- School of Medicine, University of Milano-Bicocca, 20126 Milan, Italy
| | | | | | - Paolo Marra
- School of Medicine, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Radiology, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy
| | - Mark G. Rabbat
- Division of Cardiology, Loyola University of Chicago, Chicago, IL 60611, USA
- Edward Hines Jr. VA Hospital, Hines, IL 60141, USA
| | - Sandro Sironi
- School of Medicine, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Radiology, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy
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Jallal H, Belabes S, Khatouri A. Uncommon post-infarction pseudoaneurysms: A case report. World J Cardiol 2022; 14:260-265. [PMID: 35582471 PMCID: PMC9048275 DOI: 10.4330/wjc.v14.i4.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/05/2022] [Accepted: 03/17/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Mechanical complications are a rare presentation in chronic coronary syndromes, which have significantly decreased in the primary coronary intervention era. Incomplete rupture may occur, resulting in pseudoaneurysms (PANs). Early reperfusion decreases the risk of this complication. Echocardiography is the method of choice for diagnosis.
CASE SUMMARY A 54-year-old female hypertensive patient, with a history of non-revascularized inferior and anterior ST-segment elevation myocardial infarction (MI) 4 years prior, was admitted to the cardiac unit of the hospital with complaints of abdominal pain and dyspnea lasting 2 mo. The patient was hemodynamically stable, and 12-lead electrocardiogram showed persistent ST elevation and Q wave in the inferior and apical regions. Transthoracic echocardiogram in the two-chamber view showed a narrow neck of a wide PAN in the distal apical left ventricular inferior wall. In addition, the apical four-chamber and subcostal views revealed a second bulky PAN of the apical wall separated from the first by a common organizing thrombus. Cardiac magnetic resonance imaging confirmed the coexistence of more than one PAN. The patient received conservative medical treatment, and surgery was scheduled for outside the country. The patient had worsening multiple organ failure and died 4 wk after presentation.
CONCLUSION Multifocal PANs rarely occur in chronic MI. Attention should be paid to patients with pain and cardiovascular risk factors.
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Affiliation(s)
- Hamid Jallal
- Department of Cardiology, Military Hospital of Instruction Omar Bongo Ondimba, Libreville 204040, Gabon
| | - Soufiane Belabes
- Department of Radiology, Military Hospital of Instruction Omar Bongo Ondimba, Libreville 20404, Gabon
| | - Ali Khatouri
- Department of Cardiology, Military Hospital Avicenne, University Cadi Ayyad, Marrakech 40000, Morocco
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10
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Left ventricular pseudoaneurysm post primary angioplasty. Coron Artery Dis 2021; 33:337-338. [PMID: 34974495 DOI: 10.1097/mca.0000000000001114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Banisauskaite A, Velavan P, Hasleton J, Mediratta N, Arzanauskaite M, Binukrishnan S. Myocardial rupture and left ventricular pseudoaneurysm due to late STEMI presentation during the COVID-19 pandemic lockdown: a classical case report. EUROPEAN HEART JOURNAL-CASE REPORTS 2021; 5:ytab253. [PMID: 34377907 PMCID: PMC8343434 DOI: 10.1093/ehjcr/ytab253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 03/02/2021] [Accepted: 06/10/2021] [Indexed: 02/07/2023]
Abstract
Background Left ventricular (LV) pseudoaneurysm is a serious and rare complication of myocardial infarction (MI). It occurs when an injured myocardial wall ruptures and is contained by overlying adherent pericardium or scar tissue, most commonly it develops in patients with late presentation of MI and delayed revascularization. Case summary A 64-year-old man presented to the emergency department with intermittent central chest pain radiating to back and neck and increasing on deep inspiration, which was considered to be of musculoskeletal origin for a week, but worsened despite medications. Electrocardiography showed features of ST-elevation MI; a circumflex artery occlusion was found on coronary angiogram and angioplasty was performed. Cardiovascular magnetic resonance (CMR) revealed features of healed lateral wall rupture with adherent parietal pericardium and the patient was managed conservatively. Two months later the patient returned with severe chest pain; echocardiogram and cardiac computed tomography showed significant interval progression of the pseudoaneurysm. Aneurysmectomy was performed, after which the patient recovered and had none of the previous symptoms since. Follow-up CMR study revealed improvement of LV systolic function. Discussion A rare case of post-infarction LV pseudoaneurysm was reported. Multimodality imaging helped to detect and to differentiate this complication from the true aneurysm and to follow it up and plan the treatment. Conservative treatment was not effective in this case as the pseudoaneurysm progressed; aneurysmectomy helped to improve LV systolic function.
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Affiliation(s)
- Audra Banisauskaite
- Radiology Department, Liverpool Heart and Chest Hospital NHS Foundation Trust, Thomas Drive, Liverpool L14 3PE, UK.,Radiology Department, Lithuanian University of Health Sciences, Eivenių str. 2, Kaunas 50161, Lithuania
| | - Periaswamy Velavan
- Cardiology Department, Liverpool Heart and Chest Hospital NHS Foundation Trust, Thomas Drive, Liverpool L14 3PE, UK
| | - Jonathan Hasleton
- Cardiology Department, Liverpool Heart and Chest Hospital NHS Foundation Trust, Thomas Drive, Liverpool L14 3PE, UK
| | - Neeraj Mediratta
- Cardiac Surgery Department, Liverpool Heart and Chest Hospital NHS Foundation Trust, Thomas Drive, Liverpool L14 3PE, UK
| | - Monika Arzanauskaite
- Radiology Department, Liverpool Heart and Chest Hospital NHS Foundation Trust, Thomas Drive, Liverpool L14 3PE, UK.,Cardiovascular Program ICCC - Research Institute Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Carrer de Sant Quintí, 89, 08041 Barcelona, Spain
| | - Sukumaran Binukrishnan
- Radiology Department, Liverpool Heart and Chest Hospital NHS Foundation Trust, Thomas Drive, Liverpool L14 3PE, UK
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