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Pastori P, De Rosa F, Vitali F, Fasulo A, Tortorella G, Pastore M, Malagù M, Bertini M. Interventricular Septal Hematoma Complicating Left Bundle Branch Area Pacing: A Case Report-The Devil Is Not So Black as He Is Painted. J Cardiovasc Dev Dis 2024; 11:52. [PMID: 38392266 PMCID: PMC10889678 DOI: 10.3390/jcdd11020052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 01/26/2024] [Accepted: 01/27/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND This case report outlines the presentation of an emerging complication arising from left bundle branch area pacing (LBBAP). CASE SUMMARY A 43-year-old male with no history of cardiac problems experienced recurrent episodes of syncope with no prodromal symptoms. During monitoring in the emergency department, the patient underwent an episode of asystole, leading to LBBAP implantation. The procedure encountered technical challenges, resulting in an interventricular septal hematoma and subsequent ventricular arrhythmias. Despite initial concerns, conservative management led to resolution, demonstrated through echocardiographic follow-ups. DISCUSSION This report underscores the significance of ventricular arrhythmias as indicators of interventricular septal hematoma, providing insights into its diagnosis, management, and implications for LBBAP procedures.
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Affiliation(s)
- Paolo Pastori
- Cardiology Unit, Ospedale di Fidenza, AUSL di Parma, 43036 Fidenza, Italy
| | - Fabrizio De Rosa
- Cardiology Unit, Ospedale di Fidenza, AUSL di Parma, 43036 Fidenza, Italy
| | - Francesco Vitali
- Cardiology Unit, Sant'Anna University Hospital, Department of Translational Medicine University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
| | - Andrea Fasulo
- Cardiology Unit, Ospedale di Fidenza, AUSL di Parma, 43036 Fidenza, Italy
| | | | - Monica Pastore
- Cardiology Unit, Ospedale di Fidenza, AUSL di Parma, 43036 Fidenza, Italy
| | - Michele Malagù
- Cardiology Unit, Sant'Anna University Hospital, Department of Translational Medicine University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
| | - Matteo Bertini
- Cardiology Unit, Sant'Anna University Hospital, Department of Translational Medicine University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
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Gaibazzi N, Tuttolomondo D, Rabia G, Lorenzoni V, Benatti G, De Rosa F. Standard echocardiography versus very-low mechanical index contrast-imaging: left ventricle volumes and ejection fraction multi-reader variability and reference values in a subgroup with no risk factors or cardiac disease. Heart Vessels 2019; 35:544-554. [PMID: 31531717 DOI: 10.1007/s00380-019-01506-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 09/06/2019] [Indexed: 01/08/2023]
Abstract
We retrospectively assessed the rest-phase images of 300 contrast stress- echocardiograms, during which very-low mechanical index (VLMI) imaging with ultrasound enhancing agents (UEAs) was routinely acquired in addition to greyscale echocardiography; intra- and inter-reader variability for left ventricle (LV) volumes and ejection fraction (LVEF) at rest was established in the overall cohort and normal values were calculated in the subset of subjects with no cardiac risk factors or cardiac disease and a normal stress-echocardiogram. Current recommendations for chamber quantification using echocardiography advise the use of UEAs in case of insufficient quality of endocardial visualization, but normal values for LV volumes and LVEF using UEAs have never been published using currently recommended VLMI method. Single-centre retrospective study, enrolling subjects referred to contrast stress- echocardiography for suspect coronary artery disease, including the acquisition of both standard 2D greyscale and bolus UEAs with VLMI, regardless of the image quality. This enables offline measurement of the LV volumes and LVEF for both greyscale and UEAs-VLMI images at rest in all subjects. Images were allocated to 3 readers in random order. Normal range for LV volumes and LVEF was also derived in a subset of apparently healthy subjects. In the 298 exams finally assessed, measurement variability among the three readers was lower with UEAs-VLMI, in particular for end-systolic volumes (intra-class correlation coefficient for concordance improved from 0.855 to 0.916, for LVEF from 0.68 to 0.783, p < 0.01), intra- observer variability reduced (Lin's correlation coefficient for LVEF from 0.747 to 0.857, p < 0.01). Normal mean indexed LV end-diastolic volume with UEAs-VLMI, compared to greyscale imaging, was + 14 ml/m2, while LVEF was + 5 to + 6% points. This is the largest study specifically addressing UEAs-VLMI imaging and comparing data with standard greyscale imaging; it demonstrates a reduction in measurement variability of LV volumes and LVEF. Normal reference values for VLMI ultrasound are reported for the first time in comparison with greyscale values.
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Affiliation(s)
- Nicola Gaibazzi
- Parma University Hospital, Via Gramsci 14, 43123, Parma, Italy.
| | | | - Granit Rabia
- Parma University Hospital, Via Gramsci 14, 43123, Parma, Italy
| | - Valentina Lorenzoni
- Management Institute, Sant'Anna Scuola Universitaria Superiore Pisa, Piazza Martiri Della Libertà, 33, 56127, Pisa, PI, Italy
| | - Giorgio Benatti
- Parma University Hospital, Via Gramsci 14, 43123, Parma, Italy
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Gaibazzi N, De Rosa F, Palumbo AA, Cicala G, Rabia G. Multimodal imaging for the detection of coronary fistula. Eur Heart J Cardiovasc Imaging 2019; 20:840. [DOI: 10.1093/ehjci/jez016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Nicola Gaibazzi
- Cardiology Department, Parma University Hospital, Via Gramsci 14, Parma, Italy
| | - Fabrizio De Rosa
- Cardiology Department, Parma University Hospital, Via Gramsci 14, Parma, Italy
| | | | - Gloria Cicala
- Radiology Department, Parma University Hospital, Via Gramsci 14, Parma, Italy
| | - Granit Rabia
- Cardiology Department, Parma University Hospital, Via Gramsci 14, Parma, Italy
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Pelà G, De Rosa F, Demola P, Crocamo A, Missale G, Cecchini S, Marchesi F, Visioli F, Silini EM, Roncoroni L. Resolution of late-onset heart and liver failures after reversion of jejuno-ileal bypass: a case report. Scand J Gastroenterol 2018; 53:891-894. [PMID: 29790800 DOI: 10.1080/00365521.2018.1474944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Jejuno-ileal bypass (JIB) was a kind of bariatric surgery performed from 1960s to 1980s, able to induce sustainable weight loss by creating a surgical short bowel syndrome. MATERIALS AND METHODS We report a case of an octogenarian woman who underwent in the early eighties this kind of surgery with consequent 40 kg weight loss. After 27 years, she first developed a reversible metabolic cardiomyopathy that began with signs and symptoms of heart failure. Thereafter, she was diagnosed with severe intractable liver insufficiency. RESULTS Despite her old age, the patient underwent reversal of JIB with consequent early improvement of hepatic function. CONCLUSIONS This case demonstrate that in case of long-term and life-threatening complications, it is possible to successfully reverse JIB surgery after upto 30 years. The hypothesis on pathophysiology of heart and liver insufficiency are discussed.
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Affiliation(s)
- Giovanna Pelà
- a Department of Medicine and Surgery , University Hospital of Parma , Parma , Italy
| | - Fabrizio De Rosa
- a Department of Medicine and Surgery , University Hospital of Parma , Parma , Italy
| | - Pierluigi Demola
- a Department of Medicine and Surgery , University Hospital of Parma , Parma , Italy
| | - Antonio Crocamo
- a Department of Medicine and Surgery , University Hospital of Parma , Parma , Italy
| | - Gabriele Missale
- b Unit of Hepatology , University Hospital of Parma , Parma , Italy
| | - Stefano Cecchini
- c Unit of Surgery , University Hospital of Parma , Parma , Italy
| | | | - Francesco Visioli
- d Department of Molecular Medicine , University of Padova , Padova , Italy.,e CEI UAM CSIC, IMDEA FOOD, Ctra Canto Blanco , Madrid , Spain
| | | | - Luigi Roncoroni
- c Unit of Surgery , University Hospital of Parma , Parma , Italy
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