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Barrera N, Jou K, Gallegos-Koyner FJ, Chamay S, Garcia MJ, Cerrud-Rodriguez R. Acute Transient Contrast-Induced Neurologic Deficit as a Complication of Percutaneous Coronary Intervention. Tex Heart Inst J 2024; 51:e238353. [PMID: 38715399 PMCID: PMC11076990 DOI: 10.14503/thij-23-8353] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
Acute transient contrast-induced neurologic deficit is an uncommon condition triggered by the administration of intra-arterial contrast during angiography. It can present with encephalopathy, cortical blindness, seizures, or focal deficits. This report describes a patient who presented with severe neurologic deficits after percutaneous coronary intervention, with complete symptom resolution within 72 hours.
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Affiliation(s)
- Nelson Barrera
- Department of Internal Medicine, SBH Health System, Bronx, New York
| | - Katerina Jou
- Department of Internal Medicine, SBH Health System, Bronx, New York
| | | | - Salomon Chamay
- Department of Internal Medicine, SBH Health System, Bronx, New York
| | - Mario J. Garcia
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Bronx, New York
| | - Roberto Cerrud-Rodriguez
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Bronx, New York
- Section of Cardiovascular Medicine, Yale New Haven Hospital, New Haven, Connecticut
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Barrera N, Gallegos F, Chamay S, Cerrud-Rodriguez R. Swimming With Sharks: Left Main Coronary Obstruction Following Transcatheter Aortic Valve Implantation. Cureus 2023; 15:e40514. [PMID: 37461763 PMCID: PMC10350300 DOI: 10.7759/cureus.40514] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 06/15/2023] [Indexed: 07/20/2023] Open
Abstract
Delayed coronary obstruction (DCO) occurs when there is obstruction of the coronary ostia following a transcatheter aortic valvular implantation (TAVI). It is an uncommon but serious complication that often leads to death, usually presents as severe hypotension after TAVI, and should be suspected if migration of the valve occurs. We report the case of a 70-year-old female patient with severe aortic stenosis who underwent TAVI using a 26-mm CoreValve Evolut Pro (Medtronic, Dublin, Ireland). Although the valve was implanted successfully, she experienced hypotension with intermittent ST elevations and had a cardiac arrest shortly after, requiring Advanced Cardiovascular Life Support (ACLS). An aortogram showed sealing of the sinotubular junction (STJ) by CoreValve, without coronary flow. CoreValve was then snared and repositioned in the ascending aorta recovering coronary flow and cardiac pulsatility. A second TAVI was performed and an Edwards 20 mm Sapiens 3 valve (Edwards Lifesciences, Irvine, CA, USA) was implanted as standard procedure.
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Affiliation(s)
- Nelson Barrera
- Division of Internal Medicine, St. Barnabas Hospital Health System, Bronx, USA
| | - Francisco Gallegos
- Division of Internal Medicine, St. Barnabas Hospital Health System, Bronx, USA
| | - Salomon Chamay
- Division of Internal Medicine, St. Barnabas Hospital Health System, Bronx, USA
| | - Roberto Cerrud-Rodriguez
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, USA
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Cerrud-Rodriguez R, Wiley K, Villablanca-Spinetto P, Wiley J. POSTPROCEDURAL MONOTHERAPY WITH ASPIRIN VS DAPT AFTER TAVI - AN UPDATED META-ANALYSIS OF RANDOMIZED, CONTROL TRIALS. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02337-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Castagna F, Cerrud-Rodriguez R, Villela MA, Bortnick AE. SARS-COV-2 infection presenting as ST-elevationmyocardial infarction. Catheter Cardiovasc Interv 2021; 97:E339-E342. [PMID: 32473085 PMCID: PMC7300511 DOI: 10.1002/ccd.28974] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/16/2020] [Accepted: 05/04/2020] [Indexed: 12/15/2022]
Abstract
We describe a patient presenting with chest discomfort, anterolateral ST elevation, and developing acute cardiogenic shock secondary to SARS-COV-2infection-patient zero presenting to our institution's cardiac catheterization laboratory. The emergent presentation with limited clinical information led to exposure of personnel. The diagnosis was complicated by two negative tests for SARS-COV-2, and high-clinical suspicion from the patient's occupational history led to additional testing in order to confirm the diagnosis.
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Affiliation(s)
- Francesco Castagna
- Department of Medicine, Division of Cardiology, Montefiore Health System, Albert Einstein College of Medicine, New York, New York, USA
| | - Roberto Cerrud-Rodriguez
- Department of Medicine, Division of Cardiology, Montefiore Health System, Albert Einstein College of Medicine, New York, New York, USA
| | - Miguel Alvarez Villela
- Department of Medicine, Division of Cardiology, Montefiore Health System, Albert Einstein College of Medicine, New York, New York, USA
| | - Anna E Bortnick
- Department of Medicine, Division of Cardiology, Montefiore Health System, Albert Einstein College of Medicine, New York, New York, USA
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Romero J, Tarantino N, Cerrud-Rodriguez R, Alviz I, Grupposso V, Di Biase L. Segmental left atrial appendage electrical isolation to avoid left phrenic nerve damage. HeartRhythm Case Rep 2019; 5:269-273. [PMID: 31193203 PMCID: PMC6522639 DOI: 10.1016/j.hrcr.2019.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Cerrud-Rodriguez R, Romero J, Garcia M, Natale A, Di Biase L. IS IT SAFE TO DISCONTINUE ORAL ANTICOAGULATION AFTER CATHETER ABLATION OF ATRIAL FIBRILLATION? A SYSTEMATIC REVIEW AND META-ANALYSIS. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)30936-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Romero J, Santangeli P, Pathak RK, Grushko M, Briceno D, Cerrud-Rodriguez R, Quispe R, Grupposo V, Di Biase L. Bundle branch reentrant ventricular tachycardia: review and case presentation. J Interv Card Electrophysiol 2018; 52:385-393. [PMID: 30155771 DOI: 10.1007/s10840-018-0434-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 07/27/2018] [Indexed: 11/24/2022]
Abstract
Bundle branch reentrant ventricular tachycardia (BBRVT) is characterized by a unique, fast (200-300 beats/min), monomorphic wide complex tachycardia (WCT) associated with syncope, hemodynamic compromise, and cardiac arrest. It is challenging to diagnose, requiring a His bundle recording and specific pacing maneuvers. The overall incidence has been reported to be up to 20% among patients with non-ischemic cardiomyopathy (NICM) undergoing electrophysiologic studies. We report a case of BBRVT in a patient with ischemic cardiomyopathy (ICM) presenting as a WCT with recurrent implantable-cardioverter-defibrillator (ICD) shocks. We describe all the characteristic features of BBRVT and discuss its differential. We also discuss the role of ablation for this condition.
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Affiliation(s)
- Jorge Romero
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA
| | - Pasquale Santangeli
- Penn Heart and Vascular Center, Perelman Center for Advanced Medicine, East Pavilion, 2nd Floor, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Rajeev K Pathak
- Canberra Hospital, Australian National University, Canberra, Australia
| | - Michael Grushko
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA
| | - David Briceno
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA
| | - Roberto Cerrud-Rodriguez
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA
| | - Renato Quispe
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA
| | - Vito Grupposo
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA
| | - Luigi Di Biase
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA.
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