Large Calcified Thrombus Attached to the Eustachian Valve: A Case Report.
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ABSTRACT:
SUBMITTER: Timilsina S
PROVIDER: S-EPMC8236393 | biostudies-literature | 2021 Jun
REPOSITORIES: biostudies-literature
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Large Calcified Thrombus Attached to the Eustachian Valve: A Case Report.
Timilsina Saroj S Dubin Jonathan D JD
CASE (Philadelphia, Pa.) 20210403 3
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Project description: Not available
| S-EPMC10666182 | biostudies-literature
Project description:BackgroundLeft ventricular aneurysms (LVAs) are a well-appreciated complication of acute myocardial infarction. Ventricular aneurysms involving the left ventricle (LV) typically evolve as a result of anterior myocardial infarction and are associated with greater morbidity, complication rates, and hospital resource utilization. Incidence of LVA is decreasing with advent of modern reperfusion therapies; however, in the setting of excess morbidity, clinicians must maintain an appreciation for their appearance to allow timely diagnosis and individualized care.Case summaryThis case report describes the clinical history, investigation, appearance, and management of a patient with calcified apical LVA with history of previous anterior ST-elevation myocardial infarction. The patient was initially admitted for elective coronary angiography in the setting of worsening exertional dyspnoea and subsequently underwent coronary artery bypass graft, aneurysm resection, and LV reconstruction.DiscussionLeft ventricular aneurysms are an uncommon complication experienced in the modern era of acute myocardial infarction and current reperfusion therapies, but remain an important cause of excess morbidity and complication. Evidence-based guidelines for the diagnosis, workup, and subsequent management of LVAs are lacking. The imaging findings presented in this case serve as an important reminder of the appearance of LVAs so that timely diagnosis and individualized care considerations can be made.
| S-EPMC10986394 | biostudies-literature
Project description:BackgroundEustachian valve endocarditis (EVE) is a rare entity that traditionally has been treated with antibiotics or surgery, if refractory to antibiotic treatment.Case summaryA 64-year-old man presented with right shoulder pain and new-onset hypoxia. His blood cultures were positive for methicillin-sensitive staphylococcal aureus (MSSA) 1 month ago and he was treated with antibiotics at that time. Blood cultures during this admission were again positive for MSSA. Trans-oesophageal echocardiogram showed a large independently mobile echogenic density consistent with vegetation (3.0 × 1.6 cm) on the eustachian valve (EV). The patient was a poor surgical candidate due to his multiple co-morbidities, and therefore, a non-invasive procedure called AngioVac® was selected.DiscussionIn the setting of infective endocarditis refractory to antibiotics, the large-bore percutaneous mechanical aspiration (AngioVac®, AngioDynamics, Latham, NY, USA) system is gaining increasing momentum as the treatment of choice over standard surgical intervention for debulking large vegetations. AngioVac® has provided a minimally invasive and effective measure especially in those unable to tolerate surgery. The novel percutaneous technique is linked to great success in right-sided endocarditis, with the tricuspid valve accounting for a majority of the cases. However, in rare instances, the EV may be involved. To our knowledge, we report the first case of EVE treated with AngioVac®.
| S-EPMC10166516 | biostudies-literature
Project description:Calcification of the mitral valve annulus is common in patients on dialysis. The growing number of individuals receiving dialysis has been accompanied by an increase in cases necessitating surgical intervention for mitral valve annulus calcification. In this report, we present a severe case characterized by bulky calcification of the mitral annulus, which was managed with mechanical mitral valve replacement. A 61-year-old man on dialysis presented with chest pain upon exertion that had persisted for 3 months. Cardiac echocardiography revealed severe mitral stenosis and regurgitation, accompanied by cardiac dysfunction. During surgery, an ultrasonic aspiration system was employed to remove the calcification of the mitral valve annulus to the necessary extent. Subsequently, a mechanical mitral valve was sutured into the supra-annular position. To address the regurgitation, the area surrounding the valve was sewn to the wall of the left atrium. Postoperative assessments indicated an absence of perivalvular leak and demonstrated improved cardiac function. The patient was discharged on postoperative day 22. We describe a successful mitral mechanical valve replacement in a case of extensive circumferential mitral annular calcification. Even with severe calcification extending into the left ventricular myocardium, we were able to minimize the decalcification process. This approach enabled the performance of mitral mechanical valve replacement in a high-risk patient on dialysis, thus expanding the possibilities for cardiac surgery.
| S-EPMC11392707 | biostudies-literature
Project description:BackgroundNon-calcified aortic stenosis (AS) is rare and is associated with a high risk of transcatheter valve embolization and migration (TVEM) because aortic valve complex calcification is important for stable anchoring of the prosthesis. Therefore, transcatheter aortic valve implantation (TAVI) for non-calcified AS is not preferred. However, a universally accepted strategy for TAVI in such patients is not yet established.Case summaryA 69-year-old woman with symptomatic severe AS and a high surgical risk was admitted to our institution for TAVI. Pre-procedural computed tomography (CT) revealed a non-calcified bicuspid aortic valve. Implantation of a 23 mm self-expandable valve (SEV) was planned according to the manufacturer's recommended optimal size based on CT measurements. Intraoperatively, the 23 mm SEV did not snugly fit at the aortic apparatus level. Thus, we deployed a 26 mm SEV with stable anchoring because of the stronger radial force. She was discharged without any complication. Echocardiography at 3 months follow-up showed a well-functioning transcatheter heart valve (THV) without migration or paravalvular leakage.DiscussionIn our patient with non-calcified bicuspid AS, an SEV that was one size larger than the optimal as measured on CT was successfully implanted without THV embolization. An upsized SEV may be considered when performing TAVI in patients with severe non-calcified AS.
| S-EPMC9933938 | biostudies-literature
Project description: Not available
| S-EPMC11868307 | biostudies-literature
Project description:Eustachian valve infective endocarditis is rare and mostly affects intravenous drug abusers and those with implanted medical devices or indwelling central venous catheters. The most commonly identified organism is Staphylococcus aureus. Treatment includes intravenous antibiotics for approximately 6 weeks. We present a case of Staphylococcus aureus Eustachian valve endocarditis in an individual without traditional risk factors.
| S-EPMC6793972 | biostudies-literature
Project description:The eustachian valve is an embryological remnant of the inferior vena cava valve that is absent or inconspicuous in the adult. Even when prominent, it is considered to be a benign finding. The present report describes a patient with deep venous thrombosis who had recurrent pulmonary embolism despite thrombolysis and anticoagulation. He was found to have an adherent thrombus on the eustachian valve and his symptoms resolved completely following surgical thrombectomy. The present report highlights that the eustachian valve can, on rare occasions, harbour pathology and can adversely impact the outcomes of coexisting medical problems such as deep venous thrombosis. Infective endocarditis, pulmonary embolism and systemic embolism via a patent foramen ovale are the major complications of eustachian valve pathology. Transesophageal echocardiography appears to be superior to transthoracic echocardiography in identifying eustachian valve pathology and should be considered in all patients with thromboembolism without a known source.
| S-EPMC2807839 | biostudies-literature
Project description:The case is of an 88-year-old female patient with an accidental finding of a large, calcified aneurysm near the cardiac apex. Differential diagnoses can be made with false aneurysms and congenital diverticulums. Imaging modalities beneficial for diagnosing LVA are ultrasound, X-rays, CT, MRI, including PET/CT for oncology patients.
| S-EPMC9314785 | biostudies-literature
Project description:The Eustachian valve (EV) is an embryological remnant of the inferior vena cava that during fetal life helps divert oxygenated blood from the IVC toward the foramen ovale to escape the pulmonary circulation. This remnant usually regresses after birth and is considered a benign finding in the majority of cases. However, EV can lead to complications in the neonatal period or later in life. In this short case series, we present four newborn infants with prominent EV who were symptomatic after birth and required admission to the neonatal intensive care unit.
| S-EPMC4737625 | biostudies-other