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Kassimis G, Theodoropoulos KC, Didagelos M, Zegkos T, Fragakis N, Hadjimiltiades S, Ziakas A. Rotablation-assisted percutaneous coronary intervention and deferred intravascular lithotripsy: Facilitated stenting in a young STEMI patient with familial hypercholesterolemia. Kardiol Pol 2023; 81:934-936. [PMID: 37489828 DOI: 10.33963/kp.a2023.0160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 07/17/2023] [Indexed: 07/26/2023]
Affiliation(s)
- George Kassimis
- 2nd Department of Cardiology, Hippokration Hospital, Medical School, Aristotle University of Thessaloniki, Greece.
- 1st Department of Cardiology, AHEPA General Hospital, Aristotle University of Thessaloniki, Greece.
- St. Luke's Hospital, Thessaloniki, Greece.
| | | | - Matthaios Didagelos
- 1st Department of Cardiology, AHEPA General Hospital, Aristotle University of Thessaloniki, Greece
| | - Thomas Zegkos
- 1st Department of Cardiology, AHEPA General Hospital, Aristotle University of Thessaloniki, Greece
| | - Nikolaos Fragakis
- 2nd Department of Cardiology, Hippokration Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | | | - Antonios Ziakas
- 1st Department of Cardiology, AHEPA General Hospital, Aristotle University of Thessaloniki, Greece
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Rampidis GP, Kampaktsis PΝ, Kouskouras K, Samaras A, Benetos G, Giannopoulos AΑ, Karamitsos T, Kallifatidis A, Samaras A, Vogiatzis I, Hadjimiltiades S, Ziakas A, Buechel RR, Gebhard C, Smilowitz NR, Toutouzas K, Tsioufis K, Prassopoulos P, Karvounis H, Reynolds H, Giannakoulas G. Role of cardiac CT in the diagnostic evaluation and risk stratification of patients with myocardial infarction and non-obstructive coronary arteries (MINOCA): rationale and design of the MINOCA-GR study. BMJ Open 2022; 12:e054698. [PMID: 35110321 PMCID: PMC8811605 DOI: 10.1136/bmjopen-2021-054698] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Myocardial infarction with non-obstructive coronary arteries (MINOCA) occurs in 5%-15% of all patients with acute myocardial infarction. Cardiac MR (CMR) and optical coherence tomography have been used to identify the underlying pathophysiological mechanism in MINOCA. The role of cardiac CT angiography (CCTA) in patients with MINOCA, however, has not been well studied so far. CCTA can be used to assess atherosclerotic plaque volume, vulnerable plaque characteristics as well as pericoronary fat tissue attenuation, which has not been yet studied in MINOCA. METHODS AND ANALYSIS MINOCA-GR is a prospective, multicentre, observational cohort study based on a national registry that will use CCTA in combination with CMR and invasive coronary angiography (ICA) to evaluate the extent and characteristics of coronary atherosclerosis and its correlation with pericoronary fat attenuation in patients with MINOCA. A total of 60 consecutive adult patients across 4 participating study sites are expected to be enrolled. Following ICA and CMR, patients will undergo CCTA during index hospitalisation. The primary endpoints are quantification of extent and severity of coronary atherosclerosis, description of high-risk plaque features and attenuation profiling of pericoronary fat tissue around all three major epicardial coronary arteries in relation to CMR. Follow-up CCTA for the evaluation of changes in pericoronary fat attenuation will also be performed. MINOCA-GR aims to be the first study to explore the role of CCTA in combination with CMR and ICA in the underlying pathophysiological mechanisms and assisting in diagnostic evaluation and prognosis of patients with MINOCA. ETHICS AND DISSEMINATION The study protocol has been approved by the institutional review board/independent ethics committee at each site prior to study commencement. All patients will provide written informed consent. Results will be disseminated at national meetings and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT4186676.
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Affiliation(s)
- Georgios P Rampidis
- First Department of Cardiology, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
- Cardiac Imaging Unit, Diagnostic Center "PANAGIA", Veroia, Greece
| | | | - Konstantinos Kouskouras
- Department of Radiology, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
| | - Athanasios Samaras
- First Department of Cardiology, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
| | - Georgios Benetos
- First Department of Cardiology, Hippokration Hospital, Athens, Greece
| | - Andreas Α Giannopoulos
- Department of Nuclear Medicine - Cardiac Imaging Unit, University Hospital Zurich, Zurich, Switzerland
| | - Theodoros Karamitsos
- First Department of Cardiology, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
| | | | - Antonios Samaras
- Department of Cardiology, General Hospital of Veroia, Veroia, Greece
| | - Ioannis Vogiatzis
- Department of Cardiology, General Hospital of Veroia, Veroia, Greece
| | - Stavros Hadjimiltiades
- First Department of Cardiology, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
| | - Antonios Ziakas
- First Department of Cardiology, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
| | - Ronny R Buechel
- Department of Nuclear Medicine - Cardiac Imaging Unit, University Hospital Zurich, Zurich, Switzerland
| | - Catherine Gebhard
- Department of Nuclear Medicine - Cardiac Imaging Unit, University Hospital Zurich, Zurich, Switzerland
| | | | | | | | - Panagiotis Prassopoulos
- Department of Radiology, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
| | - Haralambos Karvounis
- First Department of Cardiology, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
| | - Harmony Reynolds
- Sarah Ross Soter Center for Women's Cardiovascular Research, Leon H. Charney Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, New York, New York, USA
| | - George Giannakoulas
- First Department of Cardiology, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
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Karali K, Makedou K, Kallifatidis A, Didagelos M, Giannakoulas G, Davos CH, Karamitsos TD, Ziakas A, Karvounis H, Hadjimiltiades S. The Interplay between Myocardial Fibrosis, Strain Imaging and Collagen Biomarkers in Adults with Repaired Tetralogy of Fallot. Diagnostics (Basel) 2021; 11:diagnostics11112101. [PMID: 34829449 PMCID: PMC8621125 DOI: 10.3390/diagnostics11112101] [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] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/07/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022] Open
Abstract
Background: We sought to assess the interplay between right ventricle (RV) fibrosis, biventricular dysfunction based on global longitudinal strain (GLS) analysis, and biomarkers such as Galectin-3 (Gal-3), procollagen type III (PCIII), and NTproBNP. Methods: We studied 35 adult patients with rToF. All patients underwent a cardiac magnetic resonance (CMR) scan including feature tracking for deformation imaging. Blood biomarkers were measured. Results: LGE RV was detected in all patients, mainly at surgical sites. Patients with the highest RV LGE scoring had greater RV dilatation and dysfunction whereas left ventricular (LV) function was preserved. LV GLS correlated with RV total fibrosis score (p = 0.007). A LV GLS value of −15.9% predicted LGE RV score > 8 (AUC 0.754 (p = 0.02)). Neither RV GLS nor biomarker levels were correlated with the extent of RV fibrosis. A cut-off value for NTproBNP of 145.25 pg/mL predicted LGE RV score > 8 points (AUC 0.729, (p = 0.03)). A cut-off value for Gal-3 of 7.42 ng/mL predicted PR Fraction > 20% [AUC 0.704, (p = 0.05)]. Conclusions: A significant extent of RV fibrosis was mainly detected at surgical sites of RV, affecting RV performance. CMR-FT reveals subtle LV dysfunction in rToF patients, due to decreased performance of the fibrotic RV. Impaired LV function and elevated NTproBNP in rToF reflect a dysfunctional fibrotic RV.
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Affiliation(s)
- Konstantina Karali
- First Department of Cardiology, AHEPA Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, St. Kyriakidi 1, 54636 Thessaloniki, Greece; (M.D.); (G.G.); (T.D.K.); (A.Z.); (H.K.); (S.H.)
- Correspondence: ; Tel.: +30-6945543674 or +30-23102553558
| | - Kali Makedou
- Laboratory of Biochemistry, AHEPA General Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, St. Kyriakidi 1, 54636 Thessaloniki, Greece;
| | - Alexandros Kallifatidis
- Department of Radiology, Cardiovascular Imaging Unit, St. Luke’s Hospital, 55236 Thessaloniki, Greece;
| | - Matthaios Didagelos
- First Department of Cardiology, AHEPA Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, St. Kyriakidi 1, 54636 Thessaloniki, Greece; (M.D.); (G.G.); (T.D.K.); (A.Z.); (H.K.); (S.H.)
| | - George Giannakoulas
- First Department of Cardiology, AHEPA Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, St. Kyriakidi 1, 54636 Thessaloniki, Greece; (M.D.); (G.G.); (T.D.K.); (A.Z.); (H.K.); (S.H.)
| | - Constantinos H. Davos
- Cardiovascular Research Laboratory, Biomedical Research Foundation, Academy of Athens, 11527 Athens, Greece;
| | - Theodoros D. Karamitsos
- First Department of Cardiology, AHEPA Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, St. Kyriakidi 1, 54636 Thessaloniki, Greece; (M.D.); (G.G.); (T.D.K.); (A.Z.); (H.K.); (S.H.)
| | - Antonios Ziakas
- First Department of Cardiology, AHEPA Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, St. Kyriakidi 1, 54636 Thessaloniki, Greece; (M.D.); (G.G.); (T.D.K.); (A.Z.); (H.K.); (S.H.)
| | - Haralambos Karvounis
- First Department of Cardiology, AHEPA Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, St. Kyriakidi 1, 54636 Thessaloniki, Greece; (M.D.); (G.G.); (T.D.K.); (A.Z.); (H.K.); (S.H.)
| | - Stavros Hadjimiltiades
- First Department of Cardiology, AHEPA Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, St. Kyriakidi 1, 54636 Thessaloniki, Greece; (M.D.); (G.G.); (T.D.K.); (A.Z.); (H.K.); (S.H.)
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Kassimis G, Ziakas A, Didagelos M, Theodoropoulos KC, Hadjimiltiades S. How Should I Get Prepared for and Treat Rota Burr Entrapment in a Focally Underexpanded and Restenosed Stent: A Case Report. Cardiovasc Revasc Med 2021; 28S:197-200. [PMID: 34031007 DOI: 10.1016/j.carrev.2021.05.007] [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: 02/19/2021] [Revised: 05/07/2021] [Accepted: 05/11/2021] [Indexed: 10/21/2022]
Abstract
Although high-speed rotational atherectomy has been successfully used in selected cases of stent underexpansion secondary to heavy peri-stent calcification, a higher risk of burr entrapment demands extreme caution and surgical back-up on site. The main cause of this complication is the lack of diamond dust on the back end of the burr, which prevents backward ablation of tissues when retracted. To date, only few reports of successful burr retrieval using percutaneous bailout techniques have been published. We report a case of burr entrapment within a previously implanted left circumflex artery stent which was successfully recaptured using the dual catheter technique; following the retrieval the patient underwent routine percutaneous coronary intervention.
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Affiliation(s)
- George Kassimis
- First Cardiology Department, University General Hospital AHEPA, Aristotle University of Thessaloniki, Thessaloniki, Greece; Second Cardiology Department, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Antonios Ziakas
- First Cardiology Department, University General Hospital AHEPA, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Matthaios Didagelos
- First Cardiology Department, University General Hospital AHEPA, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos C Theodoropoulos
- First Cardiology Department, University General Hospital AHEPA, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavros Hadjimiltiades
- First Cardiology Department, University General Hospital AHEPA, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Karagiannidis E, Papazoglou AS, Sofidis G, Chatzinikolaou E, Keklikoglou K, Panteris E, Kartas A, Stalikas N, Zegkos T, Girtovitis F, Moysidis DV, Stefanopoulos L, Koupidis K, Hadjimiltiades S, Giannakoulas G, Arvanitidis C, Michaelson JS, Karvounis H, Sianos G. Micro-CT-Based Quantification of Extracted Thrombus Burden Characteristics and Association With Angiographic Outcomes in Patients With ST-Elevation Myocardial Infarction: The QUEST-STEMI Study. Front Cardiovasc Med 2021; 8:646064. [PMID: 33969012 PMCID: PMC8096895 DOI: 10.3389/fcvm.2021.646064] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 02/22/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Angiographic detection of thrombus in STEMI is associated with adverse outcomes. However, routine thrombus aspiration failed to demonstrate the anticipated benefit. Hence, management of high coronary thrombus burden remains challenging. We sought to assess for the first time extracted thrombotic material characteristics utilizing micro-computed tomography (micro-CT). Methods: One hundred thirteen STEMI patients undergoing thrombus aspiration were enrolled. Micro-CT was undertaken to quantify retrieved thrombus volume, surface, and density. Correlation of these indices with angiographic and electrocardiographic outcomes was performed. Results: Mean aspirated thrombus volume, surface, and density (±standard deviation) were 15.71 ± 20.10 mm3, 302.89 ± 692.54 mm2, and 3139.04 ± 901.88 Hounsfield units, respectively. Aspirated volume and surface were significantly higher (p < 0.001) in patients with higher angiographic thrombus burden. After multivariable analysis, independent predictors for thrombus volume were reference vessel diameter (RVD) (p = 0.011), right coronary artery (RCA) (p = 0.039), and smoking (p = 0.027), whereas RVD (p = 0.018) and RCA (p = 0.019) were predictive for thrombus surface. Thrombus volume and surface were independently associated with distal embolization (p = 0.007 and p = 0.028, respectively), no-reflow phenomenon (p = 0.002 and p = 0.006, respectively), and angiographically evident residual thrombus (p = 0.007 and p = 0.002, respectively). Higher thrombus density was correlated with worse pre-procedural TIMI flow (p < 0.001). Patients with higher aspirated volume and surface developed less ST resolution (p = 0.042 and p = 0.023, respectively). Conclusions: Angiographic outcomes linked with worse prognosis were more frequent among patients with larger extracted thrombus. Despite retrieving larger thrombus load in these patients, current thrombectomy devices fail to deal with thrombotic material adequately. Further studies of novel thrombus aspiration technologies are warranted to improve patient outcomes. Clinical Trial Registration: QUEST-STEMI trial ClinicalTrials.gov number: NCT03429608 Date of registration: February 12, 2018. The study was prospectively registered.
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Affiliation(s)
- Efstratios Karagiannidis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas S Papazoglou
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios Sofidis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evangelia Chatzinikolaou
- Hellenic Centre for Marine Research, Institute of Marine Biology, Biotechnology, and Aquaculture, Heraklion, Greece
| | - Kleoniki Keklikoglou
- Hellenic Centre for Marine Research, Institute of Marine Biology, Biotechnology, and Aquaculture, Heraklion, Greece.,Biology Department, University of Crete, Heraklion, Greece
| | - Eleftherios Panteris
- Laboratory of Forensic Medicine and Toxicology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasios Kartas
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Stalikas
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Thomas Zegkos
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Dimitrios V Moysidis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Leandros Stefanopoulos
- Lab of Computing, Medical Informatics, and Biomedical Imaging Technologies, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kleanthis Koupidis
- School of Mathematics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavros Hadjimiltiades
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George Giannakoulas
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Arvanitidis
- Hellenic Centre for Marine Research, Institute of Marine Biology, Biotechnology, and Aquaculture, Heraklion, Greece.,LifeWatch ERIC, Sector II-II, Seville, Spain
| | - James S Michaelson
- Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Haralambos Karvounis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios Sianos
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Tziatzios GD, Didagelos M, Tziatzios I, Hadjimiltiades S, Karamitsos T. Torsades de Pointes and Prolonged Self-Terminating Ventricular Fibrillation Induced by Amiodarone. Cureus 2020; 12:e11693. [PMID: 33391927 PMCID: PMC7769795 DOI: 10.7759/cureus.11693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
A 71-year-old man with a recent diagnosis of pneumonia developed paroxysmal atrial fibrillation and was admitted to the cardiology service. Amiodarone was administered intravenously to restore sinus rhythm. Significant prolongation of the QT interval (QTc = 640ms) was noted and an exceedingly prolonged (over 3 minutes), self-terminating, episode of ventricular flutter/fibrillation occurred during bedside monitoring. The event was terminated without first converting to a more organized ventricular rhythm and without any adverse neurological sequelae. Apart from the long duration of ventricular fibrillation and its spontaneous termination, our case highlights the importance of the continuous heart rhythm monitoring in patients with extreme QT interval prolongation.
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Savvoulidis P, Kalogeropoulos AP, Raptis V, Rafailidis V, Georgianos PI, Balaskas EV, Kouskouras K, Karvounis H, Hadjimiltiades S. Calcification of coronary arteries and aortic valve and circulating a-klotho levels in patients with chronic kidney disease. J Thorac Dis 2020; 12:431-437. [PMID: 32274109 PMCID: PMC7139066 DOI: 10.21037/jtd.2020.01.49] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background Evidence suggests that the anti-aging protein a-Klotho is a central modulator of mineral homeostasis. Circulating a-Klotho exerts endocrine activity and has been implicated in the process of vascular calcification, which is accelerated in patients with chronic kidney disease (CKD) and portends an unfavorable overall prognosis. However, the role of a-Klotho in this process remains unclear. The purpose of this study was to investigate the possible interaction between a-Klotho and the calcification of the aortic valve and coronary arteries in patients with CKD. Methods In this study we enrolled a total of 60 adult patients with CKD. Group 1 included 30 participants with CKD stage V and group 2 included 30 participants with CKD stage III. Results Participants in group 1 had lower levels of circulating a-Klotho compared to group 2 (390; 280–590 vs. 722; 501–897 pg/mL; P=0.001), were of younger age (55.5; 45–63 vs. 69; 62–74 years; P<0.001), had lower body mass index (25.6; 23.8–27.5 vs. 28.2; 25.7–31.1 kg/m2; P=0.036), higher serum phosphate (4.75; 4–5.6 vs. 3.35; 2.9–3.8 mg/dL; P<0.001), higher calcium-phosphate product (41; 35.1–49.2 vs. 31.5; 28.6–35 mg2/dL2; P<0.001), and higher parathyroid hormone (PTH) levels (28.4; 15–44.6 vs. 7.05; 4.3–10.2 pmol /L; P<0.001). Conclusions No statistically significant difference was found between the two groups in terms of coronary arteries and aortic valve calcification. Calcitonin, PTH and phosphate were identified as predictors for circulating a-Klotho levels whereas, only hyperlipidemia was identified as predictor for coronary artery calcification. In conclusion, circulating a-Klotho is found to decrease with worsening CKD severity but no correlation was found between the levels of a-Klotho and severity of coronary arteries and aortic valve calcification.
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Affiliation(s)
- Panagiotis Savvoulidis
- Department of Cardiology, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London, UK.,Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Vasileios Raptis
- Section of Nephrology and Hypertension, 1st Department of Medicine, AHEPA Hospital, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Rafailidis
- Department of Radiology, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiotis I Georgianos
- Section of Nephrology and Hypertension, 1st Department of Medicine, AHEPA Hospital, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Elias V Balaskas
- Section of Nephrology and Hypertension, 1st Department of Medicine, AHEPA Hospital, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Kouskouras
- Department of Radiology, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Haralambos Karvounis
- Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavros Hadjimiltiades
- Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Mouratoglou SA, Dimopoulos K, Kamperidis V, Feloukidis C, Kallifatidis A, Pitsiou G, Stanopoulos I, Grosomanidis V, Hadjimiltiades S, Karvounis H, Giannakoulas G. Right Atrial Function Predicts Clinical Outcome in Patients with Precapillary Pulmonary Hypertension. J Am Soc Echocardiogr 2018; 31:1137-1145. [DOI: 10.1016/j.echo.2018.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Indexed: 01/03/2023]
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Abstract
A 46-year-old man underwent angioplasty of a restenotic bifurcation lesion of the circumflex artery. The procedure required repeated balloon exchanges and during the last balloon inflation, no balloon was visualized. A test injection revealed a massive coronary air embolism due to expulsion of air that had accumulated in the guiding catheter shaft. The patient was rapidly resuscitated from electromechanical dissociation with intracoronary injection of adrenaline and atropine and forceful intracoronary saline injections. Inspection of the balloon revealed a defect and scratch marks at the junction of the wire part and shaft of the monorail balloon, a location that places the air leakage inside the guiding catheter. This is the first report of massive intracoronary air embolism due to an undetectable damage to the shaft of a balloon angioplasty catheter. Recognition of the problem and immediate intervention is vital in limiting the duration of cardiac dysfunction.
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Affiliation(s)
- Ioannis Tziatzios
- First Department of Cardiology, AHEPA Hospital, Aristotle University, Thessaloniki, Greece
| | - Matthaios Didagelos
- First Department of Cardiology, AHEPA Hospital, Aristotle University, Thessaloniki, Greece
| | - Stefanos Votsis
- First Department of Cardiology, AHEPA Hospital, Aristotle University, Thessaloniki, Greece
| | - Georgios Tziatzios
- First Department of Cardiology, AHEPA Hospital, Aristotle University, Thessaloniki, Greece
| | - Stavros Hadjimiltiades
- First Department of Cardiology, AHEPA Hospital, Aristotle University, Thessaloniki, Greece
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Arvanitaki A, Giannakoulas G, Mouratoglou SA, Feloukidis C, Karvounis H, Hadjimiltiades S. Balloon atrial septostomy in severe precapillary pulmonary hypertension: A single-center experience. Hellenic J Cardiol 2018; 60:384-386. [PMID: 29807193 DOI: 10.1016/j.hjc.2018.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/11/2018] [Accepted: 05/18/2018] [Indexed: 12/15/2022] Open
Affiliation(s)
- Alexandra Arvanitaki
- Cardiology Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece.
| | - George Giannakoulas
- Cardiology Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece.
| | | | - Christos Feloukidis
- Cardiology Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece.
| | - Haralambos Karvounis
- Cardiology Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece.
| | - Stavros Hadjimiltiades
- Cardiology Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece.
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Bazmpani MA, Arsos G, Zarogoulidis P, Doumas A, Dimitroulas T, Sianos G, Hadjimiltiades S, Kouskouras K, Mayer E, Karvounis H, Giannakoulas G. A case of sarcoidosis-associated pulmonary hypertension masquerading as chronic thromboembolic pulmonary hypertension. Pulm Circ 2018. [PMID: 29537341 PMCID: PMC5950934 DOI: 10.1177/2045894018768289] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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] [Indexed: 12/01/2022] Open
Abstract
Occlusive vasculopathy due to the development and accumulation of granulomas at the level of intima of large vessels, as well as mediastinal lymph nodes and fibrosing mediastinitis secondary to sarcoidosis, causing extrinsic compression of mediastinal vascular structure are uncommon mechanisms of sarcoidosis-associated pulmonary hypertension. We present a case of a 62-year-old woman with a rare manifestation of sarcoidosis, which was misclassified and treated as chronic thromboembolic pulmonary hypertension for a long period. Fluorine-18-fluorodeoxyglucose positron emission tomography played a major role in accessing final diagnosis. Mechanisms that lead to development of pulmonary hypertension, the contribution of novel imaging modalities, and treatment options are discussed.
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Affiliation(s)
- Maria Anna Bazmpani
- 1 First Department of Cardiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Georgios Arsos
- 2 Third Department of Nuclear Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Paul Zarogoulidis
- 3 Department of Respiratory Medicine, "G. Papanikalaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Argyrios Doumas
- 4 Second Department of Nuclear Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Theodoros Dimitroulas
- 5 Fourth Department of Internal Medicine, Hippokration University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George Sianos
- 1 First Department of Cardiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Stavros Hadjimiltiades
- 1 First Department of Cardiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Konstantinos Kouskouras
- 6 Department of Radiology, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eckhard Mayer
- 7 Kerckhoff Heart and Lung Center, Bad Nauheim, Germany
| | - Haralambos Karvounis
- 1 First Department of Cardiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - George Giannakoulas
- 1 First Department of Cardiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
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Kaiafa G, Bobos M, Savopoulos C, Koutsokostas T, Kouskouras K, Kalogera-Fountzila A, Zaraboukas T, Kostopoulos I, Perifanis V, Fotiadis S, Hadjimiltiades S. Heart and lymphoma: An unusual case of secondary cardiac lymphoma manifested through presyncope and syncope episodes and atrial flutter. Hellenic J Cardiol 2017; 59:182-185. [PMID: 29247778 DOI: 10.1016/j.hjc.2017.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/10/2017] [Accepted: 09/19/2017] [Indexed: 11/17/2022] Open
Affiliation(s)
- Georgia Kaiafa
- First Propedeutic Department of Internal Medicine AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Mattheos Bobos
- Department of Pathology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Savopoulos
- First Propedeutic Department of Internal Medicine AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theocharis Koutsokostas
- First Department of Cardiology, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Kostas Kouskouras
- Department of Radiology, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anna Kalogera-Fountzila
- Department of Radiology, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Thomas Zaraboukas
- Department of Pathology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Kostopoulos
- Department of Pathology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vassilis Perifanis
- First Propedeutic Department of Internal Medicine AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Spyros Fotiadis
- First Propedeutic Department of Internal Medicine AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavros Hadjimiltiades
- First Department of Cardiology, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
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Kiaos A, Tziatzios I, Hadjimiltiades S, Karvounis C, Karamitsos TD. Data on diagnostic performance of stress perfusion cardiac magnetic resonance for coronary artery disease detection at the vessel level. Data Brief 2017. [PMID: 29541674 PMCID: PMC5847623 DOI: 10.1016/j.dib.2017.11.096] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Stress perfusion cardiac magnetic resonance (CMR) has been proposed as an important gatekeeper for invasive coronary angiography (ICA) and percutaneous coronary interventions (PCI) in patients evaluated for possible coronary artery disease (CAD) (Fihn et al., 2012; Montalescot et al., 2013) [1], [2]. Several meta-analyses have evaluated the accuracy of stress perfusion CMR to diagnose CAD at the vessel level (Danad et al., 2017; Dai et al., 2016; Jiang et al., 2016; Takx et al., 2015; Li et al., 2015; Desai and Jha, 2013; Jaarsma et al. 2012; Hamon et al., 2010; Nandalur et al. 2007) [3], [4], [5], [6], [7], [8], [9], [10], [11]. However, they included in the same analysis studies with different definitions of significant CAD (i.e. fractional flow reserve [FFR] < 0.75 and < 0.80 or coronary stenosis ≥ 50% and ≥ 70%), magnetic field strength (1.5 or 3 Tesla [T]), and study protocol (integration or not of late gadolinium enhancement [LGE] into stress perfusion protocol). Data of 34 studies (6091 arteries) have been pooled with the aim of analyzing the accuracy of stress perfusion CMR for the diagnosis of ischemic heart disease at the vessel level according to different definitions of significant CAD, magnetic field strength and study protocol (Arnold et al., 2010; Bettencourt et al., 2013; Cheng et al., 2007; Chiribiri et al., 2013; Cury et al., 2006; De Mello et al., 2012; Donati et al., 2010; Ebersberger et al., 2013; Gebker et al., 2008; Greulich et al., 2015; Hussain et al., 2016; Ishida et al., 2005, 2003; Kamiya et al., 2014; Kitagawa et al., 2008; Klein et al., 2008; Klem et al., 2006; Klumpp et al., 2010; Krittayaphong et al., 2009; Lockie et al., 2011; Ma et al., 2012; Merkle et al., 2007; Meyer et al., 2008; Mor-Avi et al., 2008; Pan et al., 2015; Papanastasiou et al., 2016; Pons Lladó et al., 2004; Sakuma et al., 2005; Salerno et al., 2014; Scheffel et al., 2010; van Werkhoven et al., 2010; Walcher et al., 2013; Watkins et al., 2009; Yun et al., 2015) [12–45]. This article describes data related article titled “Diagnostic Performance of Stress Perfusion Cardiac Magnetic Resonance for the Detection of Coronary Artery Disease” (Kiaos et al., submitted for publication) [46].
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Affiliation(s)
- Apostolos Kiaos
- 1st Department of Cardiology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Tziatzios
- 1st Department of Cardiology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavros Hadjimiltiades
- 1st Department of Cardiology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Charalambos Karvounis
- 1st Department of Cardiology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theodoros D Karamitsos
- 1st Department of Cardiology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Kiaos A, Tziatzios I, Hadjimiltiades S, Karvounis C, Karamitsos TD. Diagnostic performance of stress perfusion cardiac magnetic resonance for the detection of coronary artery disease: A systematic review and meta-analysis. Int J Cardiol 2017; 252:229-233. [PMID: 29196090 DOI: 10.1016/j.ijcard.2017.11.066] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 09/28/2017] [Revised: 11/19/2017] [Accepted: 11/20/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The purpose of this study was to investigate the accuracy of qualitative stress perfusion cardiac magnetic resonance (CMR) to diagnose ischemia-causing lesions according to different definitions of significant coronary artery disease (CAD), and magnetic field strength. METHODS We searched PubMed, Web of Science, and the Cochrane Library for studies evaluating diagnostic performance of qualitative stress perfusion CMR for diagnosis of CAD versus coronary angiography or fractional flow reserve (FFR) from inception to 10 September 2017. We used hierarchical models to synthesize the available data. RESULTS Sixty-seven studies (7113 patients) met the inclusion criteria. The patient-based analysis of studies using FFR as the reference standard demonstrated a mean sensitivity of 0.90 (95% confidence interval [CI], 0.85-0.93) and a mean specificity of 0.85 (95% CI, 0.80-0.89). The patient-based analyses for detecting coronary stenosis ≥50% and coronary stenosis ≥70% at 1.5T and for detecting coronary stenosis ≥50% and coronary stenosis ≥70%, at 3T, demonstrated a mean sensitivity of 0.82 (95% CI, 0.79-0.84), 0.86 (95% CI, 0.83-0.89), 0.90 (95% CI, 0.82-0.95), and 0.91 (95% CI, 0.79-0.96), respectively; with a mean specificity of 0.75 (95% CI, 0.71-0.80), 0.77 (95% CI, 0.71-0.81), 0.79 (95% CI, 0.69-0.86), and 0.74 (95% CI, 0.59-0.85). CONCLUSION Qualitative stress perfusion CMR has high accuracy for the diagnosis of CAD, irrespective of the reference standard and the magnet strength. Studies using FFR as the reference standard had higher diagnostic accuracy on a patient level compared to studies using coronary angiography, with a notable difference in specificity.
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Affiliation(s)
- Apostolos Kiaos
- 1st Department of Cardiology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Tziatzios
- 1st Department of Cardiology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavros Hadjimiltiades
- 1st Department of Cardiology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Charalambos Karvounis
- 1st Department of Cardiology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theodoros D Karamitsos
- 1st Department of Cardiology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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15
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Ntiloudi D, Zegkos T, Bazmpani MA, Parcharidou D, Panagiotidis T, Hadjimiltiades S, Karvounis H, Giannakoulas G. Pregnancy outcome in women with congenital heart disease: A single-center experience. Hellenic J Cardiol 2017; 59:155-159. [PMID: 28873334 DOI: 10.1016/j.hjc.2017.08.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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: 05/23/2017] [Revised: 08/21/2017] [Accepted: 08/24/2017] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE Pregnancies in patients with adult congenital heart disease (ACHD) are often complicated. We aimed to highlight the nature and the rate of these complications in a single-center patient population. METHODS We retrospectively studied all the pregnancies of women who presented on an outpatient basis, and all pregnancies were reviewed for maternal and fetal outcomes. RESULTS Of 117 pregnancies from 52 ACHD patients (age at pregnancy 28.3 ± 6.6 years), 10 were therapeutically aborted. A proportion of 41.1% of the remaining 107 pregnancies were complicated either with cardiac (3.7%), obstetric (15.0%), or fetal/neonatal (11.2%) adverse events or with spontaneous abortion (17.8%). Hospitalization during pregnancy was required in 10 patients. Elective cesarean sections were initially planned for 31% of the 87 pregnancies, which were finally completed, while 8% required an emergency cesarean section, mostly for obstetric reasons. NYHA class deterioration after pregnancy was detected in 9.3% of our cohort. Modified WHO class III/IV, prior medication use, and higher body mass index (BMI) were related to cardiac complications during pregnancy or NYHA deterioration. CONCLUSION Pregnancies in ACHD patients are at high risk for complications. Advanced modified WHO class, prior medication use, and high BMI were related to adverse cardiac events.
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Affiliation(s)
- Despina Ntiloudi
- Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece
| | - Thomas Zegkos
- Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece
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Mouratoglou S, Giannakoulas G, Kamperidis V, Pitsiou G, Grosomanidis V, Hadjimiltiades S, Karvounis H. P5422Left atrial function is a predictor of clinical failure in patients with precapillary pulmonary hypertension. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5422] [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: 11/14/2022] Open
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17
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Karamitsos TD, Nikolaidou C, Koutsakis A, Anastasiadis K, Karvounis C, Hadjimiltiades S. Iatrogenic Lutembacher Syndrome after Percutaneous Mitral Commissurotomy. J Heart Valve Dis 2017; 26:368-371. [PMID: 29092127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Atrial septal defects (ASDs) are common immediately after percutaneous mitral commissurotomy (PMC). They are usually small, hemodynamically insignificant, and tend to decrease or disappear within 6 to 12 months. Herein, a case is described of persistent ASD in a patient with mitral valve stenosis who had undergone successful PMC three years previously. The patient had signs and symptoms of right heart failure and severe tricuspid regurgitation (TR) with borderline right ventricular systolic function on echocardiography, in addition to the ASD. Cardiac magnetic resonance (CMR) imaging played a significant role in decision-making by clarifying the anatomy of the ASD and severity of the shunt, measuring right ventricular systolic function, and providing absolute quantification for TR. The right ventricular systolic function was normal on CMR, rendering the patient suitable for surgical treatment. Persistent iatrogenic ASDs have become an increasingly common finding after invasive procedures requiring trans-septal puncture and the manipulation of catheters. Multimodality imaging can provide significant aid in the management of patients with valvular heart disease complicated by iatrogenic shunts.
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Affiliation(s)
- Theodoros D Karamitsos
- First Department of Cardiology, AHEPA Hospital, Aristotle University, Thessaloniki, Greece. Electronic correspondence:
| | | | - Athanasios Koutsakis
- First Department of Cardiology, AHEPA Hospital, Aristotle University, Thessaloniki, Greece
| | - Kyriakos Anastasiadis
- Cardiothoracic Department, AHEPA Hospital, Aristotle University, Thessaloniki, Greece
| | - Charalambos Karvounis
- First Department of Cardiology, AHEPA Hospital, Aristotle University, Thessaloniki, Greece
| | - Stavros Hadjimiltiades
- First Department of Cardiology, AHEPA Hospital, Aristotle University, Thessaloniki, Greece
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Giannakoulas G, Savvoulidis P, Grosomanidis V, Mouratoglou SA, Karvounis H, Hadjimiltiades S. Atrial septostomy and disease targeting therapy in pulmonary hypertension secondary to neurofibromatosis. BMC Pulm Med 2016; 16:175. [PMID: 27927206 PMCID: PMC5142319 DOI: 10.1186/s12890-016-0337-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 11/24/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Neurofibromatosis type 1 (NF1) is a rare multisystem genetic disorder. During the course of the disease it can be rarely complicated with pulmonary hypertension (PH) which confers a dismal prognosis. CASE PRESENTATION We describe the case of a 57-year-old female patient with NF1 complicated by severe precapillary PH despite dual disease-specific oral combination therapy. The patient was treated with initial atrial septostomy followed by administration of high-dose subcutaneous treprostinil with a favorable medium-term clinical and hemodynamic response. CONCLUSIONS PH secondary to NF1 may be successfully treated with the combination of atrial septostomy and PH targeted therapy in selected patients.
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Affiliation(s)
- George Giannakoulas
- Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Stilp. Kiriakidi 1, Thessaloniki, 54637, Greece.
| | - Panagiotis Savvoulidis
- Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Stilp. Kiriakidi 1, Thessaloniki, 54637, Greece
| | - Vasilios Grosomanidis
- Department of Anesthesiology and Intensive Care Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Stilp. Kiriakidi 1, Thessaloniki, 54637, Greece
| | - Sophia-Anastasia Mouratoglou
- Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Stilp. Kiriakidi 1, Thessaloniki, 54637, Greece
| | - Haralambos Karvounis
- Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Stilp. Kiriakidi 1, Thessaloniki, 54637, Greece
| | - Stavros Hadjimiltiades
- Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Stilp. Kiriakidi 1, Thessaloniki, 54637, Greece
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Ziakas A, Petroglou D, Moralidis E, Tsioufis K, Doumas M, Argiriadou E, Savopoulos C, Hadjimiltiades S, Stiliadis I, Kouparanis A, Katranas S, Lillis L, Koutsakis A, Karvounis H. Initial Experience with Renal Denervation for the Treatment of Resistant Hypertension - The Utility of Novel Anesthetics and Metaiodobenzylguanidine Scintigraphy (MIBG). Open Cardiovasc Med J 2016; 10:163-70. [PMID: 27583041 PMCID: PMC4974823 DOI: 10.2174/1874192401610010163] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 06/18/2016] [Accepted: 06/20/2016] [Indexed: 11/29/2022] Open
Abstract
Background: The Symplicity-HTN 3 trial failed to show significant difference in blood pressure (BP) lowering between patients undergoing catheter-based renal denervation (RDN) and the sham-procedure arm of the study. However, there is still optimism about the role of RDN in the treatment of resistant hypertension, because identification of patients with increased sympathetic activity thus being good RDN responders, improvements in the RDN procedure and new technology RDN catheters are all expected to lead to better RDN results. We present our initial experience with RDN for the treatment of resistant hypertension, and the utility of novel anesthetics and cardiac 123I-metaiodobenzylguanidine scintigraphy (123I-MIBG). Methods and Results: Seven patients with resistant hypertension underwent RDN and were followed up for 6 months. MIBG was performed before RDN, in order to estimate sympathetic activity and predict the response to RDN. All patients were sedated with dexmedetomidine and remifentanil during RDN. All patients tolerated the procedure well, were hemodynamically stable and their peri-procedural pain was effectively controlled. A median of 7.6 ± 2.1 and 6 ± 1.4 ablations were delivered in the right and left renal artery respectively, making an average of 6.8 burns per artery. No peri-procedural or late complications - adverse events (local or systematic) occurred. At 6 months, mean reduction in office BP was -26.0/-16.3 mmHg (p=0.004/p=0.02), while mean reduction in ambulatory BP was -12.3/-9.2 mmHg (p=0.118/p=0.045). One patient (14.3%) was a non-responder. None of the cardiac 123I-MIBG imaging indexes(early and late heart-to-mediastinum (H/M) count density ratio, washout rate (WR) of the tracer from the myocardium) were different between responders and non-responders. Conclusion: Patients with resistant hypertension who underwent RDN in our department had a significant reduction in BP 6 months after the intervention. 123I-MIBG was not useful in predicting RDN response. Dexmedetomidine and remifentanil provided sufficient patient comfort during the procedure, allowing an adequate number of ablations per renal artery to be performed, and this could probably lead to improved RDN results.
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Affiliation(s)
- Antonios Ziakas
- 1st Department of Cardiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Dimitrios Petroglou
- 1st Department of Cardiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Efstratios Moralidis
- 2nd Department of Nuclear Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Konstantinos Tsioufis
- 1st Department of Cardiology, National and Capodistrian University of Athens, Ippokrateion University Hospital, Athens, Greece
| | - Mihalis Doumas
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Ippokrateion University Hospital, Thessaloniki, Greece
| | - Elena Argiriadou
- Department of Anesthesia and Intensive Care Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Christos Savopoulos
- 1st Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Stavros Hadjimiltiades
- 1st Department of Cardiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Ioannis Stiliadis
- 1st Department of Cardiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Antonios Kouparanis
- 1st Department of Cardiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Sotirios Katranas
- 1st Department of Cardiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Leonidas Lillis
- 1st Department of Cardiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Athanasios Koutsakis
- 1st Department of Cardiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Haralambos Karvounis
- 1st Department of Cardiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
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Mouratoglou SA, Kallifatidis A, Giannakoulas G, Grapsa J, Kamperidis V, Pitsiou G, Stanopoulos I, Hadjimiltiades S, Karvounis H. The role of cardiac magnetic resonance imaging in the assessment of right ventricular function in patients with pulmonary arterial hypertension. J Cardiovasc Magn Reson 2015. [PMCID: PMC4328802 DOI: 10.1186/1532-429x-17-s1-p364] [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: 11/18/2022] Open
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Kamperidis V, Hadjimiltiades S, Mouratoglou S, Ziakas A, Sianos G, Sarafidou A, Ventoulis I, Kazinakis G, Giannakoulas G, Efthimiadis G, Parcharidis G, Karvounis H. Aortic balloon valvuloplasty before transcatheter valve replacement in high-risk patients with aortic stenosis. Herz 2015; 41:144-50. [DOI: 10.1007/s00059-015-4353-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 07/27/2015] [Accepted: 08/10/2015] [Indexed: 10/23/2022]
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Hadjimiltiades S, Ziakas A, Kazinakis G, Nikolaidou C, Anastasiadis K, Karvounis H. Avulsion of an Aortic Cusp During Aortic Balloon Valvuloplasty. JACC Cardiovasc Interv 2015; 8:e15-e16. [DOI: 10.1016/j.jcin.2014.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 08/31/2014] [Accepted: 09/10/2014] [Indexed: 11/15/2022]
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Karakyriou M, Hadjimiltiades S, Meditskou S, Nenopoulou E, Efthimiadis G, Vogazianos P, Karvounis C, Styliadis I. Embolization after percutaneous coronary intervention in acute coronary syndrome. Saphenous vein grafts versus native coronary arteries. Herz 2014; 40 Suppl 1:36-42. [PMID: 25471205 DOI: 10.1007/s00059-014-4184-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 10/27/2014] [Accepted: 11/02/2014] [Indexed: 11/29/2022]
Abstract
AIMS The aim of this study was to assess the occurrence of distal embolization and to quantify the amount of embolic material captured during stent implantation in native coronary arteries, as compared with saphenous vein grafts (SVG) in patients at different time periods after an acute coronary syndrome. PATIENTS AND METHODS In all, 104 patients presenting with unstable or stable angina underwent percutaneous coronary intervention (PCI) in 107 vessels and stent implantation in 112 lesions, 53 % of which were in SVG. RESULTS Device deployment and retrieval was successful in 111 lesions. Embolic material was detected in 74 % of the protection devices. Early PCI, during a 2-week period after the last ischemic episode, was associated with larger embolic load, especially in the right coronary artery. The length of the lesion was the only preprocedural independent variable that was found to be a significant predictor for the presence of emboli (p = 0.002). The stent diameter and the maximum dilatation pressure were the two procedural variables found to be significant predictors for the presence of emboli (p = 0.025 and p = 0.008, respectively). The irregularity of the lesion and the number of stents deployed were found to have a predictive correlation to the total area of the embolic particles (p = 0.04 and p = 0.005, respectively). CONCLUSION Distal embolization of atherosclerotic debris is a frequent phenomenon after PCI not only in SVG but also in native vessels. The amount of embolic material seems to be related to the atherosclerotic burden of the vessel and to the early timing of the procedure as related to acute coronary syndrome.
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Affiliation(s)
- M Karakyriou
- Department of Cardiology, AHEPA Hospital, Aristotle University, Thessaloniki, Greece,
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Tossios P, Karapanagiotidis GT, Hadjimiltiades S, Grosomanidis V. A rare case of subarterial ventricular septum defect associated with other cardiac pathologies in an adult. Echo Res Pract 2014; 1:I5-I6. [PMID: 26693296 PMCID: PMC4676432 DOI: 10.1530/erp-14-0022] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 06/30/2014] [Indexed: 11/08/2022] Open
Affiliation(s)
- Paschalis Tossios
- Department of Cardiothoracic Surgery, Aristotle University Medical School, AHEPA University Hospital , Stilponos Kyriakidi 154636, Thessaloniki , Greece
| | - Georgios T Karapanagiotidis
- Department of Cardiothoracic Surgery, Aristotle University Medical School, AHEPA University Hospital , Stilponos Kyriakidi 154636, Thessaloniki , Greece
| | - Stavros Hadjimiltiades
- Department of Cardiology, Aristotle University Medical School, AHEPA University Hospital , Stilponos Kyriakidi 154636, Thessaloniki , Greece
| | - Vasilios Grosomanidis
- Department of Anesthesia and Intensive Care, Aristotle University Medical School, AHEPA University Hospital , Stilponos Kyriakidi 154636, Thessaloniki , Greece
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Hadjimiltiades S, Ziakas A, Grosomanidis V, Karvounis H, Misias G, Anastasiadis K, Styliadis J. Paravalvular aortic prosthetic valve leak closure: technical aspects of the percutaneous approach. Hellenic J Cardiol 2014; 55:342-347. [PMID: 25039032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
We describe the successful closure of an aortic paravalvular bioprosthetic valve leak with the simultaneous percutaneous deployment of two vascular plugs.
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Secchi F, Cannao P, Pluchinotta F, Butera G, Carminati M, Sardanelli F, Lombardi M, Monney P, Piccini D, Rutz T, Vincenti G, Coppo S, Koestner S, Stuber M, Schwitter J, Romana P, Francesco S, Gianfranco B, Mario C, Francesco S, Massimo L, Alizadeh Sani Z, Vojdan-Parast M, Alimohammadi M, Sarafan-Sadeghi S, Seifi A, Fallahabadi H, Karami Tanha F, Jamshidi M, Hesamy M, Bonello B, Sorensen C, Fouilloux V, Gorincour G, Mace L, Fraisse A, Jacquier A, de Meester C, Amzulescu M, Bouzin C, Boileau L, Melchior J, Boulif J, Lazam S, Pasquet A, Vancrayenest D, Vanoverschelde J, Gerber B, Loudon M, Bull S, Bissell M, Joseph J, Neubauer S, Myerson S, Dorniak K, Hellmann M, Rawicz-Zegrzda D, W sierska M, Sabisz A, Szurowska E, Heiberg E, Dudziak M, Kwok T, Chin C, Dweck M, Hadamitzky M, Nadjiri J, Hendrich E, Pankalla C, Will A, Schunkert H, Martinoff S, Sonne C, Pepe A, Meloni A, Terrazzino F, Spasiano A, Filosa A, Bitti P, Tangari C, Restaino G, Resta M, Ricchi P, Meloni A, Tudisca C, Grassedonio E, Positano V, Piraino B, Romano N, Keilberg P, Midiri M, Pepe A, Meloni A, Positano V, Macchi S, Ambrosio D, De Marchi D, Chiodi E, Resta M, Salvatori C, Pepe A, Artang R, Bogachkov A, Botelho M, Bou-Ayache J, Vazquez M, Carr J, Collins J, Maret E, Ahlander B, Bjorklund P, Engvall J, Cimermancic R, Inage A, Mizuno N, Positano V, Meloni A, Santarelli M, Izzi G, Maddaloni D, De Marchi D, Salvatori C, Landini L, Pepe A, Pepe A, Meloni A, Carulli G, Oliva E, Arcioni F, Fraticelli V, Toia P, Renne S, Restaino G, Salvatori C, Rizzo M, Reinstadler S, Klug G, Feistritzer H, Aschauer A, Schocke M, Franz W, Metzler B, Melonil A, Positanol V, Roccamo G, Argento C, Benni M, De Marchil D, Missere M, Prezios P, Salvatoril C, Pepel A, Meloni A, Rossi G, Positano V, Cirotto C, Filati G, Toia P, Preziosi P, De Marchi D, Pepe A, Mongeon F, Fischer K, Teixeira T, Friedrich M, Marcotte F, Vincenti G, Monney P, Rutz T, Zenge M, Schmidt M, Nadar M, Chevre P, Rohner C, Schwitter J, Mouratoglou S, Kallifatidis A, Giannakoulas G, Grapsa J, Kamperidis V, Pitsiou G, Stanopoulos I, Hadjimiltiades S, Karvounis H, Ahmed N, Lawton C, Ghosh Dastidar A, Frontera A, Jackson A, Cripps T, Diab I, Duncan E, Thomas G, Bucciarelli-Ducci C, Kannoly S, Gosling O, Ninan T, Fulford J, Dalrymple-Haym M, Shore A, Bellenger N, Alegret J, Beltran R, Martin M, Mendoza M, Elisabetta C, Teresa C, Zairo F, Marcello N, Clorinda M, Bruna M, Vincenzo P, Alessia P, Giorgio B, Klug G, Feistritzer H, Reinstadler S, Mair J, Schocke M, Kremser C, Franz W, Metzler B, Aschauer S, Tufaro C, Kammerlander A, Pfaffenberger S, Marzluf B, Bonderman D, Mascherbauer J, Kliegel A, Sailer A, Brustbauer R, Sedivy R, Mayr H, Manessi M, Castelvecchio S, Votta E, Stevanella M, Menicanti L, Secchi F, Sardanelli F, Lombardi M, Redaelli A, Reiter U, Reiter G, Kovacs G, Greiser A, Olschewski H, Fuchsjager M, Kammerlander A, Tufaro C, Pfaffenberger S, Marzluf B, Aschauer S, Babayev J, Bonderman D, Mascherbauer J, Mlynarski R, Mlynarska A, Sosnowski M, Pontone G, Bertella E, Petulla M, Russo E, Innocenti E, Baggiano A, Mushtaq S, Gripari P, Andreini D, Tondo C, Nyktari E, Izgi C, Haidar S, Wage R, Keegan J, Wong T, Mohiaddin R, Durante A, Rimoldi O, Laforgia P, Gianni U, Benedetti G, Cava M, Damascelli A, Laricchia A, Ancona M, Aurelio A, Pizzetti G, Esposito A, Margonato A, Colombo A, De Cobelli F, Camici P, Zvaigzne L, Sergejenko S, Kal js O, Kannoly S, Ripley D, Swarbrick D, Gosling O, Hossain E, Chawner R, Moore J, Shore A, Bellenger N, Aquaro G, Barison A, Masci P, Todiere G, Strata E, Barison A, Di Bella G, Monasterio F, Feistritzer H, Reinstadler S, Klug G, Kremser C, Schocke M, Franz W, Metzler B, Levelt E, Mahmod M, Ntusi N, Ariga R, Upton R, Piechnick S, Francis J, Schneider J, Stoll V, Davis A, Karamitsos T, Leeson P, Holloway C, Clarke K, Neubauer S, Karwat K, Tomala M, Miszalski-Jamka K, Mrozi ska S, Kowalczyk M, Mazur W, Kereiakes D, Nessler J, Zmudka K, Ja wiec P, Miszalski-Jamka T, Ben Yaacoub-Kzadri I, Harguem S, Bennaceur R, Ganzoui I, Ben Miled A, Mnif N, Rodriguez Palomares J, Ortiz J, Bucciarelli-Ducci C, Tejedor P, Lee D, Wu E, Bonow R, Khanji M, Castiello T, Westwood M, Petersen S, Pepe A, Meloni A, Carulli G, Oliva E, Arcioni F, Storti S, Grassedonio E, Renne S, Missere M, Positano V, Rizzo M, Meloni A, Quota A, Smacchia M, Paci C, Positano V, Vallone A, Valeri G, Chiodi E, keilberg P, Pepe A, Barison A, De Marchi D, Gargani L, Aquaro G, Guiducci S, Pugliese N, Lombardi M, Pingitore A, Cole B, Douglas H, Rodden S, Horan P, Harbinson M, Johnston N, Dixon L, Choudhary P, Hsu C, Grieve S, Semsarian C, Richmond D, Celermajer D, Puranik R, Hinojar Baydes R, Varma N, Goodman B, Khan S, Arroyo Ucar E, Dabir D, Schaeffter T, Nagel E, Puntmann V, Hinojar R, Ucar E, Ngah N, Kuo N, D'Cruz D, Gaddum N, Schaeffter T, Nagel E, Puntmann V, Hinojar R, Foote L, Arroyo Ucar E, Dabir D, Schnackenburg B, Higgins D, Schaeffter T, Nagel E, Puntmann V, Nucifora G, Muser D, Morocutti G, Gianfagna P, Zanuttini D, Piccoli G, Proclemer A, Nucifora G, Prati G, Vitrella G, Allocca G, Buttignoni S, Muser D, Morocutti G, Delise P, Proclemer A, Sinagra G, Silva G, Almeida A, David C, Francisco A, Magalhaes A, Placido R, Menezes M, Guimaraes T, Mendes A, Nunes Diogo A, Aneq M, Maret E, Engvall J, Douglas H, Cole B, Rodden S, Horan P, Harbinson M, Dixon L, Johnston N, Papavassiliu T, Sandberg R, Schimpf R, Schoenberg S, Borggrefe M, Doesch C, Khan S, Tamin S, Tan L, Joshi S, Khan S, Memon S, Tamin S, Tan L, Joshi S, Tangcharoen T, Prasertkulchai W, Yamwong S, Sritara P, Hinojar R, Foote L, Arroyo Ucar E, Binti Ngah N, Cruz D, Schnackenburg B, Higgins D, Schaeffter T, Nagel E, Puntmann V, Nucifora G, Muser D, Masci P, Barison A, Rebellato L, Piccoli G, Daleffe E, Zanuttini D, Facchin D, Lombardi M, Proclemer A, Melao F, Paiva M, Pinho T, Martins E, Vasconcelos M, Madureira A, Macedo F, Ramos I, Maciel M, Agoston-Coldea L, Marjanovic Z, Hadj Khelifa S, Kachenoura N, Lupu S, Soulat G, Farge-Bancel D, Mousseaux E, Ben Yaacoub-Kzadri I, Harguem S, Bennaceur R, Ben Miled A, Mnif N, Dastidar A, Ahmed N, Frontera A, Lawton C, Augustine D, McAlindon E, Bucciarelli-Ducci C, Vasconcelos M, Leite S, Sousa C, Pinho T, Rangel I, Madureira A, Ramos I, Maciel M, El ghannudi S, Lefoulon A, Noel E, Germain P, Doutreleau S, Jeung M, Gangi A, Roy C, Todiere G, Pisciella L, Barison A, Zachara E, Federica R, Emdin M, Aquaro G, El ghannudi S, Lefoulon A, Noel E, Germain P, Doutreleau S, Jeung M, Gangi A, Roy C, Baydes R, Ucar E, Foote L, Dabir D, Mahmoud I, Jackson T, Schaeffter T, Higgins D, Nagel E, Puntmann V, Melao F, Paiva M, Pinho T, Martins E, Vasconcelos M, Madureira A, Macedo F, Ramos I, Maciel M. These abstracts have been selected for VIEWING only as ePosters and in print. ePosters will be available on Screen A & B throughout the meeting, Print Posters at the times indicated below. Please refer to the PROGRAM for more details. Eur Heart J Cardiovasc Imaging 2014. [DOI: 10.1093/ehjci/jeu085] [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: 11/14/2022] Open
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Efthimiadis GK, Pitsis A, Pagourelias ED, Kamperidis V, Kelpis T, Meditskou S, Hadjimiltiades S, Ninios V, Mezilis N, Maron BJ, Styliadis IH. Surgical septal myectomy for hypertrophic cardiomyopathy in Greece: a single-center initial experience. Hellenic J Cardiol 2014; 55:132-138. [PMID: 24681791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION Surgical septal myectomy is thought to be the gold standard of treatment for obstructive hypertrophic cardiomyopathy (HCM) with obstruction symptoms refractory to optimal medical therapy. In Europe, during the last 2 decades, myectomy has been set aside, while alcohol septal ablation has been widely promoted. In this paper, we analyze our first experience of surgical septal myectomy in a small cohort of patients with HCM coming from a single tertiary center. METHODS Thirty-two patients (16 male, 50%) with a mean age of 58.1 ± 14.4 (range 12-79 years) underwent myectomy for HCM symptoms refractory to negative inotropic agents. The technique used for the myectomy was the one introduced by Andrew Morrow. Mean follow-up time after procedure was 16.8 ± 13.3 months with a median of 13 months (range 4-58 months). RESULTS Post-myectomy, there was a significant improvement in patients' NYHA class (from 3.3 ± 0.46 to 1.38 ± 0.49, p<0.0005), while interventricular septum thickness was reduced from 2.3 ± 0.4 cm to 1.6 ± 0.4 cm (p<0.0005), and peak gradient at the site of obstruction from 94.9 ± 29 to 16.7 ± 7.9 mmHg (p<0.0005). During the follow-up period, only 1 out of 32 patients died, from non-cardiovascular causes, with the overall survival post-myectomy being 97.2% (95%CI: 94.5-99.9%) at 1-year follow up. CONCLUSIONS Surgical septal myectomy in patients with HCM and drug-refractory symptoms is a safe procedure that greatly improves symptoms and quality of life. Further follow-up of our patients is mandatory in order to determine whether the good survival rate achieved at 1 year will persist.
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Affiliation(s)
- Georgios K Efthimiadis
- Cardiomyopathies Center, First Cardiology Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Mouratoglou SA, Kallifatidis A, Giannakoulas G, Grapsa J, Pitsiou G, Stanopoulos I, Hadjimiltiades S, Karvounis H. The duration of interventricular septal displacement in patients with precapillary pulmonary hypertension as a potential marker of right ventricular dysfunction and pressure overload. A cardiac magnetic resonance study. J Cardiovasc Magn Reson 2014. [PMCID: PMC4045051 DOI: 10.1186/1532-429x-16-s1-p240] [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: 11/10/2022] Open
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Paraskevaidis S, Theofilogiannakos EK, Kamperidis V, Chatzizisis YS, Tsilonis K, Vassilikos VP, Dakos G, Stavropoulos G, Ziakas A, Hadjimiltiades S, Styliadis IH. Quinidine: an "endangered species" drug appropriate for management of electrical storm in brugada syndrome. Indian Pacing Electrophysiol J 2013; 13:178-80. [PMID: 24130427 PMCID: PMC3775321 DOI: 10.1016/s0972-6292(16)30670-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Brugada syndrome is an inherited channelopathy associated with an increased risk of syncope and sudden cardiac death. In rare cases it can be manifested with electrical storm. We report two cases of Brugada syndrome that presented with electrical storm and were treated successfully with oral quinidine, an "endangered species" drug.
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Affiliation(s)
- Stelios Paraskevaidis
- 1st Cardiology Department, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
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Kelpis TG, Anastasiadis K, Nimatoudis I, Kelpi MG, Hadjimiltiades S, Papakonstantinou C. Prevalence of "distressed" personality in patients with coronary artery disease and its correlation with morbidity after coronary surgery. Hellenic J Cardiol 2013; 54:362-367. [PMID: 24100179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
INTRODUCTION The "distressed" (Type-D) personality is an emerging risk factor in cardiovascular diseases and is associated with an increased risk of impaired quality of life, morbidity and mortality. The purpose of this study was to explore the prevalence of Type-D personality among patients with coronary artery disease (CAD) and its association with the development of complications following coronary artery bypass grafting surgery. METHODS A Greek version of the Type-D Personality Scale-14 (DS14), along with the Hospital Anxiety and Depression Scale (HADS) as well as the Ways of Coping Questionnaire (WCQ), were used. A cohort of 323 patients with CAD was examined. RESULTS The prevalence of Type-D personality among Greek patients with CAD was found to be 18.24%. Type-D patients showed a higher rate of anxiety and depression compared to non Type-D patients. Type-D was also associated with passive coping and negatively correlated with active coping. Regarding postoperative morbidity, type-D patients were at an increased risk of developing postoperative atrial fibrillation, while no significant differences were found in the development of any other complication. CONCLUSIONS The impact of Type-D personality on health outcomes should be studied further, both in clinical samples and in the general population.
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Affiliation(s)
- Timotheos G Kelpis
- AHEPA University Hospital, Department of Cardiothoracic Surgery, Thessaloniki, Greece
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Hadjimiltiades S. Contrast aortography and the aortic annulus. Catheter Cardiovasc Interv 2013; 81:1253. [PMID: 23456727 DOI: 10.1002/ccd.23456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2011] [Accepted: 10/31/2011] [Indexed: 11/07/2022]
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Efthimiadis GK, Pagourelias ED, Parcharidou D, Gossios T, Kamperidis V, Theofilogiannakos EK, Pappa Z, Meditskou S, Hadjimiltiades S, Pliakos C, Karvounis H, Styliadis IH. Clinical characteristics and natural history of hypertrophic cardiomyopathy with midventricular obstruction. Circ J 2013; 77:2366-74. [PMID: 23728066 DOI: 10.1253/circj.cj-12-1561] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The prevalence, clinical characteristics and natural history of patients with hypertrophic cardiomyopathy (HCM) and midventricular obstruction (MVO) have not been adequately studied. METHODS AND RESULTS A single-center cohort consisting of 423 patients (mean age, 49.3±17.2 years; 66.2% male) was thoroughly followed up for a median of 84 months (7 years; range, 6-480 months). MVO, characterized by the echocardiographic appearance of midventricular muscular apposition with a simultaneous mid-cavitary gradient ≥30mmHg, was identified in 34 patients (8%). Patients with MVO tended to be more symptomatic during their initial evaluation (>90% presented with NYHA class ≥II) compared to the rest of the HCM cohort. Apical aneurysm formation was identified in more than one-fourth of patients with MVO (26.5%), being a characteristic of the group. On multivariate Cox regression hazard analysis, presence of MVO strongly predicted progression to end-stage (burnt out) HCM and related heart failure (HF) deaths (hazard ratio, [HR], 2.62; 95% confidence interval [CI]: 1.2-8.8; P=0.047), as well as sudden death and associated lethal arrhythmic events (HR, 3.3; 95% CI: 1.26-8.85; P=0.016). CONCLUSIONS MVO is a distinct phenotype of HCM associated with unfavorable prognosis in terms of end-stage HCM, sudden death and lethal arrhythmic events. The high adverse outcome rate necessitates early recognition of MVO and appropriate therapeutic interventions.
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Anastasiadis K, Hadjimiltiades S, Antonitsis P. Successful high-risk percutaneous coronary intervention with the use of minimal extracorporeal circulation system. Catheter Cardiovasc Interv 2012; 80:845-9. [PMID: 22511509 DOI: 10.1002/ccd.24293] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2011] [Accepted: 12/10/2011] [Indexed: 11/10/2022]
Abstract
Minimal extracorporeal circulation (MECC) represents a contemporary system which integrates several advances in cardiopulmonary bypass technology in a single circuit. We challenged the efficacy of the MECC system to support the circulation in elective high-risk percutaneous coronary intervention (PCI). A 78-year-old patient with complex coronary disease who would have been otherwise rejected for interventional therapy underwent PCI with rotablation on MECC support. The MECC system provided hemodynamic support at a flow of 1.8 L min(-1) m(-2) while perfusion pressure was kept at a minimum of 70 mm Hg. This allowed for successful angioplasty of the left main stem and a chronically occluded right coronary artery, which otherwise produced significant hemodynamic compromise. This case illustrates that mechanical circulatory support with the MECC system could provide a stable environment and a "safety net" for carrying out complex percutaneous coronary intervention in high-risk patients.
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Affiliation(s)
- Kyriakos Anastasiadis
- Department of Cardiothoracic Surgery, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
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Koskinas KC, Chatzizisis YS, Kamperidis V, Anastasiadis K, Zioga C, Hadjimiltiades S, Giannoglou GD. Extremely rare case of primary cardiac chondroma in a patient presenting with acute pulmonary edema. Cardiovasc Pathol 2011; 20:374-6. [DOI: 10.1016/j.carpath.2010.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2010] [Revised: 08/17/2010] [Accepted: 09/02/2010] [Indexed: 11/26/2022] Open
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Hadjimiltiades S. On cardiac shunt calculations made too easy. Catheter Cardiovasc Interv 2011; 77:460; author reply 461. [PMID: 20853367 DOI: 10.1002/ccd.22782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Accepted: 08/12/2010] [Indexed: 11/06/2022]
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Pham QH, Von Lueder TG, Namtvedt SK, Rosjo H, Omland T, Steine K, Timoteo AT, Mota Carmo M, Simoes M, Branco LM, Ferreira RC, Kato R, Ito J, Tahara T, Yokoyama Y, Ashikaga T, Satoh Y, Na JO, Hong HE, Kim MN, Shin SY, Choi CU, Kim EJ, Rha SW, Park CG, Seo HS, Oh DJ, Ticulescu R, Brigido S, Vriz O, Sparacino L, Popescu BA, Ginghina C, Carerj S, Nicolosi GL, Antonini-Canterin F, Onaindia Gandarias JJ, Romero A, Laraudogoitia E, Velasco S, Quintana O, Cacicedo A, Rodriguez I, Alarcon JA, Gonzalez J, Lekuona I, Onaindia Gandarias JJ, Laraudogoitia E, Romero A, Velasco S, Cacicedo A, Quintana O, Subinas A, Gonzalez J, Alarcon JA, Lekuona I, Abdula G, Lund LH, Winter R, Brodin L, Sahlen A, Masaki M, Cha YM, Yuasa T, Dong K, Dong YX, Mankad SV, Oh JK, Vallet F, Lequeux B, Diakov C, Sosner P, Christiaens L, Coisne D, Kihara C, Murata K, Wada Y, Uchida K, Ueyama T, Okuda S, Susa T, Matsuzaki M, Cho EJ, Choi KY, Kwon BJ, Kim DB, Jang SW, Cho JS, Jung HO, Jeon HK, Youn HJ, Kim JH, Cikes M, Bijnens B, Velagic V, Kopjar T, Milicic D, Biocina B, Gasparovic H, Almuntaser I, Brown A, Foley B, Mulvihill N, Crean P, King G, Murphy R, Takata Y, Taniguchi M, Nobusada S, Sugawara M, Toh N, Kusano K, Itoh H, Wellnhofer E, Kriatselis C, Nedios S, Gerds-Li JH, Fleck E, Poulsen MK, Henriksen JE, Dahl J, Johansen A, Haghfelt T, Hoilund-Carlsen PF, Beck-Nielsen H, Moller JE, Dankowski R, Wierzchowiecki M, Michalski M, Nowicka A, Szymanowska K, Pajak A, Poprawski K, Szyszka A, Kasner M, Westermann D, Schultheiss HP, Tschoepe C, Watanabe T, Iwai-Takano M, Kobayashi A, Machii H, Takeishi Y, Paelinck BP, Van Herck PL, Bosmans JM, Vrints CJ, Lamb HJ, Doltra A, Vidal B, Silva E, Poyatos S, Mont L, Berruezo A, Castel A, Tolosana JM, Brugada J, Sitges M, Dencker M, Bjorgell O, Hlebowicz J, Szelenyi ZS, Szenasi G, Kiss M, Prohaszka Z, Patocs A, Karadi I, Vereckei A, Saha SK, Anderson PL, Govind S, Govindan M, Moggridge JC, Kiotsekoglou A, Gopal AS, Loegstrup BB, Christophersen TB, Hoefsten DE, Moeller JE, Boetker HE, Egstrup K, Wellnhofer E, Kriatselis C, Nedios S, Gerds-Li JH, Fleck E, Graefe M, Huang FQ, Zhang RS, Le TT, Tan RS, Sattarzadeh Badkoubeh R, Tavoosi A, Elahian AR, Drapkina O, Ivashkin VI, Vereckei A, Szelenyi ZS, Fazakas A, Pepo L, Janosi O, Karadi I, Kopitovic I, Goncalves A, Marcos-Alberca P, Almeria C, Feltes G, Rodriguez E, Garcia E, Hernandez-Antolin R, Macaya C, Silva Cardoso J, Zamorano JL, Navarro MS, Valentin M, Banes CM, Rigo F, Grolla E, Tona F, Cuaia V, Moreo A, Badano L, Raviele A, Iliceto S, Tarzia P, Sestito A, Nerla R, Di Monaco A, Infusino F, Matera D, Greco F, Tacchino RM, Lanza GA, Crea F, Nemes A, Balazs E, Pinter KS, Egyed A, Csanady M, Forster T, Loegstrup BB, Christophersen TB, Hoefsten DE, Moeller JE, Boetker HE, Egstrup K, Holte E, Vegsundvag J, Hole T, Hegbom K, Wiseth R, Nemes A, Balazs E, Pinter KS, Egyed A, Csanady M, Forster T, Sharif D, Sharif-Rasslan A, Shahla C, Khalil A, Rosenschein U, Zagatina A, Zhuravskaya N, Tyurina TV, Tagliamonte E, Cirillo T, Coppola A, Marinelli U, Romano C, Riccio G, Citro R, Astarita C, Capuano N, Tagliamonte E, Cirillo T, Marinelli U, Quaranta G, Desiderio A, Riccio G, Romano C, Capuano N, Frattini S, Faggiano P, Zilioli V, Locantore E, Longhi S, Bellandi F, Faden G, Triggiani M, Dei Cas L, Dalsgaard M, Kjaergaard J, Iversen K, Hassager C, Dinh W, Nickl WN, Smettan JS, Koehler TK, Scheffold TD, Coll Barroso MCB, Guelker JG, Fueth RF, Kamperidis V, Hadjimiltiades S, Sianos G, Efthimiadis G, Karvounis H, Parcharidis G, Styliadis IH, Velasco Del Castillo MS, Cacicedo A, Onaindia JJ, Quintana O, Alarcon JA, Rodriguez I, Telleria M, Subinas A, Lekuona I, Laraudogoitia E, Carstensen HG, Nordenberg C, Sogaard P, Fritz-Hansen T, Bech J, Galatius S, Jensen JS, Mogelvang R, Bartko PE, Graf S, Rosenhek R, Burwash IG, Bergler-Klein J, Clavel MA, Baumgartner H, Pibarot P, Mundigler G, Kirilmaz B, Eser I, Tuzun N, Komur B, Dogan H, Taskiran Comez A, Ercan E, Cusma-Piccione M, Zito C, Oreto G, Piluso S, Tripepi S, Oreto L, Longordo C, Ciraci L, Di Bella G, Carerj S, Piatkowski R, Kochanowski J, Scislo P, Grabowski M, Marchel M, Roik M, Kosior D, Opolski G, Sknouril L, Dorda M, Holek B, Gajdusek L, Chovancik J, Branny M, Fiala M, Szymanski P, Lipczynska M, Klisiewicz A, Hoffman P, Jander N, Minners J, Martin G, Zeh W, Allgeier M, Gohlke-Baewolf C, Gohlke H, Nistri S, Porciani MC, Attanasio M, Abbate R, Gensini GF, Pepe G, Duncan RF, Piantadosi C, Nelson AJ, Wittert G, Dundon B, Worthley MI, Worthley SG, Jung P, Berlinger K, Rieber J, Sohn HZ, Schneider P, Leibig M, Koenig A, Klauss V, Tomkiewicz-Pajak L, Kolcz J, Olszowska M, Pieculewicz M, Podolec P, Pieculewicz M, Przewlocki T, Tomkiewicz-Pajak L, Suchon E, Sobien B, Podolec P, Pieculewicz M, Przewlocki T, Wilkolek P, Tomkiewicz-Pajak L, Ziembicka A, Podolec P, Pieculewicz M, Przewlocki T, Tomkiewicz-Pajak L, Hlawaty M, Wilkolek P, Sobien B, Suchon E, Podolec P, Van De Bruaene A, Hermans H, Buys R, Vanhees L, Delcroix M, Voigt JU, Budts W, De Cillis E, Acquaviva T, Basile D, Bortone AS, Kalimanovska-Ostric D, Nastasovic T, Vujisic-Tesic B, Jovanovic I, Milakovic B, Dostanic M, Stosic M, Frogoudaki A, Andreou K, Parisis J, Triantafyllidi E, Gaitani S, Paraskevaidis J, Anastasiou-Nana M, Pieculewicz M, Przewlocki T, Tomkiewicz-Pajak L, Sobien B, Hlawaty M, Podolec P, De Pasquale G, Kuehn A, Petzuch K, Mueller J, Meierhofer C, Fratz S, Hager A, Hess J, Vogt M, Attenhofer Jost CH, Dearani JA, Scott CG, Burkhart HM, Connolly HM, Vitarelli A, Battaglia D, Caranci F, Padella V, Continanza G, Dettori O, Capotosto L, Vitarelli M, De Cicco V, Cortez Morichetti M, Mohanan Nair KK, Sasidaharan B, Thajudeen A, Tharakan JM, Mertens L, Ahmad N, Kantor PK, Grosse-Wortmann L, Friedberg MK, Bernard YF, Morel MA, Descotes-Genon V, Jehl J, Meneveau N, Schiele F, Kaldararova M, Simkova I, Tittel P, Masura J, Trojnarska O, Szczepaniak L, Mizia -Stec K, Cieplucha A, Bartczak A, Grajek S, Tykarski A, Gasior Z, Attenhofer Jost CH, Babovicvuksanovic D, Scott CG, Bonnichsen CR, Burkhart HM, Connolly HM, Morgan GJ, Slorach C, Hui W, Sarkola T, Lee KJ, Chaturvedi R, Benson L, Mertens L, Bradley T, Iancu ME, Ghiorghiu I, Serban M, Craciunescu I, Hodo A, Popescu BA, Ginghina C, Morgan J, Morgan GJ, Slorach C, Hui W, Roche L, Lee K, Chaturvedi R, Benson L, Bradley T, Mertens L, Morgan J, Morgan GJ, Slorach C, Hui W, Sarkola T, Lee K, Chaturvedi R, Benson L, Bradley T, Mertens L, Milanesi O, Favero V, Padalino M, Biffanti R, Cerutti A, Maschietto N, Reffo E, Vida V, Stellin G, Irtyuga O, Gamazin D, Voronkina I, Tsoyi N, Gudkova E, Moiseeva O, Aggeli C, Kazazaki C, Felekos I, Lagoudakou S, Roussakis G, Skoumas J, Pitsavos C, Stefanadis C, Cueff C, Keenan N, Steg PG, Cimadevilla C, Ducrocq G, Vahanian A, Messika-Zeitoun D, Petrella L, Mazzola AM, Villani CV, Giancola RG, Ciocca MC, Di Eusanio DEM, Nolan S, Ionescu A, Skaug TR, Amundsen BH, Hergum T, Torp H, Haugen BO, Lopez Aguilera J, Mesa Rubio D, Ruiz Ortiz M, Delgado Ortega M, Villanueva Fernandez E, Cejudo Diaz Del Campo L, Toledano Delgado F, Leon Del Pino M, Romo Pena E, Suarez De Lezo Cruz-Conde J, De Marco E, Colucci A, Comerci G, Gabrielli FA, Natali R, Garramone B, Savino M, Lotrionte M, Sonaglioni A, Loperfido F, Zdravkovic M, Perunicic J, Krotin M, Ristic M, Vukomanovic V, Zaja M, Radovanovic S, Saric J, Zdravkovic D, Cotrim C, Almeida AR, Miranda R, Almeida AG, Picano E, Carrageta M, D'andrea A, Cocchia R, Riegler L, Golia E, Scarafile R, Citro R, Caso P, Russo MG, Bossone E, Calabro' R, Noman H, Adel A, Elfaramawy AMR, Abdelraouf M, Elnaggar WAEL, Baligh E, Sargento L, Silva D, Goncalves S, Ribeiro S, Vinhas Sousa G, Almeida A, Lopes M, Rodriguez-Manero M, Aguado Gil L, Azcarate P, Lloret Luna P, Macias Gallego A, Castano SARA, Garcia M, Pujol Salvador C, Barba J, Redondo P, Tomasoni L, Sitia S, Atzeni F, Gianturco L, Ricci C, Sarzi-Puttini P, Turiel M, Sitia S, Tomasoni L, Atzeni F, De Gennaro Colonna V, Sarzi-Puttini P, Turiel M, Uejima T, Jaroch J, Antonini-Canterin F, Polombo C, Carerj S, Hughes A, Vinereanu D, Evanvelista A, Leftheriotis G, Fraser AG, Lewczuk A, Sobkowicz B, Tomaszuk-Kazberuk A, Sawicki R, Hirnle T, Michalski BW, Filipiak D, Kasprzak JD, Lipiec P, Dalen H, Haugen BO, Mjolstad OC, Klykken BE, Graven T, Martensson M, Olsson M, Brodin LA, Antonini-Canterin F, Ticulescu R, Vriz O, Enache R, Leiballi E, Popescu BA, Ginghina C, Nicolosi GL, Penhall A, Perry R, Altman M, Sinhal A, Bennetts J, Chew DP, Joseph MX, Larsen LH, Kjaergaard J, Kristensen T, Kober LV, Kofoed KF, Hassager C, Moscoso Costa F, Ribeiras R, Brito J, Boshoff S, Neves J, Teles R, Canada M, Andrade MJ, Gouveia R, Silva A, Miskovic A, Poerner TP, Stiller CS, Goebel BG, Moritz AM, Stefani L, Galanti GG, Moraldo M, Bergamini C, Pabari PA, Dhutia NM, Malaweera ASN, Willson K, Davies J, Hughes AD, Xu XY, Francis DP, Jasaityte R, Amundsen B, Barbosa D, Loeckx D, Kiss G, Orderud F, Robesyn V, Claus P, Torp H, D'hooge J, Kihara C, Murata K, Wada Y, Uchida K, Nao T, Okuda S, Susa T, Miura T, Matsuzaki M, Shams K, Samir S, Samir R, El-Sayed M, Anwar AM, Nosir Y, Galal A, Chamsi-Pasha H, Ciobanu A, Dulgheru R, Bennett S, Vinereanu D, De Luca A, Toncelli L, Cappelli F, Stefani L, Cappelli B, Vono MCR, Galanti G, Zorman Y, Yilmazer MS, Akyildiz M, Gurol T, Aydin A, Dagdeviren B, Kalangos A. Poster session V * Saturday 11 December 2010, 08:30-12:30. European Journal of Echocardiography 2010. [DOI: 10.1093/ejechocard/jeq148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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YH, Shin SM, Shim WJ, Gonzalez Mansilla A, Torres Macho J, Sanchez Sanchez V, Diez P, Delgado J, Borruel S, Saenz De La Calzada C, Pyxaras S, Valentincic M, Barbati G, Lo Giudice F, Perkan A, Magnani S, Merlo M, Pinamonti B, Sinagra G, Palecek T, Ambroz D, Jansa P, Lindner J, Vitovec M, Polacek P, Jiratova K, Linhart A, Baskurt M, Dogan GM, Abaci O, Kaya A, Kucukoglu S, Duszanska A, Kukulski T, Skoczylas I, Majsnerowska A, Nowowiejska-Wiewiora A, Streb W, Szulik M, Polonski L, Kalarus Z, Yerly PO, Prella M, Joly A, Nicod L, Aubert JD, Aebischer N, Dores H, Leal S, Rosario I, Correia MJ, Monge J, Grilo AM, Arroja I, Fonseca C, Aleixo A, Silva A, Perez-David E, Sanchez-Alegre M, Yotti R, Gomez Anta I, De La Torre J, Alarcon J, Garcia Robles JA, Lafuente J, Bermejo J, Fernandez-Aviles F, Garcia Alonso CJ, Vallejo Camazon N, Gonzalez Guardia A, Nunez R, Bosch Carabante C, Mateu L, Gual Capllonch F, Ferrer Sistach E, Lopez Ayerbe J, Bayes Genis A, Tomaszewski A, Kutarski A, Tomaszewski M, 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Greere V, Cristian G, Chiriac L, Pinte F, Droc I, Neagoe G, Stanciu S, Voicu VA, Kuch-Wocial A, Pruszczyk P, Szmigielski CA, Szulc M, Styczynski G, Sinski M, Kaczynska A, Ryabikov A, Malyutina S, Halcox J, Bobak M, Nikitin YU, Marmot M, Barbosa D, Kiss G, Orderud F, Amundsen B, Jasaityte R, Loeckx D, Claus P, Torp H, D'hooge J, Kuhl JT, Lonborg J, Fuchs A, Andersen M, Vejlstrup N, Engstrom T, Moller JE, Kofoed KF, Smith LA, Bhan A, Paul M, Monaghan MJ, Zaborska B, Stec S, Sikora-Frac M, Krynski T, Kulakowski P, Pushparajah K, Dashwood D, Barlow A, Nugent K, Miller O, Simpson J, Valeur N, Ersboll MK, Kjaergaard J, Greibe R, Risum N, Hassager C, Sogaard P, Kober L, Sahlen A, Manouras A, Shahgaldi K, Winter R, Brodin L, Popovic D, Nedeljkovic I, Petrovic M, Vujisic-Tesic B, Arandjelovic A, Stojiljkovic S, Stojiljkovic S, Jakovljevic B, Damjanovic S, Ostojic M, Agrios IA, Bramos DB, Skaltsiotis HS, Takos DT, Kaladaridis A, Vasiladiotis NV, Kottis GK, Antoniou AA, Pamboucas CP, Toumanidis STT, Locorotondo G, Porto I, Paraggio L, Fedele E, Barchetta S, De Caterina AR, Rebuzzi AG, Crea F, Galiuto L, Lipiec P, Szymczyk E, Michalski B, Wozniakowski B, Stefanczyk L, Rotkiewicz A, Shim A, Kasprzak JD, Vainer J, Habets J, Lousberg A, Pont De C, Waltenberger J, Farouk H, Heshmat H, Adel A, El Chilali K, Baghdady Y, Sorour K, Gustafsson U, Larsson M, Bjallmark A, Lindqvist P, A'roch R, Haney M, Waldenstrom A, Mladenovic Z, Tavciovski D, Mijailovic Z, Djordjevic - Dikic A, Obradovic S, Matunovic R, Jovic Z, Djuric P, Torp H, Aase S, Dalen H, Sarkola T, Redington AN, Keeley F, Bradley T, Jaeggi E, Sahlen H, Winter R, Brodin L, Sahlen A, Olsen NT, Risum N, Jons C, Mogelvang R, Valeur N, Fritz-Hansen T, Sogaard P. Poster session IV * Friday 10 December 2010, 14:00-18:00. European Journal of Echocardiography 2010. [DOI: 10.1093/ejechocard/jeq146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Paraskevaidis S, Theofilogiannakos EK, Chatzizisis YS, Mantziari L, Economou F, Ziakas A, Hadjimiltiades S, Styliadis IH. Spontaneous dissection of right coronary artery manifested with acute myocardial infarction. Open Cardiovasc Med J 2010; 4:178-80. [PMID: 21127744 PMCID: PMC2995159 DOI: 10.2174/1874192401004010178] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Revised: 07/21/2010] [Accepted: 07/23/2010] [Indexed: 11/22/2022] Open
Abstract
Spontaneous coronary artery dissection is a rare cause of acute ischemic coronary events and sudden cardiac death. It usually occurs in young women without traditional risk factors for coronary artery disease during pregnancy or postpartum period. However, it has also been reported in patients with atherosclerotic coronary disease. We present a case of spontaneous right coronary artery dissection in a 48-year male with recent myocardial infarction and previous percutaneous coronary intervention.
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Affiliation(s)
- Stelios Paraskevaidis
- 1 Cardiology Department, AHEPA Hospital, Aristotle University Medical School, Thessaloniki, Greece
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Hadjimiltiades S, Efthimiades G, Spanos P. Segmental diastolic compression of venous and arterial conduits post coronary artery bypass surgery. J Invasive Cardiol 2010; 22:E150-E152. [PMID: 20679681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
In a case of constrictive pericarditis post coronary artery bypass surgery we describe the diastolic compression of venous and arterial conduits and the timing of compression, as demonstrated during angiography, before and after pericardiectomy. In conclusion, angiographic demonstration of conduit compression is only suggestive of constriction, and consideration of the timing of compression during diastole should be a more specific sign.
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Affiliation(s)
- Stavros Hadjimiltiades
- Cardiology Clinic, AHEPA University Hospital, Stilponos Kyriakide 1, Thessaloniki, Greece.
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Efthimiadis GK, Parcharidou D, Pagourelias ED, Meditskou S, Spanos G, Hadjimiltiades S, Pliakos C, Gavrielides S, Karvounis H, Styliadis IH, Parcharidis GE. Prevalence and clinical outcomes of incidentally diagnosed hypertrophic cardiomyopathy. Am J Cardiol 2010; 105:1445-50. [PMID: 20451692 DOI: 10.1016/j.amjcard.2009.12.066] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2009] [Revised: 12/28/2009] [Accepted: 12/28/2009] [Indexed: 12/16/2022]
Abstract
The purpose of the present study was to evaluate the prevalence and prognosis of patients incidentally diagnosed with hypertrophic cardiomyopathy (HC). We studied 380 consecutive patients with HC (49.3 +/- 17.2 years; 65% men) for a median of 58 months (range 6 to 454). The patients were divided into 2 groups: those incidentally diagnosed from routine examination findings (precordial murmur and/or abnormal electrocardiographic findings) and those diagnosed either because of symptomatic status or by screening because of a family history of HC. Those patients who had been incidentally diagnosed constituted 29.2% of our study cohort. Although overall mortality did not differ between the 2 groups (p = 0.12), the patients diagnosed either because of symptoms or a family history tended to have at least a 4.5-fold greater risk of cardiovascular death (relative risk 4.5, 95% confidence interval 1.04 to 19.6, p = 0.04) and a 4.22 greater risk of sudden death (relative risk 4.22, 95% confidence interval 1.0 to 18.22, p = 0.04). Despite the greater sudden death mortality among the nonincidentally diagnosed patients, no statistically significant difference was found concerning the sudden death risk factor frequency (p = 0.96) between the 2 groups. In conclusion, the discrepancy between the low numbers of patients reported by published registries and the relatively high prevalence of the disease in the general population can be attributed to the large number of patients who remain asymptomatic, even throughout their life, awaiting an accidental diagnosis. Those patients with an incidental diagnosis have a more benign course, as shown by the total cardiovascular and composite sudden death mortality. A high level of awareness and suspicion for HC among physicians is essential for clinical recognition of such patients.
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Affiliation(s)
- Georgios K Efthimiadis
- First Cardiology Department, AHEPA University Hospital, Aristotle University of Thessaloniki Medical School, Thessaloniki, Greece.
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Ziakas AG, Koskinas KC, Gavrilidis S, Giannoglou GD, Hadjimiltiades S, Gourassas I, Theofilogiannakos E, Economou F, Styliadis I. Radial versus femoral access for orally anticoagulated patients. Catheter Cardiovasc Interv 2010; 76:493-9. [DOI: 10.1002/ccd.22527] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Anastasiadis K, Antonitsis P, Hadjimiltiades S, Karapanagiotidis G, Foroulis C, Argiriadou H, Papakonstantinou C. Management of left ventricular free wall rupture under extracorporeal membrane oxygenation support. Int J Artif Organs 2010; 32:756-8. [PMID: 19943238 DOI: 10.1177/039139880903201008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This is a case report of a patient with left ventricular free wall rupture after acute myocardial infarction that was managed successfully with the use of an extracorporeal membrane oxygenation circuit for resuscitation, surgical repair and postoperative circulatory support. Conversion to conventional cardiopulmonary bypass for surgical repair was avoided. Decompression of the left ventricle during the postoperative period promotes myocardial recovery and leads to improved fixation of surgical repair.
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Affiliation(s)
- Kyriakos Anastasiadis
- Department of Thoracic and Cardiovascular Surgery, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
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Vogiatzis I, Hadjimiltiades S, Sachpekidis V, Parcharidis G. Spontaneous coronary artery dissection and acute myocardial infarction during pregnancy. Hellenic J Cardiol 2010; 51:74-80. [PMID: 20118050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Spontaneous coronary artery dissection is a rare cause of infarction in the general population, but a common cause of myocardial infarction during pregnancy, and even nowadays carries a high risk of mortality. We describe the case of a 31-year-old primigravida who presented during the 34th week of pregnancy with the chief complaint of chest pain and was found to suffer from myocardial infarction. She was otherwise healthy and had no known risk factors for coronary artery disease. The patient was treated conservatively with nitrates, aspirin, heparin and beta-blockers, eventually sustained a large myocardial infarction and, after an initial period of instability, remained asymptomatic. A week later she delivered 3 healthy babies. A coronary angiogram performed 3 months after the initial event revealed an extensive obstructive dissection of the circumflex coronary artery. The decision whether to pursue percutaneous coronary intervention, surgical revascularisation or appropriate medical therapy, is based on clinical presentation, the extent of the dissection, and the amount of ischaemic myocardium at risk. Cardiologists must be aware of this rare entity during pregnancy or postpartum, since early diagnosis and treatment are crucial for the survival of the mother and the foetus.
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Affiliation(s)
- Ioannis Vogiatzis
- Cardiology Department, Veria Hospital, Aristotle University of Thessaloniki, Greece.
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Efthimiadis GK, Pliakos C, Pagourelias ED, Parcharidou DG, Giannakoulas G, Kamperidis V, Hadjimiltiades S, Karvounis C, Gavrielidis S, Styliadis IH, Parcharidis G. Identification of high risk patients with hypertrophic cardiomyopathy in a northern Greek population. Cardiovasc Ultrasound 2009; 7:37. [PMID: 19631000 PMCID: PMC2724406 DOI: 10.1186/1476-7120-7-37] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2009] [Accepted: 07/26/2009] [Indexed: 12/28/2022] Open
Abstract
Background The percentage of hypertrophic cardiomyopathy (HCM) patients who are in high risk for Sudden Death (SD) constitutes only a minority of all HCM population but the incidence of SD in this subset is high (at least 5% annually). The identification of this small but important proportion of high risk HCM patients has been the clue in the clinical evaluation of these patients. Methods Our study cohort consisted from 123 patients with HCM who are currently followed up in our Institution. Five clinical risk factors were assessed: a family history of premature SD, unexplained syncope, Non Sustained Ventricular Tachycardia (NSVT) on 24-h ECG monitoring, Abnormal Blood Pressure Response (ABPR) during upright exercise testing and Maximum left ventricular Wall Thickness (MWT) ≥30 mm. The purpose of our study was the identification of high risk HCM patients coming from Northern Greece. Results Fifteen patients (12.2%) of the whole cohort had MWT ≥ 30 mm, 30 patients (24.4%) had an ABPR to exercise, 17 patients (13.8%) had episodes of NSVT in 24-h Holter monitoring, 17 patients (13.8%) suffered from syncope, and 8 patients (6.5%) had a positive family history of premature SD. Data analysis revealed that 74 patients (60.1%) had none risk factor. Twenty four patients (19.5%) had 1 risk factor, 17 patients (13.8%) had 2 risk factors, 4 patients (3.25%) had 3 risk factors, and 4 patients (3.25%) had 4 risk factors, while none patient had 5 risk factors. Twenty five patients (20.3%) had 2 or more risk factors. Conclusion This study for the first time confirms that, although a 60% of patients with HCM coming from a regional Greek population are in low risk for SD, a substantial proportion (almost 20%) carries a high risk for SD justifying prophylactic therapy with amiodaron or ICD implantation.
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Efthimiadis GK, Meditskou S, Vassilikos V, Hadjimiltiades S, Styliadis IH, Parcharidis GE. Surgical septal myectomy versus septal alcohol ablation for hypertrophic obstructive cardiomyopathy. Swiss Med Wkly 2008; 138:322; author reply 322-3. [PMID: 18578089 DOI: 10.4414/smw.2008.12218] [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] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Paraskevaidis S, Giannakoulas G, Polymeropoulos K, Vassilikos V, Girasis C, Hadjimiltiades S, Parcharidis G. Diagnostic value of stored electrograms in pacemaker patients. Acta Cardiol 2008; 63:59-63. [PMID: 18372582 DOI: 10.2143/ac.63.1.2025333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Stored electrograms (EGMs) are diagnostic tools in modern pacemakers, providing data concerning arrhythmia occurrence and device function. We sought to validate the impact of stored EGMs on diagnosis and verification of arrhythmias presented after pacemaker implantation. METHODS AND RESULTS We enrolled 71 consecutive patients (mean age 64 +/- 8 years, 51 men) with a standard indication for pacemaker implantation. The following pacemaker devices were implanted: DDDR = 57, VDDR = 5, VVIR = 9. EGM triggers were atrial tachycardia (AT), non-sustained ventricular tachycardia (NSVT) and ventricular tachycardia (VT). We retrieved and analysed 362 EGMs at 3 and 6 months after implantation. The EGMs were triggered by AT in 260 EGMs (72%), by NSVT in 80 (22%) and by VT in 22 (6%). In total, 243 episodes (67%) confirmed the arrhythmic events, while 119 episodes (33%) were classified as false-positive. They were divided into false-positive AT in 85 EGMs (33%), false-positive NSVT in 28 (35%) and false-positive VT in 6 EGMs (27%). The false-positive AT cases were caused by ventricular far-field sensing from the atrial channel in 34 EGMs (40%) and noise or myopotentials in 51 EGMs (60%). Most of the false-positive VT and NSVT episodes were due to atrial fibrillation or atrial tachycardias in 21 EGMs (62%), while the rest were caused by noise in 11 EGMs (32%) or ventricular T wave oversensing in 2 EGMs (6%). CONCLUSIONS Stored EGMs in pacemaker patients were diagnostic in two thirds of arrhythmic episodes. They are useful tools to diagnose arrhythmias and identify sensing problems, and they contribute to optimal device programming and patient management.
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Affiliation(s)
- Stelios Paraskevaidis
- First Cardiology Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
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Hadjimiltiades S, Harokopos N, Papadopoulos C, Gourassas I, Spanos P, Louridas G. Left main coronary artery stenosis after aortic valve replacement. Hellenic J Cardiol 2005; 46:306-9. [PMID: 16159012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
We describe two cases with iatrogenic left main coronary artery stenosis where a symptomatology of unstable angina appeared within three months of aortic valve replacement surgery. One patient was treated with aortocoronary bypass and the other with angioplasty and stenting.
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Affiliation(s)
- Stavros Hadjimiltiades
- lst Cardiology Department, Aristotelian University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
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Hadjimiltiades S, Tsikaderis D, Louridas G. Rotational ablation of an unexpandable sirolimus-eluting stent. J Invasive Cardiol 2005; 17:116-7. [PMID: 15687540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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Boufidou A, Makedou A, Vroghistinos K, Farmakis T, Hadjimiltiades S, Kourtis A, Makedou K, Katriou D, Louridas G. Cytomegalovirus (CMV) and angiographically documented coronary artery disease. Atherosclerosis 1999. [DOI: 10.1016/s0021-9150(99)80467-5] [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: 10/23/2022]
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Abstract
Coronary perforation can be managed with prolonged balloon inflations, covered stents, or embolization of the vessel. We report on a case of a balloon-induced perforation of the distal left anterior descending artery, that was sealed by injecting preclotted autologous blood through the balloon catheter lumen at the site of the perforation. The patency of the distal vessel was maintained.
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Affiliation(s)
- S Hadjimiltiades
- A' Cardiology Clinic, AHEPA General Hospital, Aristotelion University of Thessaloníki, Greece.
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