Cardiovascular Diseases Commons^™

On Getting What We Deserve: Differeing Perspectives, Herbert L Fred

The Texas Heart Institute Journal

No abstract provided.

Paclitaxel Induces Thrombomodulin Downregulation In Human Aortic Endothelial Cells, Huang-Joe Wang, Te-Ling Lu, Haimei Huang, Huey-Chun Huang

The Texas Heart Institute Journal

Patients with paclitaxel-eluting stents are at risk of developing stent thrombosis upon premature discontinuation of dual antiplatelet therapy. In this study, we set out to clarify whether paclitaxel can modulate thrombomodulin expression in human aortic endothelial cells. Human aortic endothelial cells were stimulated with paclitaxel. Methoxyphenyl tetrazolium inner salt cell viability assay, Western blot analysis, real-time polymerase chain reaction, and immunohistochemical assay were performed. In human aortic endothelial cells, paclitaxel (10(-5) to 10(-9) mol/L) treatment for 13 hours caused significant cytotoxicity at drug concentrations greater than 10(-7) mol/L. Paclitaxel (10(-5) to 10(-9) mol/L) treatment for 5 hours downregulated thrombomodulin expression …

Closure Of A Para-Valvular Aortic Leak With The Use Of 2 Amplatzer Devices And Real-Time 2− And 3-Dimensional Transesophageal Echocardiography, Kurt S Hoffmayer, Christian Zellner, Damon M Kwan, Suma Konety, Elyse Foster, Phillip Moore, Yerem Yeghiazarians

The Texas Heart Institute Journal

Paravalvular leaks are well-recognized sequelae of mechanical aortic valve implantation. Clinical manifestations include hemolysis, arrhythmias, and congestive heart failure. Frequently, patients who receive mechanical aortic valves are poor candidates for repeat valve surgery, and the reoperative mortality rate is high. Percutaneous intervention has recently become an alternative to surgery in selected patients. Herein, we describe the percutaneous closure of an aortic paravalvular leak in a 45-year-old man who had undergone 2 aortic valve replacements with mechanical valves. The patient, who was at high surgical risk due to comorbidities, underwent the implantation of 2 AMPLATZER devices with the use of real-time …

Management Of Acute Regurgitation In Left-Sided Cardiac Valves, Nahush A Mokadam, Karen K Stout, Edward D Verrier

The Texas Heart Institute Journal

The management of acute, severe cardiac valvular regurgitation requires expeditious multidisciplinary care. Although acute, severe valvular regurgitation can be a true surgical emergency, accurate diagnosis and subsequent treatment decisions require clinical acumen, appropriate imaging, and sound judgment. An accurate and timely diagnosis is essential for successful outcomes and requires appropriate expertise and a sufficiently high degree of suspicion in a variety of settings. Whereas cardiovascular collapse is the most obvious and common presentation of acute cardiac valvular regurgitation, findings may be subtle, and the clinical presentation can often be nonspecific. Consequently, other acute conditions such as sepsis, pneumonia, or nonvalvular …

Left Atrial Ablation For Atrial Fibrillation: Creating The “Box Lesion” With A Bipolar Radiofrequency Device, Leonid Sternik, Hartzel V Schaff, David Luria, Michael Glikson, Alexander Kogan, Ateret Malachy, Maya First, Ehud Raanani

The Texas Heart Institute Journal

The maze procedure is the gold standard for the ablation of atrial fibrillation, and the “box lesion” around the pulmonary veins is the most important part of this procedure. We have created this lesion with a bipolar radiofrequency ablator, abandoning the usual use of this device (to achieve bilateral epicardial isolation of the pulmonary veins).

From March 2004 through the end of May 2010, we performed surgical ablation of atrial fibrillation in 240 patients. Of this number, 205 underwent operation by a hybrid maze technique and the remaining 35 (our study cohort) underwent the creation of a box lesion around …

Smooth Muscle Hyperplasia Due To Acta2/Myh11 Mutations: Identification Of Novel Pathology And Pathways Leading To Aneurysms And Diverse Vascular Occlusive Diseases, Christina L. Papke

Dissertations and Theses (Open Access)

Missense mutations in smooth muscle cell (SMC) specific ACTA2 (á-actin) and MYH11 (â-myosin heavy chain) cause diffuse and diverse vascular diseases, including thoracic aortic aneurysms and dissections (TAAD) and early onset coronary artery disease and stroke. The mechanism by which these mutations lead to dilatation of some arteries but occlusion of others is unknown. We hypothesized that the mutations act through two distinct mechanisms to cause varied vascular diseases: a loss of function, leading to decreased SMC contraction and aneurysms, and a gain of function, leading to increased SMC proliferation and occlusive disease. To test this hypothesis, ACTA2 mutant SMCs …