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Intranidal vessel geometry and organization underlying flow within cerebral arteriovenous malformations (AVM) is poorly understood. We examine the relationship between intranidal vessel characteristics and AVM flow. Records of patients with AVM evaluated at our institution between 2007 and 2013 were retrospectively reviewed. Patients were included if surgical specimens were available and flows were obtained before treatment using quantitative magnetic resonance angiography. Intranidal vessels were identified and the diameter and cross-sectional area of each vessel were measured from digitized images of specimen slides. The relationship between vessel diameter, vessel cross-sectional area, AVM volume, and AVM flow was assessed. Twenty-nine patients were included. Mean total number of vessels per specimen was 133. Mean total AVM flow was 340 ± 276 mL/min. Mean vessel diameter ranged from 0.18-2.37 mm and mean vessel cross-sectional area ranged from 0.09-9.46 mm(2). Linear regression analysis showed that total flow is significantly associated with larger AVM volume (R(2)=0.28, P=0.007), but not with number of vessels per section of the specimen (P=0.20) or mean vessel diameter (P=0.92). Exponential regression analysis demonstrated that AVM flow is significantly correlated to the sum of the cross-sectional vessel areas within each specimen (R(2)=0.16, P=0.05). Total AVM flow is significantly related to sum of the cross-sectional areas of all vessels within each nidus, rather than to total number of vessels or mean nidal vessel diameter. This finding suggests that the sum of the cross-sectional areas of intranidal vessels likely determines the resistance to flow within a cerebral AVM.

This registry demonstrates that MRI examinations, including thoracic MRI examinations, can be performed safely in patients who have non–MRI-conditional devices, in pacing-dependent patients with im...

Streptococcus agalactiae (S.agalactiae) is known to cause invasive infections in pregnant women, newborns, and immunosuppressed patients. It is an uncommon but life-threatening case of infective endocarditis in middle-aged otherwise healthy adults. We present a case of a patient with life-threatening infective endocaritis caused by Streptococcus agalactiae, who passed away despite medical treatment.

Cardiac metastasis is much more common than primary cardiac tumors. Lung cancer is one of the most common primary malignancies to metastasize to the heart. It is not common for metastasis in the heart to present as a cavitary mass. To our knowledge, four cases have been reported in the literature showing metastatic lung cancer to the heart, presenting as a right ventricular mass.

A 32-year-old African American female presented with dyspnea, and after several cardiac diagnostic tests, the diagnosis of an anomalous origin of the RCA from the pulmonary trunk was established by multislice coronary CT angiography. She underwent surgical correction with reimplantation of the RCA, from the pulmonary artery to the aortic root. However, 10 days after surgery, she developed frequent episodes of chest pain, and repeat coronary CTA showed a partially occlusive thrombus in the surgically reimplanted RCA. Anticoagulation with warfarin resulted in complete resolution of the patient’s symptoms.

For patients traditionally contraindicated for MRIs due to presence of non-MR-conditional cardiac implantable electronic devices (CIED), we established the Patient Registry Of Magnetic resonance imaging in Non-Approved Devices (PROMeNADe). This involves significant resources including research

Introduction/purpose The geometry and organization of intranidal vessels that underlie flow within cerebral arteriovenous malformations (AVM) have not been clearly elucidated. Here, we examine the relationship between intranidal artery characteristics and AVM flow rate. Materials and methods Records of patients with cerebral AVMs evaluated at our institution between 2007–2013 were retrospectively reviewed. Patients were included if a surgical specimen of the nidus was available and if flows were obtained before treatment using quantitative magnetic resonance angiography. Specimens were mounted on slides and stained with hematoxylin and eosin as well as with elastic special stain. Intranidal arteries were identified and the diameter and cross-sectional area of each artery were measured from digitized images of the slides. The total area of the slide studied and magnification used was the same for each patient. Total AVM flow was estimated as aggregate flow within primary arterial feeders or flow in single draining veins. AVM volume was determined from digital subtraction angiography. The relationship between vessel diameter, vessel cross-sectional area, AVM volume, and AVM flow was assessed. Results 29 patients were included. Cohort characteristics are summarized in Table 1. Mean total number of arteries per specimen was 133. Mean total AVM flow was 340 ± 276 mL/min. Mean vessel diameter ranged from 0.18–2.37 mm and mean vessel cross-sectional area ranged from 0.09–9.46 mm 2 . Linear regression analysis showed that total flow is significantly associated with larger AVM volume (R 2 = 0.28, P = 0 .007), but not with the number of arteries per section of the specimen ( P = 0 .20) or mean vessel diameter ( P = 0 .92). Exponential regression analysis demonstrated that AVM flow is significantly correlated to the sum of the cross-sectional areas within each specimen (R 2 = 0.16, P = 0 .05) (Figure 1). Conclusion Total AVM flow is significantly related to the sum of the cross-sectional areas of all arteries within each nidus, rather than to the total number of arteries or mean nidal vessel diameter. This finding suggests that the sum of the cross-sectional areas of intranidal arteries likely determines the permeability of the cerebral AVM nidus. Disclosures S. Shakur: None. T. Valyi-Nagy: None. S. Amin-Hanjani: None. L. Ya9qoub: None. V. Aletich: None. F. Charbel: None. A. Alaraj: None.