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Patients with severe thiamine deficiency leading to wet beriberi typically present with high output heart failure and predominately right sided symptoms, but a rare and acute form of beriberi known as Shoshin Beriberi can lead to acute cardiovascular collapse. A 52-year-old woman with a history of

Background Transcatheter pulmonary valve implantation is approved for the treatment of dysfunctional right ventricle to pulmonary artery conduits. However, the literature is limited because of a small patient population, and it does not reflect changing procedural practice patterns over the last decade. Methods and Results A comprehensive search of Medline and Scopus databases from inception through August 31, 2016 was conducted using predefined criteria. We included studies reporting transcatheter pulmonary valve implantation in at least 5 patients with a follow‐up duration of 6 months or more. In 19 eligible studies, 1044 patients underwent transcatheter pulmonary valve implantation with a pooled follow‐up of 2271 person‐years. Procedural success rate was 96.2% (95% confidence intervals [CI], 94.6–97.4) with a conduit rupture rate of 4.1% (95% CI , 2.5–6.8) and coronary complication rate of 1.3% (95% CI , 0.7–2.3). Incidence of reintervention was 4.4 per 100 person‐years overall (95% CI , 3.0–5.9) with a marked reduction in studies reporting ≥75% prestenting (2.9 per 100 person‐years [95% CI , 1.5–4.3] versus 6.5/100 person‐years [95% CI , 4.6–8.5]; P CI , 0.9–2.0). Conclusions Our study provides favorable updated estimates of procedural and follow‐up outcomes after transcatheter pulmonary valve implantation. Widespread adoption of prestenting has improved longer‐term outcomes in these patients.

A 67-year-old man with a history of hypertension and coronary artery disease (requiring aortocoronary bypass 18 years ago and multiple percutaneous coronary interventions) presented to a referring hospital with chief symptoms of fever, chills, and diaphoresis after a recent gastrointestinal illness

An 88-year-old woman underwent attempted percutaneous coronary intervention (PCI) through a right radial approach. Catheterization was complicated by radial artery perforation. Conservative therapeutic options including external compression, advancement of a diagnostic catheter distal to the perforation, and balloon tamponade failed to control the bleeding requiring deployment of a Polytetrafluoroethylene (PTFE)-covered stent to seal the perforation. We describe the stepwise approach advocated for managing a radial perforation and summarize relevant literature available for the same.

AIM To study the relationship of jailed polymer jacketed guide wires (PGW) with procedural myocardial infarction (PMI) after bifurcation coronary interventions. METHODS Consecutive bifurcation interventions performed from January 2010 to October 2014 were included in the study. Chart review was performed to obtain demographic, clinical and procedural data. PMI was defined as Creatine Kinase MB > 3 × upper reference limit of normal. Multivariate logistic regression was used to ascertain relationship of PGW use with PMI. RESULTS Two hundred and ninety-three patients (age 63.5 ± 12.3 years; 33.8% diabetic) were included in the study. Eighty point two percent (n = 235) were true bifurcation lesions use of PGW was associated with PMI on univariate analysis (OR = 4.1; P = 0.002). This association remained significant after adjusting for other possible risk factors (OR = 3.5; P = 0.02). CONCLUSION Our results suggest that PGW use for side branch protection may be associated with PMI. Randomized studies are needed to validate these findings.