Search

Background: Transplant renal artery stenosis (TRAS) is an uncommon complication following renal transplantation. Its usual clinical presentation includes worsening hypertension and/or renal function, without any evidence of graft rejection. Bifurcation renal artery stenosis of the transplanted renal artery is rarely encountered. Methods: Percutaneous transluminal renal angioplasty (PTRA) with or without stenting is the procedure of choice to treat TRAS. We hereby describe a patient, who presented with impaired renal functions, four months following the renal transplantation. He underwent intravascular ultrasound-guided PTRA of the bifurcation lesion of TRAS. Results and conclusion: Superior renal artery had coronary drug-eluting stent implantation, while inferior renal artery and side branch of the superior renal artery had balloon angioplasty, alone. Post-intervention, the raised serum creatinine level decreased from 2.9 mg% to 1.7 mg%. The index case described the successful PTRA and stenting of the bifurcation lesion of TRAS, the technical results of which was optimized with the use of intravascular ultrasound. [ABSTRACT FROM AUTHOR]

Interrupted inferior vena cava (IVC) with azygous continuation provides technical challenge in many percutaneous cardiac interventions. They are performed via the femoral venous access route. We describe four such cases in whom, patent ductus arteriosus (PDA) device closure was done in interrupted IVC. All the four cases were done using the femoral route. Two cases were done via retrograde approach through femoral artery access, in which one was closed with a muscular VSD device and the other with a Gianturco coil. The introduction of newer closure devices helps in the retrograde approach. Two cases were done via anterograde approach through the femoral venous route, with a loop through the azygous vein. One child had transient bradycardia due to cardiac stretch which normalized after the device deployment and introducer system removal. Thus, we describe different fem Thus, we describe different femoral approaches in interrupted IVC patients for PDA closure, with the difficulties faced and the complications managed. [ABSTRACT FROM AUTHOR]

Balloon pulmonary valvuloplasty (BPV) is an interventional procedure that has practically replaced the need of open-heart surgery in patients with severe valvular pulmonary stenosis. However, BPV in dysplastic pulmonary valve (PV) still remains a challenge in the current milieu of advanced technologies. We encountered a unique situation of severe restenosis of PV wherein the attempt to balloon dilate the valve was futile because no balloon remained stable at the level of the valve. This situation was overcome using a PDA device delivery sheath to keep the balloon positioned at the desired location. [ABSTRACT FROM AUTHOR]

Stress-induced ischemia in the right ventricular myocardium on 99mTc-MIBI myocardial perfusion scintigraphy in a rare case of double-chambered right ventricle Right ventricle (RV) myocardial perfusion assessment is not attempted in stress/rest SPECT myocardial perfusion imaging (MPI) owing to poor visualization of the RV myocardium (unless hypertrophied) likely due to lower myocardial blood flow, less myocardial thickness, and limited spatial resolution of present-day gamma cameras.[1] RV wall ischemia can occur along with left ventricular (LV) inferior wall ischemia since both are supplied by the right coronary artery (RCA) and hold significant prognostic value.[2] The authors present a rare case of a 65-year-woman with reversible perfusion defects in inferior wall of left ventricle as well as right ventricle (RV) leading to the incidental detection of double-chambered RV (DCRV) with anomalous muscle band (AMB) in coronary angiography (CAG) as the possible etiology leading to the RV myocardial hypertrophy enabling it to be detected on MPI. 4 Farag AA, Heo J, Tauxe L, Bhambhvani P, Germano G, Kavanagh P. Detection and quantitation of right ventricular reversible perfusion defects by stress SPECT myocardial perfusion imaging: A proof-of-principle study. [Extracted from the article]