Endovascular Management of External Iliac “Snowplowing” Using “Reverse Snowplow” Technique During Transcatheter Aortic Valve Replacement
Veronica Ricker,
Hunter Row,
Anyamaria Edwards,
Johnathan Beaudrie,
Cornelius Dyke,
Thomas Haldis
Issue:
Volume 7, Issue 1, March 2023
Pages:
1-4
Received:
19 December 2022
Accepted:
6 January 2023
Published:
17 January 2023
Abstract: This case describes an 84-year-old female with chronic diastolic heart failure, coronary artery disease status post coronary artery bypass and percutaneous coronary intervention, hypertension, diabetes mellitus and chronic kidney disease stage III, who presented with progressive dyspnea found to have severe aortic stenosis demonstrated by echocardiogram (aortic valve area, .06 cm2; mean gradient, 42 mm Hg). She was evaluated by the Heart Team and deemed to be a candidate for a transfemoral transcatheter aortic valve replacement (TAVR) after computed tomography angiography (CTA) evaluation. During insertion of the valve sheath through the external iliac, intimal “snowplowing” occurred resulting in complete occlusion of the iliac artery. The intima was successfully milked back into anatomical position using a “reverse snowplow” technique. Extravasation was managed with covered stents. The patient recovered over several days and was discharged home on post-procedure day 7. When appropriate, Endovascular management of vascular complications avoids the morbidity associated with open repair. Pre-operative evaluation is imperative in identifying anatomical features that pose a risk to vascular complications. This patient had an increased risk with an elevated iliofemoral tortuosity score, however, had minimal calcification and no acute angulation in the iliofemoral arterial system. This case highlights the complexity of vascular complication management and difficulty faced in identifying patients who are at risk for these types of complications.
Abstract: This case describes an 84-year-old female with chronic diastolic heart failure, coronary artery disease status post coronary artery bypass and percutaneous coronary intervention, hypertension, diabetes mellitus and chronic kidney disease stage III, who presented with progressive dyspnea found to have severe aortic stenosis demonstrated by echocardi...
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Effect of Age and Heart Rate on the Blood Pressure Parameters of 5343 Africans South of the Sahara
Pengd-Wende Habib BousseTraore,
Jean Augustin Diegane Tine,
Oumar Bassoum,
Abdoul Kane,
Adama Faye
Issue:
Volume 7, Issue 1, March 2023
Pages:
5-16
Received:
10 March 2023
Accepted:
28 March 2023
Published:
27 April 2023
Abstract: Regarding the burden of hypertension in sub-Saharan Africa, we wanted to know if age and heart rate would influence blood pressure parameters differently in black African subjects. Our research hypothesis was that there is no difference between the white race and the black race regarding the evolution of blood pressure parameters according to age and heart rate. This was a descriptive study for analytical purposes from secondary analysis of the WHO STEPwise survey in Senegal in 2015. The study included 5343 individuals. As results, isolated systolic hypertension predominated in those over 50 years of age, while isolated diastolic hypertension predominated in subjects under 50 years of age. There is a statistically significant relationship between heart rate and diastolic blood pressure (p-Value<0.001, cor=0.149). Mean diastolic blood pressure evolved in the shape of an "inverted U" with age. Mean systolic blood pressure evolved in the form of a "stair step" with age. The frequency of subjects with pathological pulse pressure was highest in the age groups [50-54 years], [55-59 years], [60-64 years] and [65-70 years]. To conclude, all these findings are also found in studies carried out on white subjects. This is explained by the physiopathology that is common to us such as the cardiac cycle, arterial rigidity, and arterial pulse wave. The measurement of the arterial pulse wave must be made systematic. It should be an integral part of blood pressure measurement because it provides additional diagnostic, prognostic and therapeutic interest in the management of arterial hypertension.
Abstract: Regarding the burden of hypertension in sub-Saharan Africa, we wanted to know if age and heart rate would influence blood pressure parameters differently in black African subjects. Our research hypothesis was that there is no difference between the white race and the black race regarding the evolution of blood pressure parameters according to age a...
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Epidemiology of Chest Pain at the University Hospital Center-Référence Nationale (CHU-RN) of N'Djamena
Dangwé Naibé Temoua,
Mayanna Habkréo,
Ali Mahamat Moussa,
Doune Narcissus,
Ata Joel
Issue:
Volume 7, Issue 1, March 2023
Pages:
17-21
Received:
21 March 2023
Accepted:
10 April 2023
Published:
27 April 2023
Abstract: Introduction: Chest pain is a frequent reason for consultation in Internal Medicine and especially in cardiology. Few data are available on this condition in Chad. The aim of this work was to describe its epidemiological characteristics. Patients and methods: This was a descriptive and analytical cross-sectional study covering a consecutive series. Included were patients aged at least 18 years, seen in a cardiology consultation for non-traumatic chest pain and having performed an ECG and cardiac ultrasound. Results: A total of 146 patients were included in the study. The mean age was 46.1± 16.3 years. The sex ratio was 0.8 in favor of women. Arterial hypertension was the main cardiovascular risk factor found (41.9%). The pain was epigastric in 41.9% of cases and retrosternal in 23.7% of cases. Dyspnea was the most common associated sign (29.9%). Etiologies were dominated by cardiac (56.4%) and digestive (46.2%) causes. The main cardiovascular etiology was coronary insufficiency (42.4%). Regarding digestive causes, they were dominated by gastropathies and gastroduodenal ulcer disease (40.2%). In 17.1% of cases the chest pain was of pulmonary origin. Conclusion: Chest pain is a frequent reason for consultation. The etiologies are diverse. Apart from the cardiovascular causes likely to compromise the vital prognosis, we must not lose sight of the digestive and pulmonary causes.
Abstract: Introduction: Chest pain is a frequent reason for consultation in Internal Medicine and especially in cardiology. Few data are available on this condition in Chad. The aim of this work was to describe its epidemiological characteristics. Patients and methods: This was a descriptive and analytical cross-sectional study covering a consecutive series....
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