Search Our Scientific Publications & Authors

J Cardiol Cases 2014 Mar 28;9(3):106-108. Epub 2013 Dec 28.

Department of Cardiology, Aberdeen Royal Infirmary, Aberdeen, United Kingdom.

We describe a case of a 45-year-old man presenting with acute myocardial infarction investigated by computed tomography coronary angiography. Interestingly all three coronary arteries arose from the right coronary cusp. The left anterior descending artery (LAD) subtended an acute angle from the aortic root, associated with significant kinking and stenosis at the ostium, before passing anteriorly, taking a sub-pulmonic course and descending in the anterior interventricular groove. Read More

J Cardiol Cases 2013 Nov 28;8(5):161-163. Epub 2013 Sep 28.

Department of Cardiology, Government Medical College, Kozhikode, Kerala 673008, India.

Isolated pulmonic valve endocarditis is an uncommon clinical entity and is usually associated with intravenous drug abuse. We describe a case of isolated pulmonary valve endocarditis in a young woman with no apparent precipitating factors other than a history of recent normal delivery. During the clinical course she suffered a pulmonary embolism which could be managed conservatively and she was discharged after a 4-week course of antibiotic therapy. Read More

Rom J Morphol Embryol 2018 ;59(3):903-909

Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, Romania;

A 46-year-old female diagnosed several years ago with arterial hypertension and an ischemic stroke with significant recovery was admitted for dyspnea on usual physical activity and fatigue. Physical examination revealed signs of heart failure with crackles on both lung bases, distented jugular veins, accentuated pulmonic valve closure (P2) and tricuspid regurgitation murmur. Echocardiography identified a large tumor in the left atrium, suggestive of atrial myxoma, which caused a severe functional mitral stenosis and produced severe pulmonary hypertension. Read More

J Cardiothorac Vasc Anesth 2018 Sep 27. Epub 2018 Sep 27.

Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD. Electronic address:

J Vet Cardiol 2018 Dec 18;20(6):405-414. Epub 2018 Oct 18.

Department of Biostatistics and Clinical Epidemiology, Université Paris-Est, Ecole Nationale Vétérinaire D'Alfort, 7 Avenue Du Général de Gaulle, 94704, Maisons-Alfort cedex, France.

Introduction: The objectives of this study were to characterize the epidemiological, clinical, and echocardiographic features of French bulldogs (FBs) with congenital pulmonic stenosis and document their survival times and risk factors for cardiac death (CD).

Animals: This study included 66 FBs with congenital pulmonic stenosis.

Methods: Prospective cohort study including a survival analysis to assess time to CD. Read More

J Am Coll Cardiol 2018 Dec;72(22):2729-2731

Department of Cardiology, Boston Children's Hospital, Cardiovascular Division, Brigham and Women's Hospital, and Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: https://twitter.com/DrAdaStefanescu.

EuroIntervention 2018 Nov 13. Epub 2018 Nov 13.

Hôpital Marie Lannelongue, Le Plessis Robinson, France.

Aims: Multiple surgical revisions are often necessary in individuals with congenital heart defects affecting the RVOT or pulmonary valve. There are no multicentre data on the feasibility and safety of percutaneous pulmonary valve implantation using the SAPIEN 3 (S3) transcatheter heart valve.

Methods And Results: Pulmonic S3 is an observational registry of patients undergoing PPVI with the S3 valve across centres in Europe and Canada. Read More

Echocardiography 2018 Dec 9;35(12):2113-2116. Epub 2018 Nov 9.

Cleveland Clinic Children's Hospital, Cleveland, Ohio.

Cor Triatriatum Dexter (CTD) is a rare congenital anomaly involving the systemic venous valves. Failure of regression of the right-sided sinus venosus valve leads to abnormal septation of the right atrium and a variety of right atrial and tricuspid valve obstructive lesions. The presentation can be varied ranging from asymptomatic to persistent neonatal cyanosis. Read More

Clin Nucl Med 2019 Jan;44(1):55-56

Nuclear Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands.

A 57-year-old man presented with shortness of breath and ankle edema. Constrictive pericarditis with an unexplained mass surrounding the heart was diagnosed by ultrasound. Accordingly, F-FDG PET/CT was performed. Read More

Heart 2018 Oct 18. Epub 2018 Oct 18.

Philadelphia Adult Congenital Heart Center, Penn Medicine and the Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Turk Thorac J 2018 Sep 13. Epub 2018 Sep 13.

Clinic of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey.

Objectives: Postoperative dyspnea is common after cardiac surgery, even in low-risk patients. Cardiac surgeons and anesthesiologists are familiar with patients suffering from dyspnea in the early postoperative period, but in some cases, conventional treatment strategies may be ineffective, and a consultation with a pulmonologist may be required. The aim of this study is to investigate the causes of dyspnea after cardiac surgery in this particular patient group. Read More

Vet Radiol Ultrasound 2018 Oct 14. Epub 2018 Oct 14.

Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California, 95616.

Coronary artery anomalies have been reported in Bulldogs and present an increased risk when performing balloon valvuloplasty. Identification of coronary anomalies has been reported using multidetector-row computed tomographic (MDCT) angiography with electrocardiographic gating. However, the utility of non-electrocardiographic-gated 16-row computed tomographic for MDCT for the identification of coronary artery anatomy or anomalies to the authors' knowledge has not been fully investigated. Read More

JACC Cardiovasc Interv 2018 Oct;11(19):1920-1929

Sidra Cardiovascular Center of Excellence, Weill Cornell Medical College, Doha, Qatar.

Objectives: This study provides the 3-year follow-up results of the COMPASSION (Congenital Multicenter Trial of Pulmonic Valve Regurgitation Studying the SAPIEN Transcatheter Heart Valve) trial. Patients with moderate to severe pulmonary regurgitation and/or right ventricular outflow tract conduit obstruction were implanted with the SAPIEN transcatheter heart valve (THV).

Background: Early safety and efficacy of the Edwards SAPIEN THV in the pulmonary position have been established through a multicenter clinical trial. Read More

PLoS One 2018 27;13(9):e0204435. Epub 2018 Sep 27.

Department of Clinical Physiology and Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden.

Background: Prior studies suggested that myocardial deformation is superior to conventional measures for assessing ventricular function. This study aimed to evaluate right ventricular (RV) myocardial deformation in response to increased afterload. Patients with the RV in the systemic position were compared with patients with the RV in the sub-pulmonic position with normal or only slightly elevated systolic right ventricular pressure. Read More

Curr Cardiol Rep 2018 Sep 26;20(11):119. Epub 2018 Sep 26.

Department of Medicine (Cardiovascular Division), University of Virginia Health System, 1215 Lee Street, PO Box 800158, Charlottesville, VA, 22908, USA.

Purpose Of Review: This article will review the current techniques in cardiac magnetic resonance imaging (CMR) for diagnosing and assessing primary valvular heart disease.

Recent Findings: The recent advancements in CMR have led to an increased role of this modality for qualifying and quantifying various native valve diseases. Phase-contrast velocity encoded imaging is a well-established technique that can be used to quantify aortic and pulmonic flow. Read More

Prog Cardiovasc Dis 2018 Sep - Oct;61(3-4):347-359. Epub 2018 Sep 17.

Division of Pediatric Cardiology, Department of Pediatrics, Duke University, Durham, NC; Address reprint requests to: Gregory A. Fleming, MD, Duke University Hospital, Division of Pediatric Cardiology, 2301 Erwin Rd, Box 3090, Durham, NC 27710. Electronic address:

Pulmonary and/or tricuspid valve dysfunction is common among individuals with congenital heart disease, and surgical intervention often carries prohibitive risks. Transcatheter valve replacement (TVR) of the right-sided cardiac valves has become a viable treatment option over the past two decades, while continued technological development aims to broaden its applicability to an even larger portion of those with repaired congenital heart disease. To date, two transcatheter valves have been approved for use in patients with dysfunctional right ventricular to pulmonary artery conduits as well as those with failing pulmonic bioprosthetic valves, and are also used off-label in the "native" RVOT and within surgically repaired/replaced but failing tricuspid valves. Read More

JACC Cardiovasc Interv 2018 Oct 12;11(19):1917-1919. Epub 2018 Sep 12.

Smidt Heart Institute and Department of Pediatrics, Cedars Sinai Medical Center, Los Angeles, California. Electronic address:

JACC Cardiovasc Interv 2018 Oct 12;11(19):1909-1916. Epub 2018 Sep 12.

Centre Hospitalier Universitaire de Nantes, Institut du Thorax, Fédération des Cardiopathies Congénitales, Service de Cardiologie, Nantes, France.

Objectives: The aim of this study was to describe and analyze data from patients treated in France with the Edwards SAPIEN transcatheter heart valve (Edwards Lifesciences LLC, Irvine, California) in the pulmonary position.

Background: The Edwards SAPIEN valve has recently been introduced for percutaneous pulmonary valve implantation (PPVI).

Methods: From April 2011 to May 2017, 71 patients undergoing PPVI were consecutively included. Read More

Cardiovasc Revasc Med 2018 Sep 3. Epub 2018 Sep 3.

Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, MA, United States of America. Electronic address:

Background/purpose: Percutaneous pulmonic valve implantation (PPVI) is an alternative treatment strategy to surgical pulmonic valve implantation (SPVI) for right ventricular outflow tract (RVOT) dysfunction. This study sought to compare outcomes of both treatment strategies.

Methods: The study population was extracted from the 2014 Nationwide Readmissions Database (NRD) using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for PPVI and SPVI. Read More

Eur Rev Med Pharmacol Sci 2018 Aug;22(16):5355-5363

Department of Pediatrics, Jingjiang People's Hospital, Jingjiang, China.

Objective: To investigate whether metformin can relieve acute respiratory distress syndrome (ARDS). Its potential mechanism was also explored.

Materials And Methods: The ARDS model was established by injecting LPS into mice that received metformin in advance and the mice in the control group. Read More

MAGMA 2018 Aug 31. Epub 2018 Aug 31.

Department of Radiology, UCSD, San Diego, CA, USA.

Purpose: With the hypothesis that 4D flow can be used in evaluation of cardiac shunts, we seek to evaluate the multilevel and interreader reproducibility of measurements of the blood flow, shunt fraction and shunt volume in patients with atrial septum defect (ASD) in practice at multiple clinical sites.

Materials And Methods: Four-dimensional flow MRI examinations were performed at four institutions across Europe and the US. Twenty-nine patients (mean age, 43 years; 11 male) were included in the study. Read More

Wien Med Wochenschr 2018 Nov 29;168(15-16):375-383. Epub 2018 Aug 29.

, Martinstraße 7, 3400, Klosterneuburg, Österreich.

During the plague epidemic 1897 in Bombay a medical commission of the Austrian Academy of Sciences carried out clinical, pathologic-anatomical, -histological and bacteriological investigations. With the plague bacteria strains brought to Vienna bacteriological investigations and infection experiments with various species of animals were done. Finishing the animal investigations, the laboratory helper Franz Barisch caught a plague infection unnoticedly and four days later, on October 18th, 1898, he died with a heavy pulmonary affection. Read More

Am J Ophthalmol Case Rep 2018 Sep 17;11:153-157. Epub 2018 Apr 17.

Vitreoretinal Division King Khaled Eye Specialist Hospital, Al Oroubah St, Riyadh, Saudi Arabia.

Purpose: To describe two young Saudi brothers with bilateral progressive retinal arterial aneurysms and a subtotal exudative retinal detachment with Coats-like presentation in the older sibling as the initial presentation of Familial Retinal Arterial Macroaneurysms (FRAM).

Observations: Two young Saudi brothers with a family history of consanguinity presented with the classic clinical presentation and genetic identification of FRAM. In this report, we describe the presence of prominent peripheral retinal capillary changes mimicking Coats' disease. Read More

Cureus 2018 Jun 5;10(6):e2737. Epub 2018 Jun 5.

Department of Paediatrics & Child Health, Aga Khan University Hospital, Karachi, PAK.

Congenitally corrected transposition of the great arteries (CCTGA) is a rare congenital cardiac defect with atrioventricular and ventriculoarterial discordance which leads to heart failure and limits patients' lifespan. We report the case of a 70-year-old lady, from a poor province in Pakistan, who presented for the first time with palpitations and was diagnosed to have CCTGA. She had moderate pulmonic valve stenosis which was protective against heart failure. Read More

J Vet Intern Med 2018 Sep 5;32(5):1570-1578. Epub 2018 Aug 5.

Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California.

Background: Velocity ratio, velocity time integral (VTI) ratio, and pulmonary valve area indexed to body surface area (iPVA) are methods of assessment of pulmonary valve stenosis (PS) severity that are less dependent on blood flow. Studies evaluating these methods are limited.

Objectives: To determine the effects of butorphanol, atenolol, and balloon valvuloplasty (BV) on velocity ratio, VTI ratio, iPVA, mean PG, and max PG. Read More

Tex Heart Inst J 2018 06 1;45(3):190-191. Epub 2018 Jun 1.

Clin Imaging 2018 Nov - Dec;52:106-112. Epub 2018 Jul 7.

Cardiology, University of Chicago Medicine, Chicago, IL, United States of America. Electronic address:

Background: Patients with surgically repaired tetralogy of Fallot (rTOF) often have residual pulmonic valve regurgitation, leading to abnormal remodeling and dysfunction of the right ventricle often requiring pulmonic valve replacement. We tested the hypothesis that 3D analysis of right ventricular (RV) shape and function may reveal differences in regional adaptive remodeling that occurs in patients with rTOF, depending on whether a transannular patch (TAP) was utilized.

Methods: Forty patients with rTOF who underwent cardiac magnetic resonance imaging (1. Read More

J Am Anim Hosp Assoc 2018 Sep/Oct;54(5):e54502. Epub 2018 Jul 24.

From the Department of Internal Medicine, BluePearl Veterinary Partners, Louisville, Kentucky (G.K.C., D.N., S.R.); and Department of Cardiology, BluePearl Veterinary Partners, Tampa, Florida (A.S.).

An 11 yr old female spayed golden retriever weighing 30.3 kg presented for evaluation of progressive lethargy, anorexia, tachypnea, stiff gait, and nonlocalized pain. On physical exam, the patient was febrile and tachycardic, and an arrhythmia with pulse deficits was noted. Read More

S D Med 2018 Mar;71(3):130-132

University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.

There are many variations of coronary anatomy encountered during coronary angiogram. Anatomy demonstrating a single coronary artery is a rare congenital coronary artery anomaly. The entire heart is supplied solely by a coronary artery with single coronary ostium. Read More

Neonatology 2018 25;114(3):198-204. Epub 2018 Jun 25.

Department of Pediatric Cardiology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.

Background: With the increasing incidence of births of very preterm very-low-birth-weight infants, there is a demand for echocardiographic reference values of cardiac dimensions.

Objectives: The aim of this study was to provide reference values of cardiac valve annulus diameters in a cohort of extremely preterm very-low-birth-weight neonates and to correlate these with patient characteristics.

Methods: Valve diameters of 376 infants of < 32 weeks' gestation and with a birth weight of ≤2,000 g were measured using 2-dimensional echocardiography. Read More

Am J Health Syst Pharm 2018 Jul 12;75(14):1018-1022. Epub 2018 Jun 12.

Pharmacy Department, Providence Alaska Medical Center, Anchorage, AK.

Purpose: A case report of fatal disseminated cryptococcosis in a patient treated with eculizumab is presented along with a review of literature suggesting a possible etiologic mechanism.

Summary: A 23-year-old man with a history of minimal change nephrotic syndrome was hospitalized for acute kidney injury and abdominal pain and swelling. He was found to have disseminated pneumococcal disease, including peritonitis, bacteremia, and pulmonic endocarditis. Read More

J Cardiothorac Vasc Anesth 2018 10 4;32(5):2402-2408. Epub 2018 May 4.

The Aortic Institute, Yale University School of Medicine, New Haven, CT.

Cardiovasc Res 2018 Jun 6. Epub 2018 Jun 6.

Institute of Medical Science, University of Toronto, Toronto, Canada.

Aims: The assumption of equivalence between right ventricular and pulmonary arterial systolic pressure is fundamental to several assessments of right ventricular or pulmonary vascular hemodynamic function. Our aims were to 1) determine whether systolic pressure gradients develop across the right ventricular outflow tract in healthy adults during exercise, 2) examine the potential correlates of such gradients, and 3) consider the effect of such gradients on calculated indices of right ventricular function.

Methods And Results: Healthy untrained and endurance-trained adult volunteers were studied using right-heart catheterization at rest and during submaximal cycle ergometry. Read More

Circ Cardiovasc Imaging 2018 Jun;11(6):e007698

Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai School of Medicine, New York, NY (F.M., J.S.-S.).

Med Phys 2018 May 28. Epub 2018 May 28.

Radiological Sciences, Graduate Division of Health Sciences, Komazawa University, Tokyo, 154-8525, Japan.

Purpose: The validation of deformable image registration (DIR)-based pulmonary ventilation mapping is time consuming and prone to inaccuracies and is also affected by deformation parameters. In this study, we developed a nonrigid phantom as a quality assurance (QA) tool that simulates ventilation to evaluate DIR-based images quantitatively.

Methods: The phantom consists of an acrylic cylinder filled with polyurethane foam designed to simulate pulmonic alveoli. Read More

Am Heart J 2018 Jul 26;201:136-140. Epub 2018 Apr 26.

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN. Electronic address:

Background: The optimal interval between serial cardiac magnetic resonance imaging (CMRI) scans for monitoring right ventricular (RV) enlargement in the setting of severe pulmonic valve regurgitation (PR) is unknown. The purposes of this study were to (1) determine the annual change in RV volume on serial CMRI scans and (2) identify the risk factors for rapid progression of RV enlargement.

Methods: A retrospective study of adults with postintervention native valve PR and ≥2 CMRI scans at Mayo Clinic Rochester from 2000 to 2015 was conducted. Read More

Catheter Cardiovasc Interv 2018 Sep 18;92(3):522-525. Epub 2018 May 18.

Department for Pediatric Cardiology and Pediatric Intensive Care, LMU - Campus Großhadern, Ludwig Maximilians University, Munich, Germany.

Despite the increasing use of percutaenous valves, little is known about valve performance after external chest compression. We report a case of a compressed pulmonary Edwards Sapien® XT valve after resuscitation. With the patient on ECMO, successful redilatation was performed with unimpaired postprocedural valve function. Read More

A A Pract 2018 Oct;11(8):230-232

Surgery, Cardiovascular Division, Saitama Prefectural Cardiovascular and Respiratory Center, Kumagaya, Japan.

Pediatr Cardiol 2018 Aug 4;39(6):1165-1171. Epub 2018 May 4.

Division of Cardiothoracic Surgery, Children's Hospital of Philadelphia, Philadelphia, USA.

The placenta is a complex organ that influences prenatal growth and development, and through fetal programming impacts postnatal health and well-being lifelong. Little information exists on placental pathology in the presence of congenital heart disease (CHD). Our objective is to characterize the placenta in CHD and investigate for distinctions based on type of malformation present. Read More

Int J Cardiol 2018 Aug 22;265:47-51. Epub 2018 Apr 22.

German Heart Centre Munich, Department of Paediatric Cardiology and Congenital Heart Defects, Munich, Germany.

Background: Patients with congenital cardiovascular disease involving the right ventricular outflow tract and with prosthetic valves in the heart are at high risk for developing infective endocarditis (IE). Recently, there has been concern about relatively high rates of IE after percutaneous pulmonary valve implantation (PPVI). Although there are factors specific to percutaneous valves that could plausibly contribute to the risk of IE, including procedural steps prior to implantation such as crimping the valved stent or mechanical forces during dilation, little is known about actual risk factors for this complication. Read More

Heart 2018 Nov 2;104(22):1864-1870. Epub 2018 May 2.

Cardiac Surgery, Bristol Royal Hospital for Children, University Hospital Bristol NHS Trust, Bristol, UK.

Objectives: Treatment of infants with tetralogy of Fallot (ToF) has evolved in the last two decades with increasing use of primary surgical repair (PrR) and transcatheter right ventricular outflow tract palliation (RVOTd), and fewer systemic-to-pulmonary shunts (SPS). We aim to report contemporary results using these treatment options in a comparative study.

Methods: This a retrospective study using data from the UK National Congenital Heart Disease Audit. Read More

Schweiz Arch Tierheilkd 2018 May;160(5):295-303

Clinic of Diagnostic Imaging, Vetsuisse Faculty, University of Zurich.

Introduction: In cardiac magnetic resonance imaging (CMR), accurate flow measurements rely on perpendicular plane-alignment with flow direction. For 2D phase contrast (PC) cardiac magnetic resonance measurements, planes have to be defined during the examination of the heart, which is time consuming and error-prone. Collection of flow information of the entire volume of the heart by a 4D flow CMR postpones plane alignment to post-processing. Read More

Clin Nucl Med 2018 Jun;43(6):e184-e185

Meningiomas are typically benign solitary intracranial tumors. Atypical (World Health Organization [WHO] grade II) or malignant/anaplastic (WHO grade III) meningiomas are seldom, and distant metastases occur only in rare exceptions. We present a case of a 54-year-old male patient with atypical (WHO grade II) meningioma who underwent 1 cycle of peptide receptor radionuclide therapy. Read More

Clin Nucl Med 2018 Jun;43(6):e186-e188

Ga-PSMA-11 PET/CT was performed in a 74-year-old man because of biochemical recurrence of prostate cancer following radiation therapy of the prostate gland 24 months earlier. Besides focal nuclide accumulation in the prostate gland suggestive of local recurrence, PET scan revealed no further pathologic uptake. However, CT showed multiple pulmonic nodules suggestive of metastases. Read More

Pol J Radiol 2017 17;82:645-659. Epub 2017 Nov 17.

Department of Pediatrics, Zagazig University, Zagazig, Egypt.

Background: The aim of the study is to emphasize the role of 128 MSCT angiography in the diagnosis of congenital cyanotic heart diseases.

Material/methods: This study included sixty patients and was conducted from December 2014 to July 2016 in the Multidetector CT unit of Zagazig University hospitals. All images included axial, MPR, MIP, and VRT and were interpreted in one session. Read More

Diseases 2018 Apr 13;6(2). Epub 2018 Apr 13.

Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB T6G 2B7, Canada.

Increased blood pressure in the pulmonary artery is referred to as pulmonary hypertension and often is linked to loud pulmonic valve closures. For the purpose of this paper, it was hypothesized that pulmonary circulation vibrations will create sounds similar to sounds created by vocal cords during speech and that subjects with pulmonary artery hypertension (PAH) could have unique sound signatures across four auscultatory sites. Using a digital stethoscope, heart sounds were recorded at the cardiac apex, 2 left intercostal space (2LICS), 2 right intercostal space (2RICS), and 4 left intercostal space (4LICS) undergoing simultaneous cardiac catheterization. Read More

Circulation 2018 May 12;137(20):e578-e622. Epub 2018 Apr 12.

Background And Purpose: The diverse causes of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease. Progressive RV dysfunction in these disease states is associated with increased morbidity and mortality. The purpose of this scientific statement is to provide guidance on the assessment and management of RHF. Read More