Venkateshwar Polsani

Stent-Assisted Coil Embolization of a Large Fusiform Aneurysm of Proximal Anterior Descending Artery Novel Treatment for Coronary Aneurysms

A 37-year-old Asian American man presented with severe stable angina of recent onset over a period of 3 weeks. He was an active policeman, whose only significant past medical history was a prolonged febrile illness with a rash at age 5. Exercise myocardial perfusion stress test was strongly positive with ST depression in inferolateral leads and large reversible perfusion defects in the inferior, inferolateral, and lateral walls of the left ventricle. Cardiac catheterization revealed a large fusiform aneurysm of the proximal left anterior descending (LAD) artery, ectasia of the proximal circumflex artery with 95% narrowing, and an occluded right coronary artery with an occluded proximal aneurysm. (Figure 1). Figure 1. Coronary angiogram showing a proximal aneurysm of the left anterior descending (LAD) artery and ecstatic circumflex artery with severe stenosis inside the ecstatic segment. Coronary CT angiogram showed 3-dimensional extent of the aneurysms, stenoses, and, in particular, the LAD aneurysms relation to the main pulmonary artery. The LAD aneurysm measured 11.7×17.7×24.2 mm, with a 2.5-mm diagonal artery arising from the side wall. (Figure 2). Figure 2. A, Computed tomography (CT) angiogram showing aneurysms and stenoses. B, CT angiogram showing …

Comparison of conventional echocardiographic parameters of RV systolic function with cardiac magnetic resonance imaging

Background Cardiac magnetic resonance (CMR) imaging is the reference standard to assess right ventricular (RV) volumes and ejection fraction. However, 2-D echocardiography is commonly used for routine assessment of the RV and a number of quantitative measures have been recommended to evaluate systolic function. Measurement of right ventricular ejection fraction (RVEF), which is a key predictor of outcomes in a range of right heart diseases, is not recommended because of the limitations of 2-D imaging of the RV. Instead Fractional Area Change (FAC %)by 2-D Echocardiography and tricuspid annular plane systolic excursion (TAPSE) are recommended as surrogate measures of RV global systolic function. The aim of our study is to compare the conventional parameters of RV systolic function currently used by 2-D echocardiography with RVEF and stroke volume (SV) measured by CMR.

Stenting of a left main coronary artery compressed by a dilated main pulmonary artery

Left main coronary artery (LMCA) disease caused by external compression by a dilated main pulmonary artery (MPA) is an uncommon clinical entity but is one of the reversible causes of chest pain in patients with pulmonary hypertension. Traditionally, treatment of LMCA disease involves coronary artery bypass graft surgery. However, for LMCA compression by a dilated MPA, coronary angioplasty with stenting has recently been reported to have good outcomes and might be more suitable in some patients with high risk associated with surgery. Herein, we describe a 54‐year‐old man with pulmonary arterial hypertension and external compression of the LMCA by the dilated main pulmonary artery that was treated with angiographic and intravascular ultrasound‐guided coronary angioplasty and stenting. Also we briefly review current literatures about LMCA compression by a dilated MPA.

3-D PRINTING OF BIOLOGICAL TISSUE-MIMICKING AORTIC ROOT USING A NOVEL META-MATERIAL TECHNIQUE: POTENTIAL CLINICAL APPLICATIONS

Mimicking the dynamic mechanical properties of the human aorta in 3D printed models is challenging because of the inherent difference between mechanical behaviors of polymeric materials and human tissues (Fig. A). We sought to print the aortic root using materials which achieved the strain-

A Rare Case of Cardiac Hemangioma Causing Ventricular Fibrillation

Internal Medicine, The Methodist Hospital, Houston, Texas; yMethodist DeBakey Heart and Vascular Center, The Methodist Hospital, Houston, Texas; and the zDepartment of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas. Manuscript received January 7, 2013; revised manuscript received January 23, 2013, accepted January 29, 2013. Journal of the American College of Cardiology Vol. 62, No. 6, 2013 2013 by the American College of Cardiology Foundation ISSN 0735-1097/

Imaging Assessment of Functional Tricuspid Regurgitation

36.00 Published by Elsevier Inc. http://dx.doi.org/10.1016/j.jacc.2013.01.104

INFERIOR VENA CAVA FILTER STRUT FRACTURE WITH RIGHT VENTRICULAR IMPLANTATION

Functional tricuspid regurgitation (TR) is mainly due to disruption in the geometry of the tricuspid annulus secondary to tricuspid annular dilatation and right ventricular enlargement with or without pulmonary hypertension. Multiple imaging modalities have been used to evaluate the severity of functional TR. Echocardiography remains the most widely utilized modality for TR assessment but there is a growing role for cardiac magnetic resonance imaging which has better spatial and temporal resolution. Multi-modality imaging techniques are sometimes needed for adequately assessing the severity of functional TR.

PROGNOSTIC VALUE OF CORONARY COMPUTED TOMOGRAPHIC ANGIOGRAPHY WITH PROSPECTS ECG GATING

A 63-year-old Caucasian female on hormone replacement therapy presented with acute onset chest pain of 48 hours duration. Her past medical history included multiple episodes of DVT and bilateral PE in 2009. She was status post placement of a prophylactic Greenfield (Meridian Bard G2) filter

Prevalence of partial anomalous pulmonary venous connection in adult patients undergoing cardiac magnetic resonance for evaluation of atrial septal defect

Coronary Computed Tomographic Angiography (CCTA) with prospective ECG gating (PG) reduces radiation exposure as compared to retrospective ECG gating (RG), yet its prognostic value is less validated. Our aim was to compare prognostic performance of 64 slice CCTA with PG vs RG in patients (pts) with

Stenting of a left main coronary artery compressed by a dilated main pulmonary artery: Stenting Left Main

Methods A total of 53 consecutive patients who were referred for evaluation of ASD by CMR from 2009-2011 were enrolled in the study. The patients with ASD in the setting of complex congenital heart disease were excluded. All patients were being considered for either percutaneous or surgical closure of ASD. The CMR protocol has been described previously and included standard SSFP (steady state free precision) cines to define the LV morphology and function, phase contrast was used to calculate the shunt fraction and define the ASD morphology, and a high resolution contrast enhanced 3-D MR angiograms were performed to assess pulmonary venous anatomy.