CT-guided drainage of postoperative pericardial effusion is a minimally invasive technique for the release of the tamponade effect of the effusion and improvement of cardiac output.

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Background Non-alcoholic fatty liver disease (NAFLD) is increasing in recognition as a hepatic condition that is unrelated to significant alcoholic consumption, but has rather, been suggested to constitute cardiovascular risk (irrespective of traditional risk factors and high-risk plaque features). Both coronary artery disease and NAFLD share the same pathophysiology and metabolic profile. NAFLD can theoretically be a source/initiator for coronary artery disease (CAD). We aimed to study the association between NAFLD, CAD, the presence of high-risk plaque features, and the severity of stenosis. Results We recruited 800 patients with suspected obstructive CAD and planned for coronary computed tomography angiography (CCTA), Exclusion criteria: heavy alcohol consumption; contraindications to contrast media; unevaluated coronary-artery segments; other known liver disease; and use of oral corticosteroids and/or amiodarone. Non-enhanced Computed Tomography abdomen was performed before the CCTA to detect NAFLD. To study the association between NAFLD and the presence of CAD, patients were classified as to either have, or not have CAD. The CAD group were then further studied for the presence of high-risk plaque features: napkin ring sign, Positive remodelling, Low Hounsfield unit (HU), and Spotty calcium; and their association with NAFLD. Thirty-two per cent of patients had NAFLD and 45% had CAD. A significant association between NAFLD and CAD was found (OR 4.21, 95% CI (confidence interval) (2.83–6.25), p = 0.000). In CAD patients, significant associations were present between NAFLD and high-risk plaque features: Napkin ring sign, Positive remodelling, Low HU, and Spotty calcium (OR 7.88, 95% CI (4.39–14.12), p < 0.001, OR 5.84, 95% (3.85–8.85), p < 0.001, OR 7.25, 95% CI (3.31–15.90), p < 0.001 and OR 6.66, 95% CI (3.75–11.82), p < 0.001), respectively. NAFLD was present in 39.30%, 50.00%, 20.00%, 54.50% and 100.00% of patients with CAD; and 1–24%; 25–49%; 50–69%; 7 = 0–99%, LMD (Left Main Disease) > 50% stenosis or 3V disease, and Total occlusion, respectively, p < 0.001. Conclusions NAFLD is strongly associated with CAD, high-risk plaque features and higher grade of stenosis.

Background The aim of this work is to assess the uses of cardiac MR in evaluating post-operative congenital heart disease procedures and related complications. Results This is a retrospective study done in between December 2015 and October 2017, including 71 patients with age ranging from 6 months to 33 years (mean age 16.75). All of the patients were referred for post-operative evaluation after echocardiographic examination to exclude post-operative complications and to plan for re-intervention if needed. Forty-three percent of patients suffered from post-operative complications. The most common congenital heart disease coming for post-operative evaluation was tetralogy of Fallot (TOF) which represented 32% of the cases. The most common post-operative complication in all procedures was pulmonary branch stenosis (12.6%) followed by patch dilatation (9.8 %) and right ventricular failure (7%). In 7 patients following TOF repair, there was aneurysmal dilatation of the patch with significant pulmonary regurgitation. The regurgitation fraction was less than 40% in 3 of them, while the remaining 4 cases showed regurgitation fraction of more than 40%, an indication for re-intervention. Conclusion MRI is an extremely useful imaging method for evaluation of normal and abnormal findings after surgical repair for congenital heart disease. It is effective in providing long-term surveillance and identifying post-procedural complications, which allowed us to further intervene on a timely manner when deemed necessary.

Background: To evaluate the role and usefulness of Multislice CT angiography (CTA) and color Doppler US (CDUS) in assessment of vascular tree of AVFs and comprehensive evaluation of possible shunt complications in ESRD patients on hemodialysis.Methods: Prospective analysis of vascular access related data was obtained from 30 patients (10 Male, 20 Female and age range 18-80 years) referred from hemodialysis unit via CTA and CDUS examination of the upper limbs. All patients were examined to identify the different types of fistula shunt related complications utilizing Doppler indices (PSV, EDV and RI) and different CTA 2D image reconstruction and 3D volume rendering techniques followed by surgical procedures as a gold standard within 2-7 days. Results: The study showed 15 patients with shunt related complications; aneurysm 33.3% (10 patients) followed by venous thrombosis 23.3% (7 patients), and arterial steal syndrome 13.3% (4 patients), and finally venous hypertension 6.6% (2 patients). Considering surgery as a gold standard the sensitivity and specificity of CDUS and CTA, in detecting aneurysms and stenosis was 100% and 100% respectively. The detection of subclavian occlusion sensitivity and specificity by CDUS was 70% and 85% respectively on the other hand CTA sensitivity and specificity was 100% and 100% respectively. Conclusions: The adjuvant diagnostic value of CTA with CDUS maximizes the evaluation of AV fistula related vascular complications approaching that of surgery.