Anatomic location of PT on fluoroscopy can be used as an additional surrogate to predict the location of IL. Patients with high BMI have a low lying IL, which may predispose them to "high sticks." The location of IEA cannot be used as a surrogate for IL in all patients.
Cardiac hemangiomas are rare cardiac tumors with fewer than 50 surgically treated cases reported in the literature. Incidence of valvular hemangiomas is extremely low, as cardiac valves are predominantly avascular structures. In this case report, we describe a 33-year-old woman who presented with progressively worsening cardiovascular symptoms. Echocardiography revealed a mitral valve mass for which she underwent surgical resection and mitral valve replacement. Histological examination of the mass revealed cavernous hemangioma of the mitral valve. Postoperative course was uncomplicated, and the patient's symptoms improved after surgery. Surgical excision of valvular hemangiomas appears to be curative in most cases and is the treatment of choice. Periodic echocardiographic follow-up is advised for early detection of tumor recurrence.
Use of iodinated contrast media (ICM) for angiography can result in contrast-induced nephropathy (CIN). Gadolinium-based contrast media (GCM) have been used in angiography with a goal to reduce the incidence of CIN. We performed a retrospective analysis involving 85 patients with renal insufficiency who underwent 97 carotid artery angiography and stenting (CAAS) procedures with a combination of GCM and ICM. The incidence of peri-procedural death, Q wave myocardial infarction (QWMI), stroke and CIN were recorded. Patients in GCM group had worse preprocedure renal function compared to ICM group. There were no peri-procedural deaths or QWMI in both groups. The incidence of stroke was 2.2% in GCM group and 0% in ICM group. The incidence of CIN were similar in GCM and ICM groups (8.5% vs. 10%, respectively, p NS). However, the predicted risk of CIN was 18.5% for GCM group and 10.4% for ICM group. Use of GCM and ICM combination for CAAS resulted in a 50% reduction in the incidence of predicted CIN risk compared to ICM.
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