The trouble with bubbles.
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Balloon Occlusion↗
Biomedical subjects
Steven L Goldberg
Publications and source records attributed to Steven L Goldberg.
Patent foramen ovale and the platypnea-orthodeoxia syndrome.
The platypnea-orthodeoxia syndrome is a rare but important condition caused by a variety of clinical entities. Several mechanisms have been postulated to cause platypnea and orthodeoxia. These mechanisms mainly involve intracardiac shunting, pulmonary vascular shunting, and ventilation-perfusion mismatching. Patent foramen ovale is an important type of intracardiac shunt that can produce platypnea-orthodeoxia in select patients. Concomitant pulmonary hypertension must be ruled out, but symptoms can occur without pulmonary hypertension in cases with altered intrathoracic anatomy and physiology. Diagnosis usually entails transthoracic or trans-esophageal echocardiogram, ideally with postural provocation by the tilt-table test. Treatment with surgical or percutaneous closure may result in symptomatic relief. The decision to intervene is based mainly on the severity of symptoms and potential morbidities associated with the defect.
Dyspnea↗
The echocardiographer's role during the placement of patent foramen ovale closure devices.
The use of TEE and ICE techniques have been extremely important in the development of closure of PFOs and ASDs using interventional techniques. These two imaging techniques have revolutionized the diagnosis and treatment of these problems and have gone far beyond TTE and its known problems for diagnosing septal defects (Fig. 21).
Catheterization↗
Why don't we practice evidence-based medicine?
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Clopidogrel↗
New strategies in the percutaneous management of coronary artery fistulae: A case report.
Coronary artery fistulae are rare anomalies often treated percutaneously. New techniques aiding in the percutaneous closure of a giant coronary artery, not previously described, are presented in a case report. These techniques include the use of intravascular ultrasound imaging and the use of electrolytically detachable platinum coils.
Arteriovenous Fistula↗
Late-term myocardial infarction after surgical ligation of a giant coronary artery fistula.
A case is presented of a patient with recurrent myocardial infarctions after surgical treatment of a giant coronary artery fistula. The etiology was due to thrombus development in a large blind pouch, with propagation into more proximal vessels. Stenting of the proximal vessel provided temporary benefit, but recurrence eventually required surgical closure of the blind pouch.
Adult↗
Stenting for acute myocardial infarction -- can we do better?
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Angioplasty, Balloon, Coronary↗
Cellular angiolipoma of the breast: immunohistochemical study and review of the literature.
We report a rare case of cellular angiolipoma of the breast in a 73-year-old woman with abnormal mammographic findings. Histopathologic examination of the tumor revealed cellular spindle cell areas associated with collapsed and patent blood vessels in a background of mature adipose tissue. A salient feature of this tumor, which was an important clue to the diagnosis, was the presence of intravascular fibrin thrombi. Immunohistochemical studies showed reactivities for endothelial and muscle markers, highlighting the obscured angiomatous component in the cellular areas of the tumor. Failure to recognize this entity may potentially lead to diagnostic pitfalls that include angiosarcoma and Kaposi's sarcoma, two of the better recognized entities in this region.
Aged↗