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Quantitative analyses and case studies of hybrid PET-MRI imaging
Published in Yi-Hwa Liu, Albert J. Sinusas, Hybrid Imaging in Cardiovascular Medicine, 2017
Leon J. Menezes, Eleanor C. Wicks, Brian F. Hutton
Amyloidosis is a clinical disorder that arises from the aggregation of insoluble fibrous deposits of misfolded proteins. Deposition of fibrillary material and the toxic effects of precursor soluble intermediates result in progressive organ dysfunction, which manifest as heart failure with restrictive physiology (Gertz, Dispenzieri, and Sher 2014). The recent development of PET tracers for amyloid plaque identification in Alzheimer’s disease has generated potential interest in the evaluation of cardiac amyloidosis, a condition that is imaged using MRI (Fontana et al. 2014) and 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid (99mTc-DPD) SPECT (Hutt et al. 2014). 11C-PIB and 18F-Florbetapir have been used to depict systemic and cardiac amyloid (Antoni et al. 2013; Dorbala et al. 2014; Lee et al. 2015). Validation with T1 mapping and ECV measurements with simultaneous PET/MRI could possibly allow earlier diagnosis and treatment monitoring (Figure 16.4).
Device profile of the AltaValve system for transcatheter mitral valve replacement: overview of its safety and efficacy
Published in Expert Review of Medical Devices, 2020
Alberto Alperi, David del Val, Alfredo Nunes Ferreira-Neto, Mathieu Bernier, Afonso B Freitas-Ferraz, François Dagenais, Josep Rodés-Cabau
A second reported case was carried out through a trans-apical approach in an 89 years-old male presenting prohibitive surgical risk due to comorbidity burden as well as posterior leaflet calcification precluding transcatheter mitral valve repair [21]. Besides, its exclusively posterior mitral annular calcification pattern prevented off-label use of commercially available prosthesis intended for aortic position. Based on CT measures, a 75 mm frame height, 70 mm frame width, and 46 mm annular ring AltaValve device was selected. After deployment and gentle adjustment, valve function was considered optimal, showing the trans-esophageal echocardiography mild paravalvular MR with normal leaflet motion and no stenosis. The patient had a sudden death on post-procedural day 5 after being weaned off from vasopressor support and mechanical ventilation. The autopsy revealed diffused myocardial amyloid deposition and a postmortem cardiac amyloidosis diagnosis was made.