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Pleural disease induced by drugs
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
Only mild adverse events, including rash and diarrhoea, have been reported with vitamin B5. There is an isolated report of a 76-year-old woman who was hospitalized with chest pain and dyspnoea.55 She had no history of atopic disease. She had been taking trimetazidine for 6 years, vitamin H (10 mg daily) and vitamin B5 (300 mg daily) for 2 months for the treatment of alopecia. Chest radiograph showed cardiac enlargement and a pleural effusion. Clinical examination and echocardiogram revealed cardiac tamponade. The absolute pleural fluid eosinophil count ranged from 1200 to 1500/μL. At pericardiectomy the fluid was a sterile exudate with protein 6.7 g/dL with 1500 eosinophils/μL. Histology showed an eosinophilic infiltrate. The pleural fluid also confirmed eosinophilia. Despite multiple thoracenteses the pleural effusion recurred, leading to thoracotomy. All studies for rheumatological disorders, infection and occult malignancy were negative. Vitamins B5 and H were discontinued, and 1 week later the patient improved dramatically with resolution of blood eosinophilia. Trimetazidine was also discontinued but readministered a few months later without symptoms or an increase in eosinophilia. The patient was symptom-free without relapse at a 2-year follow-up visit.
Safety and effectiveness of left atrial appendage closure in patients with non-valvular atrial fibrillation and prior major bleeding
Published in Expert Review of Medical Devices, 2021
Mingzhong Zhao, Cody R. Hou, Xiaolin Xiong, Felix Post, Nora Herold, Jiangtao Yu
Out of 384 consecutive patients with NVAF who underwent LAAC, four patients were switched to the Amplatzer Cardiac Plug device (St. Jude Medical, Golden Valley, MN) because of unsuitable LAA anatomy for Watchman device. Three cases of implantation with WM device were halted due to two cases of significant pericardial effusion/cardiac tamponade and one case of repeated device-associated thrombus. 377 (98.2%) cases were successfully implanted with Watchman occluders, including 137 cases in the bleeding group and 240 cases in the non-bleeding group. In the bleeding group, prior major bleedings were intracranial in 20 patients (14.6%), gastrointestinal in 86 patients (62.8%), and other major bleeding in 31 patients (22.6%). No significant difference in procedural success rate of Watchman occluders was found between the bleeding and non-bleeding groups (97.9% vs 98.4%, P = 0.723).
Laser balloon in pulmonary vein isolation for atrial fibrillation: current status and future prospects
Published in Expert Review of Medical Devices, 2021
Shota Tohoku, Stefano Bordignon, Fabrizio Bologna, Shaojie Chen, Lukas Urbanek, Felix Operhalski, KR Julian Chun, Boris Schmidt
A pooled meta-analysis [8] summarized the comparable low incidence rates of peri-procedural complications (cardiac tamponade: 1.1% [95% CI, 0.3% to 2.3%], cerebrovascular attacks: 0.3%) and there was no occurrence of atrial-esophageal fistulae. Although there was no statistically significant difference in the risk for cardiac tamponade as compared to CB ablation [5], the methodical difference in the balloon delivery, direct PV cannulation and not over the wire system, was pointed out as one of reasons for the cardiac tamponade [5,10,20,36]. From those results, it was determined that the procedural safety concerning major complications has been established for LB ablation.
Effect of congestive heart failure on safety and efficacy of left atrial appendage closure in patients with non-valvular atrial fibrillation
Published in Expert Review of Medical Devices, 2022
Mingzhong Zhao, Cody R. Hou, Jianlin Bai, Felix Post, Jens Walsleben, Nora Herold, Juan Yu, Zufeng Zhang, Jiangtao Yu
The primary endpoints during the long-term follow-up included thromboembolism, major bleeding (intracranial hemorrhage, gastrointestinal bleeding, and other major bleeding), DRT, all-cause death (cardiovascular death, and non-cardiovascular death), and combined efficacy endpoints (thromboembolism and all-cause death). The secondary endpoints included implantation success and peri-procedural complications within 7 days (thromboembolic events, major bleeding, pericardial effusion/cardiac tamponade, severe vascular complication, and procedure-related death).