Patent foramen ovale (PFO) closure for systemic hypoxemia is controversial. The first systematic, albeit retrospective, study was recently presented which showed good procedural and clinical success for PFO closure fo...Patent foramen ovale (PFO) closure for systemic hypoxemia is controversial. The first systematic, albeit retrospective, study was recently presented which showed good procedural and clinical success for PFO closure for this indication. We present a case of acute right to left intra-cardiac shunt across PFO where the shunting is not persistent. Hence making a decision on PFO closure based on the aforementioned promising trial may not have been the right decision for the patient. This case highlights that the decision on PFO closure for such indication needs to be individualized. We also review the sparse literature on PFO closure for this indication and discuss how the decision making for such indication needs to be individualized.展开更多
We present a case where defibrillation threshold was dangerously elevated to the point that the patient had no safety margin,and his implantable cardioverter-defibrillator generator was discovered to have migrated.Gen...We present a case where defibrillation threshold was dangerously elevated to the point that the patient had no safety margin,and his implantable cardioverter-defibrillator generator was discovered to have migrated.Generator migration reduces the distance between the can and the coil,effectively creating a smaller bipolar current and sparing the left ventricle from the current needed for defibrillation.This case underscores the importance of securing the generator in place,as this patient would have been spared multiple shocks and an invasive medical procedure had his generator been better secured.展开更多
文摘Patent foramen ovale (PFO) closure for systemic hypoxemia is controversial. The first systematic, albeit retrospective, study was recently presented which showed good procedural and clinical success for PFO closure for this indication. We present a case of acute right to left intra-cardiac shunt across PFO where the shunting is not persistent. Hence making a decision on PFO closure based on the aforementioned promising trial may not have been the right decision for the patient. This case highlights that the decision on PFO closure for such indication needs to be individualized. We also review the sparse literature on PFO closure for this indication and discuss how the decision making for such indication needs to be individualized.
文摘We present a case where defibrillation threshold was dangerously elevated to the point that the patient had no safety margin,and his implantable cardioverter-defibrillator generator was discovered to have migrated.Generator migration reduces the distance between the can and the coil,effectively creating a smaller bipolar current and sparing the left ventricle from the current needed for defibrillation.This case underscores the importance of securing the generator in place,as this patient would have been spared multiple shocks and an invasive medical procedure had his generator been better secured.
