BACKGROUND False tendon is a common intraventricular anatomical variation. It refers to a fibroid or fibromuscular structure that exists in the ventricle besides the normal connection of papillary muscle and mitral or...BACKGROUND False tendon is a common intraventricular anatomical variation. It refers to a fibroid or fibromuscular structure that exists in the ventricle besides the normal connection of papillary muscle and mitral or tricuspid valve. A large number of clinical studies have suggested that there is a significant correlation between false tendons and premature ventricular complexes. However, few studies have verified this correlation during radiofrequency catheter ablation of premature ventricular complexes.CASE SUMMARY A 45-year-old male was admitted to receive radiofrequency ablation for symptomatic premature ventricular complexes. A three-dimensional model of the left ventricle was established by intracardiac echocardiography using the CartoSound^TM mapping system. In addition to the left anterior papillary muscle,the posterior papillary muscle was mapped. False tendons were found at the base of the interventricular septum, and the other end was connected to the left ventricular free wall near the apex. An irrigated touch force catheter was advanced into the left ventricle via the retrograde approach. The earliest activation site was marked at the interventricular septum attachment of the false tendons and was successfully ablated.CONCLUSION This case verified that false tendons can cause premature ventricular complexes and may be cured by radiofrequency ablation guided by intracardiac echocardiography with the Carto Sound TM system.展开更多
The long head of the biceps tendon is widely recognized as an important pain generator,especially in anterior shoulder pain and dysfunction with athletes and working individuals.The purpose of this review is to provid...The long head of the biceps tendon is widely recognized as an important pain generator,especially in anterior shoulder pain and dysfunction with athletes and working individuals.The purpose of this review is to provide a current understanding of the long head of the biceps tendon anatomy and its surrounding structures,function,and relevant clinical information such as evaluation,treatment options,and complications in hopes of helping orthopaedic surgeons counsel their patients.An understanding of the long head of the biceps tendon anatomy and its surrounding structures is helpful to determine normal function as well as pathologic injuries that stem proximally.The biceps-labral complex has been identified and broken down into different regions that can further enhance a physician’s knowledge of common anterior shoulder pain etiologies.Although various physical examination maneuvers exist meant to localize the anterior shoulder pain,the lack of specificity requires orthopaedic surgeons to rely on patient history,advanced imaging,and diagnostic injections in order to determine the patient’s next steps.Nonsurgical treatment options such as anti-inflammatory medications,physical therapy,and ultrasound-guided corticosteroid injections should be utilized before entertaining surgical treatment options.If surgery is needed,the three options include biceps tenotomy,biceps tenodesis,or superior labrum anterior to posterior repair.Specifically for biceps tenodesis,recent studies have analyzed open vs arthroscopic techniques,the ideal location of tenodesis with intra-articular,suprapectoral,subpectoral,extra-articular top of groove,and extra-articular bottom of groove approaches,and the best method of fixation using interference screws,suture anchors,or cortical buttons.Orthopaedic surgeons should be aware of the complications of each procedure and respond accordingly for each patient.Once treated,patients often have good to excellent clinical outcomes and low rates of complications.展开更多
文摘BACKGROUND False tendon is a common intraventricular anatomical variation. It refers to a fibroid or fibromuscular structure that exists in the ventricle besides the normal connection of papillary muscle and mitral or tricuspid valve. A large number of clinical studies have suggested that there is a significant correlation between false tendons and premature ventricular complexes. However, few studies have verified this correlation during radiofrequency catheter ablation of premature ventricular complexes.CASE SUMMARY A 45-year-old male was admitted to receive radiofrequency ablation for symptomatic premature ventricular complexes. A three-dimensional model of the left ventricle was established by intracardiac echocardiography using the CartoSound^TM mapping system. In addition to the left anterior papillary muscle,the posterior papillary muscle was mapped. False tendons were found at the base of the interventricular septum, and the other end was connected to the left ventricular free wall near the apex. An irrigated touch force catheter was advanced into the left ventricle via the retrograde approach. The earliest activation site was marked at the interventricular septum attachment of the false tendons and was successfully ablated.CONCLUSION This case verified that false tendons can cause premature ventricular complexes and may be cured by radiofrequency ablation guided by intracardiac echocardiography with the Carto Sound TM system.
文摘The long head of the biceps tendon is widely recognized as an important pain generator,especially in anterior shoulder pain and dysfunction with athletes and working individuals.The purpose of this review is to provide a current understanding of the long head of the biceps tendon anatomy and its surrounding structures,function,and relevant clinical information such as evaluation,treatment options,and complications in hopes of helping orthopaedic surgeons counsel their patients.An understanding of the long head of the biceps tendon anatomy and its surrounding structures is helpful to determine normal function as well as pathologic injuries that stem proximally.The biceps-labral complex has been identified and broken down into different regions that can further enhance a physician’s knowledge of common anterior shoulder pain etiologies.Although various physical examination maneuvers exist meant to localize the anterior shoulder pain,the lack of specificity requires orthopaedic surgeons to rely on patient history,advanced imaging,and diagnostic injections in order to determine the patient’s next steps.Nonsurgical treatment options such as anti-inflammatory medications,physical therapy,and ultrasound-guided corticosteroid injections should be utilized before entertaining surgical treatment options.If surgery is needed,the three options include biceps tenotomy,biceps tenodesis,or superior labrum anterior to posterior repair.Specifically for biceps tenodesis,recent studies have analyzed open vs arthroscopic techniques,the ideal location of tenodesis with intra-articular,suprapectoral,subpectoral,extra-articular top of groove,and extra-articular bottom of groove approaches,and the best method of fixation using interference screws,suture anchors,or cortical buttons.Orthopaedic surgeons should be aware of the complications of each procedure and respond accordingly for each patient.Once treated,patients often have good to excellent clinical outcomes and low rates of complications.
