To treat postoperative bleeding after hepato-pancreato-biliary surgery, interventional radiology has become essential. We report a case of coincidental pseudoaneurysm and jejunal varices that were ...both successfully treated by stent-grafts. After a pancreaticoduodenectomy, the patient developed a pseudoaneurysm in the hepatic artery and a stenosis in its periphery. After establishing hepatic arterial flow by placing stent-grafts over both the pseudoaneurysm and the stenosis, the pseudoaneurysm was embolized with microcoils. Nine months later, the patient developed jejunal varices caused by a severe stricture in the main trunk of the portal vein. Percutaneous transhepatic portography was performed and stent-grafts were placed over the stenotic segment. A venoplasty using stent-grafts normalized the portal blood flow and the jejunal varices vanished. Although stenosis occurred due to scarred tissues from leakage after pancreaticoduodenectomy, stent-grafts were useful for managing jejunal bleeding post-operatively.
The acquisition of good contact force for radiofrequency catheter ablation of ventricular premature complexes (VPCs) originating from the basal septum of the left ventricle (LV) is often difficult. ...We describe a case of VPCs originating from the basal septum of the LV, which were successfully eliminated by applying radiofrequency at the right atrium (RA) side of the atrioventricular septum (AVS) without causing any significant impairment of atrioventricular conduction because the ablation catheter could obtain better contact force through the RA approach. Moreover, intracardiac echocardiography (ICE) and RA angiography effectively demonstrated the AVS.
A 58-year-old man with dilated cardiomyopathy was admitted with heart failure. He had a history of two catheter ablation procedures for ventricular tachycardia (VT) originating from the ...intraventricular septum (IVS). Before dual valve replacement (DVR), he suffered a VT storm. An electrophysiological study revealed an extended low-voltage area at the IVS with the exit of the induced VT at the anterior side. Radiofrequency application was performed at the VT exit as a landmark for surgical cryoablation (SA). During the DVR, SA was performed at the IVS using this landmark. After SA, the patient had no ventricular tachyarrhythmia.
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