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When the shaft breaks: managing a cath lab nightmare

Oliveira, Catarina; Azaredo Raposo, Miguel; Marques da Costa, José; Pinto, Fausto J.; Silva Marques, João

Objective: We describe the case of a 57-year-old male patient with anterior ST-segment elevation myocardial infarction in cardiogenic shock. Coronary angiography revealed severe left main (LM) and triple-vessel disease, and the patient was refused for surgery due to lack of distal grafting landing zone. A shaft fracture occurred during LM percutaneous coronary intervention, leaving the fractured stent hanging i...


Chronic thromboembolic pulmonary hypertension: a comprehensive review of pathog...

Cazeiro, Daniel; Azaredo Raposo, Miguel; Guimarães, Tatiana; Lousada, Nuno; Jenkins, David; Inácio, João R.; Moreira, Susana; Mineiro, Ana

Chronic thromboembolic pulmonary hypertension (CTEPH) is part of group 4 of the pulmonary hypertension (PH) classification and generally affects more than a third of patients referred to PH centers. It is a three-compartment disease involving proximal (lobar-to-segmental) and distal (subsegmental) pulmonary arteries that are obstructed by persistent fibrothrombotic material, and precapillary pulmonary arteries ...


Multidimensional CT approach to predict hemodynamics in pulmonary hypertension

Brito, Joana; Alves da Silva, Pedro; Cazeiro, Daniel; Azaredo Raposo, Miguel; Lousada, Nuno; Inácio, João R.; Guimarães, Tatiana; Almeida, Ana G.

Aim: Computed tomographic pulmonary angiography (CTPA) allows an excellent visualization of heart chambers and vessels, which may be associated with hemodynamic status in pulmonary hypertension, obviating the need for repetitive right heart catheterization (RHC). In this study, we aimed to evaluate the capacity of CTPA to predict severe hemodynamics and to correlate with clinical status and events. Material and...


Pulmonary arterial hypertension with features of venous involvement: a detectiv...

Cazeiro, Daniel; Plácido, Rui; Azaredo Raposo, Miguel; Brito, Joana; Borba, Alexandra; Guimarães, Tatiana; Pinto, Eugénia; Freitas, Pedro

Pulmonary veno-occlusive disease (PVOD) and pulmonary capillary hemangiomatosis are rare types of histopathological substrates within the spectrum of pulmonary arterial hypertension (PAH) with a very poor prognosis. They are characterized by a widespread fibroproliferative process of the small caliber veins and/or capillaries with sparing of the larger veins, resulting in a pre-capillary pulmonary hypertension ...


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