The patient is a thirty-eight-year-old man with a familial history of dilated cardiomyopathy who initially presented to the hospital with shortness of breath. Workup revealed new onset atrial fibrillation, severe mitral regurgitation with P2 prolapse, and cardiogenic shock (LVEF 24 percent). He required inotropic support and placement of an intra-aortic balloon pump. Given his acute decompensated…

This video shows a case of successful closure of an aortic pseudoaneurysm and mitral paravalvular leak via a hybrid transapical approach.The patient is a sixty-year-old man who was born with coarctation of the aorta and a bicuspid aortic valve. At age ten, he underwent repair of his coarctation via a left thoracotomy without any residual coarctation or aneurysm. At age twenty-five, he developed…

The patient was a sixty-one-year-old man with a medical history of coronary artery disease, STEMI treated with a drug-eluting stent in 2014, an abdominal aortic aneurysm, an aortic root aneurysm, and trace aortic insufficiency. In March 2012, the patient suffered a type B aortic dissection with compromise of his superior mesenteric artery, causing mesenteric ischemia. He underwent right common…

Patient Details A fifteen-year-old boy with a past medical history of asthma presented with sudden onset chest pain and orthopnea. Imaging workup in the emergency department included a chest X-ray that suggested a mediastinal mass. (A cardiac CT was initially deferred given the patient’s clinical stability.) Advanced cardiac imaging with MRI was chosen for superior soft tissue characterization…