72-year-old male had a TIA in 1995 and has been in chronic atrial fibrillation since 1992. In 2005 2 ablative procedures were ineffective. The main treatment strategy for his atrial fibrillation has consisted of rate control and oral anticoagulation. Despite several attempts of different medications (digoxin, beta-blockers) he has remained in atrial fibrillation with a relatively moderate to fast ventricular response.
47-year-old male presented with un-provoked portal and mesenteric vein thrombosis that caused persistent radiating pains of upper abdominal quadrants. The examinations found heterozygous factor II mutation, and family survey for the factor II mutation was recommended. The patient started anticoagulant therapy. In the expert's opinion, the main risk factors for portal vein thrombosis are: Prothrombotic disorder, abdominal inflammation, cirrhosis, cancer, abdominal intervention and abdominal infection.
p68-year-old male with recurrent asymptomatic paroxysmal atrial fibrillation underwent ablation of the cavo-tricuspidal isthmus. Holter exams showed sinus rhythm with brief and isolated episodes of atrial fibrillation, again with focal trigger. The choices of therapy are rate control, rhythm control, catheter ablation or antithrombotic therapy.
54-year-old obese male with end stage renal disease due to membranous nephropathy, has received 2 renal transplants in the past and is highly sensitized. He underwent coronary angiography for vessel CAD, and PTCAs and stanting were performed. His current treatment consists of multiple medications including mycophylate according to the instructions of his transplant nephrologist. His cardiologists sees no contraindication to transplantation.
74-year-old female suffers from recurrent episodes of paroxysmal atrial fibrillation (PAF) and has been recommended oral anti-coagulant therapy with warfarin (Coumadin). She has mitral regurgitation, and on the other hand was diagnosed as suffering from congenital bronchiectasis with several episodes of significant bleeding (hemoptysis). Following these hemoptoic episodes she underwent series of diagnostic as well as therapeutic pulmonary intervention (bronchoscopy, angiography, embolization).
70-year-old-male was diagnosed with colon cancer. After undergoing a right hemicolectomy, hepatic lesions were revealed. Three months after starting chemotherapy a CT revealed recurrent hepatic disease and celiac lymphadenopathy. He underwent directed therapy with radiofrequency ablation and stereotactic radiation, but unfortunately a repeat CT showed progressive disease in the liver and new pulmonary disease. Upon surgical exploration, his liver disease was deemed too extensive for surgical resection.