A simple score using clinical and laboratory data available on admission can predict the risk of AKI in patients presenting with acute myocardial infarction.

Butt et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Oral Abstracts2 9 0 THURSDAY Supplement to Transplantation July 27, 2008, Volume 86 Number 2S was Lebanese. Indications for liver transplantation were as follows: hepatitis C cirrhosis (n=29); hepatitis B cirrhosis (n=13); cryptogenic cirrhosis (n=6); hepatitis B and C co-infection cirrhosis (n=1), primary biliary cirrhosis (n=1) and hepatocellular carcinoma (n=24). All patients were either on the KFSH waiting list for liver transplantation or were denied liver transplantation in KFSH or Egypt due to unsuitable medical condition such as old age or advanced hepatocellular carcinoma (HCC). One year, 3-year and 5-year cumulative patient survival rates were 83%, 62%, and 62% respectively compared to 92%, 84% and 71% in KFSH. Median survival time of the patients was signifi cantly less than that of those transplanted in KFSH (p=0.01). One year, 3-year and 5-year cumulative graft survival rates were 81%, 59%, and 59% respectively compared to 90%, 84% and 71% in KFSH. Of the surviving patients, many suffered from multiple other morbidities. Compared to the patients transplanted in KFSH, the incidence of complications was signifi cantly higher especially biliary complications (p=0.01), sepsis (p=0.003), rejection (p=0.04), metastasis (p=0.03) and acquired HBV infection posttransplant (p=0.02). In addition, requirement of postoperative interventions (radiologic and laparotomy) as well as hospital admissions, were signifi cantly higher hence constituting a higher burden on the resources of the hospital. Conclusion: Our data shows clearly that there is a high mortality and morbidity rate in Saudi and Egyptian patients receiving transplantation in China. This could be related to poor selection criteria, long warm ischemia time, or poor post transplant care. . Although cadaveric liver transplantation in China could be an option for desperate Egyptian and Saudi patients with end stage liver disease, patients and clinicians should be aware of the possible outcomes LATE BREAKING

Background To assess the prevalence patterns of isolated/mixed rheumatic valvular lesions and associated risk factors among rheumatic heart disease (RHD) patients undergoing surgical valve replacement. Methods An analytical cross-sectional design was used. Purposive sampling was used to select 87 RHD patients who underwent a first-time valve replacement for mitral, aortic, or both valves between April 1 and October 20, 2016, at Punjab Institute of Cardiology, Lahore, Pakistan. Patients with systemic hypertension, diabetes mellitus type-II, congenital heart defects, coronary artery disease, non-rheumatic valvular degeneration, positive test for hepatitis C, or undergoing concomitant coronary artery bypass graft or a ‘redo’ valve replacement procedure were excluded. A proforma was used to collect preoperative data on patients’ demographics, laboratory investigations, electrocardiogram (ECG), and transthoracic echocardiography reports. Results Age (mean ± S.D.) was 32.79 ± 13.06 years, which was divided into four quartile-based groups. Forty-six (52.9%) cases were males. The majority (56.3%) of patients underwent mitral valve replacement. Mitral regurgitation (MR, 80%) was the most common lesion. Of 71 available ECGs, atrial fibrillation was observed in 46.5% cases. Increasing age group was negatively correlated with MR severity (τ c = -0.188, p-value = 0.033) and positively with aortic stenosis (AS) severity (τ c = 0.141, p-value = 0.010). No significant elevations were observed for anti-streptolysin O titer, C-reactive protein, and leukocyte count, though the erythrocyte sedimentation rate was abnormally high in 46.94% cases. Conclusions MR was the most common lesion. MR was more severe in younger patients whilst AS was more severe in older cases. There is little evidence of ongoing residual inflammation.

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Anomalous coronary vasculature is a rare finding among the general population. Identifying such cases is important for preventing adverse outcomes such as sudden cardiac death. We present two rare cases of aberrant coronary anatomy. In Case 1, a 4-year-old male who presented with non-exertional chest pain was found to have anomalous coronary architecture on echocardiogram. Coronary computed tomography angiogram (CCTA) confirmed an anomalous origin of the left coronary artery from the right coronary sinus with a malignant interarterial course and myocardial bridging of the left anterior descending (LAD) artery. The patient underwent a successful surgical correction of the defects. In Case 2, a full-term infant female was born with a hypoplastic right ventricle and pulmonary atresia. CCTA showed a large fistula originating from the coronary sinus on the left that drained into the superior aspect of the mid right ventricular cavity, an anomalous bridge between the left and right atrial appendages, and five fistulous connections between various vessels. The patient was transferred to another facility for cardiac transplant.

Pheochromocytoma is the underlying etiology in 0.1% of hypertensive cases. However, it may be present in up to 5.7% of patients with neurofibromatosis I (NF1). The burst of catecholamines inherent in pheochromocytoma has significant effects on the mechanical and electrical activity of the myocardium. Different theories have been postulated for myocardial stunning in patients with pheochromocytoma that include microvascular spasm, impaired fatty acid metabolism, increased production of oxygen-derived free radicals and dynamic left ventricular mid-cavity obstruction. QT interval prolongation is seen in 16% to 35% of patients with pheochromocytoma. Takotsubo cardiomyopathy (TS) is now being increasingly identified and it may be responsible for up to 40% of cases of acute catecholamine cardiomyopathy. These manifestations may sometimes precede or cloud the typical triad of a headache, sweating, and tachycardia.We herein present a case of a 42-year-old female with a unique combination of QT prolongation, torsades de pointes, and TS caused by pheochromocytoma in the background of NF1. All these complications are potentially reversible with the removal of the underlying adrenal tumor, underscoring the importance of a high suspicion for pheochromocytoma in patients with NF1.