Back to School Season: Further Your Learning with September CASE

The latest issue of CASE is now available with intriguing reports, including “Iatrogenic Aortic Valve Injury: Case Series and Review of the Literature.” CASE Editor-in-Chief Vincent Sorrell, MD, FASE, remarked, “Atmaca et al. describe a potentially under-reported iatrogenic complication during coronary angiography, left heart catheterization, and electrophysiology procedures. Owing to the increasingly complex patient population and the need to perform increased catheter manipulation using stiff wires and devices, these authors highlight a rather comprehensive, if not disarming, series of six cases. Their report associates post-procedural, acute aortic regurgitation (AR) with recent invasive procedures. They prepared a table that demonstrates multiple catheters were employed, all three cusps may be involved, and all patients had at least moderate, but most commonly severe, AR. Their table includes the extreme variability of clinical presentations ranging from days to months, as well as the variability in number of invasive procedures ranging from one to a dozen. Many of these cases underwent surgical AVR which provided additional direct inspection of the leaflets, and their report includes surgical descriptions and photographs of the cusp damage. The discussion includes an excellent description of the echo findings and their suspected mechanism of AR development, including high-quality figures and videos exhibiting suspected endocarditis or Lambl’s excrescences. These authors should be congratulated on the thoroughness of their reported findings and the now increased awareness of this important association for all of us.”

Dsouza et al. follow in the Valvular Heart Disease category with a display of serial echo findings in their patient who progressed from endocarditis-driven aortic regurgitation to a mitral valve aneurysm. Congenital Heart Disease supplies readers with two cases: Cheng et al. teach readers more about distinguishing between cor triatriatum and supravalvular mitral ring, while Mital et al. illustrate a rare anomaly in their patient with an anomalous left anterior descending coronary artery that arises from the pulmonary artery (ALADAPA). Rounding out this issue is Just Another Day in the Echo Lab featuring reports on the importance of apical image acquisition and potential mimics of apical sparing patterns, as well as an exemplary case series on Gerbode-type defects in adults after repair of tetralogy of Fallot.

With a shout out to the late Ozzy Osbourne, Dr. Sorrell’s editorial features “full disclosure” in his new format of behind-the-scenes commentary and insights from each of the published CASE reports.

Congratulations to the authors of Multimodal Imaging Diagnosis of Doubly Committed Juxta-Arterial Ventricular Septal Defect and Persistent Left Cranial Vena Cava in a Goat, presented by co-author Lauren E. Markovic, DVM, DACVIM (Cardiology), FACVIM (Interventional Cardiology), which was chosen as the 2024 CASE of the Year during ASE’s Scientific Sessions ShowCASE event!

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