Image in Cardiology
Unexpected diagnosis in a liver donor candidate
Diagnóstico inesperado num candidato a dador de fígado
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"autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Henrique Guedes, Nuno Moreno, Rui Cunha Sousa, Mário Jorge Amorim, Aurora Andrade, Paula Pinto" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Henrique" "apellidos" => "Guedes" ] 1 => array:2 [ "nombre" => "Nuno" "apellidos" => "Moreno" ] 2 => array:2 [ "nombre" => "Rui" "apellidos" => "Cunha Sousa" ] 3 => array:2 [ "nombre" => "Mário Jorge" "apellidos" => "Amorim" ] 4 => array:2 [ "nombre" => "Aurora" "apellidos" => "Andrade" ] 5 => array:2 [ "nombre" => "Paula" "apellidos" => "Pinto" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0870255116302724" "doi" => "10.1016/j.repc.2016.01.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116302724?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916302409?idApp=UINPBA00004E" "url" => "/21742049/0000003500000012/v2_201702040044/S2174204916302409/v2_201702040044/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S2174204916302392" "issn" => "21742049" "doi" => "10.1016/j.repce.2016.11.008" "estado" => "S300" "fechaPublicacion" => "2016-12-01" "aid" => "904" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2016;35:703-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1785 "formatos" => array:3 [ "EPUB" => 150 "HTML" => 1264 "PDF" => 371 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Segmental pulmonary stenosis: Importance of computed tomography angiography" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "703" "paginaFinal" => "705" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Estenose pulmonar multisegmentar, importância da angio TC" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1998 "Ancho" => 2000 "Tamanyo" => 536138 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Severe stenosis at the origin of most of the lobar pulmonary arteries and diffuse stenosis of the rest (A-D), and underdevelopment of the aortic arch (E).</p>" ] ] ] 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"idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116302712?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916302392?idApp=UINPBA00004E" "url" => "/21742049/0000003500000012/v2_201702040044/S2174204916302392/v2_201702040044/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Unexpected diagnosis in a liver donor candidate" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "707" "paginaFinal" => "708" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Betul Cengiz, Sukru Taylan Sahin, Selen Yurdakul, Ismail Polat Canbolat, Saide Aytekin" "autores" => array:5 [ 0 => array:3 [ "nombre" => "Betul" "apellidos" => "Cengiz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Sukru Taylan" "apellidos" => "Sahin" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Selen" "apellidos" => "Yurdakul" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Ismail Polat" "apellidos" => "Canbolat" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:4 [ "nombre" => "Saide" "apellidos" => "Aytekin" "email" => array:1 [ 0 => "saideaytekin@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Department of Cardiology, Istanbul Bilim University, Istanbul, Turkey" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Cardiology, Florence Nightingale Hospital, Istanbul, Turkey" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Diagnóstico inesperado num candidato a dador de fígado" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 628 "Ancho" => 951 "Tamanyo" => 91873 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transesophageal echocardiography, short-axis view during systole, showing quadricuspid aortic valve. AV: aortic valve; LA: left atrium; RA: right atrium.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Liver transplantation from living donors is a legal procedure in Turkey. The patient's spouse and relatives within the fourth degree of consanguinity or affinity can be donors. During the surgery, about 40-60% of the donor's liver is removed.</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 38-year-old female liver donor candidate was referred to our cardiology clinic for preoperative evaluation. The patient had no symptoms. On physical examination, a grade 2/6 early diastolic murmur was heard at the third left sternal intercostal space. Her blood pressure was 140/70 mmHg. Transthoracic echocardiography revealed moderate aortic regurgitation (AR) with the suspicion of quadricuspid aortic valve (QAV). Left ventricular end-diastolic and end-systolic diameters were 5.6 cm and 4.0 cm, respectively. Ejection fraction was normal. Transesophageal echocardiography confirmed the diagnosis of QAV with four equal cusps (Type A) (<a class="elsevierStyleCrossRefs" href="#fig0005">Figures 1 and 2</a>, <a class="elsevierStyleCrossRef" href="#sec0040">Video 1</a>) with moderate AR (<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>). The patient was removed from the donor list with a suggestion for regular outpatient cardiology clinic visits.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Quadricuspid aortic valve is a rare congenital cardiac anomaly that is mostly diagnosed incidentally. AR usually develops due to fibrosis and incomplete coaptation of the leaflets caused by unequal shear stress. Stenosis can occur but is rare. The risk of infective endocarditis is unknown but there have been documented cases in the literature.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Consequently, if there is unexplained AR, congenital valve anomalies including QAV should be considered as a possible cause.</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:3 [ "identificador" => "sec0010" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-11-08" "fechaAceptado" => "2015-12-08" "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0050" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0040" ] ] ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 628 "Ancho" => 951 "Tamanyo" => 91873 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transesophageal echocardiography, short-axis view during systole, showing quadricuspid aortic valve. AV: aortic valve; LA: left atrium; RA: right atrium.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 633 "Ancho" => 958 "Tamanyo" => 82277 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Transesophageal echocardiography, short-axis view at end-systole, showing quadricuspid aortic valve. AV: aortic valve; LA: left atrium; RA: right atrium.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 637 "Ancho" => 958 "Tamanyo" => 114146 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Transesophageal echocardiography, long-axis view during diastole, showing aortic regurgitation. AR: aortic regurgitation; Ao: aortic valve; LA: left atrium; LV: left ventricle.</p>" ] ] 3 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 698472 "Video" => array:2 [ "mp4" => array:2 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" ] "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003500000012/v2_201702040044/S2174204916302380/v2_201702040044/en/main.assets" "Apartado" => array:4 [ "identificador" => "9915" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in cardiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003500000012/v2_201702040044/S2174204916302380/v2_201702040044/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916302380?idApp=UINPBA00004E" ]
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| 2017 December | 45 | 5 | 50 |
| 2017 November | 14 | 12 | 26 |
| 2017 October | 19 | 12 | 31 |
| 2017 September | 16 | 11 | 27 |
| 2017 August | 17 | 9 | 26 |
| 2017 July | 15 | 7 | 22 |
| 2017 June | 26 | 14 | 40 |
| 2017 May | 26 | 7 | 33 |
| 2017 April | 16 | 6 | 22 |
| 2017 March | 43 | 35 | 78 |
| 2017 February | 35 | 15 | 50 |
| 2017 January | 34 | 19 | 53 |
| 2016 December | 32 | 10 | 42 |
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