<abstract>
<title style='display:none'>Abstract</title>
A high premature ventricular contractions (PVC) burden can disturb the patient’s condition through fatigue during exercise or palpitations. Hence, researchers started to look for treatment options that decrease PVC burden without the side effects of antiarrhythmic drugs, and vitamin D could be a valuable solution and safe alternative to drugs or catheter ablation for high-burden PVCs. We present the case of a 24-year-old patient with high-burden PVC of &gt;25,500/24 hours referred for urgent catheter ablation. Treatment with beta-blockers and calcium blockers did not reduce PVC burden. Under propafenone, there was a slight reduction in the number of PVCs to 21,200/24 hours, therefore the patient was referred for catheter ablation. As there was a vitamin D deficiency of 10.1 ng/mL, an attempt of vitamin D supplementation was done, with increase of vitamin D to 32.1 ng/mL and decrease of PVC burden to 9,600/24 hours. Further dietary supplementation increased 25-OH vitamin D to 50.2 ng/mL and decreased the PVC burden to 119/24 hours. Consequently, catheter ablation was canceled, and the patient remained free of antiarrhythmic drugs.
</abstract>

Vitamin D Supplementation Replaced Catheter Ablation in a Patient with Frequent Premature Ventricular Contractions

<abstract><title style='display:none'>Abstract</title>The significant raise in the number of patients surviving an acute myocardial infarction (AMI) has increased the burden of morbidity and disability due to acute coronary events. This has led to an increasing awareness on the need to develop specific rehabilitation programs, both during the acute phase, as well as in out-patient settings. In the pre-revascularization era, AMI was treated in bed. Regardless of the known therapeutic benefits of bed rest, there are scarce data regarding a standardized protocol for the early rehabilitation of patients with AMI. An extensive group of AMI patients are still exposed to prolonged immobilization, with current data showing a disparity in the length of post-MI bed rest, with a time of immobilization reported to be from 2 to 12 days and 2 to 28 days. The growing body of evidence on the effects of early cardiac rehabilitation programs following an AMI suggests that early mobilization after the index event could improve the inflammatory response and further modulate the ventricular remodeling process. The timing, duration, and intensity of cardiac mobilization has not yet been established, and further research on the effects of mobilization as early as the first 12 to 24 hours after the acute event could be beneficial for both short- and long-term outcomes, inflammation, and ventricular remodeling with subsequent heart failure.</abstract>

Mobilization of Patients Suffering from Acute Myocardial Infarction – When Is It Too Early?

<abstract><title style='display:none'>Abstract</title>Hematological conditions can lead to serious disturbances in blood rheology, being frequently associated with increased systemic inflammation and increased risk of bleeding. The imbalance between coagulation and thrombolytic factors in patients with acute coronary syndromes may lead to undesirable outcomes, and the success of emergency coronary angioplasty or by-pass grafting may be altered by increased bleeding in coagulopathies such as hemophilia. This paper intends to review the present knowledge in the field of acute coronary syndromes in subjects with hematological and onco-hematological disorders such as thrombotic thrombocytopenic purpura, immune thrombocytopenic purpura, von Willebrand disease, hemophilia, polycythemia vera, erythrocyte disorders, myelodysplastic syndrome, leukemia, lymphoma or myeloma.</abstract>

University of Medicine and Pharmacy, Tîrgu Mureș,

Clinic of Hematology and Bone Marrow Transplantation Unit, Tîrgu Mureș,

Acute Coronary Syndromes in Patients with Hematological Disorders

<abstract><title style='display:none'>Abstract</title>Hypertensive emergencies (HE) represent critical conditions in which extremely high blood pressure values are accompanied by acute hypertension-mediated organ damage. In this clinical setting, the main therapeutic goal is represented by the immediate reduction of blood pressure, in order to limit the extension or promote the regression of target organ damage. At present, HE are classified according to the condition or target organ involved, into: (1) malignant hypertension with or without thrombotic microangiopathy; (2) coronary ischemia or acute cardiogenic pulmonary edema; (3) acute stroke or hypertensive encephalopathy; (4) acute aortic dissection or aneurysm; and (5) eclampsia or severe preeclampsia/HELLP syndrome. The management of these conditions is different in relation to the complex pathophysiology involved in each of these types. This mini-review presents the main characteristics and management strategy for different forms of HE, revealing the particularities of management strategy for each of them.</abstract>

Modern Management of Hypertensive Emergencies

<abstract><title style='display:none'>Abstract</title> Background: Critical coarctation of the aorta is the most common congenital heart disease with ductal-dependent systemic circulation. In severe forms, this disease represents a critical condition, which can become life-threatening. The aim of this study was to evaluate the usefulness of different echocardiographic parameters in the prediction of aortic coarctation in newborns. Material and method: This is a retrospective study performed by reviewing echocardiographic images of both pre-term and full-term newborns presented with aortic coarctation to the emergency room of a clinic of pediatric cardiology. Based on echocardiographic measurements, both the common carotid artery-subclavian artery index (CSAi) and the aortic isthmus-descending aorta index (I/D) were calculated. Results: Fifty-two newborns presented in acute settings with aortic coarctation and were included in the study, divided into: subgroup 1 (n = 26) - ductal-dependent aortic coarctation; subgroup 2 (n = 2) - non-ductaldependent aortic coarctation; and subgroup 3 (n = 24) - unconfirmed aortic coarctation. ROC analysis identified a cutoff value of 1.37 for the CSAi index and a cutoff value of 0.46 for the I/D index as being associated with the highest predictive power for the diagnosis of aortic coarctation. Conclusions: The CSAi and I/D indices are simple and accessible echocardiographic parameters that can provide supplemental information for the pediatric cardiologist in acute cases of newborns with suspicion of aortic coarctation. These new indices can contribute to the decision-making process in case of pre-term and full-term newborns with suspicion of coarctation of the aorta, independent of the presence of persistent ductus arteriosus.</abstract>

Original Research. Diagnosis of the Aortic Coarctation in the Neonatal Period — a Critical Condition in the Emergency Room

<abstract><title style='display:none'>Abstract</title><bold>Background:</bold> Blood viscosity is a strong predictor of cardiovascular events. However, the relationship between blood viscosity and acute arterial occlusion (AAO) has not been studied adequately so far.<bold>Objectives:</bold> The aim of the present study was to assess the relationship between whole blood viscosity (WBV) and AAO.<bold>Material and methods:</bold> The study included 93 patients who were diagnosed with AAO between January 2017 and September 2019, and 90 age- and sex-matched healthy controls. WBV was assessed using a validated calculation formula derived from hematocrit and total plasma protein levels, both as a low (LSR) and a high (HSR) shear rate.<bold>Results:</bold> There were no significant differences between the two groups in regards to the baseline characteristics, with the exception of smoking and LDL cholesterol levels. Subjects with AAO presented significantly higher WBV values both at LSR (32.2 ± 5.0 vs. 26.6 ± 5.0, p &lt;0.001) and HSR (6.2 ± 0.3 vs. 5.7 ± 0.3, p &lt;0.001). The ROC analysis revealed a cut-off value of 27.4 for WBV at LSR (sensitivity 66%, specificity 64%, AUC = 0.770, p &lt;0.001) and a cut-off value of 5.29 in case of HSR (sensitivity 69%, specificity 74%, AUC = 0.801, p &lt;0.001) for predicting AAO. Multivariate analysis, both LSR (OR 3.33, 95% CI: 1.20–9.43, p = 0.006) and HSR (p = 0.020, OR: 1.70, 95% CI: 1.020–1.123) were independent predictors of AAO.<bold>Conclusions:</bold> This study demonstrated that WBV levels at both HSR and LSR are significantly higher in the AAO group than in the control subjects, indicating that an increased WBV may be associated with the development of AAO.</abstract>

The Relationship between Blood Viscosity and Acute Arterial Occlusion

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>Introduction</title>
Thyroid hormones influence multiple systems, but most often the impact on the cardiovascular system is what brings the patient to the emergency department. Basedow’s disease, an autoimmune condition, is one of the most common causes of hyperthyroidism. The purpose of this presentation is to raise attention to an extracardiac cause that can lead to cardiac failure.
</sec>
<sec><title style='display:none'>Case presentation</title>
A 55-year-old woman presented to our cardiology service with rapid palpitations, shortness of breath on small efforts, and extreme fatigue. The electrocardiogram revealed sinus tachycardia with a heart rate of 144 beats per min. Paraclinical investigations and a multidisciplinary team consultation led to a diagnosis of thyrotoxicosis due to Basedow’s disease. Following the initiation of cardiological and endocrinological treatments, the patient’s condition improved.
</sec>
<sec><title style='display:none'>Conclusion</title>
Although hyperthyroidism is an extracardiac cause, it brought the patient to the cardiology emergency service for heart failure symptoms. The key to achieving a correct diagnosis and determining an optimal treatment lies in the multidisciplinary approach of pathology.
</sec>
</abstract>

Heart Failure as the First Clinical Manifestation of Basedow’s Disease

<abstract>
<title style='display:none'>Abstract</title>
Coronavirus disease (COVID-19) is a viral infection caused by SARS-CoV-2 that has become a global health emergency with a negative impact on patient care. The evolution of patients with COVID-19 is unpredictable, with an unfavorable evolution in the case of patients with comorbidities. This state-of-the-art review focuses on the role of hematological inflammatory biomarkers: the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) in predicting major adverse cardiovascular events (MACE) and mortality in patients with COVID-19. In this review, we included 21 studies that investigated the role of biomarkers in the risk of mortality and MACE, reporting on a total of 7,588 patients. Regarding the clinical data, 57.49% of the patients presented hypertension (15 out of the 21 studies reported hypertensive patients), followed by ischemic heart disease in 33.56% of patients (13 studies) and diabetes in 30.37% of patients (17 studies). In additional, among the usual risk factors, 23.55% of patients presented obesity (7 studies) and 23.02% were active smokers (10 studies). We recorded an average cut-off value of 7.728 for NLR (range 2.6973–15.2), 0.594 for MLR (range 0.26–0.81), and 215.07 for PLR (range 177.51–266.9) for the risk of MACE and mortality. We also recorded an average area under the curve (AUC) of 0.783 for NLR, 0.744 for MLR, and 0.713 for PLR. Our findings suggest that these biomarkers exhibit prognostic value in predicting adverse outcomes, and that evaluating these biomarkers at admission could provide novel information in stratifying risk groups for improving patient management.
</abstract>

The Prognostic Role of Neutrophil-to-Lymphocyte Ratio, Monocyte-to-Lymphocyte Ratio, and Platelet-to-Lymphocyte Ratio in the Risk of Major Adverse Cardiovascular Events and Mortality in Patients with COVID-19: a State-of-the-Art Review

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>Introduction</title>
We report a rare case of an 80-year-old male patient with acute transformation of myelodysplastic syndrome (MDS) in the pericardial cavity, leading to cardiac tamponade.
</sec>
<sec><title style='display:none'>Case presentation</title>
The patient had been diagnosed with MDS 7 months prior. One day before presentation, he suddenly developed dyspnea. At presentation, his blood pressure was stable, but he was in tachycardic atrial fibrillation; echocardiography revealed a pericardial effusion. Aortic dissection and acute myocardial infarction were excluded by examination upon admission. His blood pressure subsequently dropped, indicating pericardial tamponade. Pericardiocentesis was performed, and 800 ml of bloody pericardial fluid were withdrawn, stabilizing his blood pressure. The blasts ratio was higher in the pericardial fluid than in the peripheral blood; bone marrow examination revealed no evidence of acute transformation, but the presence of numerous cells with chromosomal abnormalities in the pericardial sac cavity confirmed acute MDS transformation. The patient died on day 15 due to progressive multiorgan failure. The autopsy revealed a neoplastic lesion extending circumferentially throughout the epicardium.
</sec>
<sec><title style='display:none'>Conclusions</title>
When a patient with an acute onset history of hematogenous pericardial effusion is found to have a pericardial tamponade of cancerous origin, acute transformation of MDS should be considered in the differential diagnosis.
</sec>
</abstract>

An Autopsy Case of Acute Transformation of Myelodysplastic Syndrome Leading to Carcinomatous Cardiac Tamponade

From Inflammation to Acute Cardiovascular Events – a Complex Journey

Air Lock Syndrome – an Unusual Complication of Pacemaker Implantation

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>Background</title>
Time intervals related to ST-segment myocardial infarction (STEMI) revascularization are central determinants for patient outcomes. The current capability of the Romanian STEMI program to meet guideline-recommended time intervals is largely unknown.
</sec>
<sec><title style='display:none'>Aims</title>
The present study aims to assess the ability of a regional STEMI network to obtain guideline-recommended time intervals for primary percutaneous coronary intervention (pPCI) and to measure the occurrence and the extent of time delays.
</sec>
<sec><title style='display:none'>Materials and Methods</title>
This prospective study included 500 consecutive patients with STEMI at the “Prof. Dr. C.C. Iliescu” Emergency Institute for Cardiovascular Diseases, Bucharest, Romania during a period of 14 months. Complete ischemic timelines were created using several key timepoints.
</sec>
<sec><title style='display:none'>Results</title>
A secondary route (transfer from another hospital) was noted in most cases. The main time intervals were the following: patient delay 209 min, emergency medical system delay 66 min, and PCI center delay at 70 min, totaling an ischemic time of 6.4 h. A provisional stop at another hospital involved the addition of 113 min (1.8 h) until STEMI diagnosis and an additional 83 min (1.3 h) from diagnosis to revascularization, totaling a supplementary ischemic time of 3.1 h. In total, 41.5% of the patients were revascularized between 2 and 6 h from symptoms onset. The objective of revascularization in less than 120 min (from first medical contact) was accomplished in 35.5% of the patients. Prehospital thrombolysis was performed in 6.4% of the cases, although its potential benefits could have been expected in 64.5% of the patients.
</sec>
<sec><title style='display:none'>Conclusions</title>
Patients with STEMI arrive predominantly via secondary routes to the PCI center, which implies significantly increased ischemic times. The ambulance alert system and primary routes represent by far the most efficient, albeit still imperfect methods of pre-hospital approach. Prehospital thrombolysis did not compensate for the gaps existing in the performance of the current system.
</sec>
</abstract>

“Carol Davila” University of Medicine and Pharmacy

Critical Appraisal of Medical System Performance for STEMI Management – a Comprehensive Analysis of Time Efficiency

<abstract><title style='display:none'>Abstract</title>The <bold>aim</bold> of this systematic review was to analyze studies characterizing vulnerable coronary plaques using optical coherence tomography (OCT) and intravascular ultrasound (IVUS), in order to identify the most efficient invasive technique permitting plaque characterization in patients with acute myocardial infarction.<bold>Method:</bold> A total number of 432 studies were identified, 420 through database searching and 12 through manual searching. Eight duplicate studies were removed, leaving a total number of 424 studies to be screened. Twenty-six studies only available in Abstract-only form were excluded, resulting in 398 studies checked for eligibility. Eleven studies fulfilled the eligibility criteria and were included in this systematic analysis. Plaque vulnerability was investigated in plaques with thin cap fibroatheroma (TCFA) versus those with thick cap fibroatheroma, in ruptured coronary plaques versus non-ruptured coronary plaques, in culprit versus non-culprit lesions and in lipid-rich versus non-lipid-rich plaques.<bold>Results:</bold> A total of 1,568 coronary plaques in 1,225 patients with acute coronary syndromes (ACS) who underwent both IVUS and OCT for analysis of plaque features were included in the final analysis. The review identified the following IVUS-derived features as significantly correlated with plaque vulnerability: plaque burden (p &lt;0.001), remodeling index (p &lt;0.001), external elastic membrane cross-sectional area (p &lt;0.001), and the amount of necrotic core (p &lt;0.001), while OCT-derived features characterizing unstable plaque were TCFA (p &lt;0.001), lipid arch (p &lt;0.001), accumulation of macrophages (p = 0.03), and presence of intracoronary thrombus (p &lt;0.001).<bold>Conclusion:</bold> Both IVUS and OCT are invasive imaging techniques able to provide relevant information on the vulnerability of coronary atheromatous plaques, identifying, as they do, various plaque features significantly associated with unstable plaques. Information provided by the two techniques is complementary, and both methods can serve as a useful clinical diagnostic tool, especially in cases of ACS patients undergoing a revascularization procedure.</abstract>

Assessment of Coronary Plaque Vulnerability in Acute Coronary Syndromes using Optical Coherence Tomography and Intravascular Ultrasound. A Systematic Review

<abstract>
<title style='display:none'>Abstract</title>
Acute pulmonary embolism is a cardiovascular emergency with a significant morbidity and mortality. In the last decade, attempts have been made to find prognostic markers for pulmonary embolism. We conducted a systematic review of the literature for studies that assess the relationship between the neutrophil-to-lymphocyte ratio (NLR) and disease progression in patients with pulmonary embolism. We included a total of seven studies published between 2016 and 2021, reporting on a total of 4,272 patients. The mean NLR observed in these studies was 5.93, with values ranging from 5.12 to 7.3. Elevated NLR was significantly associated with an increased rate of mortality in all studies. Furthermore, the collected data revealed a 2-to-15 times higher mortality rate in the group with NLR values higher than the mean. Due to its accessibility and the simplicity with which it can be calculated, as well as the outcomes revealed in this review, we strongly emphasize that NLR should be used more in medical practice.
</abstract>

The Neutrophil-to-Lymphocyte Ratio’s Predictive Utility in Acute Pulmonary Embolism: Systematic Review

<abstract><title style='display:none'>Abstract</title> Introduction: The prognostic value of epicardial fat thickness (EFT) and inflammatory biomarkers such as hs-CRP have not been fully investigated in patients with acute myocardial infarction (AMI) and type 2 diabetes mellitus (DM). The study aim was to assess the correlation between the EFT, the persistence of elevated circulating levels of hs-CRP at 7 ± 2 days after an AMI and the amplitude of the left ventricular (LV) remodeling, in patients with type 2 DM. Methods: The study included 98 patients (45 with type 2 DM and 43 with no DM): Group 1 included 22 low-to-intermediate risk patients (hsCRP &lt;3 mg/l) and Group 2 had 23 high-risk, (hsCRP &gt;3 mg/l) patients. EFT, LV function and remodeling were assessed at baseline and at six months after AMI in both groups. Results: In the diabetic population, the EFT was significantly higher in patients who developed ventricular remodeling as compared with those who did not (8.02 ± 1.80 mm vs. 6.65 ± 2.17 mm, p = 0.02) and significantly correlated with the circulating levels of hs-CRP (r = 0.6251, p &lt;0.0001). The levels of circulating hs-CRP, at baseline, significantly correlated with the RI at six months (r = 0.39, p &lt;0.001). Also, in the diabetic population, the epicardial fat thickness was significantly higher in patients who developed ventricular remodeling as compared with those who did not (8.02 ± 1.80 mm vs. 6.65 ± 2.17 mm, p = 0.02). The epicardial adipose tissue thickness significantly correlated with the circulating levels of hs-CRP (r = 0.6251, p &lt;0.0001), while in the non-diabetic population, EFT was not significantly higher in patients who developed ventricular remodeling as compared with those who did not (71.38 ± 9.09 vs. 67.4 ± 10.17, p = 0.23). Multivariate analysis identified the hs-CRP values (OR: 4.09, p = 0.03) and the EFT (OR: 6.11, p = 0.01) as significant independent predictors for LV remodeling in diabetic population. Conclusions: A larger EFT is associated with a more severe remodeling and impairment of ventricular function in patients with type 2 DM and AMI.</abstract>

Center of Advanced Research in Multimodality Cardiac Imaging, Cardio Med Medical Center, Tîrgu Mureș, Romania, 76, 22 Decembrie 1989 St, 540124

Clinic of Cardiology, University of Medicine and Pharmacy, Tîrgu Mureș, Romania 76, 22 decembrie 1989 St 540124

Clinic of Cardiology, University of Medicine and Pharmacy, Tîrgu Mureș, Romania, 38 Gheorghe Marinescu St, 540139

Clinic of Cardiology, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Prognostic Value of Epicardial Fat Thickness as a Biomarker of Increased Inflammatory. Status in Patients with Type 2 Diabetes Mellitus and Acute Myocardial Infarction

<abstract><title style='display:none'>Abstract</title> Background: This systematic review seeks to evaluate the role of epicardial adipose tissue (EAT), quantified either by thickness, assessed by transthoracic echocardiography, or by volume, assessed by cardiac computed tomography (CT), in the follow-up of patients with acute coronary syndromes (ACS). Method: One-hundred forty-four articles were screened, from which 56 were reviewed in full-text. From those, 47 studies were excluded for the following reasons: they did not meet the inclusion criteria; they were either reviews or meta-analyses; the study cohorts included only stable coronary artery disease patients; they did not state a clear and concise study design, endpoints, or follow-up. The final draft included nine studies for systematic evaluation. Results: Of the 2,306 patients included in the review, 170 underwent cardiac CT while the remaining 2,136 underwent transthoracic echocardiography for the measurement of EAT. The analysis found that the EAT thickness was significantly associated with major adverse cardiovascular events (MACE) rates during hospitalization (OR: -1.3, 95% CI: 1.05-1.62, p = 0.020) and at three years (HR: 1.524, 95% CI: 1.0-2.2, p = 0.038). The included studies found that EAT was correlated with the following clinical and angiographic risk scores for ACS: GRACE (r = 0.438, p &lt;0.001), TIMI risk score (r = 0.363, p = 0.001), SYNTAX score (r = 0.690, p &lt;0.0001; r = 0.610, p &lt;0.01), and Gensini score (r = 0.438, p = 0.001). There was an inverse correlation between ST-segment resolution of &lt;70% after revascularization and EAT (r = −0.414, p = 0.01), and the myocardial blush grade (r = −0.549, p &lt;0.001). The EF aggregation ranged between 2.65 mm and 4.7 mm within the included studies. Conclusions: EAT, evaluated either by echocardiography or cardiac CT, correlates with the severity of coronary lesions, with the clinical and angiographic risk scores for acute coronary syndromes, with indicators for coronary reperfusion, and with short- and long-term MACE rates. Further studies are required to fully elucidate the role of this extensively studied but still novel cardiovascular biomarker as part of a risk prediction tool.</abstract>

Original research. The Assessment of Epicardial Adipose Tissue in Acute Coronary Syndrome Patients. A Systematic Review

<abstract><title style='display:none'>Abstract</title>Acute coronary syndromes represent the most severe consequences of atherosclerosis, most often triggered by the rupture of a coronary plaque, which, for various reasons, has become unstable. In many cases, these rupture-prone vulnerable plaques are difficult to diagnose, because they do not always cause significant obstruction noticeable by coronary angiography. Therefore, new methods and tools for the identification of vulnerable plaques have been proposed, many of which are currently under study. Various biomarkers have been suggested as predictors of a vulnerable plaque, as well as indicators of an increased inflammatory status associated with higher patient susceptibility for plaque rupture. Integration of such biomarkers into multiple biomarker platforms has been suggested to identify superior diagnostic algorithms for the early detection of the high-risk condition associated with an unstable plaque. The aim of this review is to summarize recent research related to biomarkers used for the early detection of vulnerable plaques and vulnerable patients.</abstract>

Department of Cardiology, University of Medicine and Pharmacy, Tîrgu Mureş,

MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest,

Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest,

The Use of Biomarkers for the Early Detection of Vulnerable Atherosclerotic Plaques and Vulnerable Patients. A Review

<abstract>
<title style='display:none'>ABSTRACT</title>
<bold>Introduction:</bold> Ruptured abdominal aortic aneurysm (AAA) has a high mortality, even when the patients reach the hospital in time and the intervention is expeditious. <bold>Case presentation:</bold> We present the case of a 66-year-old male patient, with a known history of AAA, presenting to the emergency room in a state of hypovolemic shock due to massive bleeding in the upper and lower gastrointestinal tract and acute abdominal pain, which presented an abrupt onset one hour before presentation. The computed tomography angiography identified an aortoduodenal fistula with a trajectory toward the D3 segment of the duodenum, as well as a common iliac artery occlusion and extensive atherosclerotic stigmas. The patient was rushed to the operation room where he was resuscitated with intravenous fluids, two units of packed red blood cells, and hemostatic agents. The bleeding was stopped by clamping the aorta above the aneurysm. The duodenum was sutured, and the aorta was reconstructed with an aortobifemoral graft. Unfortunately, even though intensive care procedures continued for a few hours after surgery, all therapeutic efforts failed and the patient had succumbed.
</abstract>

Clinic of Vascular Surgery, Emergency County Hospital

Department of Surgery, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology

Clinic of General Surgery, Emergency County Hospital

Fatal Aortoduodenal Fistula Caused by a Ruptured Abdominal Aortic Aneurysm - a Case Report

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Journal of Cardiovascular Emergencies

 The Journal of Cardiovascular Emergencies aims to publish top quality papers related to acute conditions in any cardiovascular pathology. The journal will mainly focus on...

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 The Journal of Cardiovascular Emergencies aims to publish top quality papers related to acute conditions in any cardiovascular...