<strong>TEHRAN</strong> <strong>HEART</strong> <strong>CENTER</strong>
<strong>TEHRAN</strong> <strong>HEART</strong> <strong>CENTER</strong> Volume: 7 Number: 4 Summary of Contents What you will find in this Issue Autumn 2012 REVIEW ARTICLE 147 Prosthetic Tricuspid Valve Thrombosis: Three Case Reports and Literature Review Ahmad Yaminisharif, MD, Mohammad Javad Alemzadeh- Ansari, MD * , Seyed Hossein Ahmadi, MD Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. * Mohammad Javad Alemzadeh-Ansari, Department of Cardiology, Tehran University of Medical Sciences, Tehran Heart Center, Karegar Street, Tehran, Iran. 1411713138. Tel: +98 21 88029600. Fax: +98 21 88029731. E-mail: aansari@razi.tums.ac.ir. common complication of prosthetic heart A valves is thrombosis. Although the incidence of prosthetic valve thrombosis (PVT) in the tricuspid position is high, there are not enough data on the management of it, in contrast to left-sided PVT. Here, we describe three cases of tricuspid PVT with three different management approaches: thrombolytic therapy; close observation with oral anticoagulants; and surgery. The first case was a woman who suffered from recurrent PVT, for which we successfully used Tenecteplase for second and third episodes. We employed Tenecteplase in this case for the first time in the therapy of tricuspid PVT. The second case had fixed leaflets in open position while being symptomless. At six months' follow-up, with the patient having taken oral anticoagulants, the motion of the leaflets was restricted and she was symptom-free. The last case was a woman who had a large thrombus in the right atrium immediately after mitral and tricuspid valvular replacement. The patient underwent re-replacement surgery and a new biological valve was implanted in the tricuspid position. Also, we review the literature on the pathology, signs and symptoms, diagnosis, and management of tricuspid PVT. ORIGINAL ARTICLES 156 Increased Carotid Artery Intima-Media Thickness in Pregnant Women with Gestational Diabetes Mellitus GholamrezaYousefzadeh, MD 1 , Hashem Hojat, MD 1 , Ahmad Enhesari, MD 1 , Mostafa Shokoohi, MSc 2* , Nahid Eftekhari, MD 1 , Mehrdad Sheikhvatan, MD 3 1 Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran. 2 Research Center for Modeling in Health, Kerman University of Medical Sciences, Kerman, Iran. 3 Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. * Mostafa Shokoohi, Research Center for Modeling in Health, Kerman University of Medical Sciences, Jihad Blvd, Shariati Street, Azadi Square, Kerman, Iran. 7619813159. Tel: +98 341 2263983. Fax: +98 341 2264079. E-mail: shokouhi.mostafa@gmail.com. Background: Pregnant women with previous gestational diabetes mellitus are at increased risk of progressive carotid artery disorders. The current study evaluated carotid intima-media thickness (IMT) in pregnant women with gestational diabetes at two time points of mid-term and full-term pregnancy to determine whether gestational diabetes mellitus causes increased IMT. Conclusion: In conclusion, an impaired OGCT test is proven to be an independent risk factor for increased carotid IMT and subsequent coronary artery disease. Even with this small study, we were able to find an increased IMT after diabetes appearance, which might be used as an indicator of a potential increased vascular risk. Furthermore, IMT measurements in diabetic pregnant women could offer an opportunity to identify a high-risk group of women who might