scholarly journals Concomitant Anomalous Right Coronary Artery and Iatrogenic Left Circumflex Artery Entrapment, Treated Successfully With Percutaneous Coronary Intervention

2012 ◽  
Vol 5 (11) ◽  
pp. 1185-1186 ◽  
Author(s):  
Carrie Eshelbrenner ◽  
S. Hinan Ahmed
2016 ◽  
Vol 157 (32) ◽  
pp. 1282-1288
Author(s):  
András Jánosi ◽  
Péter Ofner ◽  
Dániel Simkovits ◽  
Tamás Ferenci

Introduction: To the best of the authors’ knowledge, very few publications are available which report on the prognostic significance of the culprit vessel in patients with ST elevation myocardial infarction treated with successful primary percutaneous coronary intervention. Aim: The aim of the authors was to obtain data on the significance of the culprit vessel in patients with ST elevation myocardial infarction treated successfully by primary percutaneous coronary intervention. Method: The authors performed a retrospective study in 10,763 patients with ST elevation myocardial infarction who underwent successful primary percutaneous coronary intervention. The culprit vessels were the left main artery, left anterior descendent artery, left circumflex artery, and right coronary artery. The authors constructed univariate survival curves for different culprit vessels and also performed multivariate modelling of time-to-death, controlling for age, sex, and comorbidities. Results: The majority of the culprit lesions were found in the left anterior descendent artery (44.3%), the right coronary artery (40.9%), and the left circumflex artery (13.7%). The culprit vessel was overall a highly significant (p<0.0001) factor of survival, with right coronary artery exhibiting a highly significantly better prognosis (hazard ratio 0.69, 95% CI 0.61–0.79, p<0.0001) and left main artery exhibiting a significantly worse prognosis (hazard ratio 1.56, 95% CI 1.04–2.35, p = 0.0321) than the reference vessel (left anterior descendent artery). Conclusion: These data demonstrate that the culprit vessel has independent prognostic significance. Orv. Hetil., 2016, 157(32), 1282–1288.


2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yuki Hayashi ◽  
Makoto Taoka ◽  
Shunji Osaka ◽  
Satoshi Unosawa ◽  
Masashi Tanaka

Abstract Background Iatrogenic acute aortic dissection (AAD) caused by cardiovascular intervention is rare. Also rare is spontaneous coronary artery dissection (SCAD), a form of acute coronary syndrome, which develops in relatively young women without coronary risk factors. We encountered type A iatrogenic AAD caused by an intervention for SCAD. Case presentation A 53-year-old woman was brought to our hospital after cardiopulmonary resuscitation. She was diagnosed with acute coronary syndrome caused by SCAD, and percutaneous coronary intervention was carried out on her distal left anterior descending artery. The dissection proceeded to the proximal left anterior descending artery and left main coronary artery trunk, so additional percutaneous coronary intervention was performed on the left circumflex artery. After the intervention, type A AAD occurred with a primary entry tear from the left main coronary artery trunk, and computed tomography showed a type A AAD of the aortic arch. We performed emergency ascending aorta replacement and coronary artery bypass grafting to the left anterior descending artery and left circumflex artery. The patient had an uneventful recovery after the operation and was discharged on postoperative day 25. Conclusion To our knowledge, this is the first report of an iatrogenic AAD caused by percutaneous coronary intervention for SCAD.


2020 ◽  
Vol 101 (1) ◽  
pp. 18-24 ◽  
Author(s):  
F Z Abdullaev ◽  
N M Babaev ◽  
L S Shikhieva

Aim. To study the features of risk profile, coronary artery patterns, and percutaneous coronary intervention in patients aged below 40 years with acute coronary syndrome and stable angina. Methods. 208 patients with coronary artery disease aged below 40 years were examined: 51 (24.5%) patients aged 35 years and younger and 157 (75.5%) aged 3640 years. 98 (47.1%) patients were admitted with acute coronary syndrome; 110 (52.9%) patients with stable angina. In groups of acute coronary syndrome and stable angina, myocardial infarction in past medical history was revealed in 23.5% and 36.4%, respectively. 165 patients underwent percutaneous coronary intervention: 84 (50.9%) with acute coronary syndrome; 81 (40.1%) with stable angina. Results. Patients with stable angina differed by prevalence of myocardial infarction in past medical history, overweight, and family history of coronary artery disease. In group of acute coronary syndrome urban cohort prevailed as well as consumption of energy drinks among patients below 35 years; high prevalence of left ventricular dysfunction. Patients with acute coronary syndrome were characterized by involvement of one and three coronary arteries, and patients with stable angina by pathology of two and three coronary arteries. Involvement of three coronary arteries was equal in both groups. In both groups, anterior interventricular artery was target coronary artery. Patients with stable angina had the same rate of right coronary artery and left circumflex artery involvement. In patients with stable angina, right coronary artery involvement was rarer, and left main coronary artery involvement was two times more frequent than in patients with acute coronary syndrome. The group with acute coronary syndrome was characterized by predominance of discrete lesions and coronary occlusions over diffuse lesions; and the group of stable angina by diffuse lesions, and two-times less frequent coronary occlusions. Conclusion. Among patients with acute coronary syndrome aged below 36 years, revascularization of right coronary artery was predominant, and among patients aged 3640 years with acute coronary syndrome revascularization of left circumflex artery.


2014 ◽  
Vol 6 (2) ◽  
pp. 122-126
Author(s):  
AHMW Islam ◽  
S Munwar ◽  
S Talukder ◽  
AQM Reza ◽  
T Ahmed ◽  
...  

Background: Aim of the study was to evaluate the primary procedural success of percutaneous coronary intervention (PCI) of de-novo coronary artery lesion by using Bioabsorbable Vascular Scaffold (BVS) ABSORB stents eluting Everolimus. Methods: Total 16 patients were enrolled in this very preliminary study of BVS absorb. Among them, Male: 11 and Female: 5. Total 20 stents were deployed. Mean age were for Male: 56 yrs, for Female: 60 yrs. Associated coronary artery disease (CAD) risk factors were Dyslipidemia, High Blood pressure, Diabetes Mellitus, Positive family history (FH) for CAD and Smoking. Patients were followed up clinically. Results: Among the study group; 13 (81%) were Dyslipidemic, 10(62.5%) were hypertensive; 6 (37.5%) patients were Diabetic, FH 3(18.75%), and 2(18%) were all male smoker. Female patients were more obese [Body Mass Index (BMI) M 25: F 27] and developed CAD in advance age. A common stented territory was for left anterior descending artery (LAD): 6 (37.5%), left circumflex artery (LCX) 5 (25%), right coronary artery (RCA) 6(37.5%). One patient had both LCX and LAD stenting. Total 3 patients had double/overlapping stent in RCA lesion. Territory wise distributions of BVS ABSORB stent were for LAD 6(30%), RCA 9 (45%), and LCX 5 (25%). There was no periprocedural or postprocedural complication. Conclusion: BVS ABSORB Everolimus eluting vascular scaffold showed favorable clinical outcome without any major cardiac events (acute or late stent thrombosis, MI or death) over a period of 9 month. Thus, BVS ABSORB would be favorable alternative to other available drug eluting metallic stents. DOI: http://dx.doi.org/10.3329/cardio.v6i2.18352 Cardiovasc. j. 2014; 6(2): 122-126


2017 ◽  
Vol 02 (03) ◽  
pp. 021-024
Author(s):  
Narapureddy Reddy ◽  
Nemani Lalita

Background Percutaneous coronary intervention (PCI) in type C lesions has low success and has high procedural risk. We aimed at studying the outcomes of PCI in patients with type C lesions. Material and Methods Total 180 patients with type C lesions who underwent PCI from January 2007 to December 2014 were taken into study and analyzed. Results Of 180 patients, 141(78.3%) were males and 39 (21.7%) were females. Mean hemoglobin concentration, mean serum triglycerides, and mean estimated glomerular filtration rate were significantly lower in females compared with males. Seventy-seven (42.8%) patients had lesions in right coronary artery, 67 (37.2%) had lesions in left anterior descending coronary artery, 31 (17.2%) had lesions in left circumflex artery, and 5 (2.8%) had left main coronary artery disease. Complex lesions were common in males. Chronic total occlusion (CTO) was found in 140 cases and other than CTO of type C lesions in 40 patients. Predilatation was done in 169 (93.9%) patients. Successful PCI was done in 157 (87.2%) patients. Lesion could not be crossed in 11 (6.1%) patients. Only plain old balloon angioplasty could be done in 9 (5%) patients. Other complications occurred in 3 (1.67%) patients. There was no difference between female and male patients in requiring predilatation or crossing the lesion or in not being able to deliver the stent. Conclusion PCI success rate among patients with type C lesions was 87.2% with low-complication rate in the present era. There was no difference in between female and male patients in success rate or complications.


Author(s):  
Adeogo Akinwale Olusan ◽  
Paul Francis Brennan ◽  
Paul Weir Johnston

Abstract Background Isolated right ventricular myocardial infarction (RVMI) due to a recessive right coronary artery (RCA) occlusion is a rare presentation. It is typically caused by right ventricle (RV) branch occlusion complicating percutaneous coronary intervention. We report a case of an isolated RVMI due to flush RCA occlusion presenting via our primary percutaneous coronary intervention ST-elevation myocardial infarction pathway. Case summary A 61-year-old female smoker with a history of hypercholesterolaemia presented via the primary percutaneous coronary intervention pathway with sudden onset of shortness of breath, dizziness, and chest pain while walking. Transradial coronary angiography revealed a normal left main coronary artery, large left anterior descending artery that wrapped around the apex and dominant left circumflex artery with the non-obstructive disease. The RCA was not selectively entered despite multiple attempts. The left ventriculogram showed normal left ventricle (LV) systolic function. She was in cardiogenic shock with a persistent ectopic atrial rhythm with retrograde p-waves and stabilized with intravenous dobutamine thus avoiding the need for a transcutaneous venous pacing system. A computed tomography pulmonary angiogram demonstrated no evidence of pulmonary embolism while an urgent cardiac gated computed tomography revealed a recessive RCA with ostial occlusive lesion. A cardiac magnetic resonance imaging confirmed RV free wall infarction. She was managed conservatively and discharged to her local district general hospital after 5th day of hospitalization at the tertiary centre. Discussion This case describes a relatively rare myocardial infarction presentation that can present with many disease mimics which can require as in this case, a multi-modality imaging approach to establish the diagnosis.


Sign in / Sign up

Export Citation Format

Share Document