scholarly journals Right Coronary Artery STEMI following Blunt Thoracic Trauma

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Saad Sikanderkhel ◽  
Jon-Austin Ash ◽  
Kimberly O’Dell ◽  
Jacob Mok ◽  
Harish Manyam ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Motor Vehicle ◽  
Rare Complication ◽  
Coronary Intervention ◽  
Academic Community ◽  
Aspiration Thrombectomy ◽  
Cardiac Trauma ◽  
Near Misses ◽  
The Right

We present a case report of an otherwise healthy 37-year-old male without pertinent cardiac history or risk factors, who presented with cardiac trauma after a motor vehicle collision (MVC). Initial workup including electrocardiogram (ECG), transthoracic echocardiogram (TTE), and uptrending serial troponins warranted coronary angiography, during which occlusive thrombi were discovered in the proximal right coronary artery (pRCA), the right posterolateral vessel (rPL), and the right posterior descending artery (PDA). Subsequently, the patient underwent percutaneous coronary intervention of the RCA and PDA with aspiration thrombectomy. He was then initiated on dual antiplatelet therapy (DAPT) and recovered appropriately. This case is presented with the goal of enlightening the academic community of a rare complication while presenting a judicious approach to management in an attempt to decrease the occurrence of “near misses” in the future.

Abstract 17426: Acute Myocardial Infarction Due to Right Coronary Artery Occlusion Following Blunt Thoracic Trauma

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Kimberly O'Dell ◽  
Jacob Mok ◽  
Saad Sikanderkhel
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Troponin I ◽  
Motor Vehicle ◽  
Coronary Artery Occlusion ◽  
Thoracic Wall ◽  
Multiple Fractures ◽  
Aspiration Thrombectomy ◽  
St Segment Elevation ◽  
Chest Wall Trauma

Blunt thoracic wall trauma can rarely lead to acute coronary artery injury and occlusion , and mostly involves the left anterior descending artery due to its vulnerable anterior anatomic positioning. Herein, we present a case of a young man who presented as a ST segment elevation MI (STEMI) with right coronary artery (RCA) occlusion after a blunt thoracic wall trauma. Clinical Vignette: A 37-year-old man with no previous medical history was brought to our ER with blunt chest wall trauma following a motor vehicle collision. Initial workup showed multiple fractures, a right pneumothorax and a pelvic hematoma. EKG performed for chest pain showed STEMI in the inferior and lateral leads. A 2D echocardiogram then showed inferolateral wall hypokinesis. Serial troponin I levels trended up sharply from 0.4 initially. After initiating intravenous heparin and cangrelor, the patient underwent emergent coronary angiography which revealed a rare, RCA occlusion with a thrombus. The patient then successfully underwent aspiration thrombectomy with restoration of TIMI grade III blood flow. Discussion: Hence, we presented a rare case of RCA occlusion resulting from blunt thoracic wall trauma. While musculoskeletal pain may mask the symptoms of myocardial hypoperfusion, a high index of suspicion for coronary artery thrombosis can lead to desirable outcomes in such patients.

A case of delayed occlusive dissection of the right coronary artery during coronary intervention of the left anterior descending artery

2014 ◽  
Vol 30 (2) ◽  
pp. 155-161 ◽  
Author(s):  
Yoshiki Nagata ◽  
Michiro Maruyama ◽  
Isao Aburadani ◽  
Motoaki Hirazawa ◽  
Takuya Mayumi ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Intervention ◽  
Left Anterior Descending Artery ◽  
The Right

scholarly journals Successful Rotational Atherectomy for an Angulated Calcified Lesion in an Anomalous Right Coronary Artery Using the “Mother-and-Child” Technique

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Manabu Ogita ◽  
Satoru Suwa ◽  
Taketo Sonoda ◽  
Shuta Tsuboi ◽  
Katsumi Miyauchi ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Intervention ◽  
Rotational Atherectomy ◽  
Stent Expansion ◽  
Calcified Lesion ◽  
Percutaneous Coronary ◽  
Mother And Child ◽  
The Right ◽  
Anomalous Coronary

Percutaneous coronary intervention (PCI) involving the anomalous coronary artery is challenging with respect to difficulty in achieving stable catheterization. Rotational atherectomy (RA) can facilitate severely calcified lesions to improve stent delivery and stent expansion; however, its utility in tortuous and angulated coronary arteries is limited with difficulty in delivery of the RA burr. The mother-and-child technique is effective for complex PCIs with increased backup force for device delivery in such complicated cases. We report a case of successful rotational atherectomy using the “mother-and-child” technique with a Dio thrombus aspiration catheter for an angulated calcified lesion in an anomalous origin of the right coronary artery.

scholarly journals Successful Percutaneous Coronary Intervention for Atherosclerotic Coronary Lesion with Anomalous Origin of the Right Coronary Artery

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Junji Matsuda ◽  
Takashi Ikenouchi ◽  
Giichi Nitta ◽  
Shunichi Kato ◽  
Kazuya Murata ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Angina Pectoris ◽  
Right Coronary Artery ◽  
Coronary Intervention ◽  
Anomalous Origin ◽  
Coronary Artery Anomalies ◽  
Exertional Dyspnea ◽  
Percutaneous Coronary Angioplasty ◽  
Percutaneous Coronary ◽  
The Right

Congenital coronary artery anomalies, including anomalous origin of a coronary artery, can manifest as life-threatening conditions, such as myocardial infarction or arrhythmia, and may even lead to sudden death associated with specific congenital anatomical features. Such arteries can also develop atherosclerotic lesions. This report describes the case of a 75-year-old man who was admitted to our hospital due to exertional dyspnea. The right coronary artery was found to originate from the left coronary sinus and exhibit tight stenosis due to atherosclerosis, causing effort angina pectoris. This case highlights the fact that coronary artery anomalies can cause angina pectoris via both atherosclerotic and nonatherosclerotic effects, and successful revascularization was achieved noninvasively via percutaneous coronary angioplasty.

scholarly journals Multi-Vessel Coronary Artery Disease: Choice of Myocardial Revascularization Strategy

2020 ◽  
Vol 27 (4) ◽  
pp. E202041
Author(s):  
Nestor Seredyuk ◽  
Andrii Matlakh ◽  
Yaroslava Vandzhura ◽  
Mykyta Bielinskyi ◽  
Oleksii Skakun ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Myocardial Revascularization ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
The Right

Multi-vessel coronary artery disease is quite a common state, which is often diagnosed by coronary angiography in patients with both stable coronary artery disease and acute coronary syndromes. Major difficulties in percutaneous coronary intervention include stent thrombosis and the need for antiplatelet therapy (aspirin and a P2Y12 inhibitor). Stent thrombosis leads to the recurrence of myocardial infarction and may occur within the first few hours after percutaneous coronary intervention. The use of dual antiplatelet therapy, especially that combined with low-molecular-weight heparin in the first days after myocardial infarction, poses a risk of bleeding, which often occurs in real clinical practice. Among P2Y12  inhibitors, ticagrelor causes bleeding somewhat more frequently than clopidogrel. A case of multi-vessel coronary artery disease is described in this paper. Coronary angiography revealed right-dominant circulation; occlusion of the proximal and medial segments of the right coronary artery, thrombolysis in myocardial infarction flow grade 0; stenosis of the left main coronary artery (50-60%), thrombolysis in myocardial infarction flow grade 2; diffuse stenosis of the medial and distal segments of the left anterior descending artery, thrombolysis in myocardial infarction flow grade 1; stenosis of the proximal segment of the left circumflex artery (> 75%), thrombolysis in myocardial infarction flow grade 1. The patient underwent percutaneous coronary intervention; the stents were implanted in the infarct-dependent right coronary artery. The clinical course was complicated by early stent thrombosis with subsequent thrombus extraction; a day later melena developed. Bleeding was stopped, the intensity of antithrombotic therapy was reduced: the combination of aspirin and ticagrelor was replaced by the combination of aspirin and clopidogrel. Six weeks after stenting of the infarct-dependent coronary artery, complete myocardial revascularization (hybrid intervention) was performed: coronary artery bypass grafting [the left internal mammary artery → the left anterior descending artery], coronary autogenous bypass grafting [the aorta → the right coronary artery and the aorta → the left circumflex artery]. The role of fractional flow reserve or instantaneous wave-free ratio-controlled complete myocardial revascularization techniques is discussed. The following algorithm for myocardial revascularization was used: percutaneous coronary intervention for the right coronary artery + coronary artery bypass grafting-3: the left internal mammary artery → the left anterior descending artery, the aorta → the left circumflex artery, the aorta → the right coronary artery.

scholarly journals Percutaneous treatment of anomalous right coronary artery with malignant course. Report of three cases

2021 ◽  
pp. 1-7
Author(s):  
Maurício Prudente ◽  
Henrique Guimarães ◽  
Débora Rocha ◽  
Flavio Barbosa ◽  
Frederico Nacruth ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Surgical Intervention ◽  
Coronary Intervention ◽  
Percutaneous Treatment ◽  
Coronary Anomalies ◽  
Increased Risk ◽  
Percutaneous Coronary ◽  
The Right ◽  
Ischemic Events

Coronary anomalies are rare congenital malformations that are associated with an increased risk of arrhythmias, ischemic events and sudden death. Many remain asymptomatic throughout the patient’s life, and are diagnosed incidentally by imaging tests. The treatment is necessary when ischemia is confirmed or in the presence of symptoms, and surgical intervention is the method of choice. However, some studies allow percutaneous treatment to be used as an alternative, especially in anomalies of the right coronary artery. In view of this, the objective of this study was to report three cases of congenital malformation of the right coronary artery treated by percutaneous coronary intervention.

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