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Coronary Sinus

Peter Paik, Sanjay K Arukala, Anupam A Sule
Central venous catheters are placed in approximately five million patients annually in the US. The preferred site of insertion is one with fewer risks and easier access. Although the right internal jugular vein is preferred, on occasion, the left internal jugular may have to be accessed. A patient was admitted for septic shock, cerebrovascular accident, and non-ST-segment elevation myocardial infarction. A central venous line was needed for antibiotic and vasopressor administration. Due to trauma from a fall to the right side and previously failed catheterization attempts at the left subclavian and femoral veins, the left internal jugular vein was accessed...
January 9, 2018: Curēus
Fabien Squara, Didier Scarlatti, Philippe Riccini, Gauthier Garret, Pamela Moceri, Emile Ferrari
BACKGROUND: Fluoroscopic criteria have been described for the documentation of septal right ventricular (RV) lead positioning, but their accuracy remains questioned. METHODS AND RESULTS: Consecutive patients undergoing pacemaker or defibrillator implantation were prospectively included. RV lead was positioned using postero-anterior and left anterior oblique 40° incidences, and right anterior oblique 30° to rule out coronary sinus positioning when suspected. RV lead positioning using fluoroscopy was compared to true RV lead positioning as assessed by transthoracic echocardiography (TTE)...
March 13, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Shiwei Huang, Binglin Pan, He Zou, Wei Lin
BACKGROUND: Atrial fibrillation (AF) usually originates from pulmonary veins (PVs) but can also be caused by pulmonary veins outside, such as the coronary sinus (CS), the superior vena cava (SVC), and the ligament of Marshall. CASE PRESENTATION: A 69-year-old male with a history of palpitations for 10 years was referred to our institute because of its recurrence for half a day. A dynamic electrocardiogram revealed sinus rhythm (SR) and paroxysmal AF. Echocardiography demonstrated normal cardiac structure, and physical examination results were unremarkable...
March 13, 2018: BMC Cardiovascular Disorders
Margaux Alazard, Jérôme Lacotte, Jérôme Horvilleur, Mina Ait-Said, Fiorella Salerno, Vladimir Manenti, Jean-François Piechaud, Jérôme Garot, Damien Bonnet, Alice Maltret
PURPOSE: To evaluate various strategies in order to minimize the risk of coronary injury during posteroseptal accessory pathways ablation in children. METHODS: We retrospectively reviewed 68 posteroseptal accessory pathways ablation procedures (20 decremental and 48 typical accessory pathways) performed in 62 pediatric patients at our institution between July 2009 and December 2016. Only posteroseptal accessory pathways targeted near or within the coronary sinus were included and ablation was mostly performed using irrigated tip radiofrequency...
March 12, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Shannon N Nees, Jonathan N Flyer, Anjali Chelliah, Jeffrey D Dayton, Lorraine Touchette, David Kalfa, Paul J Chai, Emile A Bacha, Brett R Anderson
OBJECTIVES: Anomalous aortic origin of a coronary artery (AAOCA) from the opposite sinus of Valsalva is a rare cardiac anomaly associated with sudden cardiac death (SCD). Single-center studies describe surgical repair as safe, although medium- and long-term effects on symptoms and risk of SCD remain unknown. We sought to describe outcomes of surgical repair of AAOCA. METHODS: We reviewed institutional records for patients who underwent AAOCA repair, from 2001 to 2016, at 2 affiliated institutions...
February 8, 2018: Journal of Thoracic and Cardiovascular Surgery
Hannu Kokki, Martin Maaroos, Sten Ellam, Jari Halonen, Ilkka Ojanperä, Merja Ranta, Veli-Pekka Ranta, Aleksandra Tolonen, Oscar Lindberg, Matias Viitala, Juha Hartikainen
PURPOSE: Cardiac surgery and conventional extracorporeal circulation (CECC) impair the bioavailability of drugs administered by mouth. It is not known whether miniaturized ECC (MECC) or off-pump surgery (OPCAB) affect the bioavailability in similar manner. We evaluated the metoprolol bioavailability in patients undergoing CABG surgery with CECC, MECC, or having OPCAB. METHODS: Thirty patients, ten in each group, aged 44-79 years, scheduled for CABG surgery were administered 50 mg metoprolol by mouth on the preoperative day at 8-10 a...
March 9, 2018: European Journal of Clinical Pharmacology
Yalcin Velibey, Baris Yaylak, Tolga Sinan Guvenc, Goksel Cinier, Koray Kalenderoglu, Ozge Guzelburc, Ozlem Yildirimturk
BACKGROUND: Temporary transvenous pacemaker implantation is an important and critical procedure for emergency physicians. Traditionally, temporary pacemakers are inserted by electrocardiography (ECG) guidance in the emergency department because fluoroscopy at the bedside in an unstable patient can be limited by time and equipment availability. However, in the presence of atrial septal defect, ventricular septal defect, and patent foramen ovale, the pacemaker lead can be implanted inadvertently into the left ventricle or directly into the coronary sinus instead of right ventricle...
March 6, 2018: Journal of Emergency Medicine
Bart W Driesen, Evangeline G Warmerdam, Gert-Jan T Sieswerda, Paul H Schoof, Folkert J Meijboom, Felix Haas, Pieter R Stella, Adriaan O Kraaijeveld, Fabiola C M Evens, Pieter A F M Doevendans, Gregor J Krings, Arie P J van Dijk, Michiel Voskuil
OBJECTIVES: To describe the use of fractional flow reserve (FFR) and intravascular ultrasound (IVUS) in the evaluation of patients with anomalous coronary arteries originating from the opposite sinus of Valsalva (ACAOS). BACKGROUND: ACAOS of the right and left coronary are rare, but may lead to symptoms and impose a risk for sudden cardiac death, depending on several anatomical features. Assessment and risk estimation is challenging in (nonathlete) adults, especially if they present without symptoms or with atypical complaints...
March 9, 2018: Catheterization and Cardiovascular Interventions
Muzaffer Kahyaoğlu, Çetin Geçmen, Ahmet Güner, İbrahim Akın İzgi
No abstract text is available yet for this article.
March 2018: Anatolian Journal of Cardiology
Abdulcebbar Şipal, Serdar Bozyel, Müjdat Aktaş, Emir Derviş, Tayyar Akbulut, Onur Argan, Umut Çelikyurt, Dilek Ural, Tayfun Şahin, Ayşen Ağır, Ahmet Vural
OBJECTIVE: Failure to select the optimal left ventricular (LV) segment for lead implantation is one of the most important causes of unresponsiveness to the cardiac resynchronization therapy (CRT). In our study, we aimed to investigate the echocardiographic and clinical benefits of LV lead implantation guided by an intraoperative 12-lead surface electrocardiogram (ECG) in patients with multiple target veins. METHODS: We included 80 [42 (62.5%) male] heart failure patients who successfully underwent CRT defibrillator (CRT-D) implantation...
March 2018: Anatolian Journal of Cardiology
Carlotta Sorini Dini, Daniele Landi, Francesco Meucci, Carlo Di Mario
The Cardioband system is a transcatheter direct annuloplasty device that is implanted in patients with severe symptomatic functional mitral regurgitation (MR) due to annulus dilatation and high surgical risk. This device covers the posterior two-thirds of the annulus, from the anterolateral to the posteromedial commissure, implanted in close proximity of the left circumflex artery, atrioventricular (AV) conduction system, and coronary sinus. We present the case of an 80-year-old-gentleman with prohibitive surgical risk, treated with Cardioband implantation for functional MR with an evident P1-P2 cleft and P2-P3 indentation, a relative contraindication to MitraClip implantation...
March 6, 2018: Catheterization and Cardiovascular Interventions
William A Huang, Maereg A Wassie, Olujimi A Ajijola
His bundle pacing (HBP) has been shown to be a feasible, beneficial, and safe way to achieve cardiac resynchronization therapy (CRT) with recruitment of the heart's physiological conduction system. HBP should be considered for those with unfavorable coronary sinus (CS) anatomy, and nonresponders to biventricular (BiV) pacing. HBP CRT may also help patients with the nonleft bundle branch block form of conduction delay and heart failure (HF). HBP CRT should be considered strongly in preventing right ventricular (RV) pacing-induced cardiomyopathy, especially after atrioventricular nodal ablation given the discrete nature of the block and the low likelihood of distal block...
March 6, 2018: Current Treatment Options in Cardiovascular Medicine
Leire Unzué, Eulogio García, Beatriz López-Melgar, Pilar Agudo-Quilez
Anomalous origin of a coronary artery from the opposite sinus of Valsalva (ACAOS) is a rare malformation traditionally considered "malignant" in cases of interarterial course. Recently, a protective effect of the low interarterial subtype (between the aorta and the right ventricle outflow tract) has been described. We present an IVUS-guided percutaneous intervention in a patient with anomalous origin of the left coronary artery from the right coronary sinus presenting with anterior ischemia. In patients with ACAOS, the integration of complementary image techniques is recommended, defining the anomalous course of the vessel and providing an accurate assessment of the individual risk for each patient...
February 7, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
James H P Gamble, Neil Herring, Matthew R Ginks, Kim Rajappan, Yaver Bashir, Tim R Betts
BACKGROUND: Cardiac Resynchronization Therapy (CRT) is an effective treatment for selected patients with heart failure, but can be limited by the inability to place the left ventricular (LV) lead via the coronary sinus. OBJECTIVE: We have developed an alternative approach, placing the LV lead endocardially via an interventricular septal puncture; this study was designed to assess the feasibility and safety of this technique. METHODS: All patients were anticoagulated with warfarin (INR 2...
March 1, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Hoda Hatoum, Jennifer Dollery, Scott M Lilly, Juan A Crestanello, Lakshmi Prasad Dasi
BACKGROUND: This study aims to evaluate the effect of transcatheter aortic valve (TAV) implantation depth and rotation on pressure gradient (PG), leakage fractions (LF), leaflet shear stress and sinus washout in an effort to understand factors that may dictate optimal positioning for valve-in-valve (ViV) procedures. Sinus flow stasis is often associated with prosthetic leaflet thrombosis. While recent ViV in-vitro studies highlighted transcatheter aortic valve (TAV) supra-annular implantation potential benefits to minimize pressure gradients, the relationship between TAV depth and other determinates of valve function remains unknown...
March 1, 2018: Annals of Thoracic Surgery
J William Schleifer, Sorin V Pislaru, Grace Lin, Brian D Powell, Raul Espinosa, Celeste Koestler, Trena Thome, Lynn Polk, Zhuo Li, Samuel J Asirvatham, Yong-Mei Cha
BACKGROUND: Pacing lead-related tricuspid regurgitation (TR), a recognized complication of ventricular pacing lead implantation, may be affected by lead position or diameter. OBJECTIVE: This study sought to determine the effect of ventricular pacing lead position and diameter on pacing lead-related TR. METHODS: A randomized, prospective trial compared pacing leads in the right ventricular apex (RVA), right ventricular mid septum (RVS), or left ventricle via the coronary sinus (LV-CS) in a 1:1:1 fashion...
February 26, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Toshinobu Kazui, Theodore M Lin, Scott D Lick
We report a case of coronary sinus (CS) injury with a retrograde cardioplegia catheter and repair compromising CS patency. This resulted in acute global cardiac dysfunction shortly after weaning from bypass, which reversed after patch repair with confirmed CS patency. The case shows that acute CS occlusion may not be tolerated in some humans.
February 26, 2018: Annals of Thoracic Surgery
Andrea Silva, Maria João Baptista, Emanuel Araújo
Congenital coronary artery anomalies are modifications of their origin, course or structure and its incidence varies between 0,2 and 5,6% of the general population. Although the majority is asymptomatic, they are the second leading cause of sudden cardiac death in young athletes. The aim of this study is to highlight the main anomalies with hemodynamic significance, including the anomalous origin of a coronary artery from the opposite sinus and anomalous origin of the left coronary artery from pulmonary artery...
February 26, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Saba Hussain, Faisal Qadir, Pir Sheeraz, M Asad Bilal Awan
Sinus of Valsalva aneurysm is a rare cardiac anomaly with wide spectrum of clinical presentation ranging from asymptomatic state to dreadful complications due to compression of vital surrounding structures or aortic dissection. There are only few reported cases of sinus of Valsalva aneurysm presented with cardiac arrhythmias including complete heart block. We herein, present a case of a 50 year male who presented with complete heart block. A large noncoronary sinus of Valsalva aneurysm compressing the surrounding atrioventricular junctional tissue was detected incidentally during echocardiographic study, which was considered to be the cause of patient's complete heart block...
November 2017: Pakistan Journal of Medical Sciences Quarterly
Danica Cvetković, Vladimir Živković, Slobodan Nikolić
A 75-year-old woman was admitted to the emergency room with chest pain and vomiting. An electrocardiogram and laboratory results were suggestive for myocardial infarction of the posterior cardiac wall. Echocardiography was indicative of aortic dissection, and a CT scan of the thoracic arteries showed a massive pulmonary thromboembolism and thrombotic occlusion of the right coronary artery (RCA). The woman died shortly after admission. Autopsy confirmed the presence of thromboemboli in the right pulmonary artery and its lobar branches...
February 27, 2018: Forensic Science, Medicine, and Pathology
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