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Left main coronary artery

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https://www.readbyqxmd.com/read/28214141/feasibility-and-safety-of-same-day-discharge-after-complex-percutaneous-coronary-intervention-using-forearm-approach
#1
Michael Koutouzis, Aris Karatasakis, Emmanouil S Brilakis, Maria Agelaki, Christos Maniotis, Panagiotis Dimitriou, Efstathios Lazaris
OBJECTIVES: We sought to assess the feasibility and safety of same-day discharge (SDD) after complex percutaneous coronary intervention (PCI) using a forearm approach. BACKGROUND: SDD has been shown to be safe after elective, low-risk PCI. However, the feasibility and safety of SDD in more complex patients and lesions has received limited study. METHODS: We retrospectively reviewed 1190 elective PCIs that were performed between January 2013 and December 2015 at the Red Cross General Hospital...
February 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28213402/a-novel-method-of-standardized-myocardial-infarction-in-aged-rabbits
#2
Patrick J Morrissey, Kevin R Murphy, Jean M Daley, Lorraine Schofield, Nilufer N Turan, Karuppiah Arunachalam, J Dawn Abbott, Gideon Koren
The incidence of myocardial infarction (MI) and sudden cardiac death increases with age. Here we describe the development of a minimally invasive large animal model of MI that can be applied to young or aged animals. We demonstrate that rabbit coronary anatomy is highly variable, more so than described in previous literature. In this work we categorize the coronary pattern of 37 young and 63 aged rabbits. Aged rabbits had a higher degree of branching from the left main coronary artery. Standardizing the model across age cohorts required a new approach, targeting an area of myocardium rather than a specific vessel...
February 17, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28210637/anomalous-origin-of-the-left-coronary-artery-from-the-pulmonary-artery-an-uncommon-coronary-anomaly-with-serious-implications-in-adulthood
#3
Venkat Gangadharan, Kamesh Sivagnanam, Ghulam Murtaza, Michael Ponders, Otto Teixeira, Timir Paul
A 36-year-old woman was seen with complaints of exertional chest pain and shortness of breath. Her medical history included atrial fibrillation and diabetes. Physical examination was unremarkable except for an irregular cardiac rhythm. Myocardial perfusion imaging revealed the presence of a large area of infarction involving the entire anterior and apical walls and part of the anteroseptal wall with minimal periinfarct ischemia. Computed tomography coronary angiogram revealed an anomalous left main coronary artery arising from the main pulmonary artery...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28208917/early-post-operative-coronary-thrombosis-following-repair-of-a-proximal-coronary-artery-fistula
#4
Yashasvi Chugh, Bryan Lau, Cynthia C Taub
Patients with aneurysmal coronary artery fistulas are often a treatment challenge. We hereby, report a case of aneurysmal left main coronary artery to coronary sinus fistula repair, complicated by an early post-operative thrombosis of the left main coronary artery, necessitating an orthotropic heart transplant. Routine use of peri-procedural and long-term anti-coagulation is usually not a standard recommendation in these cases; however, early institution of the same may prevent flow stasis, thrombus formation and unfavourable outcomes pre- or post-operatively...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208116/factors-determining-left-main-coronary-artery-luminal-area
#5
Konstantinos Dean Boudoulas, Peter M Bittenbender, Haikady N Nagaraja, Omar Kahaly, Jennifer A Dickerson, Subha V Raman, Ernest L Mazzaferri, Charles A Bush
BACKGROUND: A certain minimal luminal cross-sectional area has been traditionally used in clinical practice as a cut-off value to determine severity of left main coronary artery (LMCA) stenosis. The severity of stenosis, however, depends on the baseline luminal area (ie, area prior to stenosis), which may vary among individuals. The present study was undertaken to define normal LMCA luminal area using current technology in vivo. METHODS: LMCA luminal area was determined using multislice computed tomography coronary angiography...
February 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28203572/symptomatic-type-iv-dual-left-anterior-descending-coronary-artery
#6
Kyriacos Papadopoulos, Georgios M Georgiou, Evagoras Nicolaides
Dual left anterior descending coronary artery is a rare congenital anomaly with 4 subtypes. Double left anterior descending coronary artery originating from the left main stem and the right coronary artery (type IV dual left anterior descending artery) has been reported to occur in 0.01% to 0.7% of patients undergoing cardiac catheterization. We report a case of a 49-year-old woman who was found to have this anomaly during coronary angiography. The patient had been complaining of chest pain that mimics angina pectoris and exercise tolerance test was positive for myocardial ischemia...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28194409/a-variant-in-cox-2-gene-is-associated-with-left-main-coronary-artery-disease-and-clinical-outcomes-of-coronary-artery-bypass-grafting
#7
Hanning Liu, Zhengxi Xu, Cheng Sun, Dachuan Gu, Xiao Teng, Yan Zhao, Zhe Zheng
As a particular severe phenotype of coronary artery disease (CAD), left main coronary artery disease (LMCAD) is heritable. Genetic variants related to prostaglandin metabolism are associated with LMCAD. Cyclooxygenase-2 (COX-2), a key synthase in prostaglandin pathways, displays high density in atherosclerotic lesions and promotes early atherosclerosis in CAD progression. We hypothesized that genetic variants in COX-2 gene contribute to LMCAD phenotype susceptibility compared to more peripheral coronary artery disease (MPCAD)...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28191682/aortic-root-thrombus-complicated-by-left-main-coronary-artery-occlusion-visualized-by-3d-echocardiography-in-a-patient-with-continuous-flow-left-ventricular-assist-device
#8
Monique S Tanna, Alex Reyentovich, Leora B Balsam, John A Dodson, Alan F Vainrib, Ricardo J Benenstein, Barry P Rosenzweig, Muhamed Saric
Aortic root thrombus is an uncommon complication of continuous-flow left ventricular assist devices (LVAD). We present the case of a 71-year-old man with ischemic cardiomyopathy who underwent destination therapy HeartMate II LVAD placement. Eighteen months later, he presented with a cerebrovascular accident followed by myocardial infarction. Transesophageal echocardiography revealed an aortic root thrombus spanning the left and noncoronary cusps and obliterating the left main coronary artery. We discuss the incidence, risk factors, and management of aortic root thrombus in LVAD patients...
February 13, 2017: Echocardiography
https://www.readbyqxmd.com/read/28189040/an-anti-%C3%AE-v%C3%AE-3-antibody-inhibits-coronary-artery-atherosclerosis-in-diabetic-pigs
#9
L A Maile, W H Busby, G Xi, K P Gollahan, W Flowers, N Gafbacik, S Gafbacik, K Stewart, E P Merricks, T C Nichols, D A Bellinger, D R Clemmons
BACKGROUND AND AIMS: Diabetes is a major risk factor for the development of atherosclerosis. Hyperglycemia stimulates vascular smooth muscle cells (VSMC) to secrete ligands that bind to the αVβ3 integrin, a receptor that regulates VSMC proliferation and migration. This study determined whether an antibody that had previously been shown to block αVβ3 activation and to inhibit VSMC proliferation and migration in vitro, inhibited the development of atherosclerosis in diabetic pigs. METHODS: Twenty diabetic pigs were maintained on a high fat diet for 22 weeks...
January 27, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28185417/left-main-coronary-angioplasty-of-a-9-year-old-child-with-bioresorable-vascular-scaffold
#10
Hasmukh Ravat, Swati Garekar, Vishal Changela
Familial hypercholesterolemia is an autosomal dominant disorder due to mutations in the low-density lipoprotein receptor gene, characterized by skin and tendon xanthomas, xanthelasmas, and increased risk of premature coronary artery disease. Here, we report a case of 9-year-old girl who presented with angina and dyspnoea on exertion with xanthomas and an elevated serum cholesterol and triglyceride. She had severe stenosis of the left main coronary artery (LMCA) requiring angioplasty and placement of Bioresorbable vascular scaffold (BVS)...
February 10, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28182111/a-rare-case-of-angina-pectoris-with-the-longest-ectopic-left-main-coronary-artery-arising-from-right-sinus-of-valsalva-and-a-prepulmonic-course
#11
Santosh Kumar Sinha, Vikas Mishra, Nasar Abdali, Karandeep Singh, Mukesh Jitendra Jha, Ashutosh Kumar
Knowledge of the morphoanatomical characteristics of the main trunk of the left coronary artery as well as its variations is cornerstone of hemodynamic, correct interpretation of coronary angiogram and for revascularization purpose. The left main coronary artery (LMCA) ranges from 3 to 6 mm in diameter and may be up to 10 to 15 mm in length in humans. We here report a case of the longest anomalous LMCA (56 mm) reported so far in a 35-year-old man with chronic stable angina arising from right sinus of valsalva as seen on conventional angiogram and multidetector computerized tomogram (MDCT)...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28182034/topical-vasodilator-response-in-skeletonized-internal-mammary-artery-is-there-really-a-difference
#12
Syed Raza Shah, Syed Arbab Shah, Muhammad Ahmed Jangda, Mohammad Danial Yaqub, Ayesha Altaf Jangda, Maham Khan, Muhammad Asim Khan, Brian Tomkins
AIM OF THE STUDY: Coronary artery bypass graft surgery is the gold standard for the treatment of multivessel and left main coronary artery disease. However, there is considerable debate that whether left internal mammary artery (IMA) should be taken as pedicled or skeletonized. This study was conducted to assess the difference in blood flow after the application of topical vasodilator in skeletonized and pedicled IMA. MATERIALS AND METHODS: In this study, each patient underwent either skeletonized (n = 25) or pedicled IMA harvesting (n = 25)...
January 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/28181211/post-infarct-treatment-with-pyr1-apelin-13-exerts-anti-remodeling-and-anti-apoptotic-effects-in-rats-heart
#13
Yaser Azizi, Alireza Imani, Hamed Fanaei, Safoura Khamse, Mohammad Reza Parvizi, Mahdieh Faghihi
BACKGROUND: Ischemic heart disease (IHD) is the main cause of mortality in the world. After myocardial infarction (MI) cardiomyocytes apoptosis and ventricular remodeling have been occurred. Apelin is a peptide that has been shown to exert cardioprotective effects. AIM: The aim of this study was to investigate anti-apoptotic and anti-remodeling effects of [Pyr¹]apelin-13 in the rat model of post-MI. METHODS: 36 Male Wistar rats were randomly divided into three groups: (1) sham (2) MI and (3) MI treated with [Pyr¹]apelin-13 (MI+Apel)...
February 9, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28180241/leaflet-protrusion-into-left-main-coronary-artery-detected-by-intravascular-ultrasound-after-transcatheter-aortic-valve-implantation-with-sapien-3
#14
Shunsuke Kubo, Yasushi Fuku, Takeshi Shimamoto, Tsuyoshi Goto, Kazushige Kadota
No abstract text is available yet for this article.
February 9, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28169140/influence-of-cardiovascular-risk-factors-on-the-prevalence-of-coronary-atherosclerosis-in-patients-with-angiographically-normal-coronary-arteries
#15
Daniel O Bittner, Lutz Klinghammer, Mohamed Marwan, Jasmin Schmid, Christian Layritz, Udo Hoffmann, Stephan Achenbach, Tobias Pflederer
RATIONALE AND OBJECTIVES: Cardiovascular (CV) disease is predominately influenced by CV risk factors and coronary computed tomography angiography (CTA) is capable of detecting early-stage coronary artery disease. We sought to determine the influence of CV risk factors on the prevalence of nonobstructive atherosclerosis in patients with normal-appearing coronary arteries in invasive coronary angiography (ICA). MATERIALS AND METHODS: In this retrospective analysis, we included 60 consecutive symptomatic patients, having undergone ICA and coronary CTA...
February 3, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28168062/undilatable-stent-neoatherosclerosis-treated-with-ad-hoc-rotational-atherectomy
#16
Michael Koutouzis, Maria Agelaki, Christos Maniotis, Ioannis Tsiafoutis, Vasileios Patris, Mihalis Argyriou
A middle age woman with known ischemic heart disease and old stents in proximal left anterior descending coronary artery (LAD) was admitted to Coronary Care Unit with acute coronary syndrome. The coronary angiography showed one vessel disease with significant restenosis within the previously implanted stents. The lesion was tough and remained undilatable despite high pressure balloon inflation. Eventually, the balloon ruptured creating a massive dissection of the LAD beginning immediately after the distal part of the undilatable lesion...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28165613/outcomes-of-coronary-artery-bypass-graft-surgery-versus-drug-eluting-stents-in-older-adults
#17
Mineok Chang, Cheol Whan Lee, Jung-Min Ahn, Rafael Cavalcante, Yohei Sotomi, Yoshinobu Onuma, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Patrick W Serruys, Seung-Jung Park
OBJECTIVES: Little data are available to compare coronary artery bypass graft surgery (CABG) vs percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in older adults. We evaluate the long-term outcomes of CABG vs PCI with DES in older adults with left main or multivessel coronary artery disease (CAD). DESIGN: Individual patient-level meta-analysis. SETTINGS: Databases from the BEST, PRECOMBAT, and SYNTAX trials were combined...
February 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28163834/does-heart-rate-variability-correlate-with-long-term-prognosis-in-myocardial-infarction-patients-treated-by-early-revascularization
#18
Leonida Compostella, Nenad Lakusic, Caterina Compostella, Li Van Stella Truong, Sabino Iliceto, Fabio Bellotto
AIM: To assess the prevalence of depressed heart rate variability (HRV) after an acute myocardial infarction (MI), and to evaluate its prognostic significance in the present era of immediate reperfusion. METHODS: Time-domain HRV (obtained from 24-h Holter recordings) was assessed in 326 patients (63.5 ± 12.1 years old; 80% males), two weeks after a complicated MI treated by early reperfusion: 208 ST-elevation myocardial infarction (STEMI) patients (in which reperfusion was successfully obtained within 6 h of symptoms in 94% of cases) and 118 non-ST-elevation myocardial infarction (NSTEMI) patients (percutaneous coronary intervention was performed within 24 h and successful in 73% of cases)...
January 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28161261/incomplete-revascularization-is-associated-with-an-increased-risk-for%C3%A2-major-adverse-cardiovascular-events%C3%A2-among-patients-undergoing-noncardiac-surgery
#19
Ehrin J Armstrong, Laura A Graham, Stephen W Waldo, Javier A Valle, Thomas M Maddox, Mary T Hawn
OBJECTIVES: The aim of this study was to determine whether incomplete revascularization is associated with a higher risk for major adverse cardiovascular events (MACE) and myocardial infarction (MI) among patients undergoing noncardiac surgery. BACKGROUND: Patients with coronary artery disease and prior percutaneous coronary intervention (PCI) frequently undergo noncardiac surgery. These patients may have had PCI either on all obstructive lesions (i.e., complete revascularization) or only on some (i...
January 25, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28159375/dual-supply-of-left-anterior-descending-coronary-artery-on-coronary-computed-tomographic-angiography-not-recognized-on-previous-cardiac-catheterizations
#20
Edward Mardakhaev, Mark Guelfguat, Jay S Meisner, Noah Weg
A dual left anterior descending (LAD) artery is an infrequent anomaly of the coronary circulation with rare variations that may cause symptoms. We report a 60-year-old man who underwent multiple percutaneous cardiac catheterizations with stent placements and presented with recurrent angina pectoris. Coronary computed tomographic angiography demonstrated a dual LAD with the long and short LADs originating from the right coronary artery and the left main coronary artery, respectively.
November 30, 2016: Canadian Journal of Cardiology
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