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Left main coronary artery

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https://www.readbyqxmd.com/read/28324943/overcoming-spatio-temporal-limitations-using-dynamically-scaled-in-vitro-pc-mri-a-flow-field-comparison-to-true-scale-computer-simulations-of-idealized-stented-and-patient-specific-left-main-bifurcations
#1
Susann Beier, John Ormiston, Mark Webster, John Cater, Stuart Norris, Pau Medrano-Gracia, Alistair Young, Kathleen Gilbert, Brett Cowan
The majority of patients with angina or heart failure have coronary artery disease. Left main bifurcations are particularly susceptible to pathological narrowing. Flow is a major factor of atheroma development, but limitations in imaging technology such as spatio-temporal resolution, signal-to-noise ratio (SNRv), and imaging artefacts prevent in vivo investigations. Computational fluid dynamics (CFD) modelling is a common numerical approach to study flow, but it requires a cautious and rigorous application for meaningful results...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28314672/fenestration-of-a-papyrus-pk-covered-stent-to-recover-the-occluded-left-main-bifurcation-after-sealing-a-left-main-perforation-during-a-cto-procedure
#2
Gerald S Werner, Waqar H Ahmed
Covered stents are indicated for coronary perforations, but they may seal off major side branches in that process. We report the successful sealing of an ostial left main perforation, induced by a guide catheter in the course of a retrograde approach to treat a chronic total occlusion (CTO) of the right coronary artery (RCA) in a 76year old woman with prior CABG. The implanted Papyrus covered stent, however, overlapped the left main bifurcation and occluded the non-grafted circumflex artery (CX) resulting in acute ischemia...
March 6, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28302642/pregnancy-and-the-risk-of-spontaneous-coronary-artery-dissection-an-analysis-of-120-contemporary-cases
#3
Ofer Havakuk, Sorel Goland, Anil Mehra, Uri Elkayam
BACKGROUND: Because of the rarity of this condition, information on pregnancy-associated spontaneous coronary artery dissection is limited. We reviewed a large number of contemporary pregnancy-associated spontaneous coronary artery dissection cases in an attempt to define the clinical characteristics and provide management recommendations. METHODS AND RESULTS: A literature search for cases of pregnancy-associated spontaneous coronary artery dissection reported between 2000 and 2015 included 120 cases; 75% presented with ST-segment-elevation myocardial infarction, and 80% had anterior myocardial infarction...
March 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28300667/characteristics-of-coronary-artery-disease-among-patients-with-atrial-fibrillation-compared-to-patients-with-sinus-rhythm
#4
Lukas J Motloch, Sara Reda, Robert Larbig, Ariane Wolff, Karolina A Motloch, Bernhard Wernly, Christina Granitz, Michael Lichtenauer, Martin Wolny, Uta C Hoppe
BACKGROUND: With a high prevalence of coronary artery disease (CAD) among patients with atrial fibrillation (AF), CAD is one of the main risk factors for AF. However, little is known about the characteristics of CAD in AF patients. Especially, the question, whether a specific anatomical distribution of coronary artery stenoses might predispose to AF via atrial ischemia remains speculative. To address this issue, we evaluated potential associations between angiographic characteristics of CAD and AF...
March 11, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28296170/percutaneous-coronary-intervention-or-coronary-artery-bypass-grafting-for-unprotected-left-main-coronary-artery-disease
#5
Ahmed N Mahmoud, Islam Y Elgendy, Amgad Mentias, Marwan Saad, Walid Ibrahim, Mohammad K Mojadidi, Ramez Nairooz, Parham Eshtehardi, R David Anderson, Habib Samady
BACKGROUND: Recent trials comparing PCI with CABG for unprotected left main disease yielded discrepant evidence. OBJECTIVES: To perform an updated meta-analysis of randomized trials comparing percutaneous coronary intervention (PCI) with coronary artery bypass grafting (CABG) in patients with unprotected left main coronary artery disease. METHODS: Randomized trials comparing PCI versus CABG for patients with unprotected left main coronary artery disease were included...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28296050/a-heart-within-a-heart
#6
Edward T Carreras, Maya Barghash, Michael M Givertz, Deepak L Bhatt
A 44-year-old man with a history of end-stage dilated cardiomyopathy status-post orthotopic cardiac transplant 14 years ago presented for coronary angiography in preparation for re-operative tricuspid valve replacement. Coronary angiography revealed an anomalous origin of the left coronary artery, with a common coronary trunk arising from the right coronary cusp and bifurcating into right and left main coronary arteries. Interestingly, the right and left coronary arteries coursed to form the shape of a heart, hence, a heart within a heart! © 2017 Wiley Periodicals, Inc...
March 14, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28293003/-surgical-repair-of-coronary-pulmonary-artery-fistulae-with-giant-coronary-aneurysm
#7
Naoki Hashiyama, Yusuke Katayama, Makoto Mo, Munetaka Masuda
A 69-year-old woman was referred to our hospital due to dyspnea on exertion and a heart murmur. A chest X-ray showed a bulge at the left 3rd arch and chest computed tomography( CT) revealed a giant mass adjacent to the right ventricular outflow. Multidetector-row CT and coronary angiography showed a giant coronary aneurysm (55×45 mm) and fistulae arising from the left main coronary trunk and entering into the main pulmonary artery (PA). The pulmonary to systemic flow ratio was 1.84. She was diagnosed with coronary-pulmonary artery fistulae with giant coronary aneurysm...
March 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28292545/adding-fuel-to-the-fire-coronary-artery-dissection-complicating-blunt-chest-trauma
#8
Ankit Maheshwari, Thenappan Thenappan, Gladwin Das
A 21year-old male presented to the emergency department with 6 h of atypical chest pain after suffering blunt chest trauma. His electrocardiogram revealed 1-1.5mm ST segment elevation in leads V1-V3 with reciprocal depressions in II, III, and aVF. Mid-anterior wall akinesis was observed on echocardiography associated with an estimated left ventricular ejection fraction of 40%. A left main coronary artery dissection was diagnosed and treated surgically with a bypass graft. Although rare, coronary dissections can be a catastrophic complication of chest trauma...
March 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28290908/-coronary-angioplasty-and-stenting-in-patients-older-than-80-years-immediate-and-long-term-results
#9
A M Babunashvili, D P Dundua, D S Kartashov, A A Bazarnova, A Yu Korenevich, M E Vetluzhskikh
AIM: to assess immediate and long-term results of coronary angioplasty and stenting in patients older than 80 years - a high risk group in view of the severity of concomitant pathology and extent of coronary atherosclerosis. MATERIAL AND METHODS: We conducted retrospective analysis of data from 167 patients older than 80 years (mean age 81.43+/-2.14 years) subjected to percutaneous coronary intervention from 2006 to 2013 (3.2% from total number of patients). Multivessel involvement was present in 128 patients (76...
July 2016: Kardiologiia
https://www.readbyqxmd.com/read/28290878/-immediate-outcomes-of-coronary-artery-bypass-grafting-in-patients-with-multifocal-atherosclerosis-gender-differences
#10
A N Sumin, E V Korok, R A Gaifulin, S V Ivanov, O L Barbarash
AIM: To assess the impact of presence of multifocal atherosclerosis (MFA) and gender differences on immediate outcomes after coronary artery bypass grafting (CABG) in patients with ischemic heart disease (IHD). MATERIAL AND METHODS: Medical records of patients with MFA, who underwent elective CABG (n=764, 655 men, 109 women) were reviewed retrospectively. RESULTS: Women were older (<0.001), and more often were overweight (<0.001), had diabetes (<0...
August 2016: Kardiologiia
https://www.readbyqxmd.com/read/28275559/quantitative-assessment-on-coronary-computed-tomography-angiography-ccta-image-quality-comparisons-between-genders-and-different-tube-voltage-settings
#11
Teo Chee Chian, Norziana Mat Nassir, Mohd Izuan Ibrahim, Ahmad Khairuddin Md Yusof, Akmal Sabarudin
BACKGROUND: This study was carried out to quantify and compare the quantitative image quality of coronary computed tomography angiography (CCTA) between genders as well as between different tube voltages scan protocols. METHODS: Fifty-five cases of CCTA were collected retrospectively and all images including reformatted axial images at systolic and diastolic phases as well as images with curved multi planar reformation (cMPR) were obtained. Quantitative image quality including signal intensity, image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of right coronary artery (RCA), left anterior descending artery (LAD), left circumflex artery (LCx) and left main artery (LM) were quantified using Analyze 12...
February 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28275419/early-diagnosis-and-treatment-of-coronary-heart-disease-in-symptomatic-subjects-with-advanced-vascular-atherosclerosis-of-the-carotid-artery-type-iii-and-iv-b-findings-using-ultrasound
#12
Ansgar Adams, Waldemar Bojara, Klaus Schunk
BACKGROUND: A study was conducted as to whether the early diagnosis of coronary heart disease (CHD) in symptomatic patients with advanced atherosclerosis of the carotid artery was more successful using ultrasound technology than exercise electrocardiography (ECG). METHODS: Within the scope of an occupational screening program using subjects from diverse employment sectors, people were given the opportunity to determine their risk of heart attack. During the study, the total plaque area (TPA), the maximum plaque thickness in the carotid artery and the PROCAM scores of 3,513 healthy men and 2,088 healthy women between the ages of 20 and 65 were determined...
February 2017: Cardiology Research
https://www.readbyqxmd.com/read/28274398/lower-mean-heart-dose-with-deep-inspiration-breath-hold-whole-breast-irradiation-compared-with-brachytherapy-based-accelerated-partial-breast-irradiation-for-women-with-left-sided-tumors
#13
Emma B Holliday, Steve M Kirsner, Howard D Thames, Bryan E Mason, Christopher L Nelson, Elizabeth S Bloom
PURPOSE: For left-sided breast cancer, radiation to the heart is a concern. We present a comparison of mean heart and coronary artery biologically effective dose (BED) between accelerated partial breast irradiation (APBI) and whole breast irradiation with deep inspiration breath-hold technique (DIBH-WBI). METHODS AND MATERIALS: A total of 100 patients with left-sided, early-stage breast cancer were identified. Fifty underwent single-entry catheter-based APBI and 50 underwent DIBH-WBI...
March 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28271553/mechanical-circulatory-support-in-patients-with-severe-aortic-stenosis-and-left-ventricular-dysfunction-undergoing-percutaneous-coronary-intervention
#14
REVIEW
Mohamad Alkhouli, Ahmed Al Mustafa, Zakeih Chaker, Fahad Alqahtani, Sami Aljohani, David R Holmes
Management of obstructive coronary artery disease in patients with aortic stenosis and severe left ventricular dysfunction is challenging. Mechanical circulatory support at the time of percutaneous coronary interventions may be necessary in these extreme-risk patients. We present a case in which the TandemHeart was used to support a patient with severe aortic stenosis, severe protected left main and circumflex disease, and severe cardiomyopathy and review the literature on this subject.
March 7, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28269012/cfd-analysis-of-strut-influence-on-blood-flow-in-stent-implanted-left-main-coronary-artery-bifurcation
#15
Yuya Yamada, Takahiro Tsukahara, Masahiro Motosuke, Yusuke Fujino
We numerically studied blood flows in a simulated branching pipe of coronary artery bifurcation, which is affected by stent implantation. We found that stent struts provide effects as guide vanes and blockages on the flow into circumflex branch. The former effect increases the flow rate and shear stress on the arteriosclerosis-prone site. The blockage effect may overwhelm the guide effect depending on a strut position against the inflow.
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28267960/meta-analysis-of-randomized-control-trials-comparing-drug-eluting-stents-versus-coronary-artery-bypass-grafting-for-significant-left-main-coronary-narrowing
#16
Cheng Qian, Hong Feng, Jianlei Cao, Baozhu Wei, Yanggan Wang
Previous meta-analyses showed that drug-eluting stent (DES) implantation may serve as an alternative to coronary artery bypass grafting (CABG) for unprotected left main coronary artery (ULMCA) stenosis, largely driven by data from registries. Hence, we performed a meta-analysis of randomized controlled trials (RCTs) to overcome this limitation. PubMed, the Cochrane Library, and Scopus were systematically searched through October 2016 to identify eligible RCTs. The primary outcomes were major adverse cardiac and cerebrovascular events (MACCE) at 1-year and long-term (≥3 years) follow-ups...
February 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28266826/cardiovascular-disease-update-care-of-patients-after-coronary-artery-bypass-graft
#17
Craig Barstow, Johnathan D McDivitt
Coronary artery bypass graft (CABG) is a surgical procedure in which a vessel, normally the left internal mammary artery and/or a segment of an excised vein (typically from the leg), is grafted to the coronary arteries to bypass a blockage. CABG has been shown to be superior to percutaneous coronary intervention for patients with complex three vessel disease and left main coronary artery disease. All patients undergoing CABG should receive aspirin preoperatively; they also should receive a beta blocker preoperatively to reduce the likelihood of postsurgical atrial fibrillation...
March 2017: FP Essentials
https://www.readbyqxmd.com/read/28259665/identification-of-coronary-artery-side-branch-supplying-myocardial-mass-that-may-benefit-from-revascularization
#18
Hyung Yoon Kim, Joon-Hyung Doh, Hong-Seok Lim, Chang-Wook Nam, Eun-Seok Shin, Bon-Kwon Koo, Joo Myung Lee, Taek Kyu Park, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Seung Hyuk Choi, Hyeon-Cheol Gwon, Sang-Hoon Lee, Sung Mok Kim, Yeonhyeon Choe, Jin-Ho Choi
OBJECTIVES: The authors sought to identify whether a coronary side branch (SB) is supplying a myocardial mass that may benefit from revascularization. BACKGROUND: The amount of subtending myocardium and physiological stenosis is frequently different between the main vessel (MV) and SB. METHODS: In this multicenter registry, 482 patients who underwent coronary computed tomography angiography and fractional flow reserve (FFR) measurement were enrolled...
February 25, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28259663/bioresorbable-everolimus-eluting-vascular-scaffold-for-long-coronary-lesions-a-subanalysis-of-the-international-multicenter-ghost-eu%C3%A2-registry
#19
Salvatore Geraci, Hiroyoshi Kawamoto, Giuseppe Caramanno, Neil Ruparelia, Davide Capodanno, Tommaso Gori, Holger Nef, Julinda Mehilli, Maciej Lesiak, Christoph Naber, Carlo Di Mario, Piera Capranzano, Jens Wiebe, Aleksander Araszkiewicz, Stelios Pyxaras, Alessio Mattesini, Thomas Münzel, Corrado Tamburino, Antonio Colombo, Azeem Latib
OBJECTIVES: The authors sought to investigate 1-year outcomes in patients treated with bioresorbable everolimus-eluting vascular scaffolds (BVS) for "long coronary lesions." BACKGROUND: The present substudy derived from the GHOST-EU registry included 1,722 lesions in 1,468 consecutive patients, enrolled between November 2011 and September 2014 at 11 European centers. METHODS: The lesions were divided into 3 groups according to continuous BVS length: 1) shorter than 30 mm; 2) between 30 and 60 mm; and 3) longer than 60 mm...
February 24, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28256180/left-main-coronary-artery-stenosis-severity-evaluation-and-implications-for-management
#20
REVIEW
Susan E Habibi, Rahman Shah, Chalak O Berzingi, Ryan Melchior, Kevin F Sumption, Ion S Jovin
The significant stenosis of the left main coronary artery is associated with poor outcomes and is considered a strong indication for revascularization. However, deciding whether the stenosis is significant can sometimes be challenging, especially when the degree of stenosis is intermediate, and can necessitate additional tests and imaging modalities. Areas covered: We did a literature search using keywords like 'left main', 'imaging', 'intravascular ultrasound', 'fractional flow reserve', 'computed tomographic angiography' and 'magnetic resonance imaging'...
March 2017: Expert Review of Cardiovascular Therapy
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