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Left main coronary artery

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https://www.readbyqxmd.com/read/29676045/prognostic-value-of-positive-t-wave-in-lead-avr-in-patients-with-non-st-segment-myocardial-infarction
#1
Ahmad Separham, Bahram Sohrabi, Arezou Tajlil, Leili Pourafkari, Robabeh Sadeghi, Samad Ghaffari, Nader D Nader
BACKGROUND: Lead aVR provides prognostic information in various settings in patients with ischemia. We aim to investigate the role of a positive T wave in lead aVR in non-ST segment myocardial infarction (NSTEMI). METHODS: In a prospective cohort study, we included 400 patients with NSTEMI. Presentation electrocardiogram (ECG) was investigated for presence of a positive T wave as well as ST segment elevation (STE) in aVR and study variables were compared. Predictors of primary outcome defined as hospital major adverse cardiovascular events (MACE) and secondary outcome, defined as three-vessel coronary disease and/or left main coronary artery stenosis (3VD/LMCA) stenosis in angiography, were determined in multivariate logistic regression analysis...
April 19, 2018: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/29666583/summation-and-cancellation-effects-on-qrs-and-st-segment-changes-induced-by-simultaneous-regional-myocardial-ischemia
#2
Miquel Vives-Borrás, Esther Jorge, Gerard Amorós-Figueras, Xavier Millán, Dabit Arzamendi, Juan Cinca
Simultaneous ischemia in two myocardial regions is a potentially lethal clinical condition often unrecognized whose corresponding electrocardiographic (ECG) patterns have not yet been characterized. Thus, this study aimed to determine the QRS complex and ST-segment changes induced by concurrent ischemia in different myocardial regions elicited by combined double occlusion of the three main coronary arteries. For this purpose, 12 swine were randomized to combination of 5-min single and double coronary artery occlusion: Group 1: left Circumflex (LCX) and right (RCA) coronary arteries ( n = 4); Group 2: left anterior descending artery (LAD) and LCX ( n = 4) and; Group 3: LAD and RCA ( n = 4)...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29666071/b-type-natriuretic-peptide-assessment-in-patients-undergoing-revascularization-for-left-main-coronary-artery-disease-analysis-from-the-excel-trial
#3
Björn Redfors, Shmuel Chen, Aaron Crowley, Ori Ben-Yehuda, Bernard J Gersh, Nicholas J Lembo, W Morris Brown, Adrian P Banning, David P Taggart, Patrick W Serruys, Arie Pieter Kappetein, Joseph F Sabik, Gregg W Stone
Background -Elevated B-type natriuretic peptide (BNP) is reflective of impaired cardiac function and is associated with worse prognosis among patients with coronary artery disease (CAD). We sought to assess the association between baseline BNP, adverse outcomes, and the relative efficacy of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) in patients with left main (LM) CAD. Methods -The EXCEL trial randomized patients with LMCAD and low or intermediate SYNTAX scores to PCI with everolimus-eluting stents versus CABG...
April 17, 2018: Circulation
https://www.readbyqxmd.com/read/29662510/long-term-outcomes-of-drug-eluting-stent-versus-coronary-artery-bypass-grafting-for-left-main-coronary-artery-disease-a-meta-analysis
#4
Kong-Yong Cui, Shu-Zheng Lyu, Xian-Tao Song, Fei Yuan, Feng Xu, Min Zhang, Ming-Duo Zhang, Wei Wang, Dong-Feng Zhang, Jing Dai, Jin-Fan Tian, Yun-Lu Wang
Background: It is still controversial whether percutaneous coronary intervention with drug-eluting stent (DES) is safe and effective compared to coronary artery bypass graft surgery (CABG) for unprotected left main coronary artery (ULMCA) disease at long-term follow up (≥ 3 years). Methods: Eligible studies were selected by searching PubMed, EMBASE, and Cochrane Library up to December 6, 2016. The primary endpoint was a composite of death, myocardial infarction (MI) or stroke during the longest follow-up...
February 2018: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29661597/clinical-performance-of-a-dedicated-self-apposing-stent-for-the-treatment-of-left-main-stem-disease-results-of-the-left-main-angioplasty-with-a-self-apposing-stent-the-matisse-study
#5
Bernardo Cortese, Antonio Montefusco, Fabrizio D'Ascenzo, Alessio La Manna, Giuseppe Andò, Teodoro Bisceglia, Gioel G Secco, Markus Meyer-Gessner, Wanha Wojciech, Paolo Sganzerla, Massimo Napodano, Gaetano Di Palma, Roberto A Latini, Corrado Tamburino, Pedro Silva Orrego, Andreas Baumbach
BACKGROUND: In the recent years percutaneous treatment of the left main stem (LM) has gained a precise role as a result of consistent scientific evidence vs. coronary artery bypass. A self-apposing stent offers an improved adaptation to the vessel wall, especially in case of tapered vessels; aim of this study was to investigate the role of a novel self-apposing, sirolimus-eluting stent (Stentys, France) for the treatment of LM coronary artery disease. METHODS AND RESULTS: MATISSE is a retrospective, multicenter registry, which enrolled 151 patients treated with the device at 17 international centers...
April 4, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29661004/percutaneous-versus-surgical-revascularization-for-left-main-or-multivessel-coronary-artery-disease-results-from-a-large-scale-meta-analysis-in-the-era-of-drug-eluting-stents
#6
Monica Verdoia, Lucia Barbieri, Elvin Kedhi, Harry Suryapranata, Giuseppe De Luca
The best treatment options for left main (LM) or multivessel coronary disease (MVD) are still debated. We performed a meta-analysis of randomized trials comparing percutaneous versus surgical revascularization for LM or MVD. Primary end point was overall mortality. Secondary end points were major adverse cardiovascular events, recurrent myocardial infarction, repeated revascularization, or stroke. A total of 8 randomized trials were included, involving 8694 patients, 50% undergoing percutaneous coronary intervention (PCI)...
January 1, 2018: Angiology
https://www.readbyqxmd.com/read/29660360/spontaneous-coronary-artery-dissection-in-a-woman-surgical-treatment-and-angiographic-follow-up
#7
Dionysios Pavlopoulos, Michalis Hamilos, Paris Kalogerakos, Emmanouil Kampitakis, Pantelis Tsipas, John Kokotsakis, George Lazopoulos
Spontaneous coronary artery dissection constitutes a rare entity which affects mostly women especially below the age of forty. Treatment of choice is a matter of discussion. It is suggested by many authors that therapeutic strategy should be individualized based to each patient's clinical and angiographic manifestations. We present the case of a young woman who underwent surgical revascularization for dissection of Left Main Stem by using both Internal Thoracic Arteries. Angiographic follow up revealed resolution of dissection, obstruction of Right Internal Thoracic Artery graft and reverse flow in Left Internal Thoracic Artery graft...
April 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29652272/comparison-of-immediate-extubation-versus-ultrafast-tracking-strategy-in-the-management-of-off-pump-coronary-artery-bypass-surgery
#8
Amarja Sachin Nagre, Nagesh P Jambures
Introduction: Ultrafast tracking of anesthesia (UFTA) is practiced routinely, whereas immediate on-table extubation after off-pump coronary artery bypass (OPCAB) grafting surgery has many concerns. The purpose of our study was to evaluate the safety and feasibility of immediate extubation (IE) versus UFTA. Methods: Sixty patients were enrolled who underwent OPCAB surgery. The two groups IE and UFTA had thirty patients each. Inclusion criteria were patients for OPCAB surgery including left main stenosis...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29644234/modelling-coronary-flow-after-the-norwood-operation-influence-of-a-suggested-novel-technique-for-coronary-transfer
#9
Mohammed K Al-Jughiman, Maryam A Al-Omair
Background: The dynamic behavior of the aortic sinuses has an important function in the specific characteristics of coronary blood flow. Several publications have confirmed suboptimal myocardial perfusion after the Norwood procedure. Our study was undertaken to confirm four hypotheses. First, we hypothesized that there is more resistance to coronary flow due to coronary attachments to hypoplastic aortic root and sinuses. Also, as the amalgamation of the ascending aorta with the pulmonary artery occurs above the aortic root, the coronary blood flow is not fully in antegrade pattern...
March 14, 2018: Global Cardiology Science & Practice
https://www.readbyqxmd.com/read/29644230/noble-and-excel-the-debate-for-excellence-in-dealing-with-left-main-stenosis
#10
Hamood Al Kindi, Amir Samaan, Hatem Hosny
Left main coronary artery (LMCA) disease is associated with increased morbidity and mortality. Coronary artery bypass grafting surgery (CABG) has always been the standard revascularization strategy for this group of patients. However, with the recent developments in stents design and medical therapy over the past decade, several trials have been designed to evaluate the safety and efficacy of percutaneous coronary intervention (PCI) as an alternative to CABG surgery in patients with LMCA disease. Recently, the results of two major trials, EXCEL and NOBLE, comparing CABG versus PCI in this patient population have been released...
March 14, 2018: Global Cardiology Science & Practice
https://www.readbyqxmd.com/read/29642691/high-risk-pci-how-to-define-it-today
#11
Vincenzo DE Marzo, Domenico D'Amario, Mattia Galli, Rocco Vergallo, Italo Porto
Before the percutaneous spread, the mortality rate of patients with coronary heart disease not suitable for cardiac surgery was markedly high. This limit has been progressively exceeded with the advent of minimally invasive approaches, which, although was initially intended exclusively for low risk patients, was then employed in complex patients often too compromised to undergo cardiac surgery. Given to the rising of high-risk population, due to an increase of patients with multiple chronic conditions linked to the best care offered, we are witnessing an expansion of the high-risk percutaneous coronary interventions (PCI) population...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29623280/neo-left-main-channel-creation-using-double-stenting-alongside-a-sapien-3-aortic-valve-bioprosthesis-for-left-main-coronary-obstruction-following-valve-in-valve-transcatheter-aortic-valve-replacement-a-case-report-with-review-of-literature
#12
Apurva D Patel, Thomas Haldis, Kais Al Balbissi, Timir Paul
Transcatheter aortic valve replacement in the setting of failed surgical bioprosthesis (valve-in-valve) is a valuable option for patients with bioprosthetic aortic stenosis or regurgitation who are deemed high risk for repeat open heart surgery. Although the procedure is successful with proper preprocedural assessment, instances of left main (LM) coronary artery ostium obstruction have been documented. We present a case of LM coronary obstruction in the immediate postoperative period following implantation of a 20-mm Edwards Sapien 3 valve inside the degenerated 21-mm Mitroflow bioprosthesis stenosis, which was treated with double stenting alongside the Edwards Sapien 3 valve creating a channel ("neo left main") that extended from mid-LM to the upper margin of the Edwards Sapien 3 valve...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29622979/anomalous-origin-of-left-main-coronary-artery-from-the-right-sinus-of-valsalva-presenting-as-non-st-elevation-acute-coronary-syndrome-a-case-report
#13
Anish Hirachan, Arun Maskey, Gopi Prasad Hirachan, Madhu Roka
Congenital anomalies of the coronary arteries are a cause of sudden cardiac death. Of the known anatomic variants, anomalous origination of a coronary artery from an opposite sinus of Valsalva (ACAOS) remains a major clinical issue and a challenging condition to treat. Congenital coronary anomalies are likely to be under-recognized, as completing an anatomic assessment in a very large portion of the population would seem unfeasible. However, we present a case report with image of a 49 year old male presented with acute non-ST elevation ACS for which he underwent diagnostic angiography of the coronary system which revealed a common origin of both right and left main coronary artery from right sinus of Valsalva with significant obstructive lesion in the mid segment of right coronary artery...
September 2017: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
https://www.readbyqxmd.com/read/29622965/the-relation-between-coronary-artery-disease-severity-and-fragmented-qrs-complex-in-patients-with-left-bundle-branch-block
#14
Mohamed M Al-Daydamony, Tamer M Mustafa
Background: The diagnosis of coronary artery disease (CAD) in patients with LBBB represents a clinical challenge. The presence of fragmented QRS (fQRS) complex on surface ECG may be related to myocardial ischemia, scarring or fibrosis. Objectives: To investigate the relation between fQRS and the presence and severity of CAD in patients with LBBB. Patients and methods: 56 patients with symptoms suggesting CAD and complete LBBB were submitted to full history taking and clinical examination, complete 12-leads electrocardiography (ECG) to confirm the diagnosis of LBBB and to diagnose the fragmented wide QRS (f-wQRS) complex, echocardiography, and coronary angiography; lesions with ⩾70% narrowing in major epicardial artery or ⩾50% narrowing in the left main coronary artery were considered significant; and Gensini score was calculated...
June 2017: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
https://www.readbyqxmd.com/read/29622157/delayed-coronary-obstruction-after-transcatheter-aortic-valve-replacement
#15
Richard J Jabbour, Akihito Tanaka, Ariel Finkelstein, Michael Mack, Corrado Tamburino, Nicolas Van Mieghem, Ole de Backer, Luca Testa, Pamela Gatto, Paola Purita, Zouhair Rahhab, Verena Veulemans, Anja Stundl, Marco Barbanti, Roberto Nerla, Jan Malte Sinning, Danny Dvir, Giuseppe Tarantini, Molly Szerlip, Werner Scholtz, Smita Scholtz, Didier Tchetche, Fausto Castriota, Christian Butter, Lars Søndergaard, Mohamed Abdel-Wahab, Horst Sievert, Ottavio Alfieri, John Webb, Josep Rodés-Cabau, Antonio Colombo, Azeem Latib
BACKGROUND: Delayed coronary obstruction (DCO) is an uncommon and barely reported complication following transcatheter aortic valve replacement (TAVR). OBJECTIVES: The aim of this study was to describe the incidence and pathophysiological features of DCO after TAVR, obtained from a large international multicenter registry. METHODS: Data were retrospectively collected from an international multicenter registry consisting of 18 centers between November 2005 and December 2016...
April 10, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29607115/climbing-the-hill-of-left-main-coronary-artery-revascularization-percutaneous-coronary-intervention-or-coronary-artery-bypass-graft
#16
EDITORIAL
Ciro Indolfi, Carmen Spaccarotella, Masakazu Yasuda, Salvatore De Rosa
No abstract text is available yet for this article.
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29605817/management-of-left-main-coronary-artery-disease
#17
REVIEW
Ronnie Ramadan, William E Boden, Scott Kinlay
No abstract text is available yet for this article.
March 31, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29605246/influence-of-local-myocardial-damage-on-index-of-microcirculatory-resistance-and-fractional-flow-reserve-in-target-and-nontarget-vascular-territories-in-a-porcine-microvascular-injury-model
#18
Joo Myung Lee, Hyun Kuk Kim, Kyung Seob Lim, Jun-Kyu Park, Ki Hong Choi, Jonghanne Park, Doyeon Hwang, Tae-Min Rhee, Jeong Hoon Yang, Eun-Seok Shin, Chang-Wook Nam, Joon-Hyung Doh, Joo-Yong Hahn, Bon-Kwon Koo, Myung Ho Jeong
OBJECTIVES: The aim of this study was to investigate the influence of microvascular damage in one vessel territory on invasively measured physiological parameters in the other vessel, using a porcine microvascular damage model. BACKGROUND: Although fractional flow reserve (FFR)-guided decision-making for the nonculprit stenosis in patients with acute myocardial infarction has been reported to be better than angiography-guided revascularization, there have been debates regarding the influence of microvascular dysfunction on measured FFR in nonculprit vessels...
March 22, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29602723/impact-of-a-new-adaptive-statistical-iterative-reconstruction-asir-v-algorithm-on-image-quality-in-coronary-computed-tomography-angiography
#19
Gianluca Pontone, Giuseppe Muscogiuri, Daniele Andreini, Andrea I Guaricci, Marco Guglielmo, Andrea Baggiano, Fabio Fazzari, Saima Mushtaq, Edoardo Conte, Andrea Annoni, Alberto Formenti, Elisabetta Mancini, Massimo Verdecchia, Alessandro Campari, Chiara Martini, Marco Gatti, Laura Fusini, Lorenzo Bonfanti, Elisa Consiglio, Mark G Rabbat, Antonio L Bartorelli, Mauro Pepi
RATIONALE AND OBJECTIVES: A new postprocessing algorithm named adaptive statistical iterative reconstruction (ASIR)-V has been recently introduced. The aim of this article was to analyze the impact of ASIR-V algorithm on signal, noise, and image quality of coronary computed tomography angiography. MATERIALS AND METHODS: Fifty consecutive patients underwent clinically indicated coronary computed tomography angiography (Revolution CT; GE Healthcare, Milwaukee, WI)...
March 27, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29602249/the-first-transapical-transcatheter-aortic-valve-in-valve-implantation-using-the-j-valve-system-into-a-failed-biophysio-aortic-prosthesis-in-a-patient-with-high-risk-of-coronary-obstruction
#20
Jian Ye, Arthur J Lee, Philipp Blanke, John Webb
We report the first successful valve-in-valve (ViV) implantation into a failed Edwards Biophysio surgical prosthesis (Edwards Lifesciences, Irvine, CA) and also the first use of the J-Valve system (Jie Cheng Medical Technologies, Suzhou, China) in a ViV configuration. A 77-year old male had symptomatic severe aortic stenosis secondary to failure of a 25 mm Biophysio bioprosthetic valve implanted 11 years previously, along with concomitant coronary artery bypass grafting. Transthoracic echocardiography (TTE) revealed calcified leaflets, a mean aortic gradient of 50 mm Hg, and an estimated valve area of 0...
March 30, 2018: Catheterization and Cardiovascular Interventions
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