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Coronary artery dissection

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https://www.readbyqxmd.com/read/28529807/a-novel-modified-reverse-controlled-antegrade-and-retrograde-subintimal-tracking-technique-for-bypassing-the-calcified-proximal-cap-of-coronary-total-occlusions
#1
Tsuyoshi Isawa, Masahiko Ochiai, Masato Munehisa, Tatsushi Ootomo
Antegrade crossing is the most common approach to chronic total occlusions (CTOs). However, it is sometimes difficult to penetrate the proximal hard cap with guidewires, especially in the case of CTOs of anomalous coronary arteries because of a lack of support. Herein, we describe a novel, modified reverse controlled antegrade and retrograde subintimal tracking (CART) technique in which the dissection reentry was intentionally created in the proximal segment of the vessel, not within the occluded segment, using retrograde guidewire and the aid of an antegrade balloon...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28529093/revascularization-methods-in-spontaneous-coronary-artery-dissection-a-focused-review
#2
REVIEW
Regina Lee, Itsik Ben-Dor
Spontaneous coronary artery dissection (SCAD) is becoming widely recognized as an important cause of myocardial infarction, particularly in younger women. Tendency toward conservative management has been primarily based on observational data. Intervention is recommended when coronary blood flow is compromised and high risk features such as left main involvement, ongoing ischemia, or hemodynamic or electrical instability are present. Unlike the atherosclerotic process where the superiority of stenting compared with plain old balloon angioplasty has been established in the acute setting, randomized studies for revascularization strategies for spontaneous coronary dissection are currently lacking...
May 12, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28520537/anomalous-origin-of-right-coronary-artery-from-left-coronary-sinus-13-cases-treated-with-the-reimplantation-technique
#3
Alain Cubero, Alejandro Crespo, Gadah Hamzeh, Andrés Cortes, Daniel Rivas, José Ignacio Aramendi
OBJECTIVES: Anomalous aortic origin of a coronary artery is uncommon but potentially clinically significant. Manifestations vary from asymptomatic patients to those who present with angina pectoris, myocardial infarction, heart failure, syncope, arrhythmias, and sudden death. We describe our experience with surgical reimplantation and results at midterm follow-up. METHODS: Between February 2003 and July 2016, a total of 13 patients with anomalous origin of the right coronary artery (RCA) from the left sinus underwent surgical reimplantation...
May 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28516101/early-spontaneous-resolution-of-an-iatrogenic-acute-type-a-aortic-dissection
#4
Mohammad A Zafar, Philip Y K Pang, Glen A Henry, Bulat A Ziganshin, Maryann Tranquilli, John A Elefteriades
Acute aortic dissection is a rare but devastating complication during cardiac catheterization. We present the case of an elderly female who incurred a Stanford Type A/DeBakey Type I acute aortic dissection extending into the arch vessels and descending aorta likely occurring during right coronary artery engagement for angioplasty. The patient was treated successfully by immediately sealing the entrance of the dissection via the placement of a stent and anti-impulse therapy. Follow-up computed tomography scan showed complete resolution of the dissection within one month...
December 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28516099/conservative-management-of-extensive-iatrogenic-aortic-dissection
#5
Derrick Y Tam, Amine Mazine, Asim N Cheema, Bobby Yanagawa
Iatrogenic aortic dissection (IAD) is a rare complication of percutaneous coronary interventions (PCI). There are no clear guidelines for IAD management, and limited data are available. Registry data and case series combined with extrapolations from our experience with spontaneous Type-A dissections suggest that very limited dissections are often managed conservatively with coronary stenting of the entry tear when possible, while more extensive dissections are managed surgically. We present a case report of a 50-year-old woman who underwent PCI for an ST-elevation myocardial infarction that resulted in an extensive IAD from the ostium of the right coronary artery to the aortic root, ascending aorta, and aortic arch...
December 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28515825/late-presentation-of-aortic-aneurysm-and-dissection-following-cardiac-catheterization
#6
Abimbola Shofu, G Mustafa Awan, Bassam Omar, Ghazanfar Qureshi
We report a 63-year-old female with hypertension, hyperlipidemia, and prior pacemaker insertion for atrial fibrillation with symptomatic bradycardia, who was admitted with substernal chest pressure and diaphoresis. Her electrocardiogram revealed atrial fibrillation with demand ventricular pacing and her cardiac biomarkers were negative for acute coronary syndrome. Echocardiogram revealed normal left ventricular systolic function and normal aortic root diameter. Coronary angiography revealed 60-70% obtuse marginal lesion, otherwise mild disease...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28512782/aortocoronary-artery-dissection-a-partial-aortic-root-remodelling-aortic-valve-repair-and-coronary-artery-bypass
#7
Andrei M Beliaev, Jeevesh J Thomas, Peter N Ruygrok, Colleen Bergin, Sara J Allen, Sophie E Gormack, Jens Lund
No abstract text is available yet for this article.
May 16, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28511806/st-segment-elevation-myocardial-infarction-could-be-the-primary-presentation-of-acute-aortic-dissection
#8
Qing-Yi Zhu, Shi Tai, Liang Tang, Wen Peng, Sheng-Hua Zhou, Zhen-Guo Liu, Xin-Qun Hu
BACKGROUND: Stanford type A aortic dissection (TAAD) may lead to coronary artery occlusion and malfunction. However, TAAD manifesting as acute ST-segment elevation myocardial infarction (STEMI) has not been studied. In the present study, we reported 8 TAAD cases with STEMI as the primary presentation, and analyzed their clinical characteristics and outcome. METHODS: The records were reviewed for patients admitted to the large comprehensive university hospital for PCI due to STEMI from January 1, 2002 to January 1, 2017...
May 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28509893/spontaneous-coronary-artery-dissection-insights-from-histology-and-optical-coherence-tomography
#9
Sandeep K Krishnan, Alex Zhu, Brent Larson, Timothy D Henry, Suhail Dohad
Spontaneous coronary artery dissection (SCAD) is a well-known but infrequent cause of acute coronary syndrome (ACS), and often goes unrecognized. Although management of SCAD is, at times, controversial, when a patient presents with ACS, percutaneous coronary intervention (PCI) is frequently necessary. We present a patient with ST-segment elevation myocardial infarction (STEMI) with SCAD that illustrates two important points: use of intracoronary optical coherence tomography to guide PCI, and histologic assessment to provide a unique insight into the etiology of SCAD...
2017: Reviews in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28509891/spontaneous-coronary-artery-dissection-a-review-of-pathogenesis-presentations-treatment-and-outcomes
#10
Aasim Afzal, Syed Sarmast, James W Choi, Peter A McCullough, Jeffrey M Schussler
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndromes and sudden cardiac death. The epidemiology, pathogenesis, and optimal approaches to diagnosis and management are poorly understood. Additionally, SCAD as a syndrome is commonly under-recognized and its prognosis is not well studied. Guidelines on management of SCAD have not yet been established. We present three cases of SCAD that varied in their clinical presentation and describe the different management strategies utilized...
2017: Reviews in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28504113/prognosis-of-spontaneous-coronary-artery-dissection-treated-by-percutaneous-coronary-intervention-with-optical-coherence-tomography
#11
Tsuyoshi Nishiguchi, Atsushi Tanaka, Akira Taruya, Yuichi Ozaki, Mai Nakai, Ikuko Teraguchi, Shingo Ota, Akio Kuroi, Takeyoshi Kameyama, Takashi Yamano, Tomoyuki Yamaguchi, Yoshiki Matsuo, Yasushi Ino, Takashi Kubo, Takeshi Hozumi, Takashi Akasaka
BACKGROUND: Although about half of patients with spontaneous coronary artery dissection (SCAD) face ongoing necrosis, conservative therapy is recommended due to a high complication rate in angiography-guided percutaneous coronary intervention (PCI). The aim of this study was to investigate clinical outcomes of SCAD treated by optical coherence tomography (OCT)-guided PCI. METHODS: This study consisted of consecutive 306 patients with acute coronary syndrome (ACS) who underwent OCT-guided PCI...
May 11, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28499664/stemi-with-fluctuating-closing-of-lad-and-cx-do-not-concentrate-on-the-finger
#12
Mario Sadaba, Asier Subinas, Jose Ramón Rumoroso
Case report of the male with an anterior STEMI to whom a primary PCI is performed. The angiogram shows a fluctuating close of the LAD and Cx than when an OCT is performed does not clearly see any pathological findings but when the IVUS is performed, it is clearly seen as a coronary haematoma at the LM, LAD and Cx. Stent at the LM-LAD and proximal Cx are implanted with final good result. After exchanging the guiding catheter for a diagnostic catheter to visualize the RCA, there is an aortic flap; the coronary haematoma was coming from an ascending aortic dissection...
March 27, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28479185/neuroimaging-of-takayasu-arteritis-in-a-patient-with-ulcerative-rectocolitis
#13
Lucia Monti, Rosamaria Servillo, Irene Grazzini, Leila Khader, Maurizio Acampa, Alfonso Cerase
BACKGROUND: Takayasu arteritis (TA), also known as aortoarteritis and pulseless disease, is an autoimmune, idiopathic, large-vessel vasculitis that primarily affects the aorta and its major branches, the coronary arteries, and the pulmonary arteries. METHODS: This is a peculiar clinical and radiological pattern of TA in a young female Caucasian. Her medical history included diagnosis of ulcerative rectocolitis at the age of 14. Because of the occurrence of anemia and exacerbation of rectocolitis, she had started infliximab associated with low doses of cortisone and mesalazine...
May 4, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28476875/traditional-cardiovascular-risk-factors-and-their-relation-to-future-surgery-for-valvular-heart-disease-or-ascending-aortic-disease-a%C3%A2-case-referent-study
#14
Johan Ljungberg, Bengt Johansson, Karl Gunnar Engström, Elin Albertsson, Paul Holmer, Margareta Norberg, Ingvar A Bergdahl, Stefan Söderberg
BACKGROUND: Risk factors for developing heart valve and ascending aortic disease are based mainly on retrospective data. To elucidate these factors in a prospective manner, we have performed a nested case-referent study using data from large, population-based surveys. METHODS AND RESULTS: A total of 777 patients operated for heart valve disease or disease of the ascending aorta had previously participated in population-based health surveys in Northern Sweden. Median time (interquartile range) from survey to surgery was 10...
May 5, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28461132/a-non-contrast-cmr-index-for-assessing-myocardial-fibrosis
#15
Qian Yin, Dana Abendschein, David Muccigrosso, Robert O'Connor, Thomas Goldstein, Jie Zheng
PURPOSE: Safe, sensitive, and non-invasive imaging methods to assess the presence, extent, and turnover of myocardial fibrosis are needed for early stratification of risk in patients who might develop heart failure after myocardial infarction. We describe a non-contrast cardiac magnetic resonance (CMR) approach for sensitive detection of myocardial fibrosis using a canine model of myocardial infarction and reperfusion. METHODS: Seven dogs had coronary thrombotic occlusion of the left anterior descending coronary arteries followed by fibrinolytic reperfusion...
April 28, 2017: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/28461002/use-of-a-three-stent-technique-for-a-case-of-spontaneous-coronary-artery-dissection
#16
Alexander M Dashwood, Jacqueline Saw, Priyanka Dhillon, Dale Murdoch
A 78-year-old woman presented with acute inferior ST-segment-elevation myocardial infarction and complete heart block. Angiography revealed spontaneous coronary artery dissection (SCAD) of her right coronary artery. Given her ongoing instability, we proceeded to primary coronary intervention. A strategy of sealing the distal lesion edge followed by the proximal edge containing the intramural hematoma before placing a final stent to the midsegment was decided on (3-stent strategy). Our case represents the second such "sequential stent-sandwiching" report and provides a strategy for percutaneous coronary intervention in hemodynamically unstable patients with SCAD...
February 24, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28461000/potential-sunitinib-induced-coronary-artery-and-aortic-dissections
#17
Raja Hatem, Emmanuel Bebawi, Erick Schampaert
Small-molecule multitargeted tyrosine kinase inhibitor (TKI) therapy is used in different types of cancer. These drugs have been associated with cardiovascular toxicity, including aortic dissection. To our knowledge, this is the first time that a coronary dissection potentially associated with a TKI treatment has been described.
March 9, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28457342/outcome-after-coronary-bypass-grafting-for-coronary-complications-following-coronary-angiography
#18
Ingo Slottosch, Oliver Liakopoulos, Elmar Kuhn, Antje-Christin Deppe, Maximilian Scherner, Navid Mader, Yeong-Hoon Choi, Thorsten Wahlers
BACKGROUND: Coronary complications during coronary angiography or intervention (percutaneous coronary intervention [PCI]) are uncommon. However, PCI-related coronary artery perforation, dissection, or acute occlusion frequently result in myocardial ischemia followed by hemodynamic instability and need of urgent coronary artery bypass grafting (coronary artery bypass grafting [CABG]). This single-center study aimed to investigate clinical outcomes of patients undergoing urgent CABG after life-threatening PCI complications...
April 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28452820/left-main-coronary-artery-dissection-during-aortic-valve-replacement
#19
Kenta Nakao, Toshiyuki Sawai, Junko Nakahira, Ayako Hamakawa, Hisanari Ishii, Toshiaki Minami
No abstract text is available yet for this article.
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28452228/medical-treatment-or-revascularisation-as-the-best-approach-for-spontaneous-coronary-artery-dissection-a-systematic-review-and-meta-analysis
#20
José Luís Martins, Vera Afreixo, Luís Santos, Marco Costa, José Santos, Lino Gonçalves
INTRODUCTION: Patients presenting with spontaneous coronary artery dissection (SCAD) may receive either conservative medical management or a revascularisation strategy. There is still a lack of consensus with respect to the best treatment approach for SCAD. OBJECTIVES: We sought to determine whether outcomes differ between the first-line treatment approaches (conservative versus revascularisation) in patients with SCAD. METHODS: We searched Medline, EMBASE and the Cochrane Library for studies published from January 1990 to November 2016 that compared first-line treatments for patients with SCAD...
April 1, 2017: European Heart Journal. Acute Cardiovascular Care
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