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Coronary artery dissection

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https://www.readbyqxmd.com/read/29352673/chest-pain-in-a-young-female
#1
Paul S Basel, Daniel Reschke, Michael D April
Acute Coronary Syndrome (ACS) is a common diagnosis in the emergency department (ED), the most severe manifestation of which is ST elevation on electrocardiogram (ECG). ST elevation reflects obstruction of flow through the coronary arteries, most commonly due to coronary atherosclerotic plaque rupture. However, alternative causes of coronary obstruction causing ST elevation are possible. Spontaneous coronary artery dissection (SCAD) is an unusual cause of ST elevation in ED patients which providers may encounter in patients without traditional atherosclerosis risk factors...
January 11, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29350374/extension-of-a-coronary-intramural-hematoma-after-blunt-chest-trauma
#2
Maeng Real Park, Mun Ki Min, Ji Ho Ryu, Dae Sub Lee, Kang Ho Lee
Coronary artery dissection and intramural hematoma after blunt chest trauma are rare, but life-threatening, complications. Coronary intramural hematoma extension is even rarer. A 31-year-old man was transferred to our hospital for worsening left chest pain during while he was admitted at a nearby hospital due to blunt chest trauma. Bedside echocardiography showed akinesis of the left ventricular apex and anterior wall as well as hypokinesis of the mid-to-basal anteroseptal wall and mid-to-basal lateral and posterior walls of the left ventricle...
January 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29339694/aortic-%C3%AE-smooth-muscle-actin-expressions-in-aortic-disorders-and-coronary-artery-disease-an-immunohistochemical-study
#3
Shi Min Yuan, Ning Wu
OBJECTIVE: The is to report immunohistochemical observations of aortic α-smooth muscle actin (SMA) expressions in patients with aortic aneurysm, acute aortic dissection, and coronary artery disease and to discuss phenotypic switching of smooth muscle cells (SMCs) of these lesions. METHODS: Forty-nine consecutive patients scheduled for surgical treatment for acute type A aortic dissection (20 patients), aortic aneurysm (9 patients), and coronary artery disease (20 patients) were included...
January 2018: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29334980/reoperation-for-a-giant-arch-anastomotic-pseudoaneurysm-eleven-years-after-total-arch-replacement-with-island-reconstruction
#4
Ryohei Matsuura, Yasushi Tsutsumi, Osamu Monta, Hisazumi Uenaka, Kenji Tanaka, Takaaki Samura, Hirokazu Ohashi
BACKGROUND: The long-term effects of some surgical treatment procedures of arch replacement for aortic dissection or aortic aneurysm are unknown. CASE PRESENTATION: The present study reports the case of a 68-year-old man admitted to our hospital for aortic arch anastomotic pseudoaneurysm with concomitant aortic root enlargement and coronary artery stenosis. Eleven years ago, at the age of 56 years, he underwent total arch replacement with island reconstruction for chronic aortic dissection...
January 15, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29317976/postpartum-sudden-cardiac-death-after-spontaneous-coronary-artery-dissection-in-a-patient-with-fibromuscular-dysplasia
#5
Tannaz Shoja, Craig Basman, Suresh Jain, Aditya Mangla, Zoran Lasic
Spontaneous coronary artery dissection (SCAD) is a rare entity that can cause acute myocardial infarction and sudden cardiac death (SCD) which often goes unrecognized. We report a case of SCAD in a young postpartum female who presented with sudden cardiac arrest. The patient was managed medically and found to have fibromuscular dysplasia (FMD). After being stabilized in the critical care unit, coronary angiography was performed which showed dissection of the left main artery, intramural hematoma, and the culprit lesion...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29314567/antegrade-fenestration-and-re-entry-a-new-controlled-subintimal-technique-for-chronic-total-occlusion-recanalization
#6
Mauro Carlino, Lorenzo Azzalini, Satoru Mitomo, Antonio Colombo
OBJECTIVES: To describe and evaluate the efficacy of a novel antegrade dissection/re-entry (ADR) technique, called antegrade fenestration and re-entry (AFR), for chronic total occlusions (CTO) percutaneous coronary intervention (PCI). BACKGROUND: The widespread adoption of ADR is limited by several technical, logistic, and financial factors. Therefore, novel ADR techniques are needed. METHODS: AFR consists in creating multiple fenestrations of the dissection flap separating the false and true lumen...
January 4, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29312758/the-link-between-spontaneous-coronary-artery-dissection-and-takotsubo-cardiomyopathy-analysis-of-the-published-cases
#7
REVIEW
Dario Buccheri, Giulia Zambelli
Spontaneous coronary artery dissection (SCAD) and takotsubo cardiomyopathy (TTS) are two non-atherosclerotic causes of myocardial infarction. They share several common features. Firstly, they have a predilection for the female gender and, in both, the exact mechanism has yet to be fully established. Both they could be responsible for an acute coronary syndrome. Hence, we want to do further consideration based on pathophysiology, literature review, and cases presented affected by both entities up today.
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29312747/a-lesson-from-intravascular-imaging-insights-for-recognizing-a-spontaneous-coronary-artery-dissection
#8
REVIEW
Dario Buccheri, Diego Milazzo, Salvatore Geraci, Giovanni Vaccaro, Giuseppe Caramanno
Spontaneous coronary artery dissection (SCAD) is still today an underdiagnosed disease due to the absence of angiographic hallmarks in more than 70% of cases. In several cases, an intravascular imaging is a sole tool for recognizing a dissection. Particularly, optical coherence tomography analysis (OCT) could represent the gold standard technique of easy interpretation and prompt diagnosis. Here we present a rare case of multivessel spontaneous coronary artery disease (SCAD) with atypical collateral circulation...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29303142/type-a-intramural-hematoma-in-a-patient-with-acute-coronary-syndrome-mimicking-acute-type-a-aortic-dissection
#9
Ö Gülmez, B Saritas, I Isiklar
Intramural hematoma (IMH) of ascending aorta is a rare but potentially lethal form of acute aortic syndrome (AAS). It is characterized by a hematoma within the media layer of the aorta secondary to rupture of the vasa vasorum in the absence of an intimal tear. However, the theory of "micro-tear" which cannot be easily detected has been raised. It may stabilize, regress, or progress to rupture or dissection. Similar to Type A aortic dissection (AD), patients with IMH of ascending aorta, as well as patients with persistent pain, are treated urgent surgery...
November 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29300076/modified-carbodissection-a-new-technique-for-harvesting-the-internal-mammary-artery
#10
Shegu Gilbert, Devender Singh, M K Sivakumar
The modified carbodissection technique is a new technique for harvesting the internal mammary artery during coronary artery bypass graft surgery. It is performed using an improvised instrument that consists of an electrocautery device and a carbon dioxide blower/mister. It combines electrocautery dissection and continuous controlled gas blow dissection along with saline irrigation mist. Gas dissection causes vasodilation and maintains the artery in a dilated state during dissection. Saline flow reduces the amount of heat generated at the cautery site and prevents drying and desiccation of the tissues...
October 29, 2017: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/29300070/skeletonized-internal-mammary-artery-harvest-with-diathermy-and-cold-dissection
#11
Andras Durko, Edris Mahtab, Jamie Romeo, Ad Bogers
This surgical tutorial demonstrates the technique of skeletonized internal mammary artery harvesting for coronary artery bypass grafting, using diathermy and cold dissection [1]. The procedure is performed on the left internal mammary artery, but is also applicable for harvesting the right internal mammary artery.
December 12, 2017: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/29284310/does-the-novel-delivery-system-for-the-stentys-self-apposing-coronary-stent-increase-the-risk-of-stent-edge-dissections-optical-coherence-tomography-post-stent-findings
#12
Huangling Lu, Deborah N Kalkman, Maik J Grundeken, Jan G P Tijssen, Joanna J Wykrzykowska, Robbert J de Winter, Karel T Koch
BACKGROUND: With optical coherence tomography (OCT), details of arterial injuries during percutaneous coronary intervention can be assessed accurately. There might be an increased risk of stent edge dissections with the novel delivery system for the STENTYS stent. We evaluated the prevalence of stent edge dissections using the novel Xposition delivery device as compared with the conventional delivery device. METHODS: A total of 38 patients who were treated with the self-apposing STENTYS stent and with OCT assessment at our center were retrospectively analysed...
December 28, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/29279888/prevalence-of-systemic-atherosclerosis-burdens-and-overlapping-stroke-etiologies-and-their-associations-with-long-term-vascular-prognosis-in-stroke-with-intracranial-atherosclerotic-disease
#13
Takao Hoshino, Leila Sissani, Julien Labreuche, Gregory Ducrocq, Philippa C Lavallée, Elena Meseguer, Céline Guidoux, Lucie Cabrejo, Cristina Hobeanu, Fernando Gongora-Rivera, Pierre-Jean Touboul, Philippe Gabriel Steg, Pierre Amarenco
Importance: Patients who have experienced stroke with intracranial atherosclerotic disease (ICAD) may also have concomitant atherosclerosis in different arterial beds and other possible causes for ischemic stroke. However, little is known about the frequency and prognostic effect of such overlapping diseases. Objectives: To describe the prevalence of systemic atherosclerotic burdens and overlapping stroke etiologies and their contributions to long-term prognoses among patients who have experienced stroke with ICAD...
December 26, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/29278215/percutaneous-coronary-intervention-in-the-elderly-are-drug-coated-balloons-the-future
#14
Ioannis Merinopoulos, Tharusha Gunawardena, Upul Wickramarachchi, Alisdair Ryding, Simon Eccleshall, Vassilios S Vassiliou
Balloon angioplasty revolutionised percutaneous treatment for coronary artery disease four decades ago, but vessel-threatening dissections, elastic recoil and restenosis were major drawbacks to an otherwise successful long-lasting intervention. Subsequent advances with bare metal stents and then drug eluting stents followed, aiming to mitigate the risks of acute vessel closure and restenosis. However, stent implantation often necessitates dual antiplatelet therapy for a prolonged period of time, which in itself can lead to adverse outcomes, especially in the frail elderly population at higher risk of bleeding...
December 26, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29276441/bioresorbable-scaffolds-in-spontaneous-coronary-artery-dissection-long-term-follow-up-in-4-patients
#15
Santiago Jesús Camacho Freire, Antonio Enrique Gómez Menchero, Jessica Roa Garrido, Javier León Jiménez, Rosa Cardenal Piris, José Francisco Díaz Fernández
Spontaneous coronary artery dissection is a rare condition, and diagnosis and treatment are challenging among patients who present with acute coronary syndrome. Typically, the condition affects young females who have no underlying atherosclerotic disease. To date, few cases of bioresorbable scaffold implantation for the treatment of spontaneous coronary artery dissection have been reported. Therefore, we describe the cases of 4 patients whom we treated with scaffolds. We evaluated the long-term results by using intravascular ultrasound and optical coherence tomographic scanning...
December 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/29275928/spontaneous-coronary-artery-dissection-scad-the-underdiagnosed-cardiac-condition-that-plagues-women
#16
REVIEW
Sandrine Lebrun, Rachel M Bond
Coronary heart disease (CHD) continues to be understudied, underdiagnosed, and undertreated in women. Gender and age bias complicate the evaluation of women with acute coronary syndrome (ACS). As a result, conditions like spontaneous coronary artery dissection (SCAD) are often missed. SCAD is an infrequent yet important cause of myocardial infarction (MI) with a predilection for young to middle aged women. The condition is thought to be under-reported, likely a result of both low index of suspicion as well as an unfamiliarity with SCAD's angiographic variants...
December 11, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29275829/risk-modeling-to-optimize-patient-selection-for-management-of-the-descending-thoracic-aortic-aneurysm
#17
Akiko Tanaka, Harleen K Sandhu, Wande B Pratt, Rana Afifi, Charles C Miller, Kristofer Charlton-Ouw, Maria E Codreanu, Naveed U Saqib, Ali Azizzadeh, Hazim J Safi, Anthony L Estrera
BACKGROUND: A single-institutional study comparing early and long-term outcomes of thoracic endovascular aortic repair (TEVAR) and open surgical repair (OSR) was performed to determine the appropriate treatment option for descending thoracic aortic aneurysm (DTAA). METHODS: Between 2005 and 2014, 438 DTAA patients were treated (TEVAR, 88; OSR, 350). Acute dissection and traumatic injury were excluded. Perioperative and follow-up data were reviewed. Stratified analyses were conducted to identify patients most likely to benefit from TEVAR...
December 21, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29259510/stent-choice-in-very-large-left-main-lesions-in-3-patients
#18
Iñigo Lozano, Juan Rondan, José M Vegas, Eduardo Segovia
Interventionalists encounter widely different coronary anatomies during left main coronary artery stenting. Optimal percutaneous coronary intervention in left main disease necessitates stents that achieve adequate apposition and adapt to frequently disparate diameters in the same lesion, without the need for overexpansion. Until recently, stent designs have hampered the treatment of very large lesions in left main arteries. Postdilation of the stents beyond their recommended diameters can cause restenosis, thrombosis, or arterial dissection...
October 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/29258677/sixteen-year-experience-of-david-and-bentall-procedures-in-acute-type-a-aortic-dissection
#19
Bo Yang, Himanshu J Patel, Claire Sorek, Whitney E Hornsby, Xiaoting Wu, Sarah Ward, Marc Thomas, Anisa Driscoll, Victoria A Waidley, Elizabeth L Norton, Donald S Likosky, G Michael Deeb
BACKGROUND: To examine short-term and midterm outcomes after the David and Bentall procedures in patients with an acute type A aortic dissection. METHODS: Between 2001 and 2017, patients (n = 135) with acute type A aortic dissection underwent an aortic root replacement with either the David (n = 40) or Bentall (n = 95) procedure. Perioperative outcome, reoperation rate, aortic valve function, and long-term survival were evaluated. RESULTS: The median age of the entire cohort was 56 years...
December 16, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29249430/prevalence-of-takayasu-arteritis-in-young-women-with-acute-ischemic-heart-disease
#20
Giulio Cavalli, Alessandro Tomelleri, Davide Di Napoli, Elena Baldissera, Lorenzo Dagna
OBJECTIVES: Takayasu arteritis (TA), a systemic vasculitis typically occurring in female patients aged ≤40, can affect coronary arteries and cause ischemic heart disease (IHD). In this study, we investigated the prevalence of TA in young women presenting with IHD in the Emergency Department. METHODS: We evaluated hospital records of 158,860 consecutive female patients aged <40, who accessed the Emergency Department of our institution over 8 consecutive years (2007-2015)...
February 1, 2018: International Journal of Cardiology
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