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Left main coronary artery disease

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https://www.readbyqxmd.com/read/28106619/video-assisted-thoracic-surgery-in-patients-with-previous-sternotomy-and-cardiac-surgery
#1
Derek R Serna-Gallegos, Heather E Merry, Robert J McKenna
OBJECTIVE: Although video-assisted thoracic surgery (VATS) lobectomy has become a standard approach for early-stage 1 lung cancer, concerns exist regarding potential damage to the heart or bypass grafts when VATS is performed after cardiac surgery via median sternotomy. We could find only case reports regarding VATS lobectomy after sternotomy for cardiac surgery. Therefore, we reviewed our series of patients who underwent VATS anatomic resections after sternotomy for cardiac surgery. METHODS: Between 1996 and 2010, there were 87 patients who underwent 88 pulmonary resections after sternotomy for coronary artery bypass grafting (64), valve replacement or repair (12), coronary artery bypass graft and valve replacement (6), and transplant (5)...
January 19, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28104622/renin-angiotensin-system-inhibitors-for-patients-with-stable-coronary-artery-disease-without-heart-failure-systematic-review-and-meta-analysis-of-randomized-trials
#2
Sripal Bangalore, Robert Fakheri, Simon Wandel, Bora Toklu, Jasmin Wandel, Franz H Messerli
OBJECTIVE:  To critically evaluate the efficacy of renin angiotensin system inhibitors (RASi) in patients with coronary artery disease without heart failure, compared with active controls or placebo. DESIGN:  Meta-analysis of randomized trials. DATA SOURCES:  PubMed, EMBASE, and CENTRAL databases until 1 May 2016. ELIGIBILITY CRITERIA FOR SELECTING STUDIES:  Randomized trials of RASi versus placebo or active controls in patients with stable coronary artery disease without heart failure (defined as left ventricular ejection fraction ≥40% or without clinical heart failure)...
January 19, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28102878/pulmonary-hypertension-associated-with-left-sided-heart-disease
#3
Micha Tobias Maeder, Otto D Schoch, Rebekka Kleiner, Lucas Joerg, Daniel Weilenmann, Swiss Society For Pulmonary Hypertension
Pulmonary hypertension associated with left-sided heart disease (PH-LHD) is the most common type of pulmonary hypertension. In patients with left-sided heart disease, the presence of pulmonary hypertension is typically a marker of more advanced disease, more severe symptoms, and worse prognosis. In contrast to pulmonary arterial hypertension, PH-LHD is characterised by an elevated pulmonary artery wedge pressure (postcapillary pulmonary hypertension) without or with an additional precapillary component (isolated postcapillary versus combined postcapillary and precapillary pulmonary hypertension)...
January 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28100876/primary-percutaneous-coronary-intervention-followed-by-valve-surgery-for-acute-coronary-syndrome-at-left-main-trunk-complicated-with-severe-aortic-stenosis
#4
Akira Shikuma, Jun Shiraishi, Kazunari Okawa, Masaki Yashige, Keisuke Shoji, Daisuke Ito, Masayoshi Kimura, Eigo Kishita, Yusuke Nakagawa, Masayuki Hyogo, Akiyuki Takahashi, Takahisa Sawada
An 89-year-old woman appeared to have acute coronary syndrome at the left main trunk (LMT) complicated with severe aortic stenosis, moderate-severe mitral regurgitation, depressed left ventricular (LV) function, and multivessel disease. Because of sustained hypotension even under intra-aortic balloon pumping support during emergency coronary angiograhy, we performed primary percutaneous coronary intervention solely for the LMT lesion using a bare metal stent, leading to recovery from the shock state. On the second hospital day, based on our heart-team consensus, we performed aortic valve replacement and coronary artery bypass grafting surgery, and added edge-to-edge repair (Alfieri stitch) of the mitral valve, resulting in complete revascularization and dramatically improved LV function...
January 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28100341/-comparison-on-the-long-term-outcomes-post-percutaneous-coronary-intervention-or-coronary-artery-bypass-grafting-for-bifurcation-lesions-in-unprotected-left-main-coronary-artery
#5
B G Yang, X P Yu, F Chen, S Z Lyu, Q Li, J Q He, F Yuan
Objective: To compare the long-term clinical outcomes of consecutive patients treated with coronary artery bypass grafting (CABG) or percutaneous coronary intervention(PCI) with drug-eluting stents (DES) for bifurcation lesions in unprotected left main coronary artery (ULMCA). Methods: A total of 663 consecutively patients with unprotected left main bifurcation disease (defined as stenosis≥50%) who received either drug-eluting stents (DES) implantation (n=316) or underwent CABG (n=347) between January 2003 and July 2009 in Beijing Anzhen Hospital were enrolled retrospectively in this study...
January 25, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28081585/drug-eluting-stent-placement-versus-coronary-artery-bypass-surgery-for-unprotected-left-main-coronary-artery-disease-a-meta-analysis-of-randomized-controlled-trials
#6
Sunil Upadhaya, Ramkaji Baniya, Seetharamprasad Madala, Suresh Kumar Subedi, Jahangir Khan, Ravi Kanth Velagapudi, Ghassan Bachuwa
BACKGROUND: Coronary artery bypass grafting (CABG) is the standard of care for treating left main coronary lesions. However, recently published randomized controlled trials (RCT) have shown conflicting results. We sought to compare clinical outcomes of percutaneous coronary intervention (PCI) with drug-eluting stent placement to CABG using a meta-analysis of randomized controlled trials. METHODS: A systemic search of Pubmed, Scopus, Cochrane library, and Clinicaltrials...
January 12, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28074983/-role-of-coronary-computed-tomography-angiography-for-the-diagnosis-of-coronary-anomalies
#7
Rienzi Díaz, Jorge Vega
BACKGROUND: Coronary anomalies are rare heart diseases that can cause sudden cardiac death, especially in young individuals. Coronary computed tomography angiography delivers a three-dimensional view of excellent quality with information of the origin, course and anatomic relationships of the anomalous vessel, allowing differentiation between benign and malignant variants, entities that require different management and treatment. AIM: To show that coronary computed tomography angiography is the non-invasive technique of choice for the evaluation of a coronary anomaly due to its high diagnostic accuracy...
October 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28065691/difference-in-vascular-response-between-sirolimus-eluting-and-everolimus-eluting-stents-in-ostial-left-circumflex-artery-after-unprotected-left-main-as-observed-by-optical-coherence-tomography
#8
Yusuke Fujino, Guilherme F Attizzani, Satoko Tahara, Toru Naganuma, Kensuke Takagi, Hiroto Yabushita, Wei Wang, Kentaro Tanaka, Takahiro Matsumoto, Hiroyoshi Kawamoto, Yuya Yamada, Shinnosuke Amano, Yusuke Watanabe, Takayuki Warisawa, Tomohiko Sato, Satoru Mitomo, Naoyuki Kurita, Hisaaki Ishiguro, Koji Hozawa, Takahiro Tsukahara, Masahiro Motosuke, Hiram G Bezerra, Shotaro Nakamura, Sunao Nakamura
BACKGROUND: Kissing-balloon technique (KBT) is commonly performed during percutaneous coronary intervention of distal unprotected left main coronary artery (ULM) aiming at obtaining optimal opening of the side branch (left circumflex artery; LCX) ostium. Nonetheless, detailed evaluation of vascular response to stents in LCX ostium is lacking. We therefore evaluated the vascular response to different drug-eluting stents (DES) in ostial LCX after ULM by means of optical coherence tomography (OCT)...
December 23, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28045411/comparison-of-coronary-artery-dimensions-in-patients-with-chronic-aortic-regurgitation-or-stenosis
#9
Hamza Sunman, Mehmet Erat, Kadriye Gayretli Yayla, Engin Algül, Mehmet Aytürk, Lale Dinç Asarcıklı, Murat Bilgin, Tolga Çimen, Ahmet Akyel, Sadık Açıkel, Mehmet Doğan, Ekrem Yeter
OBJECTIVE: Effects of various conditions on coronary artery dimensions is an important research topic, and data regarding effect of aortic valvular diseases are limited. Aim of the present study was to investigate effects of aortic regurgitation (AR) and aortic stenosis (AS) on coronary artery dimensions. METHODS: Coronary dimensions of 95 patients (35 with isolated AR, 30 with isolated AS, and 30 without any valvular disease) were calculated. Patients with severe coronary artery disease and concurrent moderate to severe additional valvular disease were excluded...
December 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28030655/percutaneous-coronary-intervention-with-bioresorbable-scaffolds-in-a-young-child
#10
Tamim M Nazif, Sanjog Kalra, Ziad A Ali, Dimitrios Karmpaliotis, Mariel E Turner, Thomas J Starc, Yang Cao, Charles C Marboe, Michael B Collins, Martin B Leon, Ajay J Kirtane
Importance: Although much less frequent than in adults, coronary artery disease requiring revascularization may develop in children because of homozygous familial hypercholesterolemia or other underlying conditions. Percutaneous coronary intervention (PCI) with a bioresorbable scaffold (BRS) may have advantages over metallic coronary stents in this population. Objective: To present a case of the successful treatment of unstable, multivessel coronary artery disease in a child with PCI with BRS implantation...
December 28, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/28029362/impact-of-multivessel-coronary-artery-disease-with-versus-without-left-main-coronary-artery-disease-on-long-term-mortality-after-coronary-bypass-grafting-versus-drug-eluting-stent-implantation
#11
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
Limited data are available on the impact of concomitant left main coronary artery disease (CAD) on mortality after revascularization of multivessel coronary artery disease (MVD) alone or multivessel plus left main coronary artery disease (MVLMD). This study compared long-term mortality between coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) with drug-eluting stents in 2,887 patients with MVD or MVLMD. Data were pooled from the BEST, PRECOMBAT, and SYNTAX trials. The primary outcome was death due to any cause...
October 8, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28028693/a-study-of-coronary-bifurcation-shape-in-a-normal-population
#12
Pau Medrano-Gracia, John Ormiston, Mark Webster, Susann Beier, Chris Ellis, Chunliang Wang, Örjan Smedby, Alistair Young, Brett Cowan
During percutaneous coronary intervention, stents are placed in narrowings of the arteries to restore normal blood flow. Despite improvements in stent design, deployment techniques and drug-eluting coatings, restenosis and stent thrombosis remain a significant problem. Population stent design based on statistical shape analysis may improve clinical outcomes. Computed tomographic (CT) coronary angiography scans from 211 patients with a zero calcium score, no stenoses and no intermediate artery, were used to create statistical shape models of 446 major coronary artery bifurcations (left main, first diagonal and obtuse marginal and right coronary crux)...
December 27, 2016: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/28028450/syntax-score-in-patients-with-high-computed-tomography-coronary-calcium-score
#13
Madhav Hegde, Ravindran Rajendran
OBJECTIVES: To study the conventional coronary angiogram ( CA) findings in patients with high coronary calcium on multidetector computed tomogram. MATERIALS AND METHODS: Fifty patients with coronary calcium high enough in its extent and location to interfere with the interpretation of a contrast-filled coronary artery for a significant lesion were studied with conventional CA. Framingham risk score (FRS), computed tomography (CT) coronary calcium score (CCS), and SYNTAX score (SS) from the CA were calculated by separate investigators who were blinded to other scores...
2016: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/28025191/fractional-flow-reserve-to-guide-and-to-assess-coronary-artery-bypass-grafting
#14
REVIEW
Mariano Pellicano, Bernard De Bruyne, Gabor G Toth, Filip Casselman, William Wijns, Emanuele Barbato
The aim of this review is to highlight the role of invasive functional evaluation in patients in whom coronary artery bypass graft (CABG) is indicated, and to examine the clinical evidence available in favour of fractional flow reserve (FFR) adoption in these patients, outline appropriate use, as well as point out potential pitfalls. FFR after CABG will also be reviewed, highlighting its correct interpretation and adoption when applied to both native coronary arteries and bypass grafts. Practice European guidelines support the use of FFR to complement coronary angiography with the highest degree of recommendation (Class IA) for the assessment of coronary stenosis before undertaking myocardial revascularization when previous non-invasive functional evaluation is unavailable or not conclusive...
December 23, 2016: European Heart Journal
https://www.readbyqxmd.com/read/28024657/repeat-the-electrocardiogram
#15
Mazen M Kawji, David Luke Glancy
A 71-year-old diabetic woman with intermittent chest pain and left bundle branch block was admitted to the hospital for further assessment. A repeat electrocardiogram showed new anterior T-wave inversions concordant with the QRS complexes. Thus, she had myocardial ischemia, and coronary arteriography revealed left main and triple vessel coronary disease. She went for urgent coronary artery bypass operation.
December 2, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28012553/comparison-of-percutaneous-coronary-intervention-versus-coronary-artery-bypass-grafting-for-unprotected-left-main-coronary-artery-disease
#16
REVIEW
Syed Yaseen Naqvi, Jordan Klein, Tisa Saha, Daniel J McCormick, Sheldon Goldberg
Coronary artery bypass grafting (CABG) decreases mortality in patients with significant left main (LM) coronary artery disease and for years remained the therapy of choice for patients with this ominous lesion. Advances in percutaneous coronary intervention (PCI) have enabled it to become an alternative to CABG. The results of observational registries and randomized comparisons have shown the safety and efficacy of PCI in appropriately selected patients with low or intermediate angiographic risk scores. Furthermore, the use of physiological measures of flow limitation and the use of intracoronary imaging techniques has added benefit and improved outcomes...
November 16, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28007199/coronary-artery-bypass-surgery-versus%C3%A2-drug-eluting-stent-implantation-for%C3%A2-left%C3%A2-main-or-multivessel-coronary-artery%C3%A2-disease-a-meta-analysis-of-individual-patient-data
#17
Cheol Whan Lee, Jung-Min Ahn, Rafael Cavalcante, Yohei Sotomi, Yoshinobu Onuma, Pannipa Suwannasom, Erhan Tenekecioglu, Sung-Cheol Yun, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Patrick W Serruys, Seung-Jung Park
OBJECTIVES: The authors undertook a patient-level meta-analysis to compare long-term outcomes after coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in 3,280 patients with left main or multivessel coronary artery disease (CAD). BACKGROUND: The relative efficacy and safety of CABG versus PCI with DES for left main or multivessel CAD remain controversial. METHODS: Data were pooled from the BEST (Randomized Comparison of Coronary Artery Bypass Surgery and Everolimus Eluting Stent Implantation in the Treatment of Patients With Multivessel Coronary Artery Disease), PRECOMBAT (Premier of Randomized Comparison of Bypass Surgery vs...
December 26, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27995343/pre-procedural-renal-resistive-index-accurately-predicts-contrast-induced-acute-kidney-injury-in-patients-with-preserved-renal-function-submitted-to-coronary-angiography
#18
Maciej T Wybraniec, Maria Bożentowicz-Wikarek, Jerzy Chudek, Katarzyna Mizia-Stec
The study aimed to evaluate the clinical utility of ultrasonographic intra-renal blood flow parameters, together with the wide range of different risk factors, for the prediction of contrast-induced acute kidney injury (CI-AKI) in patients with preserved renal function, referred for coronary angiography or percutaneous coronary interventions (CA/PCI). This prospective study covered 95 consecutive patients (69.5% men; median age 65 years) subject to elective or urgent CA/PCI. Data regarding 128 peri-procedural variables were collected...
December 19, 2016: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/27977615/total-revascularization-for-an-epsilon-right-coronary-artery-and-severe-left-main-disease-combined-with-profound-cardiogenic-shock-a-case-report
#19
Hsiu-Yu Fang, Wei-Chieh Lee, Chiung-Jen Wu
RATIONALE: Severe left main disease combined with right coronary artery occlusion was rarely encountered in our daily practice. Percutaneous coronary intervention in these patients was most challenging due to high probability of hemodynamic changes. PATIENT CONCERNS: Here, we report a 67-year-old man with Non-ST-Segment Elevation Myocardial Infarction (NSTEMI) and profound cardiogenic shock and we attempted coronary intervention with total revisualization for severe left main (LM) disease and angulated epsilon right coronary artery total occlusion...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27970415/tct-242-temporal-changes-in-outcomes-after-stent-or-coronary-artery-bypass-grafting-for-left-main-coronary-artery-disease-by-diabetes%C3%A2-status
#20
Min Soo Cho, Ungjeong Do, Kyusup Lee, Jung Ae Hong, Osung Kwon, Do-Yoon Kang, Jaeseokf Bae, Cheol Hyun Lee, Yu Na Kim, Se Hun Kang, Sung-Han Yoon, Pil Hyung Lee, Jung-Min Ahn, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
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