Left main coronary artery disease

An automatic coronary artery tree labeling algorithm is described to identify the anatomical segments of the extracted centerlines from coronary computed tomography angiography (CCTA) images. This method will facilitate the automatic lesion reporting and risk stratification of cardiovascular disease. Three-dimensional (3D) models for both right dominant (RD) and left dominant (LD) coronary circulations were built. All labels in the model were matched with their possible candidates in the extracted tree to find the optimal labeling result...

Patients undergoing TAVR undergo routine CT angiography (CTA) to assess aorto-iliac pathology and annular dimensions. While coronary CTA may exclude severe CAD in younger patients, its efficacy in defining CAD severity prior to TAVR may be limited. We retrospectively studied 50 consecutive patients undergoing both invasive coronary angiography (ICA) and routine pre-TAVR CTA. Severe CAD was defined as ≥50% stenosis by quantitative coronary angiography and compared to a blinded CTA visual estimation of ≥50% stenosis...

Fibrinogen (Fib) is a useful marker for predicting the severity of coronary artery disease (CAD) in adult population. However, whether Fib can be a predictor for the presence and severity of CAD in very young MI patients (≤35 years old) remains to be determined. A total of 418 males from 61,863 patients with MI who were under 35 years old were sequentially recruited in our study. The patients were divided into two main groups and three subgroups according to coronary angiograph and Gensini score (GS) system: no coronary artery stenosis (group A), the results of the coronary artery stenosis (group B); low GS, intermediate GS and high GS...

This meta-analysis compared IVUS-guided with angiography-guided PCI to determine the effect of IVUS on the mortality in patients with LM CAD. Current guidelines recommend intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) in patients with left main coronary artery disease (LM CAD; Class IIa, level of evidence B). A systematic search of the MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases was conducted to identify randomized or non-randomized studies comparing IVUS-guided PCI with angiography-guided PCI in LM CAD...

During the last 25 years angiotensin-converting enzyme inhibitors spectacularly conquered the field of cardiovascular diseases therapy. Nevertheless, lack of new studies concerning side effects associated with their chronic administration seems to be rather confusing. In our previous research, we proved that the main furnidipines' metabolite (M-2) possess multiple cardioprotective actions. Currently, we compared effects of post-infarction long-term oral treatment with M-2 and captopril on hemodynamic parameters and "ischemic cardiomyopathy" development in rats...

PURPOSE: To evaluate choroidal thickness (CTh) in patients with coronary artery disease (CAD) compared to healthy controls. DESIGN: Cross-sectional. METHODS: Setting: Ambulatory clinic of a large city hospital. Patient population: Thirty-four patients had documented CAD, defined as history of >50% obstruction in at least one coronary artery on cardiac catheterization, positive stress test, ST elevation myocardial infarction, or revascularization procedure...

BACKGROUND: The risk factors along with demographic and angiographic features associated with aorto-ostial atherosclerotic coronary artery disease usually differ from that of non-aorto-ostial atherosclerotic coronary artery disease. OBJECTIVES: This study was designed to evaluate etiology of aorto-ostial atherosclerotic coronary artery disease involving left main coronary artery (LMCA), right coronary artery or both with consideration of clinical risk factors, demographic and angiographic features...

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No abstract text is available yet for this article.

For nearly half a century, coronary artery bypass grafting has been the standard treatment for patients with obstructive left main coronary artery (LMCA) disease. However, there has been considerable evolution in the field of percutaneous coronary intervention, and especially, percutaneous coronary intervention for LMCA disease has been rapidly expanded with adoption of drug-eluting stents. Some, but not all randomized trials, have shown that percutaneous coronary intervention with drug-eluting stents might be a suitable alternative for selected patients with LMCA disease instead of bypass surgery...

The left main coronary artery (LMCA) is responsible for supplying the majority of the left ventricular myocardium. Visual estimation of stenosis severity on angiography has major limitations and methods to assess functional significance, such as Fractional Flow Reserve (FFR), have been shown to yield better outcomes but major trials examining the use of such physiological indices have excluded LMCA disease to date. Furthermore, LMCA disease commonly co-exists with downstream disease, which complicates interpretation of coronary physiological data...

Objective We aimed to determine the capacity of drug-eluting stent (DES) over-expansion in left main coronary artery disease. Methods Left main interventions with the largest available DES platforms (4.0 mm) and post-dilation performed with large non-compliant balloons (≥ 4.5 mm) were included. Maximal stent diameter (mm) and area (mm(2)) were measured using post-intervention intravascular ultrasound (IVUS). Stent diameter and area were calculated with the balloon diameter and inflation pressure. The diameter and area expansion indices were defined as follows: maximal/calculated stent diameter and maximal/calculated stent area, respectively...

OBJECTIVE: The aim of this study was to show perioperative complications of CABG procedure with and without cardiopulmonary bypass (CPB) in patients with combined coronary and carotid disease. PATIENTS AND METHODS: This retrospective survey included patients with left main stenosis greater than 50% and carotid stenosis over 50%, who had undergone CABG without carotid endarterectomy at the BH Heart Centre, from May 2009 to May 2014. The patients were divided into two groups according to the surgical method used...

Coronary artery aneurysm (CAA) is a rare anomaly. The right coronary artery is the most commonly affected, followed by the left circumflex (LCX), or the left anterior descending artery (LAD). Three-vessel disease or left main (LM) involvement is extremely rare. A giant coronary artery aneurysm (GCAA) has an extremely low incidence and refers to an aneurysm that is 20 mm or greater in size. Most CAAs occur as a consequence of atherosclerosis. Most patients with CAA are males, have three-vessel disease, and a history of myocardial infarction (MI)...

Sustained ventricular tachyarrhythmia usually occurs on the basis of structural heart disease, particularly coronary heart disease (CAD). Although monomorphic ventricular tachycardia (VT) appears mainly in patients with CAD, it is typically not triggered by acute ischemia, in contrast to polymorphic VT or ventricular fibrillation (VF). To judge if VT is caused by acute ischemia is even more difficult in context with an elevated highly sensitive troponin T which is generally elevated in sustained VT because tachycardia in chronic stable coronary artery sclerosis causes a mismatch between increased oxygen demand and limited oxygen supply...

There is limited data comparing effectiveness of coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) with drug-eluting stents in patients with non-ST-elevation acute coronary syndromes (NSTE-ACS). We compared the long-term outcomes of the 2 revascularization strategies in 1,246 patients presented with NSTE-ACS for left main or multivessel coronary artery disease. Data were pooled from the Randomized Comparison of Coronary Artery Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients with Multivessel Coronary Artery Disease (BEST) trial, the Premier of Randomized Comparison of Bypass Surgery versus Angioplasty Using Sirolimus-Eluting Stent in Patients with Left Main Coronary Artery Disease (PRECOMBAT) trial, and the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) trial...

We report a successful case of hybrid coronary revascularization of minimally invasive coronary artery bypass grafting( MICS-CABG) and percutaneous coronary intervention(PCI). The patient was a 78-year-old man with angina pectoris due to left main trunk (LMT) lesion, and had a history of repeated PCI to the left anterior descending artery (LAD) and the left circumflex artery (LCX) for angina pectoris. He presented with a chest pain on effort in June, 2015. A coronary angiogram showed a severe stenosis in the LMT extending to LAD and LCX...

OBJECTIVE: Patients presenting for cardiac surgery have unstable cardiovascular disease and haemodynamics with multiple coexisting diseases. Optimal monitoring in the perioperative period is very important for best perioperative outcome. The introduction of the flow-directed pulmonary artery catheter (PAC) into clinical practice is one of the most important and popular advances in the field of cardiac anaesthesia. The objective of the study was to determine the frequency, indications and complications of pulmonary artery catheter insertion in adult open-heart surgery patients...

Cardiogenic shock represents a state of low cardiac output and systemic hypoperfusion resulting in insufficient end-organ perfusion and consequent multiorgan failure. The main cause of this complication in the context of acute ST-elevation myocardial infarction is left ventricular dysfunction secondary to poor myocardial perfusion. In over 50% of cardiogenic shock cases, there is evidence of significant coronary stenosis within noninfarct-related arteries. Persistent ischemia in the noninfarct territory may contribute to ongoing hypotension...

OBJECTIVE: Patients undergoing coronary artery bypass graft (CABG) are recommended to undergo carotid duplex study in presence of risk factors. Aim of the study was to quantify the relationship between risk factors and presence of carotid disease and examine if screening influenced outcomes. METHODS: Over a four year period in a single institution, 4364 consecutive patients presenting for primary isolated CABG were enrolled to undergo carotid duplex scanning. Patients were grouped as no significant carotid artery stenosis (<50%), moderate stenosis (50%-70%) and severe stenosis (>70%)...