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Left main coronary artery disease

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https://www.readbyqxmd.com/read/28539596/intravascular-ultrasound-guidance-improves-the-long-term-prognosis-in-patients-with-unprotected-left-main-coronary-artery-disease-undergoing-percutaneous-coronary-intervention
#1
Jian Tian, Changdong Guan, Wenyao Wang, Kuo Zhang, Jue Chen, Yongjian Wu, Hongbing Yan, Yanyan Zhao, Shubin Qiao, Yuejin Yang, Gary S Mintz, Bo Xu, Yida Tang
This study compared the long term outcomes in patients with unprotected left main coronary artery (LMCA) disease who underwent stenting under the guidance of intravascular ultrasound (IVUS) or conventional angiography at a large single center. The primary outcome was the composite of all-cause death and myocardial infarction (MI) at 3 years. Target vessel revascularization (TVR) at 3 years was one of the secondary outcomes. Between January 2004 and December 2011, a total of 1,899 patients who underwent IVUS-guided (n = 713, 37...
May 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28539567/syntax-score-ii-predicts-long-term-mortality-in-patients-who-underwent-left-main-percutaneous-coronary-intervention-treated-with-second-generation-drug-eluting-stents
#2
Jiqiang He, Hua Zhao, Xianpeng Yu, Quan Li, Shuzheng Lv, Fang Chen, Tengyong Jiang
The aim of this study was to evaluate the capacity of the SYNTAX Score-II (SS-II) to predict long-term mortality in patients undergoing left main percutaneous coronary intervention (LM-PCI) treated with second-generation drug-eluting stents (DES).Data from 487 consecutive patients with de novo left main coronary artery disease undergoing PCI were retrospectively studied. The patients were divided into tertiles according to the SS-II: low SS-II tertile (SS-II ≤ 22), intermediate SS-II tertile (SS-II of 23 to 30), and high SS-II tertile (SS-II ≥ 30)...
May 23, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28532780/meta-analysis-comparing-coronary-artery-bypass-grafting-to-drug-eluting-stents-and-to-medical-therapy-alone-for-left-main-coronary-artery-disease
#3
Rahman Shah, Mohamed S Morsy, Darryl S Weiman, George W Vetrovec
Historically, coronary artery bypass graft (CABG) surgery has been the standard revascularization method for unprotected left main coronary artery (LMCA) disease. Over the last decade, several randomized controlled trials (RCTs) have shown favorable results for percutaneous coronary intervention (PCI) with drug-eluting stent (DES) compared with CABG; however, no RCT has been conducted directly comparing DESs with medical therapy alone (MTA). Furthermore, the 2 most recently reported larger RCTs, using new-generation DESs reached somewhat conflicting conclusions comparing the 2 revascularization strategies...
April 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28530215/takotsubo-cardiomyopathy-after-intravenous-epinephrine-administration-following-cardiac-arrest-provoked-by-pneumoperitoneum-a-case-report
#4
Waldemar Elikowski, Malgorzata Małek-Elikowska, Jacek Karoń, Maria Mrozińska, Alina Baszko, Karolina Horbacka
In stress-induced takotsubo cardiomyopathy (TC) high levels of catecholamines, including epinephrine, may be detected in blood. On the other hand, administration of exogenous epinephrine may occasionally result in TC. A CASE REPORT: The authors describe a case of a 58-year-old, otherwise healthy female, with TC which occurred after intravenous injection of 1 mg of epinephrine against cardiac arrest provoked by pneumoperitoneum performed before planned laparoscopic cholecystectomy. She was admitted 3 days earlier due to biliary colic following a dietary mistake...
April 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28529306/normalization-of-diffuse-st-depression-with-avr-elevation-after-rehydration-in-a-patient-with-severe-aortic-stenosis
#5
Sachin R Patel, Vikas J Patel, Brittany Clark, George Rust
BACKGROUND Isolated ST elevation in lead aVR in combination with global ST depression with normalization after rehydration is a unique electrocardiographic pattern that is associated with a broad range of diagnoses. Its association with left main coronary artery disease and other acute coronary syndromes suggest the need for early and aggressive cardiac evaluation. CASE REPORT A 53-year-old man presented with altered mental status and loss of consciousness. He was unresponsive, hypotensive, tachycardiac, and diaphoretic...
May 22, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28527189/patient-specific-3-d-modeling-of-blood-flow-in-a-multi-stenosed-left-coronary-artery
#6
Sarfaraz Kamangar, Irfan Anjum Badruddin, N Ameer Ahamad, Manzoor Elahi M Soudagar, Kalimuthu Govindaraju, N Nik-Ghazali, N J Salman Ahmed, T M Yunus Khan
The current study investigates the effect of multi stenosis on the hemodynamic parameters such as wall pressure, velocity and wall shear stress in the realistic left coronary artery. Patients CT scan image data of normal and diseased left coronary artery was chosen for the reconstruction of 3D coronary artery models. The diseased 3D model of left coronary artery shows a narrowing of more than 70% and 80% of area stenosis (AS) at the left main stem (LMS) and left circumflex (LCX) respectively. The results show that the decrease in pressure was found downstream to the stenosis as compared to the coronary artery without stenosis...
2017: Bio-medical Materials and Engineering
https://www.readbyqxmd.com/read/28522138/impact-of-myocardial-bridging-on-in-hospital-outcome-in-patients-with-takotsubo-syndrome
#7
Ken Kato, Hideki Kitahara, Yuichi Saito, Yoshihide Fujimoto, Yoshiaki Sakai, Iwao Ishibashi, Toshiharu Himi, Yoshio Kobayashi
BACKGROUND: Prevalence of myocardial bridging of the left anterior descending coronary artery (LAD) in patients with takotsubo syndrome (TTS) has been demonstrated. However, the impact of myocardial bridging on in-hospital outcome has not been fully evaluated. METHODS: A total of 144 consecutive patients with TTS were enrolled. Coronary angiography and left ventriculography were performed in all patients and absence of obstructive coronary disease explaining the left ventricular contraction abnormality was confirmed...
May 15, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28515856/inter-ethnic-marriages-and-severity-of-coronary-artery-disease-a-multicenter-study-of-arabian-gulf-states
#8
Amin Daoulah, Salem Al-Kaabi, Amir Lotfi, Mushabab Al-Murayeh, S Ali Nasseri, Waleed Ahmed, Salah N Al-Otaibi, Mohamed N Alama, Osama E Elkhateeb, Amy J Plotkin, Majed M Malak, Khalid Alshali, Mohamed Hamzi, Saleh Al Khunein, Mohammed Abufayyah, Alawi A Alsheikh-Ali
AIM: To assess the association of inter-ethnic vs intra-ethnic marriage with severity of coronary artery disease (CAD) in men undergoing angiography. METHODS: We conducted a prospective multicenter, multi-ethnic, cross sectional observational study at five hospitals in Saudi Arabia and the United Arab Emirates, in which we used logistic regression analysis with and without adjustment for baseline differences. RESULTS: Data were collected for 1068 enrolled patients undergoing coronary angiography for clinical indications during the period of April 1(st), 2013 to March 30(th), 2014...
April 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28506936/assessment-of-long-term-mortality-in-patients-with-complex-coronary-artery-disease-undergoing-percutaneous-intervention-comparison-of-multiple-anatomical-and-clinical-prognostic-risk-scores
#9
Bruno L Janella, Carlos M Campos, Adriano Caixeta, Breno O Almeida, Fabio Sandoli Brito, Alexandre Abizaid, Marco A Perin
AIMS: Three-vessel and left main coronary artery disease (CAD) have important prognostic implications. Consequently, numerous risk scores have been developed to stratify patients with complex CAD. The aim of the present study is to compare the predictive performance of six risk scores for occurrence of 4-year all-cause mortality. METHODS AND RESULTS: From March 2008 to December 2012, 348 consecutive patients with complex CAD undergoing percutaneous coronary intervention in a tertiary center in São Paulo, Brazil were analyzed...
May 16, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28496086/-surgical-treatment-of-left-main-trunk-coronary-artery-aneurysm-with-asymptomatic-myocardial-ischemia-report-of-a-case
#10
Satoshi Okugi, Hiroyuki Saito, Etsuji Umeda, Yoji Takiguchi
Coronary artery aneurysm is rare, and there is no established protocol for surgical indication. On preoperative examination of orthopedic surgery, a 76-year-old male was found with asymptomatic myocardial ischemia. Radiological examinations revealed triple vessel disease and a coronary artery aneurysm, 10 mm in size, at the bifurcation of the left main trunk. Combined with quintuple coronary artery bypass grafting, surgical repair of the aneurysm was peformed under cardiopulmonary bypass on beating heart. Epicardial echocardiography was used to detect the site and the blood flow on the aneurysm...
May 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28495897/geographical-difference-of-the-interaction-of-sex-with-treatment-strategy-in-patients-with-multivessel-disease-and-left-main-disease-a-meta-analysis-from-syntax-synergy-between-pci-with-taxus-and-cardiac-surgery-precombat-bypass-surgery-versus-angioplasty-using
#11
Yohei Sotomi, Yoshinobu Onuma, Rafael Cavalcante, Jung-Min Ahn, Cheol Whan Lee, David van Klaveren, Robbert J de Winter, Joanna J Wykrzykowska, Vasim Farooq, Marie-Claude Morice, Ewout W Steyerberg, Seung-Jung Park, Patrick W Serruys
BACKGROUND: The impact of sex on clinical outcomes of percutaneous coronary intervention and coronary artery bypass graft for patients with multivessel coronary disease and unprotected left main disease could be dissimilar between Western and Asian populations. METHODS AND RESULTS: To assess clinical outcomes after percutaneous coronary intervention or coronary artery bypass graft in women and men with multivessel coronary disease and unprotected left main disease, a pooled analysis (n=3280) was performed using the patient-level data from 3 large randomized trials: SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery), PRECOMBAT (Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease), and BEST (Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients with Multivessel Coronary Artery Disease) trials...
May 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28490717/erratum-two-year-clinical-outcomes-in-stable-angina-and-acute-coronary-syndrome-after-percutaneous-coronary-intervention-of-left-main-coronary-artery-disease
#12
Dae Young Hyun, Myung Ho Jeong, Doo Sun Sim, Yun Ah Jeong, Kyung Hoon Cho, Min Chul Kim, Hyun Kuk Kim, Hae Chang Jeong, Keun Ho Park, Young Joon Hong, Jun Han Kim, Youngkeun Ahn, Jung Chaee Kang
[This corrects the article on p. 1084 in vol. 31, PMID: 27756119.].
May 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28487356/intravascular-ultrasound-guidance-is-associated-with-better-outcome-in-patients-undergoing-unprotected-left-main-coronary-artery-stenting-compared-with-angiography-guidance-alone
#13
Pontus Andell, Sofia Karlsson, Moman A Mohammad, Matthias Götberg, Stefan James, Jens Jensen, Ole Fröbert, Oskar Angerås, Johan Nilsson, Elmir Omerovic, Bo Lagerqvist, Jonas Persson, Sasha Koul, David Erlinge
BACKGROUND: Small observational studies have indicated better outcome with intravascular ultrasound (IVUS) guidance when performing unprotected left main coronary artery (LMCA) percutaneous coronary intervention (PCI), but the overall picture remains inconclusive and warrants further investigation. We studied the impact of IVUS guidance on outcome in patients undergoing unprotected LMCA PCI in a Swedish nationwide observational study. METHODS AND RESULTS: Patients who underwent unprotected LMCA PCI between 2005 and 2014 because of stable coronary artery disease or acute coronary syndrome were included from the nationwide SCAAR (Swedish Coronary Angiography and Angioplasty Registry)...
May 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28475697/off-pump-coronary-artery-bypass-surgery-outcomes-in-patients-with-ischaemic-left-ventricular-systolic-dysfunction-with-or-without-detected-viable-myocardium
#14
Sen Li, Haiqing Li, Zhize Yuan, Baoli Zhang, Anqing Chen, Mi Zhou, Jun Liu, Junfeng Cai, Zhe Wang, Xiaofeng Ye, Qiang Zhao
OBJECTIVES: : The prognostic value of myocardial viability before coronary bypass grafting remains controversial. The present study evaluated the effects of off-pump coronary artery bypass (OPCAB) grafting on patients with coronary artery disease (CAD) with or without viable myocardium (VM) preoperatively detected via nuclear imaging. METHODS: : A total of 115 consecutive patients with 3-vessel disease and impaired left ventricular ejection fraction (LVEF ≤ 45%) who underwent OPCAB grafting were recruited in this prospective study...
May 5, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28473705/comparison-of-the-left-main-coronary-bifurcating-angle-among-patients-with-normal-non-significantly-and-significantly-stenosed-left-coronary-arteries
#15
Yu-Hsiang Juan, Pei-Kwei Tsay, Wei-Chih Shen, Chih-Seng Yeh, Ming-Shien Wen, Yung-Liang Wan
We evaluated the correlation of the left main coronary bifurcating angle (LCBA) with the severity of coronary atherosclerosis, risk factors of coronary artery disease (CAD) and the feasibility of measuring the LBCA using the axial plane. Coronary Computed tomography angiographies (CTAs) of 313 patients between Nov. 2006 and Oct. 2013 were reviewed and separated into three groups. Group I (211 patients) had significant stenosis (≥50%) of the left anterior descending coronary artery (LAD) and/or left circumflex coronary artery (LCX)...
May 4, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28473107/current-interventions-for-the-left-main%C3%A2-bifurcation
#16
REVIEW
Tanveer Rab, Imad Sheiban, Yves Louvard, Fadi J Sawaya, Jun Jie Zhang, Shao Liang Chen
Contemporary clinical trials, registries, and meta-analyses, supported by recent results from the EXCEL (Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Artery Disease) and NOBLE (Percutaneous Coronary Angioplasty Versus Coronary Artery Bypass Grafting in Treatment of Unprotected Left Main Stenosis) trials, have established percutaneous coronary intervention of left main coronary stenosis as a safe alternative to coronary artery bypass grafting in patients with low and intermediate SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) scores...
May 8, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28465997/over-the-exceptions-psychiatric-disorder-medical-stress-and-takotsubo-cardiomyopathy
#17
Francesca De Angelis, Ketty Savino, Viviana Oliva, Alessandra Biadetti, Stefano Coiro, Giuseppe Ambrosio
Exact natural history and physiopathology of takotsubo cardiomyopathy (TC) are incompletely understood. In the last years, a lot of special cases of TC appeared in the literature. This case report is a typical case of TC, which meets all Mayo Clinic diagnosis criteria, over the exceptions; its main feature is that it has both physical (medical) and emotional (psychiatric) triggers. The protagonist is a woman affected by anxious-depressive syndrome, hospitalized for a cardiogenic syncope. After pacemaker (PMK) implantation, she first has convulsive hysteric crisis, and the following day, she has a transient left ventricular apical ballooning without coronary artery stenosis: takotsubo syndrome...
April 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/28465968/lower-body-weight-in-men-an-epidemiological-predictor-of-enlarged-left-atrium-in-sinus-rhythm-patients-with-dilated-heart
#18
Aurora Bakalli, Ljubica Georgievska-Ismail, Nebi Musliu, Dardan Koçinaj
BACKGROUND/AIMS: The source of thrombi in patients with dilated cardiomyopathy is not necessarily from the dilated left ventricle. Left atrium (LA) and left atrial appendage (LAA) might be in charge for relatively high rate of systemic embolizations in these patients. The main aim of our study was to identify epidemiological predictors in sinus rhythm patients with dilated heart for LA and LAA dilation and/or dysfunction. PATIENTS AND METHODS: This was a prospective cross-sectional study conducted from 2009 to 2014 in 101 sinus rhythm patients with dilated heart...
July 2016: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/28457603/healthy-and-diseased-coronary-bifurcation-geometries-influence-near-wall-and-intravascular-flow-a-computational-exploration-of-the-hemodynamic-risk
#19
Claudio Chiastra, Diego Gallo, Paola Tasso, Francesco Iannaccone, Francesco Migliavacca, Jolanda J Wentzel, Umberto Morbiducci
Local hemodynamics has been identified as one main determinant in the onset and progression of atherosclerotic lesions at coronary bifurcations. Starting from the observation that atherosensitive hemodynamic conditions in arterial bifurcation are majorly determined by the underlying anatomy, the aim of the present study is to investigate how peculiar coronary bifurcation anatomical features influence near-wall and intravascular flow patterns. Different bifurcation angles and cardiac curvatures were varied in population-based, idealized models of both stenosed and unstenosed bifurcations, representing the left anterior descending (LAD) coronary artery with its diagonal branch...
April 20, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28456699/cutoff-value-and-long-term-prediction-of%C3%A2-clinical-events-by-ffr-measured-immediately-after-implantation-of-a-drug-eluting-stent-in-patients-with-coronary-artery-disease-1-to-3-year-results-from-the-dkcrush-vii-registry-study
#20
Sui-Ji Li, Zhen Ge, Jing Kan, Jun-Jie Zhang, Fei Ye, Tak W Kwan, Teguh Santoso, Song Yang, Imad Sheiban, Xue-Song Qian, Nai-Liang Tian, Tanveer S Rab, Ling Tao, Shao-Liang Chen
OBJECTIVES: This study aimed to investigate the cutoff of post-drug-eluting stent (DES) fractional flow reserve (FFR) for prediction of 1- to 3-year target vessel failure (TVF). BACKGROUND: FFR immediately after a DES implantation correlates with clinical events. However, the cutoff of post-DES FFR for predicting long-term clinical events remains understudied. METHODS: Between May 2012 and September 2013, a total of 1,476 patients who had FFR <0...
April 22, 2017: JACC. Cardiovascular Interventions
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