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At least 37 records · Page 2Linked to original sources

Anomalous LAD and CX artery arising separately from the proximal right coronary artery--a case report of single coronary artery with coronary artery disease.

Coronary artery anomaly has been reported at a rate of 0.6% to 1.3% in routine angiographic series. Moreover, single coronary artery is one of the rarest anomalies among coronary anomalies. Eventhough patients with coronary anomalies are usually asymptomatic, they may also be associated with myocardial ischemia, ventricular fibrillation, syncope, congestive heart failure, and sudden death. In this article, we report a case of single coronary artery anomaly with the left anterior descending (LAD) and left circumflex (LCx) coronary artery arising separately from the proximal right coronary artery. Since the presented case was associated with ischemic heart disease, coronary artery bypass grafting was carried out. He is currently well.

Coronary Angiography↗

Single coronary artery with subsequent coursing of right coronary artery between aorta and pulmonary artery: fractional flow reserve of the anomalous artery guiding the treatment.

A single coronary artery with an anomalous origin between the pulmonary artery and aorta is an unusual congenital anomaly. We present a 60 year old female patient with stable angina pectoris. Her coronary angiogram revealed that the right coronary artery originated from the left main stem and coursed between the great vessels. There was 90% stenosis in the left anterior descending coronary artery. We performed a fractional flow reserve study of both the anomalous origin artery and stenosed vessel. Fractional flow reserve study of the anomalous RCA did not reveal functional ischemia. We did not refer the patient to coronary artery bypass grafting but instead performed percutaneous coronary revascularization of the LAD. The patient is alive and has been free of symptoms during the 1 year follow-up.

Angina Pectoris↗

Treatment of vertebral artery aneurysms with transposition of the posterior inferior cerebellar artery to the vertebral artery combined with parent artery occlusion. Technical note.

The authors describe transposition of the posterior inferior cerebellar artery (PICA) to the vertebral artery (VA) combined with parent artery occlusion for the treatment of VA aneurysms in cases in which a clip could not be applied because of the origin of the ipsilateral PICA. The aneurysm is trapped through a lower lateral suboccipital craniectomy. The PICA is then cut just distal to the aneurysm, and the PICA and VA proximal to the aneurysm are anastomosed in an end-to-end or end-to-side fashion. The surgical procedure was successfully performed in two patients, each of whom had hypoplastic occipital arteries (OAs). The PICA contralateral to the lesion was hypoplastic in one patient and distant to the ipsilateral PICA in the other patient. Mild transient dysphagia developed postoperatively in one patient due to glossopharyngeal and vagus nerve palsy, and the other patient had an uneventful postoperative course. In both patients, postoperative cerebral angiography demonstrated good patency of the transposed PICA. These results show that transposition of the PICA to the VA is a useful procedure for the reconstruction of the PICA when parent artery occlusion is necessary to exclude a VA aneurysm involving the origin of the PICA and when OA-PICA anastomosis or PICA-PICA anastomosis cannot be performed.

Adult↗

Variant origin of superior thyroid artery, occipital artery and ascending pharyngeal artery from a common trunk from the cervical segment of internal carotid artery.

We report a case of variant origin of superior thyroid artery (STA), occipital artery (OA) and ascending pharyngeal artery (APA) from the cervical segment of internal carotid artery (ICA) in a 63-year-old male patient, who presented with acute subarachnoid hemorrhage. Four-vessel angiography showed asymptomatic occlusion of ICA giving origin to the anomalous branches. There was common origin of the STA and the OA. The APA originated from the OA. We did not find any other description in the literature on variant origin of STA from the cervical segment of ICA in the presence of a well-developed external carotid artery.

Carotid Artery, External↗

Revascularization of the anterior cerebral artery with an A3-A3 anastomosis and a superficial temporal artery bypass using an A3-radial artery graft to trap a giant anterior communicating artery aneurysm: technical case report.

OBJECTIVE AND IMPORTANCE: How to manage the distal anterior cerebral artery (ACA) circulation in the treatment of a giant anterior communicating artery aneurysm or a giant azygous A2 aneurysm is still controversial. CLINICAL PRESENTATION: We are reporting the case of a 70-year-old man who presented with an evolving giant thrombosed anterior communicating artery aneurysm. INTERVENTION: He was successfully treated by trapping the aneurysm in conjunction with an A3-A3 side-to-side anastomosis and a superficial temporal artery bypass using an A3-radial artery graft. The postoperative angiography showed an excellent filling of all the bilateral distal ACA area through the bypass. CONCLUSION: In cases in which direct clipping to preserve distal ACA flow is quite difficult, the bilateral ACA revascularization described here should be considered as another possibility.

Aged↗

[Failure of coronary artery bypass with the internal thoracic artery. Does extended use of the internal thoracic artery affect the patency of the coronary artery?].

OBJECTIVE: The aim of this study was to precise the circumstances of the failure of coronary artery bypass graft by internal thoracic artery (ITA). METHODS: It was a retrospective study which compared angiographic results between several techniques of ITA graft; 512 coronary artery bypass graft have been realized on 302 patients: 115 single left ITA grafts, 78 sequential left ITA grafts, 48 bilateral pedicled ITA grafts, 61 bilateral ITA Y grafts. The mean interval between operation and reangiography was 17.3 months (s = 4.1 months). Graft failures were occluded and non functioning ITA grafts (threadlike ITA). RESULTS: There were 11 occluded grafts (2%) and 19 non functionning grafts (4%). There was no difference of failure rate between the 4 techniques of ITA grafts (p > 0.05). The failure rate for right ITA grafts 13% was higher than for the left ITA grafts 4% (p < 0.001). The failure rate for obtuse marginal branch grafts 13% was higher than for left anterior descending artery grafts 3% (p < 0.001). CONCLUSION: The extended use of ITA doesn't increase the risk of graft failure rate. The patency of obtuse marginal branch ITA graft is less than the patency of left anterior descending artery or diagonal branch ITA grafts.

Coronary Angiography↗

Anomalous left coronary artery from pulmonary artery. Unusual case complicated by coronary arterial disease and fistula from coronary artery to left ventricle.

A 42-year-old woman with an anomalous left coronary artery originating from the pulmonary artery and a fistula from the left coronary artery to the left ventricle was treated by aortocoronary bypass grafting of an autologous saphenous vein. The presence of an abundant collateral circulation and of fistulous communications between the left coronary artery and the left ventricle, in our opinion, was the reason that this patient remained asymptomatic until the age of 40 years. We believe that this is the first report of the findings in an adult patient who had these two rare congenital anomalies complicated occlusive coronary arterial disease.

Adult↗

Vertebral artery-posterior inferior cerebellar artery bypass with a superficial temporal artery graft to treat aneurysms involving the posterior inferior cerebellar artery.

OBJECT: In patients with aneurysms that require occlusion of the posterior inferior cerebellar artery (PICA), revascularization of this artery should be performed. A novel surgical method for revascularization of the PICA is presented. METHODS: After a segment of the superficial temporal artery (STA) was harvested, the aneurysm was treated by trapping, followed by placement of a vertebral artery (VA)-PICA bypass in which the STA segment was used as a graft. When the length of the proximal PICA was inadequate, the distal end of the STA was anastomosed to the proximal PICA in an end-to-side fashion. When the length of the proximal PICA was adequate, the STA was anastomosed to the proximal PICA in an end-to-end fashion. In either case, the proximal end of the STA was anastomosed to the VA in an end-to-side fashion. This procedure was used in nine patients whose aneurysms involved the PICA. Although partial lateral medullary syndrome developed in one of them, follow-up evaluation revealed graft patency in all patients. There were no instances of recurrent hemorrhage or ischemia. CONCLUSIONS: Although this procedure requires harvesting of an STA graft and two anastomoses, it facilitates anterograde flow to the PICA territory. It also involves minimal mobilization of brainstem perforating vessels and the proximal PICA.

Adult↗

[Minimally invasive coronary artery bypass (MIDCAB) for double vessel using Y arterial graft which consists of left internal thoracic artery and right inferior epigastric artery].

MIDCAB is a rapidly evolving technique to revascularize the left anterior descending coronary artery (LAD) with the left internal thoracic artery (LITA). Our case is a 60-year-old female with unstable angina due to restenosis of the proximal LAD following PTCA and proximal stenosis of the large first diagonal branch (D1). She underwent double vessel MIDCAB (LITA-LAD and LITA-RIEA-D1) using Y composite arterial conduit with LITA and right epigastric artery (RIEA), because of chronic renal failure on maintenance hemodialysis. Postoperative course was uneventful and postoperative angiography revealed a patent Y graft. Y graft using IEA appears to be an interesting operative method in double vessel MIDCAB.

Coronary Artery Bypass↗

Off-pump coronary artery bypass grafting for the circumflex coronary artery via the left thoracotomy in redo CABG with the patent left internal thoracic artery graft to the left anterior descending artery.

Five patients had undergone off-pump coronary artery bypass grafting (CABG) as redo CABG via the left thoracotomy for the lesions of the left circumflex coronary arteries. In all patients, the internal thoracic artery (ITA) grafts to the LAD were well patent and acting significantly important in coronary circulation, however, ischemia due to the lesion of the LCX was significant. The saphenous vein grafts or the radial artery grafts were used as the materials of the grafts. The proximal ends of these grafts were anastomosed to the descending aorta. The procedures were completed successfully in all the patients and the excellent patency was shown angiographycally even in the long-term period after the surgery. Necessity of graft surgery only for the LCX lesion would be a rare occasion for a surgeon; however, these results suggest that the procedure is simple and less risky, which would encourage the surgeon to perform it in clinical situation.

Aged↗

Local pulmonary malformation caused by bilateral coronary artery and bronchial artery fistulae to the left pulmonary artery in a patient with coronary artery disease.

At 10 years of age and again at 25, our patient had been treated for pulmonary tuberculosis due to the presence of a localized pulmonary shadow. Coronary angiography at age 59 revealed 3 fistulous communications: from the right and circumflex coronary arteries and from the left bronchial artery. All 3 emptied into the same recipient artery, the distal part of a left pulmonary artery branch, which produced substantial left-to-right shunt. On computed tomography, cystic formations could be seen in the pulmonic area. The pulmonary tuberculosis for which this patient had been treated in his youth was in the same part of the lung where the shunt was discovered. Our conclusion is that the initial diagnosis was in error.

Arterio-Arterial Fistula↗

Isolated corrected transposition of great arteries and double left anterior descending artery originating from the left and right coronary artery. A rate combination of coronary artery anomaly and congenital heart disease.

A case of double left anterior descending coronary artery in a patient with isolated corrected transposition of great arteries is presented. The double artery originated from the left main stem and the right coronary artery. There were no stenoses on these two arteries. This anomaly seems to be very rare.

Cardiac Catheterization↗

Solitary arterial trunk with pulmonary atresia and arteries with supply to the left lung from both an arterial duct and systemic-pulmonary collateral arteries.

We report a case of pulmonary atresia with ventricular septal defect and absent pulmonary trunk. The sources of pulmonary blood supply were the arterial duct and systemic pulmonary collateral arteries. The left lung received blood from both sources which is very rare. One of the systemic pulmonary collateral arteries arose from the right coronary artery in an unusual fashion.

Collateral Circulation↗

Tandem bypass: occipital artery to posterior inferior cerebellar artery side-to-side anastomosis and occipital artery to anterior inferior cerebellar artery end-to-side anastomosis--a case report.

A unique example of posterior fossa revascularization is presented. A tandem bypass was performed by anastomosing the midoccipital artery to the posterior inferior cerebellar artery in a side-to-side fashion followed by anastomosis of the distal occipital artery to the anterior inferior cerebellar artery in an end-to-side fashion. The operation was designed to revascularize two separate vascular territories that were isolated in a patient thought to have an extremely compromised posterior circulation. The patient is doing well and is asymptomatic 3 years postoperatively.

Brain Stem↗

Tricuspid atresia, transposition of the great arteries, and banded pulmonary artery. Repair by arterial switch, coronary artery reimplantation, and right atrioventricular valved conduit.

A 14-year-old boy with tricuspid atresia, transposition of the great arteries, and previous pulmonary artery banding underwent repair by arterial switch procedure with coronary arterial reimplantation, plus connection of the right atrium and ventricle with a valved conduit. Pre- and postoperative hemodynamic and angiographic investigations are presented with comments on operative technique and the rationale for this unique operation.

Adolescent↗

Anomalous origin of the left coronary artery from the pulmonary artery: a case report with remarkable improvement of myocardial function following subclavian artery-coronary artery anastomosis.

A 3 2/12-year-old boy with anomalous origin of the left coronary artery from the pulmonary artery was successfully treated by anastomosis of the left subclavian artery to the anomalous vessel. A remarkable improvement in left ventricular function and electrocardiogram has occurred postoperatively. This case report supports the postulation that chronically hypoperfused, electrically silent, and minimally contractile myocardial tissue may acquire its electrical activity and function with the establishment of adeqate coronary perfusion.

Cardiopulmonary Bypass↗

The posterior inferior cerebellar artery arising from the extracranial segment of the internal carotid artery via the hypoglossal canal without an interposed segment of the basilar artery: a persistent primitive hypoglossal artery variant.

The authors present a rare case of a persistent primitive hypoglossal artery (PHA) variant ending in the posterior inferior cerebellar artery (PICA) without an interposed segment of the basilar artery and describe briefly the possible embryogenesis of this anomaly.

Carotid Artery, Internal↗

Prevalence of echocardiographic left ventricular hypertrophy in persons with systemic hypertension, coronary artery disease, and peripheral arterial disease and in persons with systemic hypertension, coronary artery disease, and no peripheral arterial disease.

Echocardiographic left ventricular (LV) hypertrophy was present in 120 of 160 patients (75%) (mean age 72 +/- 8 years) with systemic hypertension, coronary artery disease, and peripheral arterial disease (PAD) and in 43 of 94 age- and gender-matched patients (46%) with systemic hypertension, coronary artery disease, and no PAD (p<0.001). Echocardiographic LV hypertrophy was present in 63 of 68 patients with PAD (93%) with ankle-brachial indexes (ABIs) of <0.60 and in 57 of 92 patients (62%) with ABIs of 0.60 to 0.89 (p<0.001).

Aged↗