1/161. Three ventriculoplasty techniques applied to three left-ventricular pseudoaneurysms in the same patient.A 59-year-old male patient underwent surgery for triple-vessel coronary artery disease and left-ventricular aneurysm in 1994. Four months after coronary artery bypass grafting and classical left-ventricular aneurysmectomy (with Teflon felt strips), a left-ventricular pseudoaneurysm developed due to infection, and this was treated surgically with an autologous glutaraldehyde-treated pericardium patch over which an omental pedicle graft was placed. Two months later, under emergent conditions, re-repair was performed with a diaphragmatic pericardial pedicle graft due to pseudoaneurysm reformation and rupture. A 3rd repair was required in a 3rd episode 8 months later. Sternocostal resection enabled implantation of the left pectoralis major muscle into the ventricular defect. Six months after the last surgical intervention, the patient died of cerebral malignancy. Pseudoaneurysm reformation, however, had not been observed. To our knowledge, our case is the 1st reported in the literature in which there have been 3 or more different operative techniques applied to 3 or more distinct episodes of pseudoaneurysm formation secondary to post-aneurysmectomy infection. We propose that pectoral muscle flaps be strongly considered as a material for re-repair of left-ventricular aneurysms.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
2/161. Coronary artery aneurysm formation after balloon angioplasty and stent implantation.This study describes coronary angiographic and intravascular ultrasound evaluation of late coronary artery aneurysms after percutaneous balloon angioplasty and bailout stent implantation. Intravascular ultrasound distinguishes true aneurysms from pseudoaneurysms. The discussion is focused on the etiology and prognosis of this rare complication.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
3/161. Delayed development of a coronary artery pseudoaneurysm after angioplasty.One month after a successful angioplasty, one of our patients developed a new aneurysm in the right coronary artery (RCA). The aneurysm was characterized as a pseudoaneurysm by the use of intravascular ultrasound (IVUS). A stenosis that was not well seen by angiography was better depicted by IVUS. Both the pseudoaneurysm and the stenosis were successfully treated with a second angioplasty and stenting with a covered stent. Delayed development of pseudoaneurysms after dissection is an uncommon, but possible complication after angioplasty. In this case IVUS was useful for accurate characterization of the aneurysm. The use of covered stents may become a clinically useful method for treating coronary pseudoaneurysms.- - - - - - - - - - ranking = 3keywords = coronary (Clic here for more details about this article) |
4/161. Occurrence of a saccular pseudoaneurysm formation two weeks after perforation of the left anterior descending coronary artery during balloon angioplasty in acute myocardial infarction.We describe the occurrence of a localized saccular pseudoaneurysm in a 69-year-old patient 2 weeks after perforation of the left anterior descending coronary artery during balloon angioplasty in acute myocardial infarction. The therapy of perforations requires prolonged balloon inflations, perfusion balloons, covered stents, or surgery. Coronary peudoaneurysm formations are rare; their therapy requires covered stents or surgery. Cathet. Cardiovasc. Intervent. 47:341-346, 1999.- - - - - - - - - - ranking = 2.5keywords = coronary (Clic here for more details about this article) |
5/161. Spontaneous rupture of a saphenous vein graft.We present a case of spontaneous rupture of a right coronary bypass vein graft in a 57-year-old woman 10 years after coronary by-pass surgery. Although rare, this diagnosis should be considered in such patients presenting with appropriate symptoms.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
6/161. aneurysm of the posterior inferior cerebellar artery caused by a traumatic perforating artery tear-out mechanism in a child.Traumatic posterior circulation aneurysms in the absence of fractures and penetrating wounds are extremely uncommon, especially in children. To our knowledge this is the first traumatic posterior inferior cerebellar artery(pica) aneurysm reported that cannot be related to a skull fracture or a trauma caused by the edge of a rigid meningeal structure. In the present case, the initial subarachnoid hemorrhage (SAH) was caused by a perforating artery, originating from the pica, which was torn out as the result of a deceleration trauma. Such a mechanism explains both the initial SAH and the development of the false aneurysm responsible for the second SAH.- - - - - - - - - - ranking = 0.042863248481493keywords = circulation (Clic here for more details about this article) |
7/161. Pseudoaneurysm of the left ventricle progressing from a subepicardial aneurysm.A 56-year-old man presented with an inferior myocardial infarction and a huge pseudoaneurysm below the inferior surface of the left ventricle, which had progressed from a small subepicardial aneurysm over a 6-month period. Transthoracic echocardiography, doppler color flow images, radionuclide angiocardiography, magnetic resonance imaging and contrast ventriculography all revealed an abrupt disruption of the myocardium at the neck of the pseudoaneurysm, where the diameter of the orifice was smaller than the aneurysm itself, and abnormal blood flows from the left ventricle to the cavity through the orifice with an expansion of the cavity in systole and from the cavity to the left ventricle with the deflation of the cavity in diastole. coronary angiography revealed 99% stenosis at the atrioventricular nodal branch of the right coronary artery. At surgery the pericardium was adherent to the aneurysmal wall and a 1.5-cm orifice between the aneurysm and the left ventricle was seen. Pathological examination revealed no myocardial elements in the aneurysmal wall. The orifice was closed and the postoperative course was uneventful. Over-intense physical activity as a construction worker was considered to be the cause of the large pseudoaneurysm developing from the subepicardial aneurysm. These findings indicate that a subepicardial aneurysm may progress to a larger pseudoaneurysm, which has a propensity to rupture, however, it can be surgically repaired.- - - - - - - - - - ranking = 0.5keywords = coronary (Clic here for more details about this article) |
8/161. Transthoracic fistula with erosion of the ascending aorta along an IMA-protecting graft.Internal mammary artery (IMA) graft protection with nonbiodegradable material, such as polytetrafluorethylene (PTFE), is recognized as an effective means for preventing overexuberant adhesion development as well as injury of retrosternally crossing arterial grafts in the event of resternotomy and should enable better identification of the IMA graft. It is still uncertain whether the use of PTFE material is suitable for diabetic patients with complete arterial revascularization due to potential infectious complications. We report on a young diabetic patient after arterial T-grafting due to severe coronary disease and readmission with wound infection and retrosternal fistula formation 8 months after operation.- - - - - - - - - - ranking = 0.5keywords = coronary (Clic here for more details about this article) |
9/161. Left ventricular pseudoaneurysm and mitral valve regurgitation. Conservative surgical therapy.A patient with posterolateral left ventricular pseudoaneurysm, severe mitral regurgitation and coronary artery disease is reported. mitral valve insufficiency was almost completely cured by simple closure of the left ventricular defect by edge to edge apposition along the long axis of the heart.- - - - - - - - - - ranking = 0.5keywords = coronary (Clic here for more details about this article) |
10/161. Pseudoaneurysm of a septal perforator in beating heart coronary bypass grafting.A 46-year-old man with unstable angina underwent beating heart coronary bypass grafting for a left anterior descending coronary artery. Postoperative angiography showed intramuscular extravasation (6 x 8 mm) distal to the anastomosis, which was most likely the result of a needle injury caused by a snare during the operation. Follow-up angiography 2 weeks later revealed no extravasation.- - - - - - - - - - ranking = 3keywords = coronary (Clic here for more details about this article) |
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