1/329. cardiac tamponade and death from intrapericardial rupture [corrected] of sinus of valsalva aneurysm.A 35-year-old woman presented with dyspnea and chest pain. She had a large aneurysm of the non-coronary sinus of valsalva. Before her scheduled urgent surgery, the patient collapsed and died of cardiac tamponade secondary to intrapericardial rupture of the aneurysm. We would advocate urgent repair of this type of lesion to prevent such an outcome. We are aware of no other specific reports addressing extracardiac rupture of non-coronary cusp aneurysms [corrected].- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
2/329. Surgical treatment for a supra sinotubular junctional saccular aneurysm associated with aortic regurgitation.We reported a patient with a saccular ascending aortic aneurysm located just above the non-coronary sinotubular junction. The aneurysm produced severe aortic regurgitation and two episodes of cardiac tamponade. By intraoperative inspection, the border between the aneurysmal wall and non-dilated portion of the normal aortic wall was distinct, and the aortic valve leaflets and aortic annulus appeared normal. aortic valve dysfunction appeared to be caused by dilation of the noncoronary sinotubular junction and mild distortion of the noncoronary sinus because of the aneurysmal formation. We performed patch closure of the aneurysmal ostium and repaired the dilated noncoronary sinotubular junction. Postoperative echocardiography and aortography demonstrated a good coaptation of the aortic valve leaflets with trivial aortic regurgitation. Although a rupture site, dissection or carcinomatous pericarditis which is attributable to the two episodes of cardiac tamponade could not be found, pathologic examination of the aneurysm wall revealed intramural blood leakage between the mucoid degenerated media and notably thickened adventitia. In addition, there was thinning and interruption of the elastic fibers of the media. These findings are consistent with a leaking aneurysm which cause the slow development of cardiac tamponade.- - - - - - - - - - ranking = 2keywords = coronary (Clic here for more details about this article) |
3/329. Anomalous coronary artery, aortic dissection, and acute myocardial infarction.The combination of acute coronary occlusion and aortic dissection because of involvement of one or other coronary vessels in the dissection flap is uncommon. Furthermore, the occurrence of an anomalous coronary artery and its involvement in acute myocardial infarction is even more uncommon. We describe a patient with acute myocardial infarction in whom an acute aortic dissection involved the ostium of an anomalous circumflex artery.- - - - - - - - - - ranking = 3.5keywords = coronary (Clic here for more details about this article) |
4/329. Unruptured congenital aneurysm of the sinus of valsalva presenting with pulmonary stenosis.Congenital aneurysm of the sinus of valsalva is a rare cardiovascular anomaly. It is usually silent until rupture occurs. The natural history of unruptured aneurysm of the sinus of valsalva is still not clear, and the therapeutic strategy is uncertain. Here we reported a case of unruptured aneurysm of the sinus of valsalva which was correctly diagnosed before invasive diagnostic procedures. A 30-year-old female noted mild palpitation and dyspnea for 1 month. Physically, a grade 3/6 systolic ejection murmur at upper left sternal border was detected. echocardiography revealed dilatation and irregular protrusion of the right sinus of valsalva encroaching on right ventricular outflow tract to cause obstruction. With these findings, unruptured aneurysm of the sinus of valsalva with pulmonary stenosis was diagnosed. cardiac catheterization and angiography confirmed the diagnosis. The aneurysm was repaired with a Dacron patch with good results. It is concluded that sinus of valsalva aneurysm can be diagnosed by echocardiography before its rupture so as to render a proper management for this potentially life-threatening anomaly.- - - - - - - - - - ranking = 0.046267872155039keywords = stenosis (Clic here for more details about this article) |
5/329. Coronary dissection and thrombosis associated with exercise testing three months after successful coronary stenting.exercise testing is commonly performed to assess the functional result of coronary revascularization procedures and is usually not associated with any complications. However, this report documents a rare case of coronary dissection and thrombosis, which resulted in an acute myocardial infarction, in a patient who underwent stress testing 3 months following successful coronary stent implantation.- - - - - - - - - - ranking = 3.5keywords = coronary (Clic here for more details about this article) |
6/329. myocardial ischemia resulting from spontaneous dissection in a patient with massive bilateral sinus of valsalva aneurysms.We describe a patient with large sinus of valsalva aneurysms involving both the left and right coronary sinuses. Spontaneous dissection of the left coronary artery occurred, causing unstable angina, a complication heretofore not associated with this disease. Successful surgical reconstruction of the aortic root, aortic valve replacement, and coronary bypass grafting were performed. pathology revealed cystic medial necrosis.- - - - - - - - - - ranking = 1.5keywords = coronary (Clic here for more details about this article) |
7/329. Non-coronary sinus of valsalva aneurysm diagnosed after a road traffic accident.A 38 year old man with a huge unruptured sinus of valsalva aneurysm, complicated with severe valvar aortic regurgitation, is described. The aneurysm was detected by echocardiography in the asymptomatic patient who presented with an intense precordial diastolic rumble after a road traffic accident. The patient had successful surgery for the aneurysm and aortic valve replacement. Possible aetiologies for the aneurysm and a brief revision of clinical aspects and treatment are discussed.- - - - - - - - - - ranking = 2keywords = coronary (Clic here for more details about this article) |
8/329. Acute type A aortic dissection involving the left main trunk of the coronary artery--a report of two successful cases.This report describes 2 cases of a type A acute aortic dissection combined with myocardial infarction caused by a retrograde dissection into the left main trunk of the coronary artery. Successful surgical treatments, including the replacement of the ascending aorta, aortic valve resuspension and coronary artery bypass grafting, were performed in both patients, and they recovered well from cardiogenic shock. However, left ventricular function of both patients remained depressed postoperatively, which limited their quality of life. Because no definite method for salvaging infarcted myocardium has yet been established, either more timely surgery or the preoperative placement of a perfusion catheter in the left main coronary artery is mandatory.- - - - - - - - - - ranking = 3.5keywords = coronary (Clic here for more details about this article) |
9/329. Stent-grafting to descending thoracic aorta during coronary artery bypass grafting.We report on 2 patients who underwent successful concomitant operation of coronary artery bypass grafting and stent grafting to descending thoracic aortic aneurysms. The device was inserted through a small linear incision on the anterior wall of the aortic arch. Intraoperative stent grafting to descending thoracic aortic aneurysms is an alternative therapeutic option for patients who require concomitant coronary artery bypass grafting and descending aortic replacement.- - - - - - - - - - ranking = 3keywords = coronary (Clic here for more details about this article) |
10/329. Surgical angioplasty of the left main coronary artery in non-atherosclerotic lesions.Surgical angioplasty of the left main coronary artery confers several advantages over conventional bypass surgery: unrestricted forward flow is provided to the entire coronary bed and graft material is spared. The literature contains many reports of surgical angioplasty of atherosclerotic stenoses. The technique is described in five patients with non-atherosclerotic disease of the left main coronary artery: three children (a 7 year old girl who had undergone an arterial switch operation shortly after birth; a 9 year old boy with congenital supravalvar aortic stenosis; and a 10 year old girl with Kawasaki's disease) and two adults (a 51 year old woman with post-radiation stenosis; a 53 year old man with acute dissection). All patients had an uneventful recovery and are free from symptoms with a widely open left main trunk. Although technical difficulties are increased in these patients, excellent results can be achieved with this approach.- - - - - - - - - - ranking = 3.518507148862keywords = coronary, stenosis (Clic here for more details about this article) |
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