1/40. Ostial stenosis of coronary arteries after complete replacement of aortic root using gelatin-resorcinol-formaldehyde glue.Coronary ostial stenosis between an interposition graft and coronary artery is rare and fatal. A 46-year-old woman who had reconstruction of both coronary arteries using interposition grafts for type A acute dissecting aneurysm presented with acute chest pain. Emergent coronary artery bypass grafting was done with saphenous vein grafts. Inappropriate use of gelatin-resorcinol-formaldehyde glue can be associated with ostial stenosis in the long term. Transesophageal echocardiography is useful to diagnose ostial stenosis of the coronary arteries.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/40. coronary artery bypass grafting for coronary aneurysms due to Kawasaki disease.We report a 23-year-old man who underwent coronary artery bypass grafting (CABG) for coronary aneurysms associated with Kawasaki disease using the left internal thoracic artery (LITA) and right gastroepiploic artery (RGEA) after a second myocardial infarction (MI). Preoperatively, this patient showed repetitive occlusion and recanalization of coronary artery flow without coronary stenosis. Indication of bypass surgery in Kawasaki disease is usually associated with stenosis. However, even an aneurysm alone should be an indication of surgery if there is any kind of ischemic event.- - - - - - - - - - ranking = 6keywords = aneurysm (Clic here for more details about this article) |
3/40. Successful long-term therapy following saphenous vein-covered stent deployment for atherosclerotic coronary aneurysm.We describe a case of atherosclerotic aneurysm involving the left main coronary artery in a patient with prior coronary artery bypass surgery. A saphenous vein-covered stent was used to seal the aneurysm in conjunction with conventional stenting of an associated native vessel coronary stenosis. Focal late restenosis involving the stent graft was successfully treated with repeat angioplasty and brachytherapy. Autologous vein-covered stent deployment should be considered in the treatment of symptomatic or progressively enlarging coronary aneurysms.- - - - - - - - - - ranking = 7keywords = aneurysm (Clic here for more details about this article) |
4/40. Left ventricular aneurysm, aortic valve disease and coronary narrowing in a patient with Hunter's syndrome.Hunter's syndrome (mucopolysaccharidosis type 2, MPS 2) is an inherited disorder of glycosaminoglycan degradation commonly associated with cardiac disease. We present the case of a young man with unusual cardiac manifestations of this syndrome. When mixed aortic valve disease was noted in childhood, other classical features of the milder form of Hunter's syndrome were present. There was no symptomatic or echocardiographic cardiovascular deterioration until age 27 when the patient presented in severe biventricular failure. Investigations demonstrated cardiomegaly and a large apical left ventricular aneurysm. The patient died suddenly soon after this diagnosis. Post mortem examination demonstrated a hypertrophied left ventricle with a 6-cm apical aneurysm. Coronary arterial walls were diffusely thickened but with only mild lumenal stenosis. Mitral and aortic valve disease was also present. There is one previous report of ventricular aneurysm in Hunter's syndrome. Pathophysiological contributions to aneurysm formation may include abnormal coronary flow, the presence of aortic stenosis and abnormal myocardium. This patient's sudden deterioration after a long period of clinical stability reinforces the need for careful follow-up of patients with cardiac manifestations of Hunter's disease.- - - - - - - - - - ranking = 8keywords = aneurysm (Clic here for more details about this article) |
5/40. Unruptured aneurysm of the left sinus of valsalva causing coronary insufficiency: case report and review of the literature.Aneurysm of the left sinus of valsalva is extremely rare. Compression of the left coronary artery by such an aneurysm is an unusual complication of this condition and can cause coronary insufficiency. We describe the case of a 75-year-old woman who had an isolated unruptured aneurysm of the left coronary sinus with intraluminal thrombus, which caused coronary artery compression. We performed successful surgical correction by closing the mouth of the aneurysm without aortic valve replacement or coronary artery bypass grafting. A review of the world medical literature revealed 19 cases of sinus of valsalva aneurysms that hindered the coronary arterial flow. The previously published reports of this rare condition and its treatment are discussed herein.- - - - - - - - - - ranking = 8keywords = aneurysm (Clic here for more details about this article) |
6/40. Stenosed kinking of the left main coronary artery combined with an aneurysm of the ascending aorta.Stenosed kinking of the left main coronary artery is described in a 60-year-old man with an aneurysm of the ascending aorta and severe aortic valve insufficiency. An elective complete ascending aorta replacement using a valved composite graft was performed along with a shortening and direct implantation of the left main coronary artery. The right coronary artery was reimplanted as a Carrel-button.- - - - - - - - - - ranking = 5keywords = aneurysm (Clic here for more details about this article) |
7/40. Rotational ablation and stent placement for severe calcific coronary artery stenosis after Kawasaki disease.We report on a 5-year-old child who had an episode of Kawasaki disease with giant coronary artery aneurysms at the age of 4 months. Surveillance coronary angiography showed severe calcific stenosis in the proximal left anterior descending artery. Balloon angioplasty failed to resolve the obstruction. Rotational ablation was therefore performed. Surveillance angiogram performed 6 months after rotational ablation showed critical restenosis. Rotational ablation was therefore repeated, followed by stent placement. To the best of our knowledge, this is the youngest child who has undergone coronary stenting after Kawasaki disease.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
8/40. Fatal Kawasaki disease caused by early occlusive coronary artery disease.In Kawasaki disease severe coronary artery narrowing may develop at an early stage despite treatment with gammaglobulin and in the absence of prominent aneurysm formation or thrombosis. Vaso-occlusive disease may not be clinically or echocardiographically apparent until very severe.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
9/40. Successful catheter interventional therapy for acute coronary syndrome secondary to kawasaki disease in young adults.acute coronary syndrome occurred in 2 young adults who had a history of Kawasaki disease (KD), but few other coronary risk factors. The first patient was a 27-year-old male with acute myocardial infarction without stenosis detected by coronary arteriography 4 years earlier. Emergency coronary arteriography showed occlusion of the right coronary artery. Aspiration-thrombectomy and rescue balloon angioplasty were successfully performed. The second patient was a 32-year-old male with unstable angina. Right coronary arteriography showed total occlusion with severe calcification. Left coronary arteriography showed 99% stenosis at the proximal site of the circumflex artery, and a directional coronary atherectomy was performed. Histological examination of a specimen from this site revealed a lipid core, macrophages, and smooth muscle cells. Restenosis was not observed on follow-up coronary arteriography after 5-6 months in either case. The coronary stenosis in each case was probably caused by accelerated atherosclerosis at the site without aneurysm as it seemed to be 'normal' on arteriography. Conventional catheter intervention was effective treatment. The sequelae of KD should be recognized as independent coronary risk factors.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
10/40. Detection of coronary artery aneurysms, stenoses and occlusions by multislice spiral computed tomography in adolescents with kawasaki disease.In patients with Kawasaki disease (KD), serial evaluation of coronary artery aneurysms (CAAs) and luminal narrowing is essential for risk stratification and therapeutic management. Therefore, non-invasive assessment of the status of the coronary artery is of utmost importance in patient management. Multislice spiral computed tomography (MSCT) permits non-invasive visualization of the entire coronary artery system and was used in the evaluation of 4 patients with KD. CAAs and high-grade coronary artery stenoses were detected by MSCT and corroborated the findings of coronary angiograms performed within the previous 2 years. MSCT has the potential to be the standard diagnostic tool in adolescents with KD.- - - - - - - - - - ranking = 5keywords = aneurysm (Clic here for more details about this article) |
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