1/24. Stenting to reverse left ventricular ischemia due to left main coronary artery compression in primary pulmonary hypertension.Angina is a common symptom of severe pulmonary hypertension. Although many theories for the source of this pain have been proposed, right ventricular ischemia is the one most commonly accepted as the cause. We report on two patients with primary pulmonary hypertension who had angina with normal activity or on provocation. One patient had severe left ventricular dysfunction. Both were found to have severe ostial stenosis of the left main coronary artery as a result of compression from a dilated pulmonary artery. Both patients underwent stenting of the left main coronary artery with excellent angiographic results, and complete resolution of the signs and symptoms of angina and left ventricular ischemia. Left ventricular ischemia due to compression of the left main coronary artery may be a much more common mechanism of angina and left ventricular dysfunction in patients with pulmonary hypertension than previously acknowledged. Stenting of the coronary artery can be done safely with the resolution of these symptoms.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
2/24. Aortic root abscess presenting as unstable angina due to extrinsic compression of the left coronary artery.Coronary ischaemia in acute endocarditis is usually due to pre-existing coronary disease or occasionally as a result of embolism from vegetations. A 68 year old man with known mixed aortic valve disease presented with a four week history of progressive exertional angina, which became unstable. He was apyrexial with no peripheral signs of endocarditis. Three sets of blood cultures were negative. Transthoracic echocardiography with suboptimal windows confirmed moderate mixed aortic valve disease. Marked reversible ST segment depression with angina recurred at rest. aortography showed severe aortic regurgitation with a distorted aortic root. coronary angiography showed severe proximal narrowing of the left anterior descending and circumflex arteries with an unusual long and tapering contour. Emergency surgery revealed a large anterior aortic root abscess which had destroyed the left and right coronary cusps. Aortic root abscess and other rare causes of extrinsic coronary compression are discussed.- - - - - - - - - - ranking = 0.83333333333333keywords = compression (Clic here for more details about this article) |
3/24. 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 = 0.16666666666667keywords = compression (Clic here for more details about this article) |
4/24. Regional cardiac sympathetic denervation and systolic compression of a septal perforator branch in a sudden death survivor with hypertrophic cardiomyopathy.Hypertrophic cardiomyopathy is a heterogeneous primary cardiac disease with a broad clinical spectrum, including a high risk for sudden death in a certain subgroup of patients. However, the precise criteria for identifying the subgroup at high risk have not been established. The authors describe a 41-year-old man with hypertrophic cardiomyopathy who was examined after an episode of aborted sudden death. Extensive invasive and noninvasive investigations did not reveal a cardiac abnormality other than severe sympathetic denervation in the midbasal septal wall on iodine-123 MIBG SPECT imaging and concentric left ventricular hypertrophy on echocardiography. A retrospective review of the cardiac catheterization findings, however, revealed systolic compression of a septal perforator artery. The aborted sudden death of the patient was most likely associated with systolic compression of a septal branch or sympathetic denervation, which may have precipitated a ventricular arrhythmia in this patient.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
5/24. myocardial bridging as a cause of acute myocardial infarction: a case report.BACKGROUND: Systolic compression of a coronary artery by overlying myocardial tissue is termed myocardial bridging. myocardial bridging usually has a benign prognosis, but some cases resulting in myocardial ischemia, infarction and sudden cardiac death have been reported. We are reporting a case of myocardial bridging which was complicated with acute myocardial infarction associated with inappropriate blood donation. CASE PRESENTATION: A 33 year-old-man was admitted to our emergency with acute anteroseptal myocardial infarction after a blood donation. The electrocardiography showed sinus rhythm and was consistent with an acute anteroseptal myocardial infarction. We decided to perform primary percutanous intervention (PCI). myocardial bridging was observed in the mid segment of the left anterior descending coronary artery on coronary angiogram. PCI was canceled and medical follow up was decided. blood transfusion was made because he had a deep anemia. A normal hemoglobin level and clinical reperfusion was achieved after ten hours by blood transfusion. At the one year follow up visit, our patient was healthy and had no cardiac complaints. CONCLUSIONS: myocardial bridging may cause acute myocardial infarction in various clinical conditions. Although the condition in this case caused profound anemia related acute myocardial infarction, its treatment and management was unusual.- - - - - - - - - - ranking = 0.16666666666667keywords = compression (Clic here for more details about this article) |
6/24. Intracoronary fracture and embolization of a coronary angioplasty balloon catheter: retrieval by a simple technique.We report a technique for retrieval of a balloon along with a portion of its shaft from the coronary system using a simple technique that does not involve the use of snare or any other retrieval tool. An additional angioplasty wire and a balloon catheter were used to remove the balloon from the coronary system.- - - - - - - - - - ranking = 0.11289809421649keywords = fracture (Clic here for more details about this article) |
7/24. Inadvertent dilation of a saphenous vein graft stenosis by the PercuSurge GuardWire distal protection balloon.Distal embolization protection devices are fast becoming an integral part of percutaneous vein graft interventions. The distal elastomeric balloon of the PercuSurge GuardWire system is supposed to be atraumatic to the vessel wall. We report the inadvertent dilation of a moderate distal stenosis at the site of GuardWire balloon inflation while intervening on a critical proximal saphenous vein graft stenosis. This case illustrates that plaque compression and potential vessel wall trauma might occur during the inflation of the PercuSurge GuardWire distal protection balloon.- - - - - - - - - - ranking = 0.16666666666667keywords = compression (Clic here for more details about this article) |
8/24. Milking-like effect secondary to systolic expansion of a post-infarction left ventricular aneurysm.Systolic compression of coronary arteries is almost always due to the existence of myocardial bridging. We present a patient with a post-infarction left ventricular aneurysm in whom coronary angiography showed a milking-like effect with systolic compression of the distal left anterior descending coronary artery.- - - - - - - - - - ranking = 0.33333333333333keywords = compression (Clic here for more details about this article) |
9/24. Coronary arterial compression treated by stenting after replacement of the mitral valve in a child.We describe the clinical history of a nine years old girl with Shone's syndrome. She underwent balloon angioplasty of the aortic coarctation in infancy, and later developed severe sub-aortic stenosis and moderate mitral valvar stenosis. The mitral valve was therefore replaced with a mechanical prosthesis, and the sub-aortic shelf was resected. Immediately after the operation, she developed signs of myocardial ischemia. coronary angiography showed compression of the middle part of the circumflex artery by the mechanical prosthesis, the obstructed segment being successfully dilated using a coronary arterial stent.- - - - - - - - - - ranking = 0.83333333333333keywords = compression (Clic here for more details about this article) |
10/24. Acute myocardial infarction due to left main compression aortic dissection treated by direct stenting.We describe a case of acute myocardial infarction (AMI) due to compression of the left main coronary artery (LMCA) by a false channel created by an acute aortic dissection (AAD). The dynamic pattern of artery obstruction is detailed as a key element to the diagnosis of extrinsic coronary compression throughout the angiography. Treatment by direct stenting restored complete anterograde coronary flow and improved myocardial perfusion.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
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