1/165. Anomalous origin of the left main coronary artery: anatomical correction and concomitant LIMA-to-LAD grafting.A 55-year-old woman with angina pectoris and exertional dyspnea underwent surgical correction of an anomalous left main coronary artery (LMCA) originating from the right sinus of valsalva. During the operation, the roof of the intramurally coursing LMCA was opened into the aortic lumen, and a neo-coronary ostium was created by suturing the circumference of the LMCA intima to the aortic intima. In addition, a left internal mammary artery (LIMA) to left anterior descending (LAD) coronary artery anastomosis was performed. Post-operative coronary angiography demonstrated two independent, patent orifices of both the LMCA and the right coronary artery. The technique presented herein, of combined anatomical correction and LIMA-to-LAD grafting, is feasible and leads to distinct angiographic and clinical improvement.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
2/165. Anomalous origin of a coronary artery in a transplanted heart.Upon routine coronary angiography one year after surgery in a 62-year-old male recipient of a heart transplant, an abnormal origin of the left anterior descending coronary artery from the pulmonary artery was found in the donor heart. This very rare congenital anomaly had not been detected during harvesting and transplantation of the heart, and to our knowledge it has never been described before in a heart transplant patient. The donor was a 43-year-old male who died of a spontaneous intracranial bleeding. The recipient continues to enjoy a normal functional capacity and is free of anginal complaints, though there is evidence of ischaemia in the left anterior descending artery territory on exercise thallium-201 myocardial perfusion imaging.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
3/165. Multiple spontaneously occurring coronary artery-left ventricular communications: a case report.A search of the literature revealed that spontaneous coronary artery-left ventricular communications have only rarely been reported. These fistulae are frequently associated with angina pectoris which has been attributed to a ventricular steal phenomenon. The patient described herein presented with angina pectoris and was found to have multiple coronary arterioventricular communications without significant coronary atherosclerosis.- - - - - - - - - - ranking = 2keywords = angina (Clic here for more details about this article) |
4/165. Anomalous origin of the right coronary artery from the left anterior descending coronary artery: a case report.We report on a 59-year-old man with effort angina of recent onset and a very uncommon right coronary artery originating from the middle portion of the left anterior descending; a tight stenosis of the left anterior descending coronary artery was also detected which involved the origin of the aberrant vessel.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
5/165. Unusual congenital coronary anomaly and myocardial ischaemia.Angiography was used to diagnose a rare congenital coronary anomaly with myocardial ischaemia in a woman with typical angina. All three coronary arteries arose from a solitary coronary ostium in the right aortic sinus; the left anterior descending coronary artery followed a septal course, the circumflex coronary artery ran behind the ascending aorta, and the right coronary artery followed a normal course. No significant coronary lumen narrowing was found. Transoesophageal echocardiography confirmed the anomalous origin and course of the aberrant coronary arteries. An exercise test reproduced angina, and ECG changes and myocardial perfusion study showed an anterior reversible defect. In contrast to previous reports, myocardial ischaemia was associated with the septal (intramuscular) course of the left anterior descending coronary artery; there was no other significant coronary artery disease.- - - - - - - - - - ranking = 2keywords = angina (Clic here for more details about this article) |
6/165. An adult case of bland white garland syndrome with huge right coronary aneurysm.We report the case of a 62-year-old male patient with left main coronary artery originating from the pulmonary trunk, severe mitral insufficiency, and huge right coronary artery aneurysm. He is the oldest such patient among those reported in the literature, surviving to the sixth decade without any anginal symptoms. He is also the first such case with such a huge and calcified right coronary artery aneurysm and a prominent collateral from the noncoronary circulation.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
7/165. Cardiac arrest during exercise: anomalous left coronary artery from the pulmonary trunk.Anomalous origin of the left coronary artery from the pulmonary trunk is associated with high mortality in infancy but in rare cases the condition is diagnosed in adults. The present report describes three adult cases of this anomaly. Two of the patients (age 18 and 34 years) were resuscitated from cardiac arrest, which had occurred in relation to physical exercise. The third patient (20 years) had presented with angina pectoris and signs of ischaemia on exercise ECG. In all patients, coronary arteriography revealed a large right coronary artery with collateral filling of the left coronary artery, which originated from the pulmonary trunk. A successful surgical correction of the anomalous coronary artery was performed in two of the patients.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
8/165. Anomalous coronary arterial pattern.The clinical history of an adult patient with anginal-like pain is described. A coronary angiography revealed the existence of a hypoplastic left coronary artery, a right coronary artery which passed around the posterior surface of the heart and continued into the anterior surface of the heart to give off an anterior descending artery and the presence of a "conus" artery. The embryonic genesis of hypoplastic coronary artery and of a similar aberration, single coronary artery, are discussed.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
9/165. Diffuse multiple coronary arteries to left ventricular fistulas.Coronary artery to left ventricular fistula is an unusual anatomic anomaly consisting of a communication between one of the coronary arteries and the left ventricle. Only sporadic cases have been published in the literature. Diffuse multiple fistulas involving both left and right coronary arteries are even rarer. This report describes a 60-year-old woman with diffuse multiple fistulas communicating between both coronary arteries and the left ventricle. The patient manifested clinically with exertional angina and myocardial ischemia, as evidenced by a positive stress exercise test, which represents the coronary "steal" phenomenon.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
10/165. sick sinus syndrome in a patient with single coronary artery anomaly.Single coronary artery anomaly is very rare. The reported manifestations include angina pectoris and congestive heart failure. Here we describe a case of single coronary artery anomaly presenting as sick sinus syndrome, which has no literature precedence. A 47-year-old woman had complained of intermittent dizziness for years. A Holter electrocardiogram showed sinus bradycardia and junctional or ventricular rhythm with a maximal ventricular pause of up to 3.2 seconds. Electrophysiologic study revealed prolonged corrected sinus nodal recovery time. coronary angiography showed that the left anterior descending artery had a long course with a side branch originating from the proximal part and coursing anteriorly to the territory of the proximal portion of the right coronary artery. The sinus node is usually supplied by the sinoatrial branch via the right coronary artery. aortography showed that the right coronary artery ostium was absent. A permanent pacemaker was implanted and the patient was discharged in good condition. The present case suggests that coronary artery anomaly may lead to compromised blood supply to the sinus node, and hence sick sinus syndrome.- - - - - - - - - - ranking = 1keywords = angina (Clic here for more details about this article) |
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