1/260. 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 = 1keywords = coronary (Clic here for more details about this article) |
2/260. Septal branch right ventricular fistula: a complication in coronary artery snaring.We report a septal branch right ventricular fistula complicated after coronary snaring in coronary artery bypass surgery without aortic cross-clamping. The tip of the needle of the snaring suture is made blunt in order to decrease the risk of mechanical injury, but trauma to the septal branch is possible. This rare complication of snaring should be taken into consideration in performing aortic nonclamping coronary artery bypass surgery.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
3/260. Left coronary artery-left ventricular fistula with acute myocardial infarction, representing the coronary steal phenomenon: a case report.A 59-year-old man presented with a left anterior descending coronary artery to left ventricular fistula manifesting as myocardial infarction, representing the coronary steal phenomenon. electrocardiography showed poor R progression in leads V1 through V3. The biochemical markers of myocardial injury were elevated. creatine kinase level was 509 IU/l, creatine kinase MB isoenzyme (CK-MB)47 IU/l, cardiac troponin t 0.62 ng/ml, myosin light chain 6.1 ng/ml, and myoglobin 142 ng/ml. thallium-201 myocardial perfusion imaging with dobutamine stress showed a dobutamine-induced perfusion deficit of the anteroseptal wall of the left ventricle with 0.1 mV ST-segment depression in II, III, aVF, V5, and V6. The mean left anterior descending blood flow measured with the Doppler guidewire was increased from 211 to 378 ml/min. Selective coronary arteriography showed dominant left coronary artery with the contrast medium streaming into the left ventricle via a maze of fine vessels from the distal left anterior descending coronary artery. No critical stenosis of the left anterior descending coronary artery was observed. Administration of acetylcholine 100 micrograms into the left coronary artery did not induce vasoconstriction of that artery. The fistula terminating in the left ventricle was ligated surgically and the patient became free of chest pain. thallium-201 myocardial perfusion imaging with dobutamine stress revealed no perfusion deficit of the anteroseptal wall of the left ventricle. The presence of coronary steal phenomenon was detected by dobutamine stress myocardial imaging.- - - - - - - - - - ranking = 2.2857142857143keywords = coronary (Clic here for more details about this article) |
4/260. Antegrade transcatheter closure of coronary artery fistulae using vascular occlusion devices.Two children (a 9 year old boy and a 2.5 year old girl) with coronary artery fistulae communicating with the right ventricle underwent successful transcatheter occlusion using an antegrade technique. A Rashkind double umbrella device was used in one case and an Amplatzer duct occluder in the other.- - - - - - - - - - ranking = 0.71428571428571keywords = coronary (Clic here for more details about this article) |
5/260. Single coronary arteries: two cases with distinct and previously undescribed angiographic patterns.Single coronary artery is a rare congenital anomaly, sometimes associated with myocardial ischemia. We present the clinical and angiographic features of two symptomatic patients with documented myocardial ischemia and with distinct and previously undescribed patterns of single right coronary arteries. These cases are new variants of the types R-I and R-II-A, in which the most probable mechanisms of ischemia are the insufficient blood supply, due to the long trajectories of the single arteries and the presence of underdeveloped vessels. Also, our second case presented with a fistulae from the LCX to the left ventricle, which is another determinant of myocardial ischemia.- - - - - - - - - - ranking = 0.85714285714286keywords = coronary (Clic here for more details about this article) |
6/260. Surgical treatment of the congenital fistulae of coronary arteries.Six cases of coronary artery fistulae surgically treated are presented. All patient but one was male; the ages varied from 4 to 44 years. The fistulae originated from the left coronary artery in three cases from the right in two cases and from both arteries in one case. The draining heart chambers were the right atrium in three, the right ventricle in two and the pulmonary artery in one case. Associated lesions were present in three cases. One patient died on the early postoperative period and the evolution was satisfactory in five cases.- - - - - - - - - - ranking = 0.85714285714286keywords = coronary (Clic here for more details about this article) |
7/260. Aortic septal defect and coronary-systemic micro-fistulae.This report concerns a 32-year-old man, who at the age of 11, had an aortic septal defect with severe pulmonary hypertension. The defect was partially closed and the patient was left with a continuous murmur, an a-v shunt and marked diminution of pulmonary hypertension. Five years later he was asymptomatic, auscultation was normal and no shunt was found at cardiac catheterization. At 32 years of age, although asymptomatic he had abnormal "T" waves, and a selective coronary angiography demonstrated micro-fistulae involving the anterior descending coronary artery. It is suggested that these fistulae may be responsible for the abnormality of ventricular repolarization.- - - - - - - - - - ranking = 0.85714285714286keywords = coronary (Clic here for more details about this article) |
8/260. Early presentation of a congenital coronary artery fistula in a neonate.A neonate developed severe congestive heart failure secondary to a congenital coronary artery fistula requiring emergent surgery. Intraoperative transesophageal echocardiography helped guide successful emergent closure of the fistula without complications.- - - - - - - - - - ranking = 0.71428571428571keywords = coronary (Clic here for more details about this article) |
9/260. Aorto-right artrial fistula: a rare complication of aortic dissection.We describe the successful surgical repair of an acute aortic dissection that had caused an aorto-right atrial fistula in a 67-year-old man. The patient was admitted to the hospital on an emergency basis because of severe heart failure. The diagnosis of acute aortic dissection with rupture into the right atrium was confirmed by use of intraoperative transesophageal echocardiography, although rupture of a sinus of valsalva aneurysm into the right atrium had been suggested initially by 2-dimensional and Doppler transthoracic echocardiography. At surgery, we found the patient to have aortic arch dissection with complete separation of the right coronary artery from the sinus of valsalva and a false lumen that had ruptured into the right atrium. The aortic arch was repaired directly. The ascending aorta was successfully replaced with a composite graft. Aortic dissection with rupture into the right atrium is extremely rare and leads to death rapidly. As shown in this case, such a condition might be mistaken for an aneurysmal rupture of the sinus of valsalva, with use of transthoracic echocardiography alone. Transesophageal echocardiography is a useful noninvasive method to further define or confirm the diagnosis. Early surgical intervention is necessary in patients with this condition to prevent profound shock and end-organ failure.- - - - - - - - - - ranking = 0.14285714285714keywords = coronary (Clic here for more details about this article) |
10/260. Left circumflex coronary artery-to-left atrium fistulas detected by transesophageal echocardiography in heart transplant recipients.Coronary fistulas are uncommon after heart transplantation. We report two cases of fistulas from an atrial branch of the circumflex coronary artery to the left atrium after heart transplantation. This has not been previously reported in the literature. They were detected with transesophageal echocardiography, and images are shown for the first time. Transesophageal echocardiography may be useful in the follow-up of heart transplant recipients.- - - - - - - - - - ranking = 0.71428571428571keywords = coronary (Clic here for more details about this article) |
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