1/61. Traumatic rupture of the aortic valve and ascending aorta diagnosed by transesophageal echocardiography.The most common site for rupture of the aorta as a consequence of blunt chest trauma is at the level of the isthmus. rupture of the aortic valve with concomitant rupture of the ascending aorta is an uncommon entity and only relatively few patients sustaining such an injury survive to surgery. early diagnosis of such injuries are critical to facilitate timely intervention. We report a case of a 17-year old male who sustained a rupture left coronary cusp and ascending aorta in a road traffic accident. The diagnosis was preoperatively made by transesophageal echocardiography and he underwent successful surgical repair with primary apposition of the torn cusp and closure of the aorta with a pericardial patch. Preoperative diagnosis of this rare combination of injury has hitherto not been made by transesophageal echocardiography.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
2/61. Oozing type cardiac rupture repaired with percutaneous injection of fibrin-glue into the pericardial space: case report.Two patients, a 56-year-old man and an 81-year-old woman who were admitted to hospital because of anteroseptal acute myocardial infarction, were initially treated successfully with direct percutaneous transluminal coronary angioplasty. However, both patients later developed sudden cardiogenic shock due to cardiac tamponade caused by left ventricular free wall rupture (LVFWR). Prompt, life-saving pericardiocentesis was performed, then fibrin-glue was percutaneously injected into the pericardial space. After the procedure, there was no detectable pericardial effusion on echocardiography and the hemodynamic state became stable. The surgical treatment was the standard procedure for LVFWR, but percutaneous fibrin-glue therapy can also be considered for oozing type LVFWR.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
3/61. Coronary arteriovenous fistula with papillary muscle rupture.We describe a patient who had a coronary arteriovenous fistula (CAVF) and whose mitral valve papillary muscle ruptured from chronic ischemia due to a coronary steal phenomenon. He was treated surgically with ligation of the CAVF (left circumflex to coronary sinus), coronary artery bypass grafting, and mitral valve replacement. This is the first report of papillary muscle rupture related to CAVF.- - - - - - - - - - ranking = 4keywords = coronary (Clic here for more details about this article) |
4/61. Late stent thrombosis after successful rescue of a major coronary artery rupture with a polytetrafluoroethylene-covered stent.We describe a case in which we successfully treated a major left anterior descending artery rupture with a polytetrafluoroethylene-coated stent. The patient presented with acute antero-apical myocardial infarction 52 days after the initial procedure and cardiac catheterization revealed late stent thrombosis, which was successfully treated by primary angioplasty.- - - - - - - - - - ranking = 4keywords = coronary (Clic here for more details about this article) |
5/61. Ruptured cardiac hydatid cyst masquerading as acute coronary syndrome: report of a case.The case of a 40-year-old man hospitalized for investigation of a doubtful diagnosis of acute coronary syndrome is reported herein. Two-dimensional echocardiography and angiography showed a cardiac cyst localized in the left ventricular apex in close proximity to the left anterior descending coronary artery. Surgery performed with the aid of cardiopulmonary bypass revealed that the cyst had ruptured partially into the left ventricle and filled with thrombus. This case is of particular interest because of the rarity of cardiac localization of a hydatid cyst, and the conflict between the severity of the complications that occurred and the absence of correlated symptoms.- - - - - - - - - - ranking = 6keywords = coronary (Clic here for more details about this article) |
6/61. Left anterior descending coronary artery to right ventricular fistula complicating coronary stenting.Coronary artery perforation is a rare complication of percutaneous transluminal coronary angioplasty (PTCA) and coronary stenting, most commonly creating a communication between the coronary artery lumen and the pericardial space. We report a case where vessel rupture following stent deployment led to the development of a fistula between the left anterior descending coronary artery and the right ventricle.- - - - - - - - - - ranking = 12keywords = coronary (Clic here for more details about this article) |
7/61. coronary sinus rupture with retrograde cardioplegia.coronary sinus (CS) rupture occurring during retrograde cardioplegia (RCP) is a rare complication. patients with left ventricular hypertrophy are at higher risk for injury to the CS. The patient was a 66-year-old female with hypertension, ischemic cardiomyopathy and dysrhythmias, who had evidence of an anterior wall myocardial infarction, congestive heart failure and angina. During coronary artery bypass surgery, antegrade cardioplegia was initially administered, but aortic insufficiency prevented adequate myocardial cooling. RCP was then administered and the heart cooled appropriately. After approximately 300 ml of blood cardioplegic solution had been given, the CS pressure suddenly dropped from 30 mmHg to zero. RCP administration was stopped, and the surgeon palpated a hematoma over the area of the CS, which later ruptured upon rotation of the heart. A primary repair could not be performed, so a pericardial patch was placed over the area of disruption, which appeared to provide adequate hemostasis. The patient was weaned from cardiopulmonary bypass (CPB), but began to bleed freely from the CS distal to the pericardial patch. The patient was placed back on CPB to allow further repair of the CS, but the tissues were thin and friable and the ventricle disassociated from the ventricular septum. The situation was deemed not salvageable and further attempts at repair were stopped. The perfusionist should monitor infusion pressures and the CS waveform during RCP delivery. Changes in the waveform may indicate cannula malposition, loss of balloon seal, or, more rarely, CS rupture; such changes should prompt immediate cessation of RCP delivery.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
8/61. Anterolateral papillary muscle rupture: diagnosis and successful treatment (a case report).We report the case of a young man presenting with chest pain, dyspnea, and syncope in whom transthoracic and transesophageal echocardiography helped to diagnose anterolateral papillary muscle rupture. After cardiac catheterization (which confirmed the severe mitral regurgitation and showed two vessel coronary disease), mitral valve replacement was performed together with coronary bypass grafting.- - - - - - - - - - ranking = 2keywords = coronary (Clic here for more details about this article) |
9/61. Perforation of the descending aorta by the tip of an intra-aortic balloon pump catheter.Perforation of the proximal descending aorta occurred in a patient on intra-aortic balloon pump (IABP) support after emergency coronary intervention for acute myocardial infarction. The IABP catheter was inserted under fluoroscopic guidance into the right femoral artery without difficulty, but after 8 h on IABP support the patient went into shock with a left hemothorax. Emergency surgery was performed with cardiopulmonary bypass and a perforation of the proximal descending aorta with active bleeding was found and successfully repaired. A distorted descending aorta in which the IABP catheter was kinked, as in the aortic arch, was discovered during surgery and confirmed postoperatively with 3-dimensional computed tomography scans, particularly in the lateral view. Not only the antero-posterior but also the lateral fluoroscopic view is recommended to prevent aortic perforation by a kinked IABP catheter.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
10/61. Obstructive intramural coronary amyloidosis and papillary muscle rupture.Mitral papillary muscle rupture is usually caused by ischaemia as a complication of myocardial infarction. In a 76 year old patient with no significant disease or major cardiovascular risk factors, papillary muscle rupture was caused by obstructive intramural coronary amyloidosis, an unusual cause.- - - - - - - - - - ranking = 5keywords = coronary (Clic here for more details about this article) |
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