Cases reported "Rare Diseases"

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1/22. Coil embolization therapy in congenital coronary arterial fistulas.

    Three pediatric patients (8.5 years, 3 years, and 1 month) presented with congenital coronary arterial fistulas. In all cases the fistulas entered into the right side of the heart (main pulmonary artery, n = 1; right ventricle, n = 2). In the first patient, the fistula and an open ductus arteriosus were closed during the same intervention. The second patient presented with a single left coronary ostium and residual shunt from the coronary artery system to the right ventricle after surgery. The third child had pulmonary atresia with intact ventricular septum and a fistula from the left coronary artery to the right ventricle. The fistulas in all patients were managed with coil occlusion. fistula occlusion was documented with angiocardiography.
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ranking = 1
keywords = coronary
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2/22. Extraction of the radial artery during transradial coronary angiography: an unusual complication.

    The transradial approach is currently an accepted alternative for vascular access during percutaneous coronary interventions. Access-site complications, such as mild hematoma, hematic effusions, and reduced or absent radial pulse, have been reported. We report the occurrence of total extraction of the radial artery during sheath removal. The occurrence of this complication emphasizes the need for meticulous attention and prudence when a patient complains of local pain during sheath extraction.
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ranking = 0.625
keywords = coronary
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3/22. Simplified technique for correction of anomalous origin of left coronary artery from the anterior aortic sinus.

    Anomalous origin of the left main coronary artery from the right anterior coronary sinus has been associated with high incidence of sudden death in young adults. We describe a simplified approach to this rare congenital anomaly, which avoids the need for commissural post resuspension or relocation of the coronary button.
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ranking = 0.875
keywords = coronary
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4/22. Calcified patent ductus arteriosus diagnosed following aortic valve replacement.

    A 71-year-old woman underwent aortic valve replacement for severe, symptomatic aortic stenosis. The left ventricle filled rapidly when the left ventricular vent was switched off and postoperatively she was slow to recover with bilateral pleural effusions. These findings prompted early reinvestigation, initially with echocardiography and subsequently with multi-detector row computed tomography. Using a retrospectively electrocardiographic-gated acquisition, adapted from a noninvasive coronary angiography protocol, a calcified, persistently patent ductus arteriosus was identified as the cause for her perioperative and postoperative condition. The defect has since been closed successfully using a transcatheter technique.
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ranking = 0.125
keywords = coronary
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5/22. Uncommon presentation and surgical correction of unroofed coronary sinus syndrome.

    A 59-year-old man with signs and symptoms of congestive heart failure, occurring a few months after an infective episode, underwent cardiac investigations revealing severe biventricular dysfunction, persistent left superior vena cava with almost completely unroofed coronary sinus, and critical stenosis of the proximal right coronary artery. Surgical correction of the congenital malformation associated with revascularization of the right coronary allowed a prompt recovery of clinical conditions and ventricular function.
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ranking = 0.875
keywords = coronary
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6/22. amlodipine associated hyperpigmentation.

    amlodipine is a potent peripheral and coronary vasodilator with high selectivity for vascular smooth muscle, and is widely used in mild to moderate hypertension, chronic stable angina and vasospastic angina. Its most prevalent side effects are peripheral edema, flushing and headache. Cutaneous adverse reactions associated with amlodipine have been rarely reported. Herein, a male patient is described to develop oral mucosal and cutaneous hyperpigmentation one year after starting amlodipine, which became more noticeable with time. Although cutaneous hyperpigmentation was most prominent on the photoexposed areas, there was no history of previous photosensitivity, pruritus or flushing. To our knowledge, no case of oral and cutaneous hyperpigmentation associated with amlodipine has been formally reported up to date.
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ranking = 0.125
keywords = coronary
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7/22. Surgically revascularized dual LAD.

    Dual left anterior descending artery (or dual anterior interventricular artery, LAD) is a rare coronary artery anomaly. Dual but normally originated LAD has been usually reported to have no clinical significance. In this case report, we present a case of 75 year old male with anginal symptoms in whom coronary arteriography showed normally originated dual LAD with two branches of almost equal caliber. The course of both branches were supplying the usual territory of LAD and both of the branches had significant proximal stenosis. The patient underwent a coronary artery bypass grafting operation and both branches were grafted. This normally originated dual LAD case may be considered to be interesting, because dual LAD branches were symmetrically involved with the atherosclerotic process in their proximal segments. In addition, this condition was demonstrated intraoperatively and the two branches were revascularized with bypass grafting.
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ranking = 0.375
keywords = coronary
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8/22. A very rare anatomic variation of the right ventricular branch: right ventricular descending branch from the anterior interventricular branch.

    The anterior interventricular branch of the left coronary artery has the most constant distribution in the human heart and rarely gives off right ventricular branches. Here we report a case with a right ventricular branch which diverged from the anterior interventricular branch and descended on the anterior right ventricular wall parallel to the anterior interventricular sulcus; we termed it the "right ventricular descending branch." This artery gave a collateral artery to the occluded anterior interventricular branch at the apex, and had prevented anterior myocardial infarction. The right ventricular descending branch should be precisely identified in order to perform successful myocardial revascularization procedures such as coronary artery bypass grafting and percutaneous coronary intervention, especially in a patient with anterior interventricular branch occlusion.
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ranking = 0.375
keywords = coronary
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9/22. Subperiosteal orbital hemorrhage complicating cardiac surgery.

    Subperiosteal orbital hemorrhage (SPOH) following cardiac surgery has not been previously reported. We present a patient who developed diplopia and right eye proptosis immediately after cardiac surgery for a mitral valve repair and coronary artery bypass graft. A computed tomography (CT) study demonstrated a right superior SPOH. The diplopia and proptosis resolved spontaneously within 4 weeks. Follow-up CT showed complete resolution of the SPOH.
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ranking = 0.125
keywords = coronary
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10/22. Spontaneous coronary dissection during postpartum: etiology and controversies in management.

    A 31-year-old female with a history of toxic oil syndrome in childhood, presented with spontaneous left main coronary dissection 4 weeks after an uncomplicated delivery. She had an extensive myocardial infarction, severe left ventricular dysfunction and cardiogenic shock which did not resolve following urgent surgical revascularization. Temporary left ventricular support and heart transplantation were necessary. We analyze the etiology and treatment sequence in what to our knowledge is the first case with these characteristics to be reported.
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ranking = 0.625
keywords = coronary
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