1/88. Right ventricular thrombosis early after bidirectional Glenn shunt.thrombosis in the right ventricle occurred early after bidirectional superior cavopulmonary shunt in 2 patients with pulmonary atresia with intact ventricular septum and major right ventricular coronary artery communication, and perioperative brain infarction occurred in 1 patient. Clinicians should be aware of the hazards of this potentially lethal complication, and transfusion of platelets and fresh plasma should be minimized. Although the hemodynamic state is good, echocardiography should be performed frequently and strict anticoagulation should be started as early as possible.- - - - - - - - - - ranking = 1keywords = atresia (Clic here for more details about this article) |
2/88. Effect of CABG on coronary flow reserve in atresia of the left coronary ostium.We evaluated the change of coronary flow reserve using a Doppler guidewire before and after coronary artery bypass grafting to assess the coronary hemodynamic effect of surgical revascularization in a 13-year-old boy with congenital atresia of the left coronary ostium, which is one of the rarest of the congenital coronary anomalies. Coronary flow reserve in the right coronary artery and left anterior descending artery increased significantly after coronary revascularization, and a microvascular bed developed in the left anterior descending artery.- - - - - - - - - - ranking = 5keywords = atresia (Clic here for more details about this article) |
3/88. A most peculiar coronary circulation in a patient with pulmonary atresia and intact ventricular septum.A patient with pulmonary atresia and intact ventricular septum was found to have a right ventricular-dependent coronary circulation. In this infant both coronary arteries lacked their normal proximal connection with the aorta, perhaps the most egregious form of this prejudicial coronary circulation. Even more interesting was a direct collateral vessel originating from the descending thoracic aorta and connecting with the coronary circulation. This patient has undergone bilateral modified Blalock-Taussig shunts, and left ventricular function seems preserved.- - - - - - - - - - ranking = 5keywords = atresia (Clic here for more details about this article) |
4/88. A case of a persistent left vena cava superior with atresia of the right atrial ostium of the coronary sinus.A persistent left vena cava superior with an atretic ostium of the coronary sinus was found during the routine dissecting course in the embalmed cadaver of an 83-year-old woman who had died from cardiac infarction. The left vena cava superior was very narrow in diameter (4 mm), originated at the lateral part of the left vena brachiocephalica and ran down between the venae pulmonales sinistrae and the auricula sinistra. The vena cava opened into the sinus coronarius of the heart, which terminated as a blind sac due to an atretic ostium. The vena coronaria sinistra as well as the vena interventricularis posterior drained into the sinus coronarius. Congenital atresia of the coronary opening is a rare malformation and is usually associated with other anomalies. The congenital ostial atresia could be the cause of a persistent left vena cava superior, which then takes over the drainage of the cardiac veins.- - - - - - - - - - ranking = 6keywords = atresia (Clic here for more details about this article) |
5/88. pulmonary atresia with intact ventricular septum, antegrade coronary-right ventricular sinusoidal communication, and wolff-parkinson-white syndrome.A fenestrated Fontan operation was performed successfully in a patient with pulmonary atresia with intact ventricular septum, an antegrade sinusoidal communication, and wolff-parkinson-white syndrome. Unlike most cases, blood flow in the sinusoidal communication was antegrade, from the left anterior descending artery to the right ventricle. This is the first report of the combination of pulmonary atresia with intact ventricular septum and wolff-parkinson-white syndrome.- - - - - - - - - - ranking = 6keywords = atresia (Clic here for more details about this article) |
6/88. Congenital atresia of the ostium of the left coronary artery. Diagnostic difficulty and successful surgical revascularization in two patients.We report two cases of congenital atresia of the ostium of the left coronary artery. Case 1: a six-month-old infant presenting with serious cardiac insufficiency. A noninvasive diagnosis of dilated myocardiopathy was established and the clinical picture was pharmacologically compensated. When the patient was nine months of age, a hemodynamic study was performed that revealed congenital atresia of the ostium of the left coronary artery; the infant immediately underwent a successful anastomosis of the internal mammary artery with the left coronary artery. Case 2: an eleven-year-old asymptomatic boy with a history of heart murmur from the age of six months on, was referred for surgery with a diagnosis of anomalous origin of the left coronary artery from pulmonary trunk. A definitive diagnosis of atresia of the left coronary ostium was only established during surgery. Successful surgical revascularization with the left internal mammary artery, and left ventricular aneurysmectomy were performed.- - - - - - - - - - ranking = 7keywords = atresia (Clic here for more details about this article) |
7/88. Mechanisms of myocardial ischemia in a patient with left main coronary artery atresia.This report describes the different clinical and instrumental manifestations of coronary ischemia in a patient with left main coronary artery atresia. exercise test and thallium-201 perfusion scintigraphy during isometric exercise test were negative for angina and electrocardiographic changes. Conversely, dipyridamole infusion caused severe angina, marked ST-segment changes and diffuse thallium-201 uptake abnormalities. This peculiar anatomical condition offers the opportunity of high-lighting the role played by the microcirculation in determining myocardial ischemia.- - - - - - - - - - ranking = 5keywords = atresia (Clic here for more details about this article) |
8/88. myocardial infarction due to coronary abnormalities in pulmonary atresia with intact ventricular septum.We describe the clinical course, angiography, and histopathology of a newborn male with pulmonary atresia and intact ventricular septum who succumbed to a myocardial infarction. angiography demonstrated right ventricular-dependent coronary circulation and focal areas of coronary narrowing. His clinical course was characterized by attacks of sudden irritability, consistent with ischemia. histology demonstrated significant coronary artery narrowing secondary to fibromuscular dysplasia as well as evidence of new and old infarction. This case illustrates the severity of coronary lesions in pulmonary atresia and the potential for progression of coronary obstruction and insufficiency, and it provides correlation between angiography, ischemic symptoms, and pathology.- - - - - - - - - - ranking = 6keywords = atresia (Clic here for more details about this article) |
9/88. pulmonary atresia, ventricular septal defect, and coronary-pulmonary artery fistula.We report 2 patients with pulmonary atresia, ventricular septal defect, and coronary-pulmonary fistula. The fistula originated from the left anterior descending artery in 1 patient, and from the right coronary artery in the other. Both patients survived staged correction in which right ventricular outflow was reconstructed with autologous fistula tissue. One patient with pulmonary hypertension suddenly died 9 months after surgery. Twenty-four patients with pulmonary atresia, ventricular septal defect, and coronary-pulmonary fistula have been reported previously.- - - - - - - - - - ranking = 6keywords = atresia (Clic here for more details about this article) |
10/88. Accessory pathway associated with an anomalous coronary vein in a patient with wolff-parkinson-white syndrome.We report a case of wolff-parkinson-white syndrome coexistent with atresia of the coronary sinus (CS) ostium and persistence of the left superior vena cava. The accessory pathway was located at the blind end of the CS, which was bumped with mechanical loss of preexcitation during mapping by a catheter from within the CS. The accessory pathway was successfully ablated with radiofrequency energy applied to this site from the right atrium. This unique combination of anatomically matched anomalies may be important in suggesting a potential embryologic link between the accessory pathway and the coronary vein.- - - - - - - - - - ranking = 1keywords = atresia (Clic here for more details about this article) |
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