Cases reported "Coronary Vessel Anomalies"

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1/174. Right ventricular myocardial bridge in a patient with pulmonary hypertension--a case report.

    Myocardial bridge is a not uncommon finding in routine diagnostic coronary angiography or pathological examination of the heart. It is almost always confined to the left ventricle and the left anterior descending coronary artery. This report describes a patient with chronic lung disease, severe left ventricular dysfunction, and pulmonary hypertension in whom coronary angiography revealed bridging of the right ventricular branch of the right coronary artery.
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2/174. Dual anterior interventricular arteries.

    A patient with dual left anterior descending (R. interventricularis anterior of the left coronary artery) coronary artery is presented. A normally arising left anterior descending was hypoplastic, and an anomalous left anterior descending, which arose from the right sinus aorticus had a normal caliber. The anomalous left anterior descending artery traversed between the aorta and the pulmonary artery supplying most of the anterior myocardial wall of the left ventricle. This rare coronary anomaly can potentially have implications on percutaneous coronary interventions or on surgical revascularization procedures.
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3/174. 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.
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4/174. Transcatheter closure of a large coronary artery fistula with the Amplatzer duct occluder.

    We report the successful percutaneous closure of a large coronary artery fistula from the obtuse marginal artery to the right ventricle in an 8-month-old boy using the Amplatzer duct occluder. The device was positioned and deployed via the venous system, using a guidewire that had been advanced via the aorta, coronary artery, and fistula to the venous circulation. Cathet. Cardiovasc. Intervent. 48:188-190, 1999.
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5/174. 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.
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6/174. 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.
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7/174. 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.
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8/174. 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.
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9/174. Multiple coronary arteriovenous fistulae.

    A case with multiple congenital coronary arteriovenous fistulae is reported. The right coronary artery was communicating with the right ventricle. The left coronary artery was entering directly into the pulmonary trunk and two terminal branches of the anterior descending into the left ventricle. The direct communication of the left coronary artery without interposition of an accessory artery or a circoid plexus is met for the first time.
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10/174. 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.
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