Acute take-off of the right coronary artery with long intra-aortic wall course presenting as chronic coronary ostium occlusion in a patient with end-stage heart failure

2006 ◽  
Vol 25 (6) ◽  
pp. 740-742 ◽  
Author(s):  
S LITOVSKY ◽  
J HENDERSON ◽  
J TALLAJ ◽  
D MCGIFFIN ◽  
B RAYBURN ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Aortic Wall ◽  
Coronary Ostium ◽  
End Stage Heart Failure ◽  
The Right ◽  
End Stage

scholarly journals Specific morphological characteristics of the coronary arteries

2013 ◽  
Vol 19 (2) ◽  
pp. 112-116
Author(s):  
V. Ispas ◽  
D.M. Iliescu ◽  
R. Baz ◽  
P. Bordei
Keyword(s):  
Coronary Artery ◽  
Left Ventricle ◽  
Right Coronary Artery ◽  
Free Edge ◽  
Coronary Ostium ◽  
Posterior Surface ◽  
Circumflex Artery ◽  
The Third ◽  
Marginal Artery ◽  
The Right

Abstract In 68% of cases, the left coronary ostium is at the free edge of the left sigmoid valve in 22% of cases over the edge of the valve and in 8% of cases under the free edge of the valve. In 56% of cases, the right coronary ostium is at the free edge of the left sigmoid valve in 28% of cases over the edge of the valve and in 16% of cases under the free edge of the valve. We found 5 cases with two right coronary ostium and 2 cases with two left coronary ostium. We found that in 38% of cases, the left coronary artery ends in three branches, such as anterior interventricular, circumflex and left marginal arteries, in rest of the cases, the left coronary artery ending by two branches like the anterior interventricular and circumflex arteries in which case the marginal artery originate from circumflex artery and rarely from anterior interventricular artery, or both, in this last case the left marginal artery being double. We found only 8 cases in which the circumflex artery ends as posterior interventricular artery in rest of the cases being represented by the right coronary artery end. Circumflex artery ends by two branches quite often and rarely with three branches which can sometimes be long, down to near the apex of the heart. In 8% of cases, the circumflex artery was less developed and do not vascularize other than the left side of the posterior surface of the left ventricle, sometimes his terminal ramus being left marginal artery. The right coronary artery frequently ends on diaphragmatic surface of the heart either as a single branch in posterior interventricular groove, by bifurcation or even rarely by trifurcation, when one or two branches are located in the posterior interventricular groove. Sometimes the right coronary artery ends on the posterior surface of the left ventricle, where the posterior interventricular artery occurs as collateral branch of the right coronary artery, the right coronary artery extending their vascularization territory to the posterior surface of the left ventricle, right up to the apex of the heart, the right coronary dominance, the circumflex artery in this case ending on the lateral surface of the heart. The right coronary artery may end up on the posterior surface of the right ventricle in which case posterior interventricular artery is represented by the terminal portion of the circumflex artery. The right coronary artery rarely ended as the posterior interventricular artery can reach the apex of the heart. We have found that the dominant type of a coronary artery can be held not only in the number of collateral, but also by their caliber at their origin from the aorta. We encountered 7 cases in which there is a third coronary artery, in 5 cases the third coronary artery being an anterior right I called her middle coronary artery or right ventricular branch and anterior ventricular artery, and in two cases the third coronary artery represent the circumflex artery. In 6 cases of the 7 cases described the third coronary artery showed no atrial branches

scholarly journals Mortality and long-term outcomes of palliative inotropes in ischemic and non-ischemic cardiomyopathy

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Tolia ◽  
M Khan ◽  
S Khan ◽  
D Alexander ◽  
M Soltys ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Artery ◽  
Ischemic Cardiomyopathy ◽  
Circulatory Support ◽  
Complication Rates ◽  
Number Of Patients ◽  
Significant Difference ◽  
History Of ◽  
End Stage Heart Failure ◽  
End Stage

Abstract Background Palliative inotropes are frequently utilized for symptom management in patients with end stage heart failure who are unable to undergo durable advanced heart failure therapies. With the advent of improved medical management and early intervention, palliative inotropes may allow for improved patient outcomes than seen previously. In this study, we aim to investigate the survival and outcomes of palliative inotrope therapy and its impacts on ischemic versus non-ischemic cardiomyopathy. Methods We retrospectively analyzed 220 patients with American Heart Association Stage D heart failure who were discharged with palliative inotrope therapy after January 1, 2010. Patients who underwent mechanical circulatory support (MCS) or those who underwent heart transplant were excluded. Those with a history of coronary artery disease, myocardial infarction, history of percutaneous intervention, or coronary artery bypass grafting were assigned to ischemic cardiomyopathy (ICM), while patients without these findings were assigned to non-ischemic cardiomyopathy (NICM). Statistical analysis was completed using Chi-Square and Student's t-tests, wherein p<0.05 was considered statistically significant. Results Of the 220 patients, 87 had NICM as opposed to 133 with ICM. Mean age was found to be higher among patients with ICM (70 [62–79]) compared to NICM (65 [55–72], p-value <0.01). No significant difference was seen in total days on inotrope therapy (p=0.6). While more patients in both groups were placed on milrinone as opposed to dobutamine, there was no difference between patients with ischemic and NICM (p=0.66 and 0.51 respectively). Although a greater number of patients with NICM had been lost to follow up, admitted to hospice, or expired at 2 years (p<0.01), survival at 3 months, 1 year, and 2 years showed no difference between both groups. No difference was seen in number of hospitalizations or clinic visits in one year. Both groups had similar complication rates with intravenous-access related PICC line infections and new arrhythmias. (See Table). Conclusion Despite more frequent use of durable mechanical support devices, many patients who are deemed unsuitable for invasive measures are treated with palliative inotrope therapy. We have found that there is no significant difference in survival, complications, and outcomes of patients on palliative inotropes among ischemic and NICM. These findings show the versatility of palliative inotrope therapy in end stage heart failure. Further studies with larger populations need to be evaluated. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Characterization of coronary arteries in Giant Anteater (Myrmecophaga tridactyla: Myrmecophagidae)

2019 ◽  
Vol 71 (2) ◽  
pp. 545-552
Author(s):  
C.A.T. Cruvinel ◽  
T.M.A. Cruvinel ◽  
L.P.N. Aires ◽  
R.F. Rodrigues ◽  
A.P.F. Melo
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Left Coronary Artery ◽  
Coronary Vessels ◽  
Coronary Ostium ◽  
Thoracic Cavity ◽  
Whole Heart ◽  
The Right ◽  
Single Coronary Ostium

ABSTRACT Were used twelve (12) adult anteaters (Myrmecophaga tridactyla), adults, 6 (six) males and 6 (six) females, weighing from 20 to 27.32kg from free life. The thoracic cavity was opened until visualization of the whole heart and lungs and later injection of the coronary vessels. The right coronary artery emerged through a single coronary ostium of the aorta, 50%, emitting the intermediate branch and the subsinuous interventricular branch, had a path directed to the subsurface interventricular groove. In the other 50%, the right coronary artery was not present, showing only its branches, intermediate branch and subsurface interventricular branch with emergence of the aorta. Left coronary artery presented, in 83.33%, origin from the aorta in single ostium, issuing the circumflex and interventricular paraconal branches. In 16.66%, the left coronary artery was not evidenced originating from the aorta, but its branches, circumflex and interventricular paraconal.

Abstract 243: End Stage heart Failure Cardiac Stem Cells has Strong Regenerative Ability compared to Congenital Heart Cardiac Stem cells

2013 ◽  
Vol 113 (suppl_1) ◽  
Author(s):  
Rachana Mishra ◽  
Sudhish Sharma ◽  
David Simpson ◽  
Savitha Desmukh ◽  
Sunjay Kaushal
Keyword(s):  
Heart Failure ◽  
Stem Cells ◽  
Myocardial Infarct ◽  
Small Population ◽  
Cardiac Stem Cells ◽  
Undifferentiated Cells ◽  
End Stage Heart Failure ◽  
Regenerative Ability ◽  
The Right ◽  
End Stage

Cellular based therapy is an important component of cardiac regenerative medicine. We have already identified and characterized a small population of undifferentiated cells present throughout the human heart that have the characteristics of cardiac stem cells. To date, no study has examined the potential application of human cardiac derived stem cells (hCDCs) generated from End Stage Heart Failure (ESFH) pediatric patient’s heart. In this study, we characterized samples from ESFH (recipients of heart transplant) and CDH (donors of the heart transplantation) to quantify the expression of various cardiac progenitor markers by immunofluorescence, flow cytometry and RT-PCR. The numbers of cardiac progenitor cells were highest in the right atria as compared to other chambers of the end-stage heart. FACS and IF analysis demonstrated significantly higher c-kit (9.36±1.384 vs 3.056±0.39, n=5) and ISL1 (33.61±4.0 vs 3.708±0.93) expressions in hCDCs derived from ESFH compare to CDH myocardium. Also, there was a tendency for increased FLK1 and Sca-1 expression in ESFH patients respectively. To determine, the functional potential, hCDCs were transplanted into a rodent myocardial infarct (MI) model. ESFH-derived hCDCs produced a stronger recovery of ventricular function than CDH-derived hCDCs (ESFH, n=5, EF=57+3% vs. CDH, n=5, 41.5±3%, P<0.05). We also observed significantly higher secretion of VEGF (ESFH, n=5: 1.928±0.3623 vs CDH, n=5: 0.93±0.08, P<0.05) and SDF-1α (ESFH, n=5: 3.1±0.6934 vs CDH, n=5: 0.99±0.1471, P<0.05) by the ESFH-derived hCDCs as compared to CDH-derived hCDCs. This correlated with increased angiogenesis in the MI model at 28days. This study demonstrates that ESFH-derived hCDCs are highly functional and secrete angiogenic cytokines, more than CDH-derived hCDCs. To understand the mechanism of this activity will be critical for future clinical study.

scholarly journals End-stage heart failure patients should be treated instantly despite a pandemic with all-time available technology to ensure best outcomes

2020 ◽  
Vol 22 (Supplement_P) ◽  
pp. P33-P37
Author(s):  
Marie-Cécile Bories ◽  
Ramzi Abi Akar
Keyword(s):  
Heart Failure ◽  
Heart Transplantation ◽  
Care Delivery ◽  
Left Ventricular ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
End Stage Heart Failure ◽  
Available Technology ◽  
The Right ◽  
End Stage

Abstract Since the earliest cases of coronavirus disease 2019 (COVID-19) infection were reported, our care delivery systems have been reorganized and challenged in unprecedent ways, specifically the cardiovascular community. COVID-19 poses a challenge for heart transplantation, affecting donor selection, immunosuppression, and posttransplant management. Left Ventricular Assist Device (LVAD) therapy is currently a viable option for patients with end-stage heart failure as a bridge to heart transplantation or destination therapy. Here, we present a therapeutic strategy for the management of acute HF with Intermacs profiles from 1 to 4, with or without Covid-19 infection, exemplified by serie of patients presenting with severe HF and successfully treated by LVAD therapy during the spread of the Covid-19 pandemic and the French national lockdown. This experience has shown that we still have the capacity to provide the right therapy for the right disease to the right patient. LVAD implantation seems to be the treatment of choice for advanced HF due to the lack of healthy donor hearts for cardiac transplantation. Covid or non-Covid context, we have to take care of our patients with end-stage HF the best we can.

Associated Coronary Anomalies in 135 Iranian Patients with Tetralogy of Fallot

2005 ◽  
Vol 13 (4) ◽  
pp. 307-310 ◽  
Author(s):  
Manouchehr Hekmat ◽  
Sima Rafieyian ◽  
Mahnoush Foroughi ◽  
Majidi Mohammad M Tehrani ◽  
Beheshti Mahmoud Monfared ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Tetralogy Of Fallot ◽  
Coronary Arteries ◽  
Right Coronary Artery ◽  
Primary Repair ◽  
Coronary Ostium ◽  
Coronary Anomalies ◽  
The Right ◽  
Single Coronary Ostium ◽  
Iranian Patients

Coronary artery anomalies are common among patients with tetralogy of Fallot. One hundred and thirty-five patients (80 males and 55 females) with tetralogy of Fallot who underwent repair between 1995 and 2002 were studied to determine the incidence of coronary anomalies in Iranian patients. Eight (5.9%) patients (4 males and 4 females) had a surgically relevant coronary artery anomaly: single coronary ostium in 5, origin of the left anterior descending artery from the right coronary artery in 2, and origin of the right coronary artery from the left coronary artery in 1. The surgical technique in 3 of these patients was repair of the ventricular septal defect with a transverse incision on the right ventricle, without damage to the coronary arteries. In another patient, an allograft aortic valve cylinder was inserted. In the other 4 patients with a single coronary ostium, placement of a limited transannular patch was adequate. Consideration of these anomalies during primary repair could decrease the risk of operation in such patients. However, it seems that the presence of anomalous coronary arteries does not affect incremental risk after surgical repair.

Early Congestive Heart Failure due to Origin of the Right Coronary Artery from the Pulmonary Artery

CHEST Journal ◽  
1992 ◽  
Vol 102 (5) ◽  
pp. 1610-1612 ◽  
Author(s):  
Ugo Vairo ◽  
Bruno Marino ◽  
Giuseppe De Simone ◽  
Carlo Marcelletti
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Coronary Artery ◽  
Pulmonary Artery ◽  
Right Coronary Artery ◽  
The Right

Case of WPW and anomalous right coronary in a teenager with cardiac symptoms

2021 ◽  
Vol 14 (3) ◽  
pp. e241112
Author(s):  
Nathan Albrecht ◽  
Keore Mckenzie ◽  
Sunita Ferns
Keyword(s):  
African American ◽  
Chest Pain ◽  
Coronary Artery ◽  
Ct Angiography ◽  
Supraventricular Tachycardia ◽  
Right Coronary Artery ◽  
Coronary Sinus ◽  
Coronary Ostium ◽  
Cardiac Symptoms ◽  
The Right

A 17-year-old African-American man was being followed for palpitations and chest pain. CT angiography revealed an anomalous right coronary artery from the left coronary sinus and he underwent unroofing of the right coronary ostium. There was a manifest pre-excitation on postoperative ECGs, and review of prior ECGs at initial presentation showed subtle pre-excitation suggesting a left lateral pathway. An electrophysiology study revealed easily inducible supraventricular tachycardia (SVT) and rapid anterograde conduction via the pathway which was successfully ablated. Eight months postablation, the patient remains asymptomatic with no evidence of pre-excitation on ECG.

Anomalous right coronary artery from the pulmonary artery (ARCAPA), and aberrant right subclavian artery in a 2-month infant with heart failure

2013 ◽  
Vol 24 (5) ◽  
pp. 935-937 ◽  
Author(s):  
Mohammad Mahdavi ◽  
Koorosh Vahidshahi ◽  
Ramin Baghai Tehrani ◽  
Hamidreza Poor Ali-Akbar ◽  
Mohammad Rad Godarzi
Keyword(s):  
Heart Failure ◽  
Coronary Artery ◽  
Pulmonary Artery ◽  
Subclavian Artery ◽  
Right Coronary Artery ◽  
Male Infant ◽  
Aberrant Right Subclavian Artery ◽  
Infancy And Childhood ◽  
The Right

AbstractAnomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a very rare congenital heart anomaly. Most of the cases are asymptomatic during infancy and childhood. We report ARCAPA associated with aberrant right subclavian artery in a 2-month male infant presenting with heart failure. We used computed tomography angiography for confirming the diagnosis and also for post-operative follow-up.

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