scholarly journals TCTAP C-002 Percutaneous Coronary Intervention of an Acute Coronary Syndrome Patient with Anomalous Origin of Right Coronary Artery Arising from the Left Coronary Sinus

2018 ◽  
Vol 71 (16) ◽  
pp. S69-S70
Author(s):  
Iswanto Pratanu ◽  
Anudya Kartika Ratri
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Sinus ◽  
Acute Coronary Syndrome Patient ◽  
Coronary Intervention ◽  
Syndrome Patient ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

scholarly journals Features of coronary artery patterns and percutaneous coronary intervention in patients with acute coronary syndrome and stable angina in patients aged below 40 years

2020 ◽  
Vol 101 (1) ◽  
pp. 18-24 ◽  
Author(s):  
F Z Abdullaev ◽  
N M Babaev ◽  
L S Shikhieva
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Right Coronary Artery ◽  
Stable Angina ◽  
Coronary Intervention ◽  
Left Circumflex Artery ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

Aim. To study the features of risk profile, coronary artery patterns, and percutaneous coronary intervention in patients aged below 40 years with acute coronary syndrome and stable angina. Methods. 208 patients with coronary artery disease aged below 40 years were examined: 51 (24.5%) patients aged 35 years and younger and 157 (75.5%) aged 3640 years. 98 (47.1%) patients were admitted with acute coronary syndrome; 110 (52.9%) patients with stable angina. In groups of acute coronary syndrome and stable angina, myocardial infarction in past medical history was revealed in 23.5% and 36.4%, respectively. 165 patients underwent percutaneous coronary intervention: 84 (50.9%) with acute coronary syndrome; 81 (40.1%) with stable angina. Results. Patients with stable angina differed by prevalence of myocardial infarction in past medical history, overweight, and family history of coronary artery disease. In group of acute coronary syndrome urban cohort prevailed as well as consumption of energy drinks among patients below 35 years; high prevalence of left ventricular dysfunction. Patients with acute coronary syndrome were characterized by involvement of one and three coronary arteries, and patients with stable angina by pathology of two and three coronary arteries. Involvement of three coronary arteries was equal in both groups. In both groups, anterior interventricular artery was target coronary artery. Patients with stable angina had the same rate of right coronary artery and left circumflex artery involvement. In patients with stable angina, right coronary artery involvement was rarer, and left main coronary artery involvement was two times more frequent than in patients with acute coronary syndrome. The group with acute coronary syndrome was characterized by predominance of discrete lesions and coronary occlusions over diffuse lesions; and the group of stable angina by diffuse lesions, and two-times less frequent coronary occlusions. Conclusion. Among patients with acute coronary syndrome aged below 36 years, revascularization of right coronary artery was predominant, and among patients aged 3640 years with acute coronary syndrome revascularization of left circumflex artery.

scholarly journals Percutaneous coronary intervention to left anterior descending artery/right coronary artery bifurcation: this is not a typo! A case report

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Usman Azhar Khan ◽  
Divyesh Sharma ◽  
Paul McGlinchey ◽  
Aaron Peace
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Intervention ◽  
Anomalous Origin ◽  
Heart Team ◽  
Coronary Syndrome ◽  
Left Anterior Descending Artery ◽  
Percutaneous Coronary

Abstract Background Anomalous origin of the right coronary artery (RCA) is a rare congenital anomaly. A single coronary artery arising from the left sinus of Valsalva, with the RCA originating from the left anterior descending artery (LAD), is extremely rare. We report the case of an anomalous origin of the RCA from the mid LAD with a significant bifurcation lesion, in the setting of an acute coronary syndrome, endangering both the RCA and LAD territories. Case summary An 85-year-old female presented with a non-ST elevation acute coronary syndrome. Transradial coronary angiography revealed an anomalous origin of the RCA arising from the mid LAD beyond a large first septal perforator. There was significant stenosis involving anomalous RCA/LAD bifurcation classified as Medina 1, 1, 1. Following discussion at heart team meeting, she underwent successful percutaneous coronary intervention. The LAD/RCA bifurcation was treated using a two-stent culotte technique without any complications. Computed tomography coronary angiogram was performed which confirmed a benign course of the anomalous RCA anterior to aorta and pulmonary artery. Discussion This anomaly poses a significant challenge in revascularization due to the large area of myocardium subtended by the LAD and RCA and usually an acute angle of bifurcation. Moreover, CTCA can be useful to ascertain the course of anomalous RCA.

IMMEDIATE AND 4-YEAR OUTCOME OF PATIENTS WITH ACUTE CORONARY SYNDROME UNDERGOING PERCUTANEOUS CORONARY INTERVENTION FOR LEFT MAIN CORONARY ARTERY DISEASE

2021 ◽  
pp. 8-11
Author(s):  
Saroj Mandal ◽  
Sidnath Singh ◽  
Kaushik Banerjee ◽  
Aditya Verma ◽  
Vignesh R.
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Ejection Fraction ◽  
Coronary Intervention ◽  
Left Ventricular Ejection ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
The Mean

Background: The treatment of LMCAD has shifted from coronary artery bypass grafting (CABG) to Percutaneous coronary intervention (PCI). However, data on long-term outcomes of PCI for LMCA disease, especially in patients with acute coronary syndrome (ACS) remains limited and conicting. This study aims to nd the association of the immediate and 4-year mortality in ACS patients with LMCA disease treated by PCI based on ejection fractions at admission. Methods: A retrospective analytical study was conducted. Patients were divided at admission into those with reduced left ventricular ejection fraction and those with preserved ejection fraction. Results: Forty (58.8%) of the patients presented with preserved EF. The mean age of the patients was 71.6±7.1 years. The mean LVEF of the preserved group was 61.6±4.3% and signicantly higher than that of the reduced group. Age and cardiovascular risk factor prole was similar between the two groups. Patients with reduced ejection fraction had signicantly higher levels of serum creatinine and signicantly lower levels of Hb and HDL. Mean hospital stay was signicantly longer for patients with preserved EF. In-hospital deaths were also similar between the two groups. The reduced EF group had a signicantly higher allcause mortality in the 4-year follow-up period. The mean years of follow-up for all participants was 4.2±1.3 years. Conclusion: It was seen that in patients presenting with ACS and undergoing PCI due to LMCAD, LVEF at admission, singly and in in multivariate regression is an important predictor of in hospital and 4-year mortality

Should the primary percutaneous coronary intervention pathway be redesigned?

2019 ◽  
Vol 14 (8) ◽  
pp. 1-15
Author(s):  
Sue Dean
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Elevation Acute Coronary Syndrome

Background/Aims The primary percutaneous coronary intervention pathway for patients experiencing an ST segment elevation acute coronary syndrome excludes patients with aVR ST elevation. These patients are treated on the non-ST segment elevation acute coronary syndrome pathway, which means that they have a coronary angiogram +/− intervention during their inpatient stay. Patients with non-ST segment elevation acute coronary syndrome have worse outcomes nationally. As such, research is required to demonstrate areas for improvement. This article examines the association between aVR ST segment elevation on the electrocardiogram and significant left main stem, proximal left anterior descending, or 3-vessel coronary artery stenosis in acute coronary syndrome to establish whether the primary percutaneous coronary intervention pathway should be redesigned. Methods Existing literature was searched, and relevant studies were considered and evaluated. Data were collected within local NHS Trusts on patients who had aVR ST segment elevation on the electrocardiogram. The data were analysed, and the findings were compared and synthesised with the literature. Results The study demonstrated a relationship between aVR ST segment elevation and significant disease. However, because of the numbers involved, analysis to demonstrate statistical significance was not possible, with the exception of aVR ST segment elevation and left main stem coronary artery, left anterior descending coronary artery and triple vessel disease, where p<0.05 in the population with left main stem coronary artery occlusion +/− other disease. The study demonstrated that aVR ST segment elevation should be treated as an ST segment elevation acute coronary syndrome equivalent, as it is a high-risk finding. These patients should go immediately to the cardiac catheter laboratory for a primary percutaneous coronary intervention. Conclusion The need for a change in the primary percutaneous coronary intervention pathway was established.

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