Prolonged sinus arrest due to the obstruction of a sinus node branch after percutaneous coronary intervention of the right coronary artery

2021 ◽  
Author(s):  
Ruri Shimizu ◽  
Rie Aoyama ◽  
Joji Ishikawa ◽  
Kazumasa Harada
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Sinus Node ◽  
Coronary Intervention ◽  
Sinus Arrest ◽  
Percutaneous Coronary ◽  
The Right

scholarly journals Multi-Vessel Coronary Artery Disease: Choice of Myocardial Revascularization Strategy

2020 ◽  
Vol 27 (4) ◽  
pp. E202041
Author(s):  
Nestor Seredyuk ◽  
Andrii Matlakh ◽  
Yaroslava Vandzhura ◽  
Mykyta Bielinskyi ◽  
Oleksii Skakun ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Myocardial Revascularization ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
The Right

Multi-vessel coronary artery disease is quite a common state, which is often diagnosed by coronary angiography in patients with both stable coronary artery disease and acute coronary syndromes. Major difficulties in percutaneous coronary intervention include stent thrombosis and the need for antiplatelet therapy (aspirin and a P2Y12 inhibitor). Stent thrombosis leads to the recurrence of myocardial infarction and may occur within the first few hours after percutaneous coronary intervention. The use of dual antiplatelet therapy, especially that combined with low-molecular-weight heparin in the first days after myocardial infarction, poses a risk of bleeding, which often occurs in real clinical practice. Among P2Y12  inhibitors, ticagrelor causes bleeding somewhat more frequently than clopidogrel. A case of multi-vessel coronary artery disease is described in this paper. Coronary angiography revealed right-dominant circulation; occlusion of the proximal and medial segments of the right coronary artery, thrombolysis in myocardial infarction flow grade 0; stenosis of the left main coronary artery (50-60%), thrombolysis in myocardial infarction flow grade 2; diffuse stenosis of the medial and distal segments of the left anterior descending artery, thrombolysis in myocardial infarction flow grade 1; stenosis of the proximal segment of the left circumflex artery (> 75%), thrombolysis in myocardial infarction flow grade 1. The patient underwent percutaneous coronary intervention; the stents were implanted in the infarct-dependent right coronary artery. The clinical course was complicated by early stent thrombosis with subsequent thrombus extraction; a day later melena developed. Bleeding was stopped, the intensity of antithrombotic therapy was reduced: the combination of aspirin and ticagrelor was replaced by the combination of aspirin and clopidogrel. Six weeks after stenting of the infarct-dependent coronary artery, complete myocardial revascularization (hybrid intervention) was performed: coronary artery bypass grafting [the left internal mammary artery → the left anterior descending artery], coronary autogenous bypass grafting [the aorta → the right coronary artery and the aorta → the left circumflex artery]. The role of fractional flow reserve or instantaneous wave-free ratio-controlled complete myocardial revascularization techniques is discussed. The following algorithm for myocardial revascularization was used: percutaneous coronary intervention for the right coronary artery + coronary artery bypass grafting-3: the left internal mammary artery → the left anterior descending artery, the aorta → the left circumflex artery, the aorta → the right coronary artery.

scholarly journals Iatrogenic Dissection of The Right Coronary Artery and The Ascending Aorta Secondary to Percutaneous Coronary Intervention: A Case Report

2020 ◽  
Vol 23 (3) ◽  
pp. E366-E369
Author(s):  
Changjiang Yu ◽  
Fan He ◽  
Huaidong Chen ◽  
Jianmao Hong ◽  
Ximing Qian
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Intervention ◽  
Ascending Aorta ◽  
Artery Dissection ◽  
Coronary Artery Dissection ◽  
Percutaneous Coronary ◽  
Aorta Replacement ◽  
The Right

Iatrogenic dissections of coronary artery and aorta is a rare and potentially fatal event, often following percutaneous coronary intervention (PCI). The prognosis of patients often depends on early accurate diagnosis and timely and effective treatment. There are no definite guidelines for the treatment of acute coronary artery dissection caused by PCI. Here, we report a 50-year-old patient with iatrogenic dissection of the right coronary artery and type A aortic dissection who underwent PCI for chest pain. We performed emergency surgery of right coronary artery ostium repair, aortic valvoplasty, ascending aorta replacement, and aortic arch descending stent implantation for the patient. The operation went smoothly, and the patient successfully was discharged two weeks after the operation.

Use of Extra Deep Guide-Catheter Intubation for Rotablation-Facilitated Percutaneous Coronary Intervention of the Right Coronary Artery

2019 ◽  
Vol 20 (11) ◽  
pp. 13-14
Author(s):  
George Latsios ◽  
Konstantinos Toutouzas ◽  
Antonios Karanasos ◽  
Dimitrios Tousoulis
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Intervention ◽  
Guide Catheter ◽  
Percutaneous Coronary ◽  
The Right

PP-122 Percutaneous Coronary Intervention to the Right Coronary Artery with Anomalous Origin

2016 ◽  
Vol 117 ◽  
pp. S83-S84
Author(s):  
Alper Buğra Nacar ◽  
Ali Erayman ◽  
Raşit Tanırcan ◽  
Nihat Şen
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Intervention ◽  
Anomalous Origin ◽  
Percutaneous Coronary ◽  
The Right

scholarly journals Successful Revascularization to Right Coronary Artery by Percutaneous Coronary Intervention after Endovascular Therapy for Leriche Syndrome

2014 ◽  
Vol 7 ◽  
pp. CCRep.S13551 ◽  
Author(s):  
Takeshi Niizeki ◽  
Kazuyoshi Kaneko ◽  
Shigeo Sugawara ◽  
Toshiki Sasaki ◽  
Yuichi Tsunoda ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Endovascular Therapy ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Inferior Wall ◽  
Leriche Syndrome ◽  
Percutaneous Coronary ◽  
The Right

A 69-year-old man with effort angina was admitted to our institution. Echocardiography showed poor left ventricular systolic function with akinesis of the anterior wall and severe hypokinesis of the inferior wall. We performed coronary angiography, which revealed two diseased vessels including chronic total occlusion in the left anterior descending artery and severe stenosis in the right coronary artery (RCA). In addition, aortography revealed aortoiliac occlusive disease known as Leriche syndrome. As the patient's symptom was stable, we first planned to perform endovascular therapy (EVT) for Leriche syndrome to make a route for intra-aortic balloon pumping. We prepared a bi-directional approach from bi-femoral arteries and a left brachial artery. The guidewire was passed through the occlusive area using the retrograde approach. The self-expanding stents were deployed by a kissing technique. At one week after EVT, a 6Fr sheath was inserted from the right radial artery and an intra-aortic balloon pump was successfully inserted through the right femoral artery for percutaneous coronary intervention (PCI) to the RCA. Two drug-eluting stents were successfully deployed to RCA after using an atherectomy device (rotablator). We reported the case as a successfully performed PCI to the RCA after EVT for Leriche syndrome.

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