Unexpected ischemia during transcatheter patent arterial duct closure

2019 ◽  
Vol 29 (11) ◽  
pp. 1410-1411
Author(s):  
Ondrej Materna ◽  
Vojtech Suchanek ◽  
Oleg Reich
Keyword(s):  
Coronary Artery ◽  
Delivery System ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Single Coronary Artery ◽  
Posterior Aspect ◽  
Inferior Caval Vein ◽  
Arterial Duct ◽  
The Right ◽  
Patent Arterial Duct

AbstractA child undergoing routine transcatheter patent arterial duct closure developed severe transient ischemic changes in the electrocardiogram (Pardee waves) while the aortic retention skirt of the Amplatzer™ Duct Occluder was pulled against the duct orifice. The occluder was then released, and the delivery system was pulled back to inferior caval vein which led to electrocardiogram normalisation. Aortic root angiography showed a single coronary artery originating from the right sinus of Valsalva with the left coronary stem wedged behind the posterior aspect of the right ventricular outflow tract. We believe that the left coronary artery was compressed while applying tension on the occluder delivery system.

Risk factors for augmentation of the flow of blood to the lungs in pulmonary atresia with intact ventricular septum after radiofrequency valvotomy

2005 ◽  
Vol 15 (2) ◽  
pp. 141-147 ◽  
Author(s):  
Mazeni Alwi ◽  
Geetha Kandavello ◽  
Kok-Kuan Choo ◽  
Bilkis A. Aziz ◽  
Hasri Samion ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Tricuspid Valve ◽  
Pulmonary Atresia ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Ventricular Septum ◽  
Intact Ventricular Septum ◽  
Arterial Duct ◽  
The Right ◽  
Patent Arterial Duct

Some patients with pulmonary atresia with an intact ventricular septum, mild to moderate right ventricular hypoplasia, and a patent infundibulum remain duct dependent on the flow of blood through the arterial duct despite adequate relief of the obstruction within the right ventricular outflow tract.The objective of our study was to review the risk factors for stenting of the patent arterial duct, or construction of a Blalock-Taussig shunt, in the patients with pulmonary atresia and an intact ventricular septum who remain duct-dependent following radiofrequency valvotomy and dilation of the imperforate pulmonary valve.We reviewed the data from 53 patients seen between November 1995 and December 2001. Of the 47 patients who survived, 6 required stenting of the patent arterial duct, while 4 needed construction of a modified Blalock-Taussig shunt to augment the flow of blood to the lungs at a mean of 7 plus or minus 5.7 days following the initial intervention. The remaining 37 patients required no additional procedures. We compared the findings in these two groups.The mean diameter of the tricuspid valve in the patients requiring early reintervention was 8.5 plus or minus 3.7 millimetres, giving a Z-score of −1.1 plus or minus 1.47, whilst those in the group without early reintervention had values of 10.7 plus or minus 2.2 millimetres, giving a Z-score of −0.58 plus or minus 1.18 (p equal to 0.003). No statistically significant differences were found in right ventricular morphology, McGoon ratio, or residual obstruction across the right ventricular outflow tract after decompression of the right ventricle.The diameter of the tricuspid valve, therefore, appears to be the only factor predicting the need for augmentation of flow of blood to the lungs. As just over one-fifth of our survivors required such augmentation, we hypothesize that stenting of the patent arterial duct may be performed as an integral part of primary transcatheter therapy in patients with pulmonary atresia and intact ventricular septum who have moderate right ventricular hypoplasia and a small tricuspid valve.

Single coronary artery–right ventricular fistula

2011 ◽  
Vol 22 (2) ◽  
pp. 209-212
Author(s):  
Juan M. Carretero ◽  
Jorge R. Palacios ◽  
Fredy H. Prada
Keyword(s):  
Coronary Artery ◽  
Right Ventricular ◽  
Right Ventricular Outflow Tract ◽  
Coronary Artery Fistula ◽  
Ventricular Outflow Tract ◽  
Single Coronary Artery ◽  
Coronary Fistula ◽  
Selective Angiography ◽  
Operative Evaluation ◽  
The Right

AbstractWe report a rare case of a male child aged 4 years and 5 months who was diagnosed with a coronary artery fistula and left single coronary artery. Pre-operative evaluation with echocardiography and selective angiography showed a dilated and tortuous single coronary artery draining into the right ventricular outflow tract. The coronary fistula was ligated. The post-operative and clinical courses were uneventful.

scholarly journals Anomalous left coronary artery from the pulmonary artery: modified extra-anatomic reimplantation

2020 ◽  
Author(s):  
Waleed Albadi ◽  
Bernard Kreitmann ◽  
François Roubertie
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Right Ventricular ◽  
Coronary Sinus ◽  
Left Coronary Artery ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Anomalous Left Coronary Artery ◽  
The Right ◽  
Anomalous Left Coronary

Abstract The anomalous origin of the left coronary artery from the pulmonary artery in the position of a non-facing coronary sinus is extremely rare. The anatomical position of the ectopic ostia will determine which is the appropriate operative approach to create a dual-coronary supply. This report describes a technique of modified extra-anatomical rerouting using autologous pericardium patch and pulmonary artery flap to create a neo-composite coronary trunk passing anterior to the right ventricular outflow tract.

scholarly journals Discovery of a Symptomatic Left Anomalous Coronary Artery from the Opposite Sinus and Postoperative Considerations

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Ahmad Slim ◽  
John Thurlow ◽  
Jennifer Blevins ◽  
Shaun Martinho ◽  
Brian Markelz
Keyword(s):  
Coronary Artery ◽  
Right Ventricular Outflow Tract ◽  
Rare Condition ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Anomalous Origin ◽  
Complex Anatomy ◽  
Increased Risk ◽  
The Right

This is the case of an 18 year old active duty soldier with symptoms of exertional chest pressure and syncope who was found to have anomalous origin of the left main coronary artery (LMCA) from the right coronary cusp (RCC) traveling partially between the great vessels before taking a septal approach between the left ventricular outflow tract (LVOT) and the right ventricular outflow tract (RVOT). Anomalous origin of coronary arteries is a rare condition that carries an increased risk of angina, myocardial ischemia, and sudden cardiac death (SCD). Surgical treatment of such anomalies with both high and lower risk features can be challenging, and traditional benefit from surgical correction may not be achieved due to complex anatomy. As evident by our patient, this rare condition even though benign from sudden death standpoint could be debilitating despite best efforts and available resources.

scholarly journals A Rare Coronary Artery Anomaly: Double Left Anterior Descending Artery

2012 ◽  
Vol 2 ◽  
pp. 83 ◽  
Author(s):  
Guray Oncel ◽  
Dilek Oncel
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Multislice Computed Tomography ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Anterior Wall ◽  
Coronary Anomalies ◽  
Left Main ◽  
Left And Right ◽  
The Right

Double left anterior descending coronary artery arising from the left and right coronary arteries is one of the rarest of coronary anomalies. In this report, we present a case of double left anterior descending coronary artery with one originating from the left main stem and the second one originating from the same ostium with the right coronary artery, passing to the left side following an inter-arterial course between aorta and right ventricular outflow tract and spreading to the anterior wall of the left ventricle. The diagnosis was made with multislice computed tomography angiography. To our knowledge, only a few such cases have been published in the literature so far.

Correction of Tetralogy of Fallot Associated With Anomalous Coronary Artery Without Extracardiac Conduit

2020 ◽  
Vol 11 (3) ◽  
pp. 343-345 ◽  
Author(s):  
Kaoutar Benjaout ◽  
Julia Mitchell ◽  
Julie Gauthier ◽  
Jean Ninet
Keyword(s):  
Coronary Artery ◽  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Anomalous Coronary Artery ◽  
Extracardiac Conduit ◽  
The Right ◽  
Anomalous Coronary

Between 1983 and 2016, we operated on 14 children with tetralogy of Fallot with an anomalous coronary artery crossing the pulmonary infundibulum, which is an anomaly that makes the repair complex. The technique used was the enlargement of the right ventricular outflow tract underneath the mobilized coronary artery. All patients had right ventricular outflow tract relief without coronary artery injury. Only one patient required the use of an extracardiac conduit. There was neither in-hospital mortality nor coronary anomaly requiring reintervention. Mobilizing the anomalous coronary artery in tetralogy of Fallot repair often allows relief of obstruction without using an extracardiac conduit.

Double-outlet extension for narrowed retroaortic space

2019 ◽  
Vol 28 (2) ◽  
pp. 123-125
Author(s):  
Suguru Tarui ◽  
Yoshinori Miyahara ◽  
Nobuo Oyama ◽  
Takanari Fujii ◽  
Kozo Ishino ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Surgical Repair ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Cyanotic Congenital Heart Disease ◽  
Pulmonary Artery Stenosis ◽  
Right Pulmonary Artery ◽  
The Right ◽  
Rastelli Operation

In cyanotic congenital heart disease, an enlarged aorta often compresses the retroaortic space, resulting in pulmonary artery narrowing. We experienced a case of a 10-year-old boy with severe pulmonary artery stenosis resulting from a narrowed retroaortic space after a Rastelli operation. The right pulmonary artery was closely aligned with the left coronary artery, which made pulmonary artery stenting difficult. We performed surgical repair including aortic extension with an interposition graft and elongation of the right ventricular outflow tract (double-outlet extension). This procedure was effective for enlargement of the retroaortic space and separation of the pulmonary artery from the coronary artery.

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