scholarly journals Giant Intramural Right Ventricular Hematoma after PCI in a Patient with Condition after CABG

2020 ◽  
Vol 09 (01) ◽  
pp. e11-e14
Author(s):  
Maximilian Vondran ◽  
Tamer Ghazy ◽  
Terezia Bogdana Andrási ◽  
Jürgen Graff ◽  
Ardawan Julian Rastan
Keyword(s):  
Coronary Artery ◽  
Right Ventricular ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Intramural Hematoma ◽  
Coronary Intervention ◽  
Heart Team ◽  
Coronary Artery Perforation ◽  
Life Threatening ◽  
The Right

AbstractCoronary artery perforation secondary to percutaneous coronary intervention (PCI) is a rare, but a potentially life-threatening complication. There is a misconception that cardiac tamponade rarely occurs in patients with prior coronary artery bypass grafting (CABG). We first describe a giant right ventricular intramural hematoma following PCI via a saphenous vein graft to treat a distal stenosis of the right coronary artery, and its successful treatment with redo cardiac surgery. Complex elective PCIs on patients after CABG should be performed in specialized centers with a well-established heart team that has the expertise to treat any of the potential complications.

scholarly journals Off-pump coronary artery bypass concomitant with retrieval of broken guide wire stuck in the brachial artery: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuan Xue ◽  
Lu Dai ◽  
Wenjian Jiang ◽  
Hongjia Zhang
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Brachial Artery ◽  
Guide Wire ◽  
Artery Bypass ◽  
Effective Means ◽  
Coronary Intervention ◽  
Off Pump ◽  
Pump Coronary Artery Bypass ◽  
The Right

Abstract Background The broken guide wire could get stuck anywhere during coronary artery angiography, but the broken guide wire in the brachial artery is extremely rare. Case presentation In this report, we describe our experience with a case of off-pump coronary artery bypass (OPCABG) concomitant with the retrieval of a broken guide wire stuck in the brachial artery: a 56-year-old male patient was referred to our hospital because of tri-vessel disease and a broken guide wire stuck in the right brachial artery. He received OPCABG concomitant with the retrieval of the broken guide wire stuck in the brachial artery under general anesthesia. The patient was discharged uneventfully, and 12 months follow-up showed an excellent surgical outcome. Conclusion Open surgery is an effective means for treating patients with a guide wire stuck in the brachial artery during percutaneous coronary intervention.

scholarly journals Debate of Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting in a Multimorbidity Patient with Complex Coronary Lesions

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Sotirios Mitsiadis ◽  
Nikolaos Miaris ◽  
Antonios Dimopoulos ◽  
Anastasios Theodosis-Georgilas ◽  
Spyridon Tsiamis ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Syntax Score ◽  
Complete Revascularization ◽  
Total Occlusion ◽  
Diagonal Branch ◽  
Coronary Lesions ◽  
Artery Disease ◽  
The Right

Background. While complete revascularization in coronary artery disease is of high priority, the method of implementation in patients with complex coronary lesions and multiple comorbidities is not directed by published guidelines. Case Presentation. A 53-year-old female with a chronic total occlusion of the right coronary artery and a bifurcation lesion of the left anterior descending artery and the first diagonal branch, presented with non-ST elevation myocardial infarction. Her past medical history concerned thymectomy and prior chest radiation for thymoma, myasthenia gravis, peripheral artery disease, and cervical cancer treated with surgery and radiation. Although SYNTAX score II favored surgical revascularization, the interventional pathway was finally successfully followed. However, it was complicated with vessel perforation and tamponade managed with pericardiocentesis. Conclusion. Comorbidities are not all involved in common risk models and require individualization until more evidence comes to light.

scholarly journals Coronary–Cameral Fistula Caused by Guidewire Trauma and Resolved by Coil Embolization

2016 ◽  
Vol 43 (4) ◽  
pp. 338-340 ◽  
Author(s):  
Suvro Banerjee ◽  
Soumya Patra
Keyword(s):  
Coronary Artery ◽  
Right Ventricular ◽  
Coil Embolization ◽  
Coronary Intervention ◽  
Effort Angina ◽  
Coronary Angiogram ◽  
Vessel Disease ◽  
Percutaneous Coronary ◽  
Coronary Cameral Fistula ◽  
The Right

A 57-year-old woman presented with effort angina. A coronary angiogram revealed critical 2-vessel disease, for which she subsequently underwent percutaneous coronary intervention. During angioplasty, a coronary guidewire—inadvertently passed into the right ventricle through the septal branches of the posterior descending coronary artery—caused a coronary artery-to-right ventricular fistula. This fistula was successfully closed percutaneously by coil embolization. To our knowledge, this is the first report of a case in which a coronary artery-to-right ventricular fistula caused by a guidewire was managed successfully by coil embolization.

Two-Vessel Off-Pump Coronary Artery Bypass Grafting by Left Thoracotomy in a Complex Reoperative Case

2014 ◽  
Vol 17 (2) ◽  
pp. 77
Author(s):  
Shinya Unai ◽  
Gary Cook ◽  
Hitoshi Hirose ◽  
Nicholas Cavarocchi ◽  
John Entwistle
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Preoperative Evaluation ◽  
Descending Aorta ◽  
Left Thoracotomy ◽  
Off Pump ◽  
Triple Vessel Disease ◽  
The Right

An 83-year-old male with a history of three prior sternotomies, including coronary artery bypass surgery (CABG), presented with unstable angina. Cardiac catheterization showed left main and triple-vessel disease. The saphenous vein graft (SVG) to the right coronary artery was diseased but patent, and the SVG to the left anterior descending artery (LAD) was occluded. Preoperative evaluation showed a heavily calcified ascending aorta and minimum disease on the descending aorta. He successfully underwent a left thoracotomy 2-vessel off-pump CABG using the descending aorta for the proximal anastomosis. The left thoracotomy approach is a useful alternative to avoid complications associated with resternotomy, especially in patients with a hostile chest, although visualization of the target vessels may be limited.

Percutaneous Coronary Intervention for Left Main and Multivessel Coronary Artery Disease – A Review of Strategies

2012 ◽  
Vol 7 (2) ◽  
pp. 86
Author(s):  
Oluseun Alli ◽  
David Holmes ◽  
◽  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Syntax Score ◽  
Heart Team ◽  
Percutaneous Coronary

Patients with complex and multivessel disease present challenging clinical problems in defining treatment strategies. The Synergy between PCI with taxus and cardiac surgery (SYNTAX) trial, which included both a randomised as well as a registry experience has clarified many issues. These include the extent and severity of the disease, the clinical presentation, and the metrics used for comparison. The development, validation and application of the SYNTAX score has been of fundamental importance. In those patients with the least complex coronary anatomy, using hard endpoints such as death and myocardial infarction, the outcomes of treatment with either percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) are similar although repeat revascularisation rates remain higher with PCI. In those patients with more extensive and complex disease, coronary artery bypass remains the standard of care. It must be remembered that the drug-eluting stent tested in SYNTAX was a first generation device and that newer generations are safer and more effective. Perhaps the most important guidance in the field of treatment of complex multivessel coronary disease is the attention paid to the Heart Team concept wherein both interventional cardiologists and cardiovascular surgeons are strongly encouraged to work together in these patients to identify the optimal approach consistent with the patients needs and objectives.

Results of Endoscopic Radial Artery Harvesting in 1577 Patients

2013 ◽  
Vol 8 (6) ◽  
pp. 398-402 ◽  
Author(s):  
Kamellia R. Dimitrova ◽  
Gabriela R. Dincheva ◽  
Darryl M. Hoffman ◽  
Helbert DeCastro ◽  
Charles M. Geller ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Radial Artery ◽  
Artery Bypass ◽  
Intramural Hematoma ◽  
Coronary Intervention ◽  
Kaplan Meier ◽  
Harvesting Technique ◽  
Social Security Death Index ◽  
Extensive Calcification ◽  
Allen Test

Objective We reviewed 1577 consecutive patients undergoing coronary artery bypass grafting (CABG) using endoscopic harvesting of the radial artery (RA) to define our current results. Methods Since 2000, we have performed endoscopic RA harvest on 1577 consecutive patients; 1476 patients had isolated CABG, and 101 patients had CABG and other procedures. The mean ± SD age was 59.4 ± 9.0 years; 80.2% were men and 40% had diabetes mellitus. All data were prospectively collected. All-cause mortality was determined using the Social Security Death Index. Results There were nine in-hospital or 30-day deaths, for an operative mortality of 0.57%: mortality was 0.34% in isolated CABG and 3.85% in CABG/combined procedures. The overall estimated Kaplan-Meier survival at 1, 5, and 10 years was 99%, 95%, and 88%. In 37 patients, the RAs were not harvested or were not used for grafting because of a positive Allen test, extensive calcification or dissection, intramural hematoma, and scarring from previous arterial lines or catheterization. During postoperative follow-up, five patients (0.32%) were treated for incisional infection, and there were no ischemic hand complications. Three patients had a perioperative myocardial infarction in the RA graft distribution, and 15 patients had a coronary artery reintervention in the RA graft distribution. Two other patients had a percutaneous coronary intervention of their RAs. The overall RA patency at 10 years was 82%. Conclusions Endoscopic harvest of the RA is an excellent minimally invasive conduit harvesting technique with minimal morbidity.

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