scholarly journals Sudden cardiac arrest of a 16-year-old boy with left main coronary artery atresia: a case report

2020 ◽  
Vol 4 (4) ◽  
pp. 1-5
Author(s):  
Nobunari Tomura ◽  
Takuo Nakagami ◽  
Shinichiro Yamaguchi ◽  
Hitoshi Yaku ◽  
Peysh A Patel
Keyword(s):  
Heart Failure ◽  
Coronary Artery ◽  
Rare Disease ◽  
Left Main Coronary Artery ◽  
Cardiopulmonary Arrest ◽  
Artery Bypass ◽  
False Negative ◽  
Congenital Defect ◽  
Left Main ◽  
Exercise Induced

Abstract Background In many cases, the cause of exercise-induced cardiopulmonary arrest in young persons is thought to be fatal arrhythmia, and one of the causes is ischaemic heart disease. Left main coronary artery atresia (LMCAA) is an extremely rare disease in which there is a congenital defect of the left main coronary artery, causing heart failure and exercise-induced angina attacks at a young age. Thus, it is disease that should be differentiated when examining young persons with chest pain. Case summary A 16-year-old boy experienced sudden cardiopulmonary arrest during soccer practice, was brought to our hospital for emergency treatment after return of spontaneous circulation. Elective coronary angiography revealed findings indicating an osmium defect in the left coronary artery (LCA) and blood flow via collateral circulation from the right coronary artery. Contrast-enhanced coronary computed tomography (CT) angiography showed a defect in the LCA ostium and LMCAA was diagnosed in the patient. After coronary artery bypass grafting was performed, but the patient was discharged in an ambulatory state with a wearable cardiac defibrillator. Postoperative course has been favourable. Discussion Left main coronary artery atresia is an extremely rare disease in which there is a congenital defect of the left main trunk of the coronary artery and should be differentiated when encountering cases of heart failure or exercise-induced angina/arrhythmia attacks in young persons who are not at risk for atherosclerosis. Exercise electrocardiogram may show a false negative result, and therefore coronary CT is useful for diagnosis.

Salvage myocardial revascularisation in spontaneous left main coronary artery dissection with cardiogenic shock – the role of mechanical circulatory support

Perfusion ◽  
2016 ◽  
Vol 32 (2) ◽  
pp. 171-173 ◽  
Author(s):  
Ashok Padukone ◽  
Ahmed K. Sayeed ◽  
Nandor Marczin ◽  
Diana García Sáez ◽  
Bartlomiej Zych ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Cardiogenic Shock ◽  
Mechanical Circulatory Support ◽  
Left Main Coronary Artery ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
Circulatory Support ◽  
Artery Dissection ◽  
Left Main ◽  
Coronary Artery Dissection

Spontaneous left main coronary artery dissection is a rare cause of acute coronary events or sudden cardiac death, constituting less than 1% of all epicardial coronary artery dissections. It is often fatal and is mostly recognized at post-mortem examination in young victims of sudden death. More than 70% of the reported cases occurred in women, particularly during pregnancy and the peripartum period and those on oral contraceptives. The clinical presentation is highly variable and prognosis varies widely, depending predominantly on the speed of diagnosis. Treatment options include medical therapy, revascularization with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) and mechanical circulatory support in cases of cardiogenic shock. We report a case of spontaneous dissection of the left main stem coronary artery, with extension into the left coronary territory, which occurred in a 41-year-old lady, complicated by profound cardiogenic shock requiring recovery with extracorporeal mechanical circulatory support after salvage myocardial revascularization.

scholarly journals Unprotected Left Main is now no more Domain of Surgeon

2021 ◽  
Vol 4 (14) ◽  
pp. 01-06
Author(s):  
Ranjit Sharma
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Left Main Coronary Artery ◽  
Artery Bypass ◽  
Bypass Grafts ◽  
Left Main ◽  
Significant Stenosis

Unprotected Left Main Coronary Artery (ULMCA) disease is defined as significant stenosis in the Left Main Coronary Artery (LMCA) and there were no previous Coronary artery bypass surgery (CABG) or patent bypass grafts to the left anterior descending (LAD) or left circumflex (LCX) arteries

scholarly journals Left Main Coronary Artery Interventions

2019 ◽  
Vol 14 (3) ◽  
pp. 124-130 ◽  
Author(s):  
Mirvat Alasnag ◽  
Lina Yaqoub ◽  
Ammar Saati ◽  
Khaled Al-Shaibi
Keyword(s):  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Artery Bypass ◽  
Percutaneous Coronary Interventions ◽  
Left Main ◽  
The Past ◽  
Coronary Interventions ◽  
Percutaneous Coronary ◽  
European Society Of Cardiology

The management of left main coronary artery (LMCA) disease has evolved over the past two decades. Historically, coronary artery bypass grafting (CABG) surgery has been the gold standard for the treatment of LMCA disease. However, with the advancements in percutaneous coronary interventions (PCIs) and stent technology, PCI in select patients has achieved comparable outcomes to CABG. As such, this has led to changes in the American College of Cardiology and European Society of Cardiology guidelines, which recommend that PCI might be an alternative to CABG in select patients. In this review article, we describe the historical perspective and early experience with coronary interventions of LMCA disease, landmark clinical trials and their effect on guidelines, and the role of intravascular imaging in the management of LMCA lesions.

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