scholarly journals Unduly long left main (79 mm) coronary artery arising from right coronary sinus in a 64-year-old diabetic man

2019 ◽  
Vol 12 (7) ◽  
pp. e229815
Author(s):  
Santosh Kumar Sinha ◽  
Puneet Aggarwal ◽  
Mahmodula Razi ◽  
Vinay Krishna
Keyword(s):  
Coronary Artery ◽  
Coronary Sinus ◽  
Cardiac Death ◽  
Left Main Coronary Artery ◽  
Incidental Finding ◽  
Coronary Angiogram ◽  
Exertional Dyspnoea ◽  
Coronary Artery Anomalies ◽  
Left Main ◽  
Extensive Search

Coronary artery anomalies are usually an incidental finding on coronary angiogram. Most of them are benign, although few of them are malignant which may cause sudden cardiac death. A 64-year-old diabetic, hypertensive man underwent coronary angiography for evaluation of exertional dyspnoea, and angina which revealed an anomalous left main coronary artery (LMCA) arising from right coronary sinus which was unduly long (79 mm) but free from any disease. To the best of our knowledge after extensive search in literature, this is the longest LMCA to be ever reported. The patient was managed conservatively.

Congenital Left Main Coronary Artery to Coronary Sinus Fistula

2011 ◽  
Vol 14 (4) ◽  
pp. 255 ◽  
Author(s):  
Fotios A. Mitropoulos ◽  
Meletios A. Kanakis ◽  
Periklis A. Davlouros ◽  
George Triantis
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Coronary Sinus ◽  
Left Main Coronary Artery ◽  
Coronary Artery Fistula ◽  
Left Main ◽  
Coronary Fistula ◽  
Excellent Outcome ◽  
Surgical Ligation ◽  
Congenital Coronary Artery Fistula

Congenital coronary artery fistula is an extremely rare anomaly that may involve any of the coronary arteries and any of the cardiac chambers. We report the case of a 14-year-old female patient with a symptomatic congenital coronary fistula starting from the left main coronary artery and draining to the coronary sinus. The patient underwent surgical ligation of the fistula and had an excellent outcome.

Abstract 14575: Systematic Review and Meta-analysis of Intravascular Ultrasound-guided Percutaneous Left-main Coronary Artery Intervention

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sameer Saleem ◽  
Shuaibahmed Arab ◽  
Waqas Ullah ◽  
Sundas Younas ◽  
Bashar Al hemyari ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
Coronary Artery ◽  
Stent Implantation ◽  
Cardiac Death ◽  
Left Main Coronary Artery ◽  
Meta Analysis ◽  
Ultrasound Guided ◽  
Left Main ◽  
Relative Odds

Introduction: Previous meta-analyses have reported reduced cardiovascular mortality and myocardial infarction in intravascular ultrasound-guided (IVUS) stent implantation in comparison to angiography-only approach. However, these studies have unanimously excluded patients with unprotected left-main coronary artery (LMCA) disease, questioning its widespread applicability. We performed a systematic review and meta-analysis to investigate the prognostic significance of IVUS-guided LMCA intervention. Methods: Studies comparing clinical outcomes between IVUS-guided and angiography-only percutaneous LMCA intervention were identified through PubMed, Cochrane and EMBASE databases until June, 2020. Data was analyzed using a random effect model to calculate the relative odds of all-cause death, cardiac death, left-main revascularization, myocardial infarction, stent thrombosis and stroke. Results: A total of 13 studies comprising 7680 patients were included. The odds of all-cause death (OR 0.6, 95%CI 0.47-0.78; p<0.0001), cardiac death (OR 0.37, 95%CI 0.26-0.54; p<0.00001), left-main revascularization (OR 0.63, 95%CI 0.45-0.89; p=0.009) and myocardial infarction (OR 0.77 [95%CI 0.60-0.98; p=0.04]) were significantly lower in patients who underwent IVUS-guided LMCA stent implantation compared to angiography-only approach. There was no significant difference observed in the relative odds of stent thrombosis (OR 0.57, 95%CI 0.31-1.05; p=0.07) and stroke (OR 1.7, 95%CI 0.56-5.14; p=0.35) between the two arms at least 1-year of the index procedure. A subgroup analysis based on study design and sensitivity analysis based on the characteristics of the included studies mirrored the pooled results. Conclusion: IVUS-guided LMCA intervention is associated with overall improved cardiovascular outcomes than angiography-only approach. Large scale randomized controlled trials are needed to validate our findings.

scholarly journals Does Type 5 of Takayasu's Arteritis Require Subclassification?

2018 ◽  
Vol 03 (01) ◽  
pp. 023-026
Author(s):  
Sandeep Moode ◽  
Suneethi Malayathi ◽  
Jyotsna Maddury ◽  
Lalita Nemani
Keyword(s):  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Takayasu’S Arteritis ◽  
Pulmonary Vasculature ◽  
Takayasu's Arteritis ◽  
Coronary Angiogram ◽  
Left Main ◽  
Clinical Presentations ◽  
Study Population ◽  
Inflammatory Vascular Disease

Abstract Background Takayasu's arteritis (TA) is an inflammatory vascular disease of the young involving the large elastic arteries resulting in occlusive or ectatic changes, mainly in the aorta and its major branches as well as the pulmonary artery and its branches. Materials and Methods The authors reviewed the TA patients admitted over 2 years in their department and who underwent catheterization. They noted the clinical presentations, two-dimensional (2D) echocardiographic features, and angiogram details of all these patients. Results The study population constituted 24 patients with mean age of 28 years. Out of them, 21 (87.5%) were females. Most of the admitted TA patients presented with claudication complaints (79.2%), 37.5% patients had breathlessness, and 12.5% patients had typical stable angina symptoms. Five patients had 2D echo abnormalities, and rest of the patients had normal echocardiogram. Coronary angiogram (CAG) along with aortogram and selective peripheral arteriograms were performed of all these patients. Left main coronary artery (LMCA) disease was seen in three (12.5%) patients. Case details of two (8.3%) patients with multiple anomalous communications of the coronaries with pulmonary vasculature were described. Conclusion TA patients who came for catheterization were predominantly females, mainly involving the aorta and its main branches. In the authors’ TA series of patients, type 5 presentation was there in five (20.8%) patients (three cases of LMCA + two cases of coronary artery to pulmonary parenchymal fistulas). They propose to subclassify type 5 of TA, as they report coronary artery to pulmonary parenchymal fistulas along with the previous literature.

Ischaemic heart disease: coronary artery anomalies

2016 ◽  
Author(s):  
Eugenio Picano ◽  
Fausto Pinto ◽  
Blazej Michalski
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Cardiac Death ◽  
Incidental Finding ◽  
Superior Vena ◽  
Vena Cava ◽  
Coronary Anomalies ◽  
Coronary Artery Anomalies ◽  
Venous Structure ◽  
Coronary Artery Segment

Coronary anomalies occur in less than 1% of the general population and their clinical presentation can range anywhere from a benign incidental finding to the cause of sudden cardiac death. Since congenital coronary arteries anomalies are often considered as the first cause of cardiac death in young athletes in Europe, careful attention has to be paid in this specific subpopulation in case of suggestive symptoms. Although focused expert echocardiography is the first-line imaging tool, coronary computed tomography or radiation-free magnetic resonance imaging are recommended for more definitive definition of the coronary course in persons suspected of having coronary artery anomalies. Most coronary anomalies belong to the group of anomalous origin. Aneurysms are defined as dilations of a coronary vessel 1.5 times the normal adjacent coronary artery segment. Coronary artery fistulas are communications between one or more coronary arteries and a cardiac chamber (coronary-cameral), the pulmonary artery, or a venous structure (such as the sinus or superior vena cava).

scholarly journals Case Report: ALCAPA syndrome: successful repair with an anatomical and physiological alternative surgical technique

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 1680
Author(s):  
Luis Gustavo Vilá Mollinedo ◽  
Andrés Jaime Uribe ◽  
José Luis Aceves Chimal ◽  
Roberto Pablo Martínez-Rubio ◽  
Karen Patricia Hernández-Romero
Keyword(s):  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Exertional Dyspnoea ◽  
Left Main ◽  
Anomalous Left Coronary Artery ◽  
Adult Age ◽  
Paroxysmal Tachycardia ◽  
Congenital Cardiac Disease ◽  
Infarction Heart ◽  
Anomalous Left Coronary

Anomalous left coronary artery from the pulmonary artery, or ALCAPA syndrome, is a rare congenital cardiac disease that can cause myocardial infarction, heart failure and even death in paediatric patients. Only few untreated patients survive until adult age. Here we present the case of a 33-year-old female patient with paroxysmal tachycardia, syncope and mild exertional dyspnoea. She was diagnosed with ALCAPA syndrome and underwent surgical correction with an alternative technique of left main coronary artery extension to the aorta.

scholarly journals Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery

2017 ◽  
Vol 5 (1) ◽  
pp. 232470961668462 ◽  
Author(s):  
Venkat Gangadharan ◽  
Kamesh Sivagnanam ◽  
Ghulam Murtaza ◽  
Michael Ponders ◽  
Otto Teixeira ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Main Coronary Artery ◽  
Main Pulmonary Artery ◽  
Shortness Of Breath ◽  
Left Heart ◽  
Coronary Angiogram ◽  
Left Main ◽  
Large Area ◽  
The Right

A 36-year-old woman was seen with complaints of exertional chest pain and shortness of breath. Her medical history included atrial fibrillation and diabetes. Physical examination was unremarkable except for an irregular cardiac rhythm. Myocardial perfusion imaging revealed the presence of a large area of infarction involving the entire anterior and apical walls and part of the anteroseptal wall with minimal periinfarct ischemia. Computed tomography coronary angiogram revealed an anomalous left main coronary artery arising from the main pulmonary artery. Right and left heart catheterizations demonstrated moderate pulmonary hypertension with a slight step-up in oxygen saturation between the right ventricle and main pulmonary artery. Coronary angiography showed a large tortuous right coronary artery with collaterals to the left anterior descending artery that drained into the main pulmonary artery. She was referred for surgery. This case demonstrates a rare coronary artery anomaly in an adult where survival is dependent on collateral circulation.

scholarly journals Left main coronary artery compression by a dilated main pulmonary artery and left coronary sinus of Valsalva aneurysm in a patient with heritable pulmonary arterial hypertension and FLNA mutation

2017 ◽  
Vol 7 (3) ◽  
pp. 734-740 ◽  
Author(s):  
Akihiro Hirashiki ◽  
Shiro Adachi ◽  
Yoshihisa Nakano ◽  
Yoshihiro Kamimura ◽  
Takeshi Ogo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pulmonary Arterial Hypertension ◽  
Pulmonary Artery ◽  
Coronary Sinus ◽  
Left Main Coronary Artery ◽  
Main Pulmonary Artery ◽  
Sinus Of Valsalva ◽  
Left Main ◽  
External Compression ◽  
Pulmonary Arterial

Left main coronary artery (LMCA) disease due to external compression by a dilated main pulmonary artery (MPA) is an uncommon clinical entity. Here, we describe a 52-year-old woman with pulmonary arterial hypertension (PAH) and anteroseptal old myocardial infarction (OMI). The cause of the OMI was external compression of the LMCA by the dilated MPA and aneurysm of the left coronary sinus of Valsalva. The patient’s sister (aged 56 years) had also been diagnosed with PAH and both women had a novel heterozygous splicing mutation, IVS2-2A > G (c.374-2A > G in NM_001456), in the filamin A ( FLNA) gene. To our knowledge, this is the first report of HPAH which is likely to be due to FLNA mutation and compression of the LMCA between a dilated MPA and aneurysm of the left coronary sinus of Valsalva.

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