scholarly journals Induction of myocardial infarcts of a predictable size and location by branch pattern probability-assisted coronary ligation in C57BL/6 mice

2004 ◽  
Vol 286 (3) ◽  
pp. H1201-H1207 ◽  
Author(s):  
Dongchoon Ahn ◽  
Linda Cheng ◽  
Chanil Moon ◽  
Harold Spurgeon ◽  
Edward G. Lakatta ◽  
...  
Keyword(s):  
Heart Disease ◽  
Coronary Artery ◽  
Left Coronary Artery ◽  
Left Ventricular ◽  
Myocardial Infarctions ◽  
Branch Points ◽  
Left Main ◽  
Uniform Size ◽  
Disease Research ◽  
Coronary Ligation

The ability to create experimental myocardial infarctions of reproducible size and location is tantamount to progress in multiple facets of ischemic heart disease research. Branches of the mouse left main descending coronary artery penetrate the myocardium close to their origin and require “blind” ligation. Our objective was to develop a technique for ligation of nonvisible coronary artery branches to permit the reliable creation of infarcts of uniformly small size and location. From latex castings of the left coronary artery of C57BL/6J mice ( n = 53), we calculated the highest probability for the location of branch points of two of three left ventricular (LV) branches distal to the origin of the left main descending artery. On the basis of these anatomic probabilities, we blindly ligated two areas that were likely to be locations of these nonvisible LV branches. We were successful in producing two types of small transmural myocardial infarctions (16.04 ± 3.64 and 4.68 ± 1.47% of the LV) in 57% of attempts. Thus our branch pattern probability-assisted method permits routine creation of small infarcts of uniform size in the mouse.

scholarly journals ASYMPTOMATIC ANOMALOUS LEFT CORONARY ARTERY FROM THE PULMONARY ARTERY (ALCAPA) IN AN ADULT.

2021 ◽  
Author(s):  
Demetrio Sharp Dimitri ◽  
Andrew Panakos ◽  
Carlos Alfonso ◽  
Vicente Orozco-Sevilla
Keyword(s):  
Coronary Artery ◽  
Mitral Regurgitation ◽  
Pulmonary Artery ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Left Coronary Artery ◽  
Left Ventricular ◽  
Mitral Insufficiency ◽  
Shortness Of Breath ◽  
Left Main

We describe a patient in whom this anomaly was diagnosed during cardiac catheterization for evaluation of progressive shortness of breath and mild to moderate mitral regurgitation founded on a transthoracic echocardiogram.A 58-year-old hypertensive female was evaluated for progressive shortness of breath. Her physical examination showed a regular heart rate and rhythm, with normal heart sounds with a holosystolic systolic murmur on the 4th intercostal midclavicular line on auscultation. Electrocardiography showed normal sinus rhythm and criteria and possible left ventricular hypertrophy. Stress Echocardiogram showed with no evidence of ischemia preserved left ventricular function with an ejection fraction of 55-60%, with mild to moderate mitral regurgitation. Patient underwent a coronary catheterization for persistent shortness of breath which indicated no evidence of obstructive coronary disease, normal left ventricular function with mild to moderate mitral insufficiency. Angiography of the right coronary artery showed a very large and tortuous artery that collateralizes into the left main system and supplies the entire left coronary artery system. The left main coronary origin was from the pulmonary artery. CTA confirmed the same findings. The recommendations between cardiology and cardiothoracic surgery were to maximize medical therapy and follow up due to lack of myocardial ischemia or severe valvular disease. Currently there are no guidelines or gold standard management for patients with adult form of ALCAPA that present without ischemic burden or for patients with the disease that present asymptomatic with significant coronary collateralization.

Quantitative Assessment of Left Ventricular Function of Coronary Atherosclerotic Heart Disease with 640-Slice Dynamic Volume CT in Comparison to Echocardiography

2021 ◽  
Vol 11 (5) ◽  
pp. 1378-1383
Author(s):  
Zirong Wang ◽  
Tingting Song ◽  
Da Yu
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Left Coronary Artery ◽  
Left Ventricular ◽  
Coronary Artery Imaging ◽  
Artery Disease

Objective: The primary aim is to investigate the correlation between 640-slice dynamic volume computer tomography (DVCT) and echocardiography (ECHO) in the function of left ventricular (LV), and the value of DVCT in the evaluation of left coronary artery disease (LCA) and geometry and function of left ventricular, by measuring the difference of left ventricular function of coronary atherosclerotic heart disease with DVCT in comparison to ECHO. Materials and Methods: Sixty-three patients of coronary heart disease (CHD) with left coronary artery disease were selected, all of them were examined by DVCT coronary imaging and ECHO. On the basis of the American Society of Cardiovascular Computed Temography, the study applied the Coronary Artery Disease Report and Data System (CAD-RADS) to assess the left cornary artery. The end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF) and myocardial mass (MM) of function parameters of the left ventricle were counted. The function parameters of DVCT and ECHO were comparatively analyzed. Results: The results showed that there was a positive correlativity between the value of EDV, ESV, SV and EF which measured through DVCT and the ECHO (r = 0.69, 0.90, 0.60, 0.71 respectively, P < 0.05 all). The differences of ESV, SV, EF between CAD-RADS 2 and 4, CAD-RADS 3 and 4 were significant (P < 0.05). The differences of data of EDV and MM between CAD-RADS 2, 3 and 4 were statistically significant (P < 0.05). Conclusion: Both DVCT coronary artery imaging and ECHO can accurately assess left ventricular function and have a high correlation. DVCT coronary artery imaging can assess CAD and analyze the function of left ventricular. EDV and MM change significantly in CAD-RADS 3, which providing important quantitative data for clinical diagnosis and treatment plan of coronary heart disease.

Repair of Anomalous Left Coronary Artery from Pulmonary Artery (ALCAPA) beyond Infancy

2013 ◽  
Vol 16 (4) ◽  
pp. 210 ◽  
Author(s):  
Sachin Talwar ◽  
Aandrei Jivendra Jha ◽  
Shiv Kumar Choudhary ◽  
Saurabh Kumar Gupta ◽  
Balram Airan
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Respiratory Tract ◽  
Left Coronary Artery ◽  
Nyha Class ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Anomalous Left Coronary Artery ◽  
Tract Infections ◽  
Anomalous Left Coronary

Between January 2002 and December 2012, five patients (4 female) underwent corrective surgery for anomalous left coronary artery from pulmonary artery (ALCAPA). They were older than 1 year (range, 3-56 years). One of the 2 patients younger than 10 years had presented with congestive heart failure, and the other had experienced repeated episodes of lower respiratory tract infection since childhood. Of the remaining 3 adult patients, 2 had experienced angina with effort, and 1 patient had had repeated respiratory tract infections since childhood, with mild dyspnea on effort of New York Heart Association (NYHA) class II. Three patients had the anomalous left coronary artery implanted directly into the ascending aorta via coronary-button transfer, and 2 patients underwent coronary artery bypass with obliteration of the left main ostium. Two patients underwent concomitant mitral valve repair procedures, and 1 patient underwent direct closure of a perimembranous ventricular septal defect. Four patients survived the surgery, and 1 patient died because of a persistently low cardiac output. Follow-up times ranged from 3 months to 4 years. All survivors are in NYHA class I and have left ventricular ejection fractions of 45% to 60%, with moderate (n = 1), mild (n = 1), or no (n = 2) mitral insufficiency. We conclude that a few naturally selected patients with ALCAPA do survive beyond infancy and can undergo establishment of 2 coronary systems with satisfactory results.

Outcomes of surgical repair of anomalous origin of the left coronary artery from the pulmonary artery in infants and children

2021 ◽  
pp. 1-6
Author(s):  
Tong Feng ◽  
Guo Zhangke ◽  
Bai Song ◽  
Fan Fan ◽  
Zhen Jia ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Mitral Regurgitation ◽  
Ejection Fraction ◽  
Pulmonary Artery ◽  
Left Coronary Artery ◽  
Surgical Repair ◽  
Left Ventricular ◽  
Anomalous Origin ◽  
Dimension Index

Abstract Objectives: Anomalous origin of the left coronary artery from the pulmonary artery is associated with high mortality if not timely surgery. We reviewed our experience with anomalous origin of the left coronary artery from the pulmonary artery to assess the preoperative variables predictive of outcome and post-operative recovery of left ventricular function. Methods: A retrospective review was conducted and collected data from patients who underwent anomalous origin of the left coronary artery from the pulmonary artery repair at our institute from April 2005 to December 2019. Left ventricular function was assessed by ejection fraction and the left ventricular end-diastolic dimension index. The outcomes of reimplantation repair were analysed. Results: A total of 30 consecutive patients underwent anomalous origin of the left coronary artery from the pulmonary artery repair, with a median age of 14.7 months (range, 1.5–59.6 months), including 14 females (46.67%). Surgery was performed with direct coronary reimplantation in 12 patients (40%) and the coronary lengthening technique in 18 (60%). Twelve patients had concomitant mitral annuloplasty. There were two in-hospital deaths (6.67%), no patients required mechanical support, and no late deaths occurred. Follow-up echocardiograms demonstrated significant improvement between the post-operative time point and the last follow-up in ejection fraction (49.43%±19.92% vs 60.21%±8.27%, p < 0.01) and in moderate or more severe mitral regurgitation (19/30 vs 5/28, p < 0.01). The left ventricular end-diastolic dimension index decreased from 101.91 ± 23.07 to 65.06 ± 12.82 (p < 0.01). Conclusions: Surgical repair of anomalous origin of the left coronary artery from the pulmonary artery has good mid-term results with low mortality and reintervention rates. The coronary lengthening technique has good operability and leads to excellent cardiac recovery. The decision to concomitantly correct mitral regurgitation should be flexible and be based on the pathological changes of the mitral valve and the degree of mitral regurgitation.

scholarly journals Anomalous Origin of the Left Anterior Descending Coronary Artery in an Adult

2021 ◽  
Vol 10 (01) ◽  
pp. e9-e10
Author(s):  
Keisuke Shibagaki ◽  
Chikara Shiiku ◽  
Hiroyuki Kamiya ◽  
Yoichi Kikuchi
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Pulmonary Artery ◽  
Congenital Heart ◽  
Left Coronary Artery ◽  
Internal Thoracic Artery ◽  
Artery Bypass ◽  
Anomalous Origin ◽  
Bypass Grafting

AbstractAn anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart disease. Among the variants, an anomalous origin of the left anterior descending coronary artery from the pulmonary artery (ALADPA) is extremely rare. Here, we report a case of ALADPA in an adult that was treated with coronary artery bypass grafting using the left internal thoracic artery.

Coronary artery z score values in adolescent elite male soccer players

2020 ◽  
pp. 1-5
Author(s):  
Stephan Gerling ◽  
Tobias Pollinger ◽  
Markus Johann Dechant ◽  
Michael Melter ◽  
Werner Krutsch ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
High Intensity ◽  
Left Main Coronary Artery ◽  
Left Ventricular ◽  
Soccer Players ◽  
Z Score ◽  
Left Main ◽  
Luminal Diameter ◽  
The Mean

Abstract Background: With the increased training loads at very early ages in European elite youth soccer, there is an interest to analyse coronary artery remodelling due to high-intensity exercise. Design and methods: Prospective echocardiographic study in 259 adolescent elite male soccer players and 48 matched controls. Results: The mean age was 12.7 ± 0.63 years in soccer players and 12.6 ± 0.7 years in controls (p > 0.05). Soccer players had significant greater indexed left ventricular mass (93 ± 13 g/m2 versus 79 ± 12 g/m2, p = 0.001). Both coronary arteries origin could be identified in every participant. In soccer players, the mean diameter of the left main coronary artery was 3.67 mm (SD ± 0.59) and 2.61 mm (SD ± 0.48) for right main coronary artery. Controls showed smaller mean luminal diameter (left main coronary artery, p = 0.01; right main coronary artery, p = 0.025). In soccer players, a total of 91% (n = 196) and in controls a total of 94% (n = 45) showed left main coronary artery z scores within the normal range: −2.0 to 2.0. In right main coronary artery, a pattern of z score values distribution was comparable (soccer players 94%, n = 202 vs. controls 84%, n = 40). A subgroup of soccer players had supernormal z score values (>2.0 to 2.5) for left main coronary artery (9%, n = 19, p = 0.01) and right main coronary artery (6%, n = 10, p = 0.025), respectively. Conclusion: Elite soccer training in early adolescence may be a stimulus strong enough to develop increased coronary arteries diameters. In soccer players, a coronary artery z score >2.0–2.5 might reflect a physiologic response induced by multiannual high-intensity training.

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