scholarly journals Aneurysm of the Descending Branch of the Right Coronary Artery, Situated in the Wall of the Right Ventricle, and Opening into the Cavity of the Ventricle, Associated with Great Dilatation of the Right Coronary Artery and Non-Valvular Infective Endocarditis

1912 ◽  
Vol 5 (Study_Dis_Child) ◽  
pp. 20-26 ◽  
Author(s):  
E. Salusbury Trevor
Keyword(s):  
Coronary Artery ◽  
Infective Endocarditis ◽  
Right Ventricle ◽  
Right Coronary Artery ◽  
The Right

scholarly journals 478 A rare case of right ventricular ischaemia and ventricular tachycardia in neonate caused by intermittent occlusion of origin of the right coronary artery by an echogenic mass

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Padmanabhan
Keyword(s):  
Ventricular Tachycardia ◽  
Coronary Artery ◽  
Early Diagnosis ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Right Coronary Artery ◽  
Perinatal Asphyxia ◽  
Poor Condition ◽  
Post Surgery ◽  
The Right

Abstract OnBehalf Cornwall A term neonate with poor condition at birth was noted to be markedly bradycardic when crying. ECG showed first degree heart block. Echocardiogram demonstrated poor bi-ventricular function. He was treated for Hypoxic ischemic encephalopathy (HIE). In the next few hours he developed short episodes of ventricular tachycardia with left bundle branch block and non-conducted P waves suggesting an origin of tachycardia from the right ventricle. His repeat ECHO suggested that he had right ventricular infarction due to a very rare finding of intermittent occlusion of the origin of the right coronary artery by an echogenic mass. He was transferred for emergency cardiac surgery to remove a clot of 1.6cm, occluding the right coronary artery. Histology findings were in keeping with a thrombus. Thrombophilia screen for both parents and infant were negative. MRI Brain did not show evidence of HIE suggesting his poor condition at birth was secondary to intermittent coronary ischemia. Discussion: Myocardial infarction (MI) in neonates is a rarely encountered and potentially life-threatening condition, with mortality rate as high as 90%. We present one of the first reported cases of successful surgical management of an acute right coronary artery thrombosis after an early diagnosis. The cause of thrombosis remains unclear in our patient. They were born in poor condition with initial pH 6.9 and lactate of 10, but with a structurally normal heart and negative thrombophilia screen. Perinatal asphyxia is a potential cause; however there is doubt that this may be a symptom rather than cause of the right coronary artery occlusion. Early diagnosis was key in management after a high level of clinical suspicion. He made significant recovery with near normal RV function, and is currently on captopril and carvedilol post-surgery. This is one of the first cases to document near full return of cardiac function following ischaemia to the right ventricle Abstract 478 Figure. 5

Defective regional myocardial development and vascularization in one variant of tricuspid atresia—clinical and necropsy findings in three cases

1992 ◽  
Vol 2 (1) ◽  
pp. 42-52 ◽  
Author(s):  
William N. O'Connor ◽  
Carol M. Cottrill ◽  
Michael T. Marion ◽  
Jacqueline A. Noonan
Keyword(s):  
Coronary Artery ◽  
Right Ventricle ◽  
Tricuspid Valve ◽  
Right Coronary Artery ◽  
Interventricular Septum ◽  
Ventricular Myocardium ◽  
Tricuspid Atresia ◽  
Subaortic Stenosis ◽  
Myocardial Development ◽  
The Right

SummaryFive previously reported cases have established the combination of a small right ventricle (sometimes with Uhl's anomaly), imperforate tricuspid valve with fibrotic tensor apparatus, congenital absence of the pulmonary valve, and an intact interventricular septum with muscular subaortic stenosis as a rare variant of tricuspid atresia. In this study of three new autopsy cases, we additionally identified Ebstein's malformation of the imperforate tricuspid valve, partial Uhl's anomaly, regional dysplasia of right ventricular myocardium and thinning of the interventricular septum by intramyocardial sinusoids from the right ventricle. All three new cases had epicardial anomalies of the right coronary artery—a fistula to right ventricle, ostial stenosis and proximal arterial hypoplasia. Sinusoidal connections from the right ventricle to the right coronary artery and to the sclerotic left anterior descending artery were identified in serial sections of the right ventricle and septum. Myofiber disarray, with thick walled intramyocardial arteries and sinusoids from left ventricle, involved the bulging subaortic interventricular septum. These studies are consistent with the hypothesis that defective development of the the right ventricle, along with its blood supply and associated atrioventricular and arterial valves, may underlie this unusual form of congenital heart disease.

The Influence of Collateral Flow on the Antegrade and Retrograde Distribution of Cardioplegia in Patients with an Occluded Right Coronary Artery 

1998 ◽  
Vol 89 (5) ◽  
pp. 1099-1107 ◽  
Author(s):  
Solomon Aronson ◽  
Eric Jacobsohn ◽  
Robert Savage ◽  
Mario Albertucci
Keyword(s):  
Coronary Artery ◽  
Right Ventricle ◽  
Right Coronary Artery ◽  
Contrast Echocardiography ◽  
Coronary Artery Occlusion ◽  
Artery Occlusion ◽  
Collateral Flow ◽  
Predictive Values ◽  
Antegrade Cardioplegia ◽  
The Right

Background The predictive value of electrocardiography (ECG) and coronary angiography for cardioplegia distribution in patients with an occluded right coronary artery was evaluated. Methods Coronary angiograms and ECGs were evaluated in 15 patients with right coronary artery occlusion. Prediction of antegrade cardioplegia distribution was based on ECG evidence of infarction and coronary collateral flow determined from the angiogram. Antegrade and retrograde delivery of cardioplegia was directly assessed in all patients by myocardial contrast echocardiography. Intraoperative transesophageal echocardiographic images of the right ventricular free wall, the apex, and the intraventricular septum were recorded while 4 ml of Albunex (Mallinckrodt Medical, St. Louis, MO) was injected into antegrade and retrograde cardioplegic catheters during cardioplegia delivery. The observed (myocardial contrast echocardiography) cardioplegia distribution was compared to the predicted cardioplegia distribution. Sensitivity, specificity, positive predictive values, and negative predictive values were calculated. Results Eighty seven of 90 (97%) segments were analyzed. Angiography and ECG poorly predicted incomplete cardioplegia distribution. Electrocardiography was a better predictor of inadequate cardioplegia distribution to the right ventricle than was angiography. The negative predicted values of cardioplegia distribution ranged from 20 to 50% for the septum and right ventricle, respectively, with ECG criteria and from 0 to 33% for the septum and apex, respectively, with angiographic criteria. Antegrade cardioplegia delivery was distributed to the right ventricle in 31% of patients, despite 100% occlusion of the right coronary artery; whereas retrograde cardioplegia delivery to the right ventricle occurred 20% of the time. Conclusions In the presence of 100% right coronary artery occlusion, retrograde cardioplegia delivery is not often observed and antegrade delivery of cardioplegia to the right ventricle is not easily predicted. The preoperative angiography and ECG are not predictive of coronary collateral circulation and therefore not predictive of cardioplegia distribution to the right ventricle.

Single right coronary artery with right ventricular fistula and congenital absence of left coronary artery: an extremely rare combination

2019 ◽  
Vol 29 (11) ◽  
pp. 1402-1403
Author(s):  
Tamer Yoldaş ◽  
Meryem Beyazal ◽  
Utku A. Örün
Keyword(s):  
Coronary Artery ◽  
Right Ventricle ◽  
Right Coronary Artery ◽  
Left Coronary Artery ◽  
Coronary Artery Fistula ◽  
Left Ventricular ◽  
Congenital Absence ◽  
Collateral Vessels ◽  
The Right ◽  
Single Right Coronary Artery

AbstractWe report an extremely rare case of a 14-month-old girl who was diagnosed with a single right coronary artery with coronary artery fistula communicating with the right ventricle and congenital absence of left coronary artery. Angiography showed a dilated and tortuous single right coronary artery draining into the right ventricle, absence of left coronary system, and left ventricular coronary circulation supplied via collateral vessels.

scholarly journals ST segment elevation caused by ostial right coronary artery obstruction in infective endocarditis: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Alexander Bolton ◽  
Georges Hajj ◽  
Laila Payvandi ◽  
Christopher Komanapalli
Keyword(s):  
Coronary Artery ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Right Coronary Artery ◽  
Tertiary Care ◽  
Care Facility ◽  
Coronary Syndrome ◽  
St Segment ◽  
Coronary Embolization ◽  
The Right

Abstract Background Acute coronary syndrome (ACS) is a rare, but serious complication of infective endocarditis, and diagnosis can be challenging given clinical overlap with other syndromes. A rare cause of ACS in infective endocarditis is mechanical obstruction of the coronary artery. We present the case of a patient with infective endocarditis who developed ST segment myocardial infarction due to occlusion of the right coronary artery ostium by a vegetation. Case presentation A 53-year-old female with no prior history of coronary artery disease was transferred to our tertiary care facility for evaluation and treatment of suspected myopericarditis. After transfer she developed inferior ST segment elevations on ECG along with fever and positive blood cultures for methicillin susceptible Staphylococcus aureus (MSSA). A transesophageal echocardiogram revealed a vegetation on the aortic valve that intermittently prolapsed into the right coronary ostium. She decompensated from a hemorrhagic brain infarct and subsequently transferred to the intensive care unit. She underwent surgical aortic valve debridement without prior cardiac catheterization given the danger of septic coronary embolization. After a prolonged hospital course with multiple complications, she was able to discharge home, with no neurologic deficits on follow-up. Conclusions ACS presents a diagnostic and therapeutic challenge in the setting of infective endocarditis. Careful attention to the history, physical exam and testing can help differentiate infective endocarditis from other conditions sharing similar symptoms. Traditional atherosclerotic ACS management may cause great harm when treating patients with infective endocarditis. The presence of a multidisciplinary endocarditis team is ideal to provide the best clinical outcomes for this population.

scholarly journals Aortic Valve Endocarditis Complicated by ST-Elevation Myocardial Infarction

2014 ◽  
Vol 41 (6) ◽  
pp. 668-670 ◽  
Author(s):  
Benjamin E. Jenny ◽  
Yassar Almanaseer
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Right Coronary Artery ◽  
Medical Literature ◽  
Abscess Formation ◽  
Clinical Event ◽  
St Elevation ◽  
The Right

Infective endocarditis complicated by abscess formation and coronary artery compression is a rare clinical event with a high mortality rate, and diagnosis requires a heightened degree of suspicion. We present the clinical, angiographic, and echocardiographic features of a 73-year-old woman who presented with dyspnea and was found to have right coronary artery compression that was secondary to abscess formation resulting from diffuse infectious endocarditis. We discuss the patient's case and briefly review the relevant medical literature. To our knowledge, this is the first reported case of abscess formation involving a native aortic valve and the right coronary artery.

scholarly journals Coronary arteries morphometry and their vascular territories

2013 ◽  
Vol 19 (3) ◽  
pp. 130-135
Author(s):  
V. Ispas ◽  
P. Bordei ◽  
D. M. Iliescu ◽  
R. Baz
Keyword(s):  
Coronary Artery ◽  
Right Ventricle ◽  
Coronary Arteries ◽  
Right Coronary Artery ◽  
Left Coronary Artery ◽  
Ct Scanner ◽  
Circumflex Artery ◽  
Marginal Artery ◽  
The Right ◽  
Coronary Dominance

Abstract Our study was performed on a total of 24 angioCT’s by each coronary artery executed on a GE LightSpeed VCT64 Slice CT Scanner. To assess the type of vascularization (coronary dominance) we used also dissection on fresh and formalin preserved hearts, injection of contrast substance followed by radiography and plastic mass injection followed by corrosion. Left coronary artery from origin I found a diameter of between 4.1 to 5.8 mm, the length of the left main coronary artery until its branching (bi or trifurcation) ranging from 3 to 11.8 mm. The diameter of the anterior interventricular artery, was between 1.8 to 3.4 mm, and when the anterior interventricular artery branched off a left marginal artery, it was less voluminous than the case when the marginal artery origin by trifurcation of coronary artery, with 1.8-2.5 mm. Anterior interventricular artery detach left anterior ventricular branches with a diameter of 1.2-2.2 mm. Circumflex artery present a diameter of 2.1 to 4.2 mm at the left aspect of the heart circumflex artery has a diameter of 2.1 to 3.4 mm. On the posterior surface of left ventricle from circumflex artery branches come off with 1.2 to 2.4 mm in diameter. Left marginal artery, when originate from the left coronary artery had a diameter of 2.1 to 2.8 mm. The right coronary artery presents at origin a diameter of 3.1 to 5.4 mm, from the coronary right for the anterior aspect of the right ventricle unhooking the branches with a diameter of 2.2 to 4.2 mm. To the posterior of the right ventricle right coronary artery gave branches with a diameter of 1.6 to 2.6 mm. Right marginal artery had a diameter of 1.6-2.2 mm, and in one case (4.17% from cases) had a diameter of 3.4 mm (when the right coronary origin was 5.4 mm ). From right the coronary atrial branches detaches with a caliber of 0.6-2 mm. Regarding the coronary dominance, we found on a number of 88 hearts that in 29.54% of cases there is predominance of right coronary artery in 25% of cases there is a predominance of the left coronary artery, and in 45.46% of cases there is a balance between the territories of the vascularity of the two coronary arteries.

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