scholarly journals Commissural Malalignment as a predictor of coronary artery abnormalities in patients with transposition of great arteries

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Mohamed Al Nasef ◽  
Mohammed H. Alghamdi ◽  
Maria L. Bello Valls ◽  
Ahmed M. Zahrani ◽  
Ali AlAkfash ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
Pulmonary Valve ◽  
Transposition Of Great Arteries ◽  
Coronary Artery Abnormalities ◽  
Semilunar Valves ◽  
Abnormal Coronary Artery ◽  
Effective Level ◽  
A Minor

Abstract Background In patients with transposition of the great arteries (TGA), commissural malalignment (CM) between semilunar valves may be associated with abnormal coronary (CA) pattern. We intend to assess the degree of CM with incidence of unusual CA anatomy. Methods We proposed a ratio to measure the distance of both ends of the anterior facing sinuses of the pulmonary valve from the facing commissure of the aortic valve. We labeled it as D1 and D2 distance. A ratio (C ratio) of the smaller distance (either D1 or D2 whichever is shorter) over the sum of both D1 and D2 was taken (D1 or D2 whichever is shorter / D1 + D2). We related this ratio with the incidence of the unusual CA anatomy in D-TGA patients. Results We had a total of 158 patients. We defined the point beyond which the C-Ratio becomes significantly associated with abnormal coronary artery pattern, this represents the median effective level (EL50). The EL50 of the C-Ratio was found to be equal to 31% (0.31). The prediction revealed that the CA pattern would most probably be usual when there is a minor commissural malalignment (C-Ratio less than the EL50) and most probably be unusual when there is a major malalignment (C-Ratio is greater than the EL50). The sensitivity was 71% and the specificity 88% (p-value < 0.0001). Conclusions The C-Ratio helps to categorize the degree of CM as minor (less than 0.31) or major (more than 0.31). A higher C-Ratio predicts a higher incidence of unusual CA pattern.

scholarly journals Commissural Malalignment as a Predictor of Coronary Artery Abnormalities in Patients with Transposition of Great Arteries

2020 ◽  
Vol 22 (Supplement_Q) ◽  
pp. Q1-Q4
Author(s):  
M Al Nasef ◽  
Mohammed H Alghamdi ◽  
Maria L Bello Valls ◽  
Ahmed M Zahrani ◽  
Ali AlAkfash ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
Pulmonary Valve ◽  
P Value ◽  
Transposition Of Great Arteries ◽  
Coronary Artery Abnormalities ◽  
Semilunar Valves ◽  
Abnormal Coronary Artery ◽  
Effective Level ◽  
A Minor

Abstract Background In patients with transposition of the great arteries (TGA), commissural malalignment (CM) between semilunar valves may be associated with abnormal coronary (CA) pattern. We intend to assess the degree of CM with incidence of unusual CA anatomy. Methods We proposed a ratio to measure the distance of both ends of the anterior facing sinuses of the pulmonary valve from the facing commissure of the aortic valve. We labeled it as D1 and D2 distance. A ratio (C ratio) of the smaller distance (either D1 or D2 whichever is shorter) over the sum of both D1 and D2 was taken (D1 or D2 whichever is shorter/D1+D2). We related this ratio with the incidence of the unusual CA anatomy in D-TGA patients Results We had a total of 158 patients. We defined the point beyond which the C-Ratio becomes significantly associated with abnormal coronary artery pattern, this represents the median effective level (EL50). The EL50 of the C-Ratio was found to be equal to 31% (0.31). The prediction revealed that the CA pattern would most probably be usual when there is a minor commissural malalignment (C-Ratio less than the EL50) and most probably be unusual when there is a major malalignment (C-Ratio is greater than the EL50). The sensitivity was 71% and the specificity 88% (p-value &lt;0.0001). Conclusions The C-Ratio helps to categorize the degree of CM as minor (less than 0.31) or major (more than 0.31). A higher C-Ratio predicts a higher incidence of unusual CA pattern

CABG With Internal Thoracic Artery in Children With Congenital Heart Defects: A Good Option When It Is the Only One

2020 ◽  
Vol 11 (6) ◽  
pp. 748-752
Author(s):  
Christian Kreutzer ◽  
Gustavo Bastianelli ◽  
Benjamin Chiostri ◽  
Guillermo Gutierrez ◽  
Daniel Alberto Klinger ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
Valve Replacement ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Internal Thoracic Artery ◽  
Pulmonary Valve ◽  
Heart Defects ◽  
Right Ventricular Outflow Tract ◽  
Pulmonary Valve Replacement

Objective: Coronary complications may present during or after repair of congenital heart defects. We report coronary artery bypass grafting (CABG) by internal thoracic artery (ITA) grafts to either coronary artery in children with congenital anomalies. Methods: Four cases who underwent CABG with ITA grafts from March 2016 to March 2020 were retrospectively reviewed. Results: At the time of operation, patient’s ages and weight were 7 and 20 months old and 14 and 15 years old and 6.5, 10, 40, and 45 kg, respectively. Diagnosis were anomalous origin of the left coronary artery from the pulmonary artery with leftward lateral ostial origin (n = 1), neopulmonary annulus hypoplasia post arterial switch with contiguous right coronary artery (RCA) arising from the left facing sinus (n = 1), RCA stenosis after the Ross procedure (n = 1), and right coronary ostial obstruction after aortic valve replacement in truncus arteriosus (n = 1). Procedures included left ITA to left coronary ostium (n = 1), right ventricular outflow tract (RVOT) enlargement with pulmonary valve replacement with left ITA to RCA (n = 1), RVOT enlargement with pulmonary valve replacement with right ITA to RCA (n = 1), and aortic valve re-replacement, pulmonary valve replacement, and right ITA to RCA (n = 1). At last follow-up, all four patients were asymptomatic, with normal ventricular function, and all grafts were patent. Conclusions: The use of CABG in children is valuable alternative when dealing with complex coronary anatomy not suitable for classic repairs. In children, graft patency is required to be longer than 50 years; therefore, use of arterial grafts seems mandatory.

A Case of Unicuspid Aortic Valve Associated with a Single Coronary Artery and Ventricular Septal Defect

Choonpa Igaku ◽  
2006 ◽  
Vol 33 (1) ◽  
pp. 75-81
Author(s):  
Hiroko ISHIGAMI ◽  
Masatsugu IWASE ◽  
Keiko HYOUDO ◽  
Idumi AOYAMA ◽  
Mamoru ITO ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Single Coronary Artery

Early and Late Mortality of Patients Undergoing Aortic Valve Replacement After Previous Coronary Artery Bypass Graft Surgery

Circulation ◽  
1995 ◽  
Vol 92 (9) ◽  
pp. 163-168 ◽  
Author(s):  
Sayid F. Fighali ◽  
Amilcar Avendaño ◽  
MacArthur A. Elayda ◽  
Vei Vei Lee ◽  
Cesar Hernandez ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Valve Replacement ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Late Mortality

scholarly journals Desquamation in Kawasaki Disease

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 317
Author(s):  
Ling-Sai Chang ◽  
Ken-Pen Weng ◽  
Jia-Huei Yan ◽  
Wan-Shan Lo ◽  
Mindy Ming-Huey Guo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Laboratory Data ◽  
Ivig Treatment ◽  
Low Grade ◽  
High Grade ◽  
Laboratory Findings ◽  
Coronary Artery Abnormalities ◽  
Cell Counts ◽  
Hands And Feet

(1) Background: Desquamation is a common characteristic of Kawasaki disease (KD). In this study, we analyzed patients’ varying desquamation levels in their hands or feet, in correlation with clinical presentation, to assess the relationship. (2) Methods: We retrospectively reviewed children with KD. We analyzed their age, laboratory data before intravenous immunoglobulin (IVIG) treatment and coronary artery abnormalities (CAA) based on the desquamation level of their hands and feet. We classified the desquamation level from 0 to 3 and defined high-grade desquamation as grade 2 and 3. (3) Results: We enrolled a total 112 patients in the study. We found the hands’ high-grade desquamation was positively associated with age and segmented neutrophil percentage (p = 0.047 and 0.029, respectively) but negatively associated with lymphocyte and monocyte percentage (p = 0.03 and 0.006, respectively). Meanwhile, the feet’s high-grade desquamation was positively associated with total white blood cell counts (p = 0.033). Furthermore, we found that high-grade hand desquamation had less probability of CAA formation compared with that of a low grade (7.1% vs. 40.8%, p = 0.016). (4) Conclusions: This report is the first to demonstrate that the desquamation level of hands or feet in KD is associated with different coronary artery abnormalities and laboratory findings.

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