scholarly journals Is the Prevalence of Coronary Artery Anomalies Different in Countries with Small Populations? – A Retrospective Study in Northern Cyprus

2021 ◽  
Vol 24 (6) ◽  
pp. E1027-E1032
Author(s):  
Musa Muhtaroglu ◽  
Sevda Lafci Fahrioglu ◽  
Osman Beton ◽  
Sezgin İlgi
Keyword(s):  
Coronary Artery ◽  
Patient Population ◽  
Coronary Artery Anomalies ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Autopsy Series ◽  
Coronary Artery Fistulas ◽  
Angiographic Data ◽  
The Right ◽  
Treatment Procedures

Background: Although the prevalence of coronary artery anomalies (CAA) is due to accidental and rare discoveries, it varies between different countries or geographies. CAA are rare congenital disorders having various clinical definitions. Its prevalence varies in angiographic and autopsy series in adult populations and is approximately 1% in average. While the incidence ranges from 0.2% to 5.64% in coronary angiographic (CAG) studies, it is around 0.3% in autopsy series. We aimed to estimate the frequency of CAA in our patient population. Methods: The coronary angiographic data of 4099 consecutive adult patients, who underwent CAG between January 2019 and December 2020, were analyzed and retrospectively studied. Results: The mean age of the total patients who underwent CAG was 61.59 ± 13.67 years (range, 18-98 years). CAA were found in 76 patients (1.85% incidence), origin and course anomaly in 62 patients (81.6%), and coronary artery termination anomaly in 14 patients (18.4%). Separate exits of the left anterior descending (LAD) and left circumflex (LCX) coronary artery from the left sinus of Valsalva (LSV) were the most common anomalies (36.84%). Coronary artery fistulas were seen in 14 (18.42%) patients. Abnormal origin of left circumflex artery (LCX) from the right coronary artery (RCA) or right sinus valsalva (RSV) was seen in 13 (17.11%) patients. Outflow anomalies from the contralateral coronary sinus were detected in 10 (13.16%) patients. Conclusion: The incidence and pattern of CAA in our patient population showed similarity with previous studies. Physicians should be aware of CAA that may be associated with potentially serious cardiac incidents, because recognition of these CAA is important for the decision of treatment procedures.

scholarly journals Anomalous Origin of Coronary Arteries

2020 ◽  
Author(s):  
Xhevdet Krasniqi ◽  
Hajdin Çitaku
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Interventional Cardiology ◽  
Anomalous Origin ◽  
Coronary Artery Anomalies ◽  
Circumflex Artery ◽  
Artery Disease ◽  
Recent Classification ◽  
The Right ◽  
And Function

Coronary arteries supply the heart muscle with blood maintaining myocardial hemostasis and function. Coronary artery anomalies may persist after birth affecting cardiovascular system through haemodynamic impairment caused from shunting, ischaemia, especially in young children or adolescents and young adults. In patients undergoing coronary angiography the incidence of anomalous origination of the left coronary artery from right sinus is 0.15% and the right coronary artery from the left sinus is 0.92%. A recent classification of the coronary anomalies is based on anatomical considerations, recognizing three categories: anomalies of the origin and course, anomalies of the intrinsic coronary artery anatomy, and anomalies of the termination. In the setting of anomalous coronary artery from the opposite sinus, the proximal anomalous CA may run anterior to the pulmonary trunk (prepulmonic), posterior to the aorta (retroaortic), septal (subpulmonic), or between the pulmonary artery and the aorta itself (interarterial). Among them, only those with an interarterial aorta-pulmonary course are regarded as hidden conditions at risk of ischaemia and even sudden death. We presented two cases with anomalous origin of coronary arteries from opposite sinus, and two other cases with anomalous origin of left circumflex artery. The atherosclerotic coronary artery disease leads to the need of coronarography which can find out the presence of coronary artery anomalies. Anomalous origin of coronary artery that is present with atherosclerotic changes continues to exist as a challenge during treatment in interventional cardiology.

scholarly journals Simultaneous stenting of the left main coronary stem and internal carotid artery in a hemodynamically unstable patient

2011 ◽  
Vol 68 (8) ◽  
pp. 712-715 ◽  
Author(s):  
Dragan Sagic ◽  
Zelimir Antonic ◽  
Milan Stanisic ◽  
Nenad Ilijevski ◽  
Predrag Milojevic ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Carotid Artery ◽  
Carotid Stenting ◽  
Main Stem ◽  
Left Main ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Unstable Patient ◽  
Left Main Stem ◽  
The Right

Introduction. Combined endovascular interventions on carotid and coronary arteries are rare. Stenting of the unprotected coronary left main stem is a high risk procedure. We presented hemodynamically unstable patient with combined carotid artery and left main stem coronary artery stenting. Case report. A 78-year-old female patient was admitted to our institution for right carotid endaterectomy. The patient had 80% stenosis of the right carotid artery and occlusion of the left carotid artery. Coronary angiography revealed 70% ostial left main stenosis, occlusion of the right coronary artery and the left circumflex artery, and 80% stenosis of the left anterior descending artery. Simultaneous carotid artery endaterectomy and coronary artery by-pass grafting were considered. Due to high perioperative risk, surgery was rejected, and the patient was treated endovascularly with stenting of arteries occluded. The procedure was completed without complications and the patient was hemodynamically stabilised. Conclusion. This report illustrates simultaneous coronary and carotid stenting as a successfull lifesaving procedure.

scholarly journals Extraction of morphometry and branching angles of porcine coronary arterial tree from CT images

2009 ◽  
Vol 297 (5) ◽  
pp. H1949-H1955 ◽  
Author(s):  
Thomas Wischgoll ◽  
Jenny S. Choy ◽  
Ghassan S. Kassab
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Topological Analysis ◽  
Minimum Energy ◽  
Power Laws ◽  
Ct Images ◽  
Arterial Tree ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
The Right

The morphometry (diameters, length, and angles) of coronary arteries is related to their function. A simple, easy, and accurate image-based method to seamlessly extract the morphometry for coronary arteries is of significant value for understanding the structure-function relation. Here, the morphometry of large (≥1 mm in diameter) coronary arteries was extracted from computed tomography (CT) images using a recently validated segmentation algorithm. The coronary arteries of seven pigs were filled with Microfil, and the cast hearts were imaged with CT. The centerlines of the extracted vessels, the vessel radii, and the vessel lengths were identified for over 700 vessel segments. The extraction algorithm was based on a topological analysis of a vector field generated by normal vectors of the extracted vessel wall. The diameters, lengths, and angles of the right coronary artery, left anterior descending coronary artery, and left circumflex artery of all vessels ≥1 mm in diameter were tabulated for the respective orders. It was found that bifurcations at orders 9–11 are planar (∼90%). The relations between volume and length and area and length were also examined and found to scale as power laws. Furthermore, the bifurcation angles follow the minimum energy hypothesis but with significant scatter. Some of the applications of the semiautomated extraction of morphometric data in applications to coronary physiology and pathophysiology are highlighted.

scholarly journals Safety and Efficacy of Guidezilla Extension Catheter for the Percutaneous Treatment of Complex Coronary Lesions

2020 ◽  
Vol 23 (2) ◽  
pp. E147-E150
Author(s):  
Tao Chen ◽  
Weihao Xu ◽  
Yulun Cai ◽  
Qi Wang ◽  
Jun Guo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Percutaneous Treatment ◽  
Target Lesion ◽  
Lesion Length ◽  
Circumflex Artery ◽  
Chronic Total Occlusions ◽  
Left Circumflex Artery ◽  
Coronary Lesions ◽  
Procedural Success ◽  
The Right

Background: The GuidezillaTM support extension catheter is designed to provide extra back-up support and efficient device delivery during complex percutaneous coronary interventions (PCIs), such as in treatment of severe calcification, tortuous chronic total occlusions (CTOs), and coronary anomalies. The aim of this study was to describe our initial experience with the GuidezillaTM extension catheter in the treatment of complex coronary artery lesions. Methods: This study retrospectively analyzed data from 165 PCI cases that used the GuidezillaTM guide extension catheter between March 2015 and August 2017. We collected patient clinical characteristics, target lesion characteristics, and procedural details. Results: Eighty-six percent of patients had complex Type C lesions, and 13.9% had Type B lesions. Lesion length ranged from 8 mm to 130 mm (≤ 20 mm, 15.4%; 20–40 mm, 35.8%; > 40 mm, 49.1%). The right coronary artery (59.2%) was the most common intervention vessel followed by the left ascending artery (30.6%) and the left circumflex artery (10.2%). CTO accounted for 38% of all lesions, followed by distortions (28%), heavy calcification (24%), proximal stent thrombosis (9%), and coronary artery origin anomalies (1%). A total of 142 patients underwent successful PCI using the GuidezillaTM extension catheter. The success rate was 86%. Conclusion: The GuidezillaTM guide extension catheter was an effective and safe technique in the transradial treatment of complex coronary lesions. Use of the GuidezillaTM guide extension catheter can shorten the procedure time and ensure overall procedural success with a reduced complication rate in cases where adequate progress using angioplasty devices has not been achieved.

Analysis of blood flow in the entire coronary arterial tree

2005 ◽  
Vol 289 (1) ◽  
pp. H439-H446 ◽  
Author(s):  
N. Mittal ◽  
Y. Zhou ◽  
C. Linares ◽  
S. Ung ◽  
B. Kaimovitz ◽  
...  
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Coronary Blood Flow ◽  
Flow Distribution ◽  
Model Parameters ◽  
Coronary Perfusion ◽  
Arterial Tree ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
The Right

A hemodynamic analysis of coronary blood flow must be based on the measured branching pattern and vascular geometry of the coronary vasculature. We recently developed a computer reconstruction of the entire coronary arterial tree of the porcine heart based on previously measured morphometric data. In the present study, we carried out an analysis of blood flow distribution through a network of millions of vessels that includes the entire coronary arterial tree down to the first capillary branch. The pressure and flow are computed throughout the coronary arterial tree based on conservation of mass and momentum and appropriate pressure boundary conditions. We found a power law relationship between the diameter and flow of each vessel branch. The exponent is ∼2.2, which deviates from Murray’s prediction of 3.0. Furthermore, we found the total arterial equivalent resistance to be 0.93, 0.77, and 1.28 mmHg·ml−1·s−1·g−1 for the right coronary artery, left anterior descending coronary artery, and left circumflex artery, respectively. The significance of the present study is that it yields a predictive model that incorporates some of the factors controlling coronary blood flow. The model of normal hearts will serve as a physiological reference state. Pathological states can then be studied in relation to changes in model parameters that alter coronary perfusion.

Arrhythmias

2014 ◽  
pp. 851-859
Author(s):  
Murali Chiravuri ◽  
Thomas M. Tadros ◽  
Usha B. Tedrow
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Superior Vena ◽  
Vena Cava ◽  
Av Node ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Sa Node ◽  
Bundle Of His ◽  
The Right

In the normal heart the sinoatrial (SA) node serves as the principal pacemaker and determines the heart rate. The SA node consists of groups of pacemaker cells marked by their ability to spontaneously depolarize and are located at the junction of the right atrium and the superior vena cava. The blood supply to the SA node is variable with the sinus nodal artery arising from the right coronary artery in 60% percent of cases and from the left circumflex artery in 40% of cases. Following depolarization of the SA nodal cells, the signal traverses the atrium before arriving at the atrioventricular (AV) node. The AV node is marked by its ability to delay impulse propagation, which allows for coordinated contraction of the atria and ventricles. The AV nodal artery arises from the right coronary artery in 90% of cases and from the left circumflex artery in 10% of cases. After exiting the AV node, the impulse is transmitted through the bundle of His, the right and left bundle branches, and ultimately exits the terminal Purkinje fibers of the conduction system into the myocardium near the apex of the heart.

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