scholarly journals Pattern of left main stenosis at a tertiary cardiac center of Nepal

2017 ◽  
Vol 14 (1) ◽  
pp. 29-30
Author(s):  
Binay Kumar Rauniyar ◽  
Milan Gautam ◽  
Ranjit Sharma ◽  
Subodh Bir Singh Kansakar ◽  
Rajib Rajbhandari ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Main Stem ◽  
Left Main ◽  
Vessel Disease ◽  
Left Main Stem ◽  
Triple Vessel Disease ◽  
Cardiology Department ◽  
Artery Disease ◽  
Cardiac Center ◽  
Left Main Stem Disease

Background and Aims: Left main stem stenosis is defined as a lesion occupying more than 50% of the lumen diameter. Various studies have shown that left main stem stenosis occurs in 4%-6% of all the patients undergoing coronary angiography. We aim to find out the pattern of Left main stem disease in cardiology department of a tertiary cardiac center of Nepal.Methods: This was a retrospective study and was conducted from the properly maintained record of 2 years (August 2011 to July 2013) from cardiaccatheterization labs of Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Nepal.Results: During the study period 3290 coronary angiogram were done. Among them 102 (3.1%) patients had left main stem stenosis of more than 50%. Mean age of the patients with left main stem stenosis was 60.6±10.1yrs. Most of (73.5%) of patients with left main stem stenosis were of age more than 55 years. Most (80.3%) of them were male. Ostial left main stem stenosis was present in 32 (31.3%) patients whereas distal left main stem stenosis was present in 70 (68.6%) patients. In patients with Left main stem stenosis, single vessel disease was present in 12 (11.7%), double vessel disease in 33(32.3%) and triple vessel disease in 49 (48.0%) patients, whereas 8 (7.8%) patients with non-critical coronary artery disease.Conclusion: Left main stem disease is not an uncommon angiographic finding and is often associated with multivessel coronary artery disease. It commonly occurs in distal part of vessel and the patients were older males.Nepalese Heart Journal 2017; 14(1): 29-30

scholarly journals Angiographic Severity of Coronary Artery Disease in Diabetic and Non-Diabetic Patients in a Tertiary Care Centre

2015 ◽  
Vol 10 (1) ◽  
pp. 13-17 ◽  
Author(s):  
Tanjima Parvin ◽  
KMHS Sirajul Haque ◽  
Md Abu Siddique ◽  
SM Ahsan Habib ◽  
Mukhlesur Rahman ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Main Stem ◽  
Diabetic Patients ◽  
Left Main ◽  
Coronary Syndrome ◽  
Vessel Disease ◽  
Left Main Stem ◽  
Severe Coronary Artery ◽  
Artery Disease

Objective: Diabetes mellitus, a common metabolic disorder, is often associated with severe coronary artery disease. In this study, we compared the angiographic severity of coronary artery disease in diabetic patients compared with that of non diabetic patients.Methods: This observational study comprised of 102 subjects who had coronary artery disease on coronary angiography in the Department of Cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2009 to December 2009. The patients were divided into two groups: one group with 24 (23.5%) diabetic patients and another group with 78 (76.5%) non diabetic patients. Demographic, clinical, laboratory and angiographic data were analyzed and compared between two groups.Results: Mean age±SD of the study subjects was 52.8±9.5 years and 94 (92%) of them were male. Diabetic patients were older (mean age±SD; 57.6±9.5 versus 51.3±9.9 years; p 004), and had higher frequency of hypertension (75% versus 50%, p 0.036), chronic stable angina (71% versus 41%, p 0.018), and lower frequency of smoking (42% versus 67%, p 0.034) and acute coronary syndrome (29% versus 59%; p 0.018) in comparison to non diabetic patients. Left main stem disease (21% versus 5%, p 0.031) and three-vessel disease (50% versus 31%, p 0.094) were more prevalent in diabetic patients. Severe coronary artery stenosis was significantly more present in diabetics than non diabetics (Gensini score, 50.9±29.9 versus 32.6±21.9, p 0.001).Conclusion: Diabetic patients are more likely to have severe and extensive coronary artery disease. Left main stem and triple vessel disease are more commonly seen in diabetic patients compared to non diabetic patients.University Heart Journal Vol. 10, No. 1, January 2014; 13-17

scholarly journals Revascularisation of left main stem disease: a prospective analysis of modern practice and outcomes in a non-surgical centre

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000804
Author(s):  
J J Coughlan ◽  
Nial Blake ◽  
Napohn Chongprasertpon ◽  
Munir Ibrahim ◽  
Samer Arnous ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Main Stem ◽  
Left Main ◽  
Clinical Registry ◽  
Left Main Stem ◽  
Modern Drug ◽  
Artery Disease ◽  
Left Main Stem Disease

PurposeIn this study, we sought to prospectively analyse the management and long term outcomes associated with revascularisation of left main stem disease via percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in our centre.MethodsThis prospective study enrolled all patients with unprotected left main stem disease undergoing revascularisation from January 2013 to June 2014. Baseline characteristics, hospital presentation and hospital stay length were collected. Patients were followed up at 1, 2 and 3 years. Primary outcomes of Major Adverse Cardiovascular and Cerebrovascular Events (MACCE) were defined as death, Q wave myocardial infarction, stroke, repeat revascularisation and readmission within 30 days.Results56 patients with significant left main stem coronary artery disease were identified from the clinical registry. 27 patients underwent PCI (median age 67.7) and 29 CABG (median age 68.6). PCI patients had a higher surgical risk as measured by mean euroSCORE (4.95±5.8 vs 3.11±3.85). At 3 years, total MACCE occurred in 29.6% of the PCI cohort and 27.5% of the CABG cohort. Death occurred in three patients in the PCI group within the first 6 months. Death occurred in one patient in the CABG group over 2 years postprocedure. Two patients in the CABG cohort presented with Transient Ischemic Attacks (TIAs) at 2-year follow-up. At 3 years, revascularisation occurred in three patients in the PCI cohort. There were no revascularisation events in the CABG cohort.ConclusionsPCI with modern drug eluting stents is a reasonable treatment option for unprotected left main stem disease in a non surgical centre.

Surgery for Chronic Total Occlusion of the Left Main Stem: A 10-Year Experience

2009 ◽  
Vol 17 (5) ◽  
pp. 472-476 ◽  
Author(s):  
Raja Parvez Akhtar ◽  
Mumraiz Salik Naqshband ◽  
Abdul Rehman Abid ◽  
Zafar Tufail ◽  
Abdul Waheed ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Chronic Total Occlusion ◽  
Artery Bypass ◽  
Main Stem ◽  
Hospital Death ◽  
Left Main ◽  
Total Occlusion ◽  
Vessel Disease ◽  
Left Main Stem ◽  
Ischemic Attack

Chronic total occlusion of the left main stem coronary artery is rare. This retrospective study was conducted to evaluate outcomes of coronary artery bypass grafting between June 1998 and June 2008 in patients with chronic left main stem total occlusion. There were 17 (0.025%) cases detected in 67,082 coronary angiograms. The 14 men and 3 women had a mean age of 55.32 ± 9.2 years. Risk factors included diabetes in 8, hypertension in 6, and smoking in 6. Of 54 grafts applied, 15 were arterial and 39 were venous; 14 patients had 3-vessel disease, and 3 had 4-vessel disease. Three patients required intraaortic balloon counterpulsation perioperatively. The mean intensive care unit stay was 2.1 ± 1.2 days, and hospital stay was 7.1 ± 1.5 days. Postoperatively, one patient suffered myocardial infarction, another had a transient ischemic attack with spontaneous recovery, and 2 developed atrial fibrillation. There was no operative or hospital death. Surgical revascularization is considered appropriate treatment for chronic total occlusion of the left main stem.

scholarly journals Prevalence of Left main coronary artery disease with diabetes and hypertension in STEMI patients

2021 ◽  
Vol 15 (6) ◽  
pp. 1456-1458
Author(s):  
F. Ali ◽  
Q. A. Saboor ◽  
T. Mahmud ◽  
F. Ali ◽  
H. Bashir ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Exposed Group ◽  
Main Stem ◽  
Diabetic Patients ◽  
Left Main ◽  
Unexposed Group ◽  
Left Main Stem ◽  
Male Patients ◽  
Artery Disease ◽  
Left Main Stem Disease

Aim: To determine the association of left main stem disease with diabetes and hypertension in STEMI patients underwent coronary angiography Methodology: This study was conducted at Department of Cardiology, Sheikh Zayed Hospital, Lahore during January to June 2019 where 220 patients with age ranging from 40-70 years whether male or female, presenting with STEMI, In Exposed Group: Patients presenting with STEMI having diabetes and hypertension and Unexposed Group: Patients of STEMI without diabetes and hypertension. We excluded all cases with recurrent MI or undergoing recurrent PCI (on medical record), valvular heart disease, and cardiogenic shock. Then two groups were formed i.e. exposed group with diabetes and hypertension and unexposed group without diabetes and hypertension. All patients underwent angiography by a senior consultant cardiologist with assistance of researcher. On angiography, presence of LMS disease was ≥50% occlusion (stenosis) in LMS artery. Angiography reports were assessed and LMS disease was noted labeled. Patients with LMS disease was managed as per hospital protocol. Results: In this study risk of LMS was higher among exposed group as compared to un exposed group. i.e. exposed: 19.1% & Unexposed: 5.5%, RR=3.50 The risk of LMS among exposed group was higher for patients in the age group 51-60 years (RR=8.00), for male patients (RR=5.76) risk for LMS was higher as compared to female patients in exposed group, patients with normal BMI (RR:2.20) and patients with shorter duration of STEMI in exposed group had higher risk for LMS (1-4 weeks: RR=7.54). Conclusion: Results of this study showed that hypertensive and diabetic patients presenting with STEMI had higher risk for LMS disease. Keywords: Left main stem, Diabetes, Hypertension, Coronary, Angiography

scholarly journals Frequency of significant carotid artery disease on carotid angiography in patients with left main stem coronary artery disease.

2021 ◽  
Vol 28 (09) ◽  
pp. 1252-1256
Author(s):  
Aatar Yaqoob ◽  
Sonia William ◽  
Muhammad Yasir
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Carotid Artery ◽  
Carotid Artery Disease ◽  
Main Stem ◽  
Carotid Angiography ◽  
Left Main ◽  
Arterial Access ◽  
Left Main Stem ◽  
Artery Disease

Objectives: To determine the frequency of significant carotid artery disease on carotid angiography in patients presenting with left main stem coronary artery disease. Study Design: Cross Sectional study. Setting: Department of Cardiology, Faisalabad Institute of Cardiology, Faisalabad. Period: October 2016 to April 2017. Material & Methods: 140 patients were included in this study. To diagnose carotid artery disease, carotid angiography was performed. Imaging was performed while subjects were lying in a supine position. Arterial access gained through femoral artery and using Headhunter carotid angiography catheter (6F). Lateral, AP and ipsilateral oblique views was obtained. Results: Age ranges between 40-75 years with mean age of 53.91±7.05 years. There were 94 (67.2%) male patients while remaining 46 patients (32.8%) were female. Carotid artery disease was found in 54 patients (38.6%). Stratification with regard to gender and age was carried out. Conclusion: In conclusion, frequency of carotid artery disease in patients with left main stem coronary artery disease is high in our population. Therefore, screening of carotid artery disease should be recommended in patients with CAD, especially in older patients with multivessel CAD.

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