scholarly journals Myocardial infarction in an adult with cystic fibrosis and heart and lung transplant

2013 ◽  
Vol 8 ◽  
Author(s):  
James Eaden ◽  
Daniel Peckham
Keyword(s):  
Myocardial Infarction ◽  
Cystic Fibrosis ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Lung Transplant ◽  
Coronary Intervention ◽  
Cardiac Risk ◽  
Cardiac Transplant ◽  
Cardiac Events ◽  
Left Anterior Descending Artery

We present a case of myocardial infarction in a 19 year old female with cystic fibrosis who had a heart and lung transplant performed at the age of four years old. She presented atypically with a one day history of severe, intermittent, central, sharp chest pain, radiating to her back and down her left arm. A coronary angiogram showed proximal stenosis of the left anterior descending artery and right coronary artery. She was treated with percutaneous coronary intervention, involving drug eluting stents to the left anterior descending artery (LAD) and the right coronary artery (RCA). In this study we discuss the pathophysiology, investigations and treatment of cardiac transplant vasculopathy. Although complete reversal of LAD and RCA stenosis was achieved, routine followup with coronary angiography and careful control of cardiac risk factors will be important to identify and reduce future restenosis and adverse cardiac events.

scholarly journals Acute Myocardial Infarction Showing Total Occlusion of Right Coronary Artery and Thrombus Formation of Left Anterior Descending Artery.

2001 ◽  
Vol 42 (3) ◽  
pp. 365-369 ◽  
Author(s):  
Shinobu Hosokawa ◽  
Yoshikazu Hiasa ◽  
Hiroshi Miyamoto ◽  
Naoki Suzuki ◽  
Takefumi Takahashi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Thrombus Formation ◽  
Total Occlusion ◽  
Left Anterior Descending Artery

A case of delayed occlusive dissection of the right coronary artery during coronary intervention of the left anterior descending artery

2014 ◽  
Vol 30 (2) ◽  
pp. 155-161 ◽  
Author(s):  
Yoshiki Nagata ◽  
Michiro Maruyama ◽  
Isao Aburadani ◽  
Motoaki Hirazawa ◽  
Takuya Mayumi ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Intervention ◽  
Left Anterior Descending Artery ◽  
The Right

scholarly journals Multi-Vessel Coronary Artery Disease: Choice of Myocardial Revascularization Strategy

2020 ◽  
Vol 27 (4) ◽  
pp. E202041
Author(s):  
Nestor Seredyuk ◽  
Andrii Matlakh ◽  
Yaroslava Vandzhura ◽  
Mykyta Bielinskyi ◽  
Oleksii Skakun ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Myocardial Revascularization ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
The Right

Multi-vessel coronary artery disease is quite a common state, which is often diagnosed by coronary angiography in patients with both stable coronary artery disease and acute coronary syndromes. Major difficulties in percutaneous coronary intervention include stent thrombosis and the need for antiplatelet therapy (aspirin and a P2Y12 inhibitor). Stent thrombosis leads to the recurrence of myocardial infarction and may occur within the first few hours after percutaneous coronary intervention. The use of dual antiplatelet therapy, especially that combined with low-molecular-weight heparin in the first days after myocardial infarction, poses a risk of bleeding, which often occurs in real clinical practice. Among P2Y12  inhibitors, ticagrelor causes bleeding somewhat more frequently than clopidogrel. A case of multi-vessel coronary artery disease is described in this paper. Coronary angiography revealed right-dominant circulation; occlusion of the proximal and medial segments of the right coronary artery, thrombolysis in myocardial infarction flow grade 0; stenosis of the left main coronary artery (50-60%), thrombolysis in myocardial infarction flow grade 2; diffuse stenosis of the medial and distal segments of the left anterior descending artery, thrombolysis in myocardial infarction flow grade 1; stenosis of the proximal segment of the left circumflex artery (> 75%), thrombolysis in myocardial infarction flow grade 1. The patient underwent percutaneous coronary intervention; the stents were implanted in the infarct-dependent right coronary artery. The clinical course was complicated by early stent thrombosis with subsequent thrombus extraction; a day later melena developed. Bleeding was stopped, the intensity of antithrombotic therapy was reduced: the combination of aspirin and ticagrelor was replaced by the combination of aspirin and clopidogrel. Six weeks after stenting of the infarct-dependent coronary artery, complete myocardial revascularization (hybrid intervention) was performed: coronary artery bypass grafting [the left internal mammary artery → the left anterior descending artery], coronary autogenous bypass grafting [the aorta → the right coronary artery and the aorta → the left circumflex artery]. The role of fractional flow reserve or instantaneous wave-free ratio-controlled complete myocardial revascularization techniques is discussed. The following algorithm for myocardial revascularization was used: percutaneous coronary intervention for the right coronary artery + coronary artery bypass grafting-3: the left internal mammary artery → the left anterior descending artery, the aorta → the left circumflex artery, the aorta → the right coronary artery.

scholarly journals A szívinfarktusért felelős ér prognosztikus jelentőségének vizsgálata ST-elevációs szívinfarktusos betegekben

2016 ◽  
Vol 157 (32) ◽  
pp. 1282-1288
Author(s):  
András Jánosi ◽  
Péter Ofner ◽  
Dániel Simkovits ◽  
Tamás Ferenci
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Left Circumflex Artery ◽  
Percutaneous Coronary ◽  
St Elevation

Introduction: To the best of the authors’ knowledge, very few publications are available which report on the prognostic significance of the culprit vessel in patients with ST elevation myocardial infarction treated with successful primary percutaneous coronary intervention. Aim: The aim of the authors was to obtain data on the significance of the culprit vessel in patients with ST elevation myocardial infarction treated successfully by primary percutaneous coronary intervention. Method: The authors performed a retrospective study in 10,763 patients with ST elevation myocardial infarction who underwent successful primary percutaneous coronary intervention. The culprit vessels were the left main artery, left anterior descendent artery, left circumflex artery, and right coronary artery. The authors constructed univariate survival curves for different culprit vessels and also performed multivariate modelling of time-to-death, controlling for age, sex, and comorbidities. Results: The majority of the culprit lesions were found in the left anterior descendent artery (44.3%), the right coronary artery (40.9%), and the left circumflex artery (13.7%). The culprit vessel was overall a highly significant (p<0.0001) factor of survival, with right coronary artery exhibiting a highly significantly better prognosis (hazard ratio 0.69, 95% CI 0.61–0.79, p<0.0001) and left main artery exhibiting a significantly worse prognosis (hazard ratio 1.56, 95% CI 1.04–2.35, p = 0.0321) than the reference vessel (left anterior descendent artery). Conclusion: These data demonstrate that the culprit vessel has independent prognostic significance. Orv. Hetil., 2016, 157(32), 1282–1288.

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