Left Main Stenting | ScienceGate

Background: Aim of the study was to evaluate the primary procedural success of percutaneous coronary intervention of unprotected left main coronary artery stenosis using either Bare-metal stents or drug eluting stent. Methods: Total 33 patients were enrolled in this very preliminary non-randomized prospective cohort study. Among them, Male: 25 and Female: 8. Total 35 stents were deployed. Mean age were for Male: 59 yrs, for Female: 62 yrs. Associated coronary artery diseases risk factors were dyslipidemia, High Blood pressure, Diabetes Mellitus, Positive family history for coronary artery diseases and smoking. Results: Among the study group; 26 (78%) were Dyslipidemic, 24(70%) were hypertensive; 17 (51.5%) patients were Diabetic, 11(33%) were smoker and 7(21%) patients had family history of Ischaemic heart disease. Female patients were more obese (BMI M 26: F 27) and developed coronary artery diseases in advance age. Common stented territory were left main: 20 (60%), Left main to left anterior descending artery 7 (22%) and Left main to left circumflex artery 6 (18%). Average length and diameter of stent was 3.5 and 18 mm respectively. Stent used: Bare Metal Stent 5 (15%), Drug Eluting Stent: 28 (85%). Among the different Drug Eluting Stents, Everolimus eluting stents were 11 (39.3%), Sirolimus eluting 10(35.7%), Paclitaxel eluting 3 (10.7%), Biolimus eluting 3 (10.7%) and Zotarolimus eluting1 (3.6%). In the present study, overall survival outcome was 94% (31 patient), mortality of cardiac cause 3% (1 patient) and 1 patient (3%) died of hepatocellular carcinoma. Conclusion: Our study has shown that percutaneous coronary intervention of the unprotected left main is a safe and effective alternative to Coronary Artery Bypass Graft (CABG). DOI: http://dx.doi.org/10.3329/cardio.v6i2.18349 Cardiovasc. j. 2014; 6(2): 107-111

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Ligation of a Fistula between the Left Main Coronary Artery and Both the Pulmonary Artery and the Right Ventricle

The Heart Surgery Forum ◽

10.1532/hsf98.20111083 ◽

2012 ◽

Vol 15 (2) ◽

pp. 119 ◽

Cited By ~ 2

Author(s):

I. Halil Algin ◽

Aytekin Yesilay ◽

N. Murat Akcar

Keyword(s):

Cardiopulmonary Bypass ◽

Coronary Artery ◽

Pulmonary Artery ◽

Right Ventricle ◽

Left Main Coronary Artery ◽

Coronary Artery Fistula ◽

Left Main ◽

Symptomatic Disease ◽

Coronary Artery Fistulas ◽

The Right

The frequency of coronary artery fistula among all coronary angiography patients is 0.1% to 0.2%; however, involvement of both the pulmonary artery and the right ventricle is a rare clinical entity. A 53-year-old man patient was admitted to our clinic with rarely occurring chest pain, palpitations, and dyspnea. A coronary angiogram showed a fistula between the left main coronary artery and both the pulmonary artery and the right ventricle. We performed a ligation of this fistula without cardiopulmonary bypass. Aorta and right ventricle sutures were made, and the proximal and distal portions of the fistula were obliterated with 5-0 Prolene sutures and previously prepared Teflon felt. The patient recovered and was discharged without any complications. The surgical indications for coronary artery fistulas are symptomatic disease, an aneurysmic coronary artery, signs of heart failure, and ischemia. The surgical options in such cases�depending on whether the fistula is complicated or not�are simple ligation or transarterial ligation under cardiopulmonary bypass.

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Emergency Management for Critical Left Main Coronary Artery Stenosis

The Heart Surgery Forum ◽

10.1532/hsf98.20101057 ◽

2011 ◽

Vol 14 (1) ◽

pp. 12

Author(s):

Onur Sokullu ◽

Numan Ali Aydemir ◽

Erol Kurc ◽

Batuhan Ozay ◽

Fuat Bilgen ◽

...

Keyword(s):

Survival Rate ◽

Left Main Coronary Artery ◽

Myocardial Revascularization ◽

Coronary Bypass ◽

Percutaneous Intervention ◽

Bypass Grafting ◽

Left Main ◽

Bypass Group ◽

The Mean ◽

Late Survival

Background: Increased experience and improvements in technology seem to have encouraged the use of percutaneous interventions for left main coronary artery (LMCA) occlusions. There is no consensus, however, and the data are inadequate on whether surgery or percutaneous procedures should be the intervention of choice for critical occlusions.Methods: From January 2002 to December 2006, 108 patients with unprotected LMCA stenosis >80% were treated at our center. Eighty-three patients (77%) underwent bypass grafting and 20 (18%) underwent percutaneous intervention for the purpose of myocardial revascularization. We analyzed parameters demonstrated as risk factors for myocardial revascularization and their predicted effects on outcome.Results: Five patients (5%) died following emergency cardiopulmonary resuscitation before any intervention was performed. The early survival rate was 84.1% in the coronary bypass group and 63% in the percutaneous intervention group. The mean (SD) survival time was 55.7 2.6 months in the bypass group and 7.6 1.3 months in the percutaneous group. The late-survival rate was also significantly higher in the bypass group. The mean late-survival time was 44.5 3.6 months in the bypass group and 2.3 0.8 months in the percutaneous group.Conclusion: Although emergency percutaneous interventions are lifesaving in some cases, these results clearly demonstrate that coronary bypass grafting should be the intervention of choice for myocardial revascularization in patients with critical LMCA occlusion.

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Congenital Left Main Coronary Artery to Coronary Sinus Fistula

The Heart Surgery Forum ◽

10.1532/hsf98.20101085 ◽

2011 ◽

Vol 14 (4) ◽

pp. 255 ◽

Cited By ~ 4

Author(s):

Fotios A. Mitropoulos ◽

Meletios A. Kanakis ◽

Periklis A. Davlouros ◽

George Triantis

Keyword(s):

Coronary Artery ◽

Coronary Arteries ◽

Coronary Sinus ◽

Left Main Coronary Artery ◽

Coronary Artery Fistula ◽

Left Main ◽

Coronary Fistula ◽

Excellent Outcome ◽

Surgical Ligation ◽

Congenital Coronary Artery Fistula

Congenital coronary artery fistula is an extremely rare anomaly that may involve any of the coronary arteries and any of the cardiac chambers. We report the case of a 14-year-old female patient with a symptomatic congenital coronary fistula starting from the left main coronary artery and draining to the coronary sinus. The patient underwent surgical ligation of the fistula and had an excellent outcome.

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