Takayasu’s arteritis with left main stem stenosis of single coronary artery

Abstract Background Takayasu's arteritis (TA) is an inflammatory vascular disease of the young involving the large elastic arteries resulting in occlusive or ectatic changes, mainly in the aorta and its major branches as well as the pulmonary artery and its branches. Materials and Methods The authors reviewed the TA patients admitted over 2 years in their department and who underwent catheterization. They noted the clinical presentations, two-dimensional (2D) echocardiographic features, and angiogram details of all these patients. Results The study population constituted 24 patients with mean age of 28 years. Out of them, 21 (87.5%) were females. Most of the admitted TA patients presented with claudication complaints (79.2%), 37.5% patients had breathlessness, and 12.5% patients had typical stable angina symptoms. Five patients had 2D echo abnormalities, and rest of the patients had normal echocardiogram. Coronary angiogram (CAG) along with aortogram and selective peripheral arteriograms were performed of all these patients. Left main coronary artery (LMCA) disease was seen in three (12.5%) patients. Case details of two (8.3%) patients with multiple anomalous communications of the coronaries with pulmonary vasculature were described. Conclusion TA patients who came for catheterization were predominantly females, mainly involving the aorta and its main branches. In the authors’ TA series of patients, type 5 presentation was there in five (20.8%) patients (three cases of LMCA + two cases of coronary artery to pulmonary parenchymal fistulas). They propose to subclassify type 5 of TA, as they report coronary artery to pulmonary parenchymal fistulas along with the previous literature.

Download Full-text

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

University Heart Journal ◽

10.3329/uhj.v10i1.24590 ◽

2015 ◽

Vol 10 (1) ◽

pp. 13-17 ◽

Cited By ~ 2

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

Download Full-text

PTCA of the left main stem following protective coronary artery bypass grafting

European Journal of Cardio-Thoracic Surgery ◽

10.1016/1010-7940(91)90044-k ◽

1991 ◽

Vol 5 (6) ◽

pp. 326-329 ◽

Cited By ~ 3

Author(s):

H RUPPRECHT ◽

H OELERT ◽

S TRAUTMANN ◽

T POP ◽

S IVERSEN ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Main Stem ◽

Bypass Grafting ◽

Left Main ◽

Artery Bypass Grafting ◽

Left Main Stem

Download Full-text

Successful management of left main coronary artery stenosis with a paclitaxel-eluting stent in Takayasu's arteritis

International Journal of Cardiology ◽

10.1016/j.ijcard.2005.02.024 ◽

2006 ◽

Vol 108 (1) ◽

pp. 120-123 ◽

Cited By ~ 9

Author(s):

Woong Chol Kang ◽

Seung Hwan Han ◽

Tae Hoon Ahn ◽

Eak Kyun Shin

Keyword(s):

Coronary Artery ◽

Left Main Coronary Artery ◽

Coronary Artery Stenosis ◽

Takayasu’S Arteritis ◽

Artery Stenosis ◽

Takayasu's Arteritis ◽

Left Main ◽

Successful Management ◽

Main Coronary Artery Stenosis

Download Full-text

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

Vojnosanitetski pregled ◽

10.2298/vsp1108712s ◽

2011 ◽

Vol 68 (8) ◽

pp. 712-715 ◽

Cited By ~ 1

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.

Download Full-text

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

Asian Cardiovascular and Thoracic Annals ◽

10.1177/0218492309343857 ◽

2009 ◽

Vol 17 (5) ◽

pp. 472-476 ◽

Cited By ~ 5

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.

Download Full-text