scholarly journals Successful PCI of Anomalous Left Circumflex Coronary Artery Arising from Right Coronary Sinus – A Case Report

2019 ◽  
pp. 1-4
Author(s):  
Gurkirat Singh ◽  
Hemant Khemani ◽  
Shakil Shaikh ◽  
Narender Omprakash Bansal
Keyword(s):  
Coronary Artery ◽  
Coronary Sinus ◽  
Coronary Arteriography ◽  
Anomalous Origin ◽  
Drug Eluting Stent ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Coronary Syndrome ◽  
Drug Eluting ◽  
Significant Lesion

Coronary artery anomalies occur in 1.3-5.6% of patients undergoing coronary arteriography. An anomalous origin of LCX from right coronary sinus is the most common congenital variant. It is usually considered “benign” since it is not known to predispose individuals to sudden cardiac death. Such vessels are particularly predisposed to atherosclerotic disease in their proximal portion, due to the acute angulation of its origin from the aorta and its posterior retro aortic course. We present a case of 55 years old female admitted with acute coronary syndrome. Coronary angiogram showed the anomalous origin of the left circumflex artery from right coronary sinus. This artery had a significant lesion which was successfully stented with a drug-eluting stent.

scholarly journals A Case Summary of the Application of a Drug-Eluting Stent Combined with a Drug-Coated Balloon in Left Main Coronary Artery Disease

2021 ◽  
Author(s):  
Jun-Qing Gao
Keyword(s):  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Drug Eluting Stent ◽  
Restenosis Rate ◽  
Left Main ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Clinical Events ◽  
Drug Eluting ◽  
Drug Coated Balloon

Objective: To evaluate the clinical efficacy of a drug-eluting stent (DES) combined with a drug-coated balloon (DCB)in the treatment of left main coronary artery bifurcation lesions.Methods: A retrospective analysis was conducted on the clinical data of eight patients with left main coronary arterybifurcation lesions treated with a DES combined with a DCB who were admitted to our hospital from July 2016 to July2017. These eight patients all underwent DES treatment for their left main coronary artery and left anterior descendingcoronary artery lesions, and DCB treatment at the ostium of the left circumflex artery; six of the patients underwentsurgical procedures under the guidance of intravascular ultrasonography. Immediate postoperative angiography wasused to evaluate the patency of the diseased vessels, and the restenosis rate at the 6-month follow-up after the operationand the incidence of serious clinical events within 6 months were assessed as well.Results: The use of a DES combined with a DCB in the treatment of left main coronary artery bifurcation lesions hada low restenosis rate (left main coronary artery (8.4 ± 5.3)%, left anterior descending coronary artery (18.2 ± 5.0)%,left circumflex artery (30.5 ± 16.5)%). No serious clinical events occurred in any patients.Conclusion: A DES combined with a DCB is a safe and effective interventional treatment for left main artery coronarybifurcation lesions.

scholarly journals Left Circumflex Artery Rupture with Left Atrial Tamponade and Functional Mitral Stenosis

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Weiting Huang ◽  
Khaled Mohamed Emadeldin Moheb Hammad ◽  
Victor Tar Toong Chao ◽  
Khung Keong Yeo
Keyword(s):  
Left Atrium ◽  
Coronary Sinus ◽  
Mitral Stenosis ◽  
Left Atrial ◽  
Pulmonary Veins ◽  
Fluid Collection ◽  
Artery Dissection ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Coronary Syndrome

The growth in percutaneous transluminal devices has enabled operators to tackle more complex, native, and post-bypass surgery anatomy. However, complications such as coronary artery dissection, coronary perforation, retrograde aortic dissection, arrhythmias, and acute coronary syndrome still occur with resulting mortality rates of up to 4.2% in complex interventions. Perforation of the circumflex artery is of particular interest in view of its position and relation to the surrounding cardiac structures. This is a site of potential fluid collection, and as the left atrium is fixed to the parietal pericardium at the entry of the pulmonary veins, fluid in the oblique sinus can accumulate enough pressure to compress the left atrium and the coronary sinus. We present a case of left circumflex artery perforation which demonstrates the physiologic complications of coronary sinus and left atrial compression and the resultant functional mitral stenosis.

scholarly journals Superdominant Right Coronary Artery with Absent Left Coronary Artery and Left Circumflex Artery with Anomalous Left Anterior Descending Artery

2022 ◽  
Author(s):  
Bhavneet Singh ◽  
Rekha Gupta ◽  
Sreenivas Reddy
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Sinus ◽  
Left Coronary Artery ◽  
Therapeutic Modality ◽  
Single Coronary Artery ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Single Vessel ◽  
Left Anterior Descending Artery

AbstractThe occurrence of super-dominant “single coronary artery” is an extremely rare and seldom reported phenomenon. The heart is dependent on a single vessel which makes its occlusion, if present, catastrophic. Here, the authors present an extremely rare combination of superdominant right coronary artery coexisting with absent left coronary artery and left circumflex artery with abnormal origin of left anterior descending artery from right coronary sinus. Precise morphological and physiological knowledge and evaluation of these anomalies is a must for opting the best available therapeutic modality and better prognosis.

scholarly journals Variations in the Left Coronary Artery

2017 ◽  
Vol 16 (1) ◽  
pp. 42-47
Author(s):  
Sultana Ruma Alam
Keyword(s):  
Coronary Artery ◽  
Left Coronary Artery ◽  
Artery Bypass ◽  
Clinical Manifestations ◽  
Coronary Arteriography ◽  
Ascending Aorta ◽  
Main Stem ◽  
Aortic Sinus ◽  
Circumflex Artery ◽  
Left Circumflex Artery

Background : There is a large spectrum of variations in the disposition of coronary arteries. Many of these variations are 'normal' and not considered as 'anomalous'1. These variations mainly occur in the Left Coronary Artery (LCA)2. While some of these are benign and have no clinical consequences, other variants can cause important clinical manifestations including sudden death of the individual3. Lack of knowledge of such variations can pose difficulties in percuteneous coronary arteriography, coronary artery bypass surgery or prosthetic valve replacement. A cadaveric study in unsuspected population can help to understand the variations that will be useful to determine the prevalence of certain variations. Thus the objective of this study was to analyze the characteristics of LCA that may be used in the diagnosis and treatment of its pathologies.Methods: The study was carried out in the Department of Anatomy, Chittagong Medical College (CMC) Chittagong over a period between Jan 2012 to Dec 2013 with ethical clearance. A detailed dissection of LCA and its branches in 50 cadaveric human hearts, fixed in 10% formalin was carried out to study normal and variant anatomy of LCA. The length of the main stem of LCA was measured by slide calipers.Results: The LCA was found to arise from the Left Posterior Aortic Sinus (LPAS) of the ascending aorta in 100% cases. The level of the ostia (Opening of coronary artery) was above the free margin of the aortic cusps in 98% cases. In all samples ostia were present below sinutubular ridge (A slight circumferential thickening separating bulbar aortic sinus and proximal ascending aorta). The length of the main stem of LCA (From origin to the point of termination into main branches) was found to range from 0.5-2 cm. The LCA showed bifurcation in 74%, trifurcation in 26% of cases. Left Anterior Descending artery (LAD) was found to terminate at the apex of the heart in 68% and at the posterior interventricular groove in 32% cases. The Left Circumflex artery (LCx) was terminated at the crux of the heart in 52%, near the crux in 44% and by crossing the crux in 4% cases. The Left Marginal Artery (LMA) which was present only in 34% cases, found to terminate nearer to the apex of the heart. 0% Left dominance of heart was observed.Conclusion: Simple attention to potential variations in the origin, number, level of ostia, length of the main stem, branching pattern, termination and distribution of LCA can greatly enhance clinical outcomes.Chatt Maa Shi Hosp Med Coll J; Vol.16 (1); Jan 2017; Page 42-47

Successful endovascular extraction of newer generation Angio-Seal collagen plug and anchor after acute embolization

Vascular ◽  
2013 ◽  
Vol 22 (3) ◽  
pp. 214-217 ◽  
Author(s):  
Nidal Abi Rafeh ◽  
Faisal B Saiful ◽  
Georges Khoueiry ◽  
Mohammad Zgheib ◽  
Salman Arain
Keyword(s):  
Coronary Bypass ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Closure Device ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Vascular Laboratory ◽  
History Of ◽  
Drug Eluting ◽  
The Right

A 75-year-old woman with past medical history of coronary bypass, atrial fibrillation, mitral valve repair undergoes percutaneous coronary intervention of left circumflex artery with a drug eluting stent. An Angio-Seal vascular closure device was used post procedure to obtain hemostasis. Shortly after deployment, frank bleeding was observed necessitating manual compression at the arteriotomy site. After hemostasis was achieved, the right lower extremity was found to be pale, bluish with feeble pulses. Doppler ultrasound was emergently performed revealing decreased blood flow after mid superficial femoral artery (SFA) and an echo lucent object lodged luminally in the SFA. Patient was urgently taken to the vascular laboratory where an Angio-Seal device, including the collagen plug and anchor, was successfully removed endovascularly patient made full recovery and was discharged home the following day.

Anomalous Origin of the Left Circumflex Artery From the Right Coronary Sinus With an Interarterial Course

2008 ◽  
Vol 23 (2) ◽  
pp. 142-144 ◽  
Author(s):  
Jin Hur ◽  
Young-Jin Kim ◽  
Ji Eun Nam ◽  
Tae Hoon Kim ◽  
Kyu Ok Choe ◽  
...  
Keyword(s):  
Coronary Sinus ◽  
Anomalous Origin ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
The Right

P971Impact of treatment strategy on 1-year outcome for Left Main trifurcation lesions

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Tani ◽  
S Mitomo ◽  
K Tanaka ◽  
S Tahara ◽  
S Nakamura
Keyword(s):  
Clinical Outcomes ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Restenosis Rate ◽  
Left Main ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Significant Difference ◽  
Drug Eluting

Abstract Background/Introduction Limited data exist regarding procedural strategy and clinical outcomes after percutaneous coronary intervention (PCI) for unprotected left main (LM) trifurcation lesion. Purpose The aim of this study is to evaluate 1-year clinical outcomes after LM trifurcation PCI comparing different strategies in kissing balloon inflation (KBI). Methods From 1, January, 2011 to 31, March, 2017, patients who underwent LM trifurcation PCI with second generation drug-eluting stent in our center were retrospectively analyzed. They were categorized into single-stent KBT group (KBT in left anterior descending artery [LAD] and left circumflex artery [LCX], or LAD and high lateral branch [HL]) and no-KBT group. Primary endpoint is restenosis in the lesions. Results Among 1301 patients who underwent LM PCI during the study period, 163 patients (12.5%) had a trifurcation lesion. Regarding the number of stents used for the lesions, 1, 2 and 3 stents were used in 75.4%, 22.0% and 2.5%, respectively. Median follow-up period of LM trifurcation patients was 265 days (interquartile range: 81–564). In the no-KBT group (64 patients), 19 patients experienced restenosis of HL and LCX (HL: 8 patients, LCX: 0 patient, and both: 11 patients). In the KBT-group, KBT for LAD and LCX was performed in 47 patients, and of them, 19 patients experienced restenosis of LM-LAD, HL and LCX (HL: 12 patients, LCX: 6 patients and all: 1 patient). On the other hand, in 9 patients with KBT for LAD and HL, there were no restenosis cases at 1-year follow-up. There was no statistically significant difference in restenosis rate between the no-KBI and KBT group (29.6% vs. 40.4%, p=0.69). Restenosis rates in each segments Conclusion After LM trifurcation PCI, restenosis rate at 1-year follow-up was high, and no difference between no-KBT and KBT group overall. However, there was no restenosis case in patients with KBT for LAD and HL.

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