coronary ostium
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2021 ◽  
Vol 9 (34) ◽  
pp. 10666-10670
Author(s):  
Fang-Jie Hou ◽  
Xiao-Teng Ma ◽  
Yu-Jie Zhou ◽  
Jun Guan

2021 ◽  
Vol 37 ◽  
pp. 100917
Author(s):  
Jun-Hyok Oh ◽  
Yuhei Kobayashi ◽  
Guson Kang ◽  
Takeshi Nishi ◽  
Martin J. Willemink ◽  
...  

2021 ◽  

Left coronary ostial stenosis, which is associated with sudden death, occasionally occurs in individuals with Williams syndrome. However, surgical methods that provide reliable long-term revascularization remain unknown among infants and young children with coronary ostial stenosis. We describe the case of an 18-month-old boy with Williams syndrome who presented with cardiogenic shock due to left coronary ostial stenosis. We performed patch augmentation of the left coronary ostium using glutaraldehyde-treated autologous pericardium. At the last follow-up, the patient was well without any adverse events or myocardial ischemia.


2021 ◽  
Author(s):  
Shigeto Tsuji ◽  
Shogo Shimada ◽  
Yoshifumi Itoda ◽  
Haruo Yamauchi ◽  
Minoru Ono

Abstract Background: Quadricuspid aortic valve is a rare congenital heart disease that may be associated with coronary ostium anomalies. Care should be taken to avoid occluding or compressing the coronary ostium while performing aortic valve replacement.Case presentation: Herein, we report a case of a 59-year-old woman who underwent aortic valve replacement for a quadricuspid aortic valve with severe aortic regurgitation. Intraoperatively, the aortic valve had four cusps of almost equal size and the right coronary artery arose adjacent to one of the commissures. The annular stitches were placed in a non-everting mattress fashion with pledgets on the ventricular side, and stitches near the right coronary ostium were transitioned to the subannular ventricular myocardium to maintain the distance from the ostium. Further, we selected a small prosthesis because oversized prosthetic valve could potentially compress the right coronary ostium.Conclusions: While performing aortic valve replacement for a quadricuspid aortic valve associated with a right coronary ostium anomaly, careful selection of the size of the prosthesis and modification of the annular stitches are essential to prevent obstruction of the coronary ostium.


Cureus ◽  
2021 ◽  
Author(s):  
Suganya Karikalan ◽  
Munish Sharma ◽  
Megha K Chandna ◽  
Harish Chandna ◽  
Salim Surani

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jacek Pająk ◽  
Maciej Aleksander Karolczak ◽  
Michał Buczyński ◽  
Wojciech Mądry ◽  
Darren James Grégoire ◽  
...  

Abstract Background Coronary steal phenomenon and myocardial ischemia is a complication following decompression of a hypertensive right ventricle in patients with left coronary-cameral fistulae. Case presentation We present a 12-year-old girl with a complex heart defect successfully operated on using a hybrid surgical-interventional approach to decompress the ventricle, embolize the fistula and reconstruct the atretic left coronary ostium. Conclusions A novel hybrid strategy is the best solution for coronary-cameral fistulas reliant on high ventricular pressure at high risk for coronary steal phenomenon.


Acta Medica ◽  
2021 ◽  
pp. 1-3
Author(s):  
Yusuf Ziya Şener ◽  
Uğur Canpolat ◽  
Hikmet Yorgun ◽  
Tuncay Hazırolan ◽  
Kudret Aytemir

Single coronary artery is a rare congenital anomaly associated with sudden cardiac death even though most of the cases are asymptomatic. Cardiac computerized tomography angiography plays an essential role in establishing the diagnosis of single coronary artery and designating the arterial course. Being aware of coronary anomaly is crucial in some cases scheduled for catheter ablation of premature ventricular complex neighboring to coronary arteries to prevent radiofrequency ablation related vascular injury.


Sensors ◽  
2021 ◽  
Vol 21 (18) ◽  
pp. 6087
Author(s):  
Byunghwan Jeon

Extraction of coronary arteries in coronary computed tomography (CT) angiography is a prerequisite for the quantification of coronary lesions. In this study, we propose a tracking method combining a deep convolutional neural network (DNN) and particle filtering method to identify the trajectories from the coronary ostium to each distal end from 3D CT images. The particle filter, as a non-linear approximator, is an appropriate tracking framework for such thin and elongated structures; however, the robust `vesselness’ measurement is essential for extracting coronary centerlines. Importantly, we employed the DNN to robustly measure the vesselness using patch images, and we integrated softmax values to the likelihood function in our particle filtering framework. Tangent patches represent cross-sections of coronary arteries of circular shapes. Thus, 2D tangent patches are assumed to include enough features of coronary arteries, and the use of 2D patches significantly reduces computational complexity. Because coronary vasculature has multiple bifurcations, we also modeled a method to detect branching sites by clustering the particle locations. The proposed method is compared with three commercial workstations and two conventional methods from the academic literature.


2021 ◽  
Vol 8 ◽  
Author(s):  
Muhua Cao ◽  
Tianyu Wu ◽  
Jiawei Zhao ◽  
Zhuo Du ◽  
Zhuozhong Wang ◽  
...  

Objective: This study compared focal geometry and characteristics of culprit plaque erosion (PE) vs. non-culprit plaques in ST-segment elevated myocardial infarction (STEMI) patients in whom optical coherence tomography (OCT) identified PE as the cause of the acute event.Background: Culprit PE is a distinct clinical entity with specific coronary risk factors and its own tailored management strategy. However, not all plaques develop erosion resulting in occlusive thrombus formation.Methods: Between January 2017 and July 2019, there were 484 STEMI patients in whom OCT at the time of primary percutaneous intervention identified culprit lesion PE to be the cause of the event; 484 culprit PE were compared to 1,132 non-culprit plaques within 1,196 imaged vessels.Results: Culprit PE were highly populated at “hot spots” within the proximal 40 mm in the left anterior descending artery (LAD) and tended to cluster proximal to a nearby bifurcation mainly in the LAD. Minimal lumen area (MLA) <2.51 mm2 and AS (area stenosis) >64.02% discriminated culprit PE from non-culprit plaques. In the multivariable analysis, focal geometry (LAD location, distance from coronary ostium <40 mm, and location proximal to a nearby bifurcation), luminal narrowing (MLA <2.51 mm2, AS > 64.02%), and TCFA phenotype were independent predictors of culprit PE overall. Cholesterol crystals were predictive of culprit PE with underlying LRP morphology while the absence of calcification and microchannels were risk factors for culprit PE with an underlying non-LRP. Similarities and differences in predictors of culprit PE were found between males and females; distance from coronary ostium <40 mm, MLA <2.51 mm2, TCFA, and less spotty calcium were risk factors of culprit PE in males, but not in females while smaller RVD was associated with culprit PE only in females.Conclusions: Irrespective of underlying lesion substrates and patient risk factors, there are lesion-specific and OCT-identifiable predictors of developing culprit PE in erosion-prone vulnerable patients.


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