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HELENA TIZÓN-MARCOS M.D. ROBERT DE LAROCHELLIÈRE M.D. ERIC LAROSE M.D. 《Journal of interventional cardiology》2009,22(4):362-367
The incidence and morbidity associated with stent fracture are unknown. Recommendations and evidence-based treatment are lacking. We report a case of symptomatic fracture of a sirolimus-eluting stent advancing from the left main into the circumflex coronary artery, forming an acute angle with calcifications at the hinge point; the literature is reviewed and treatment options are discussed. 相似文献
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Intrinsic and Extrinsic Cardiac Pseudotumors: Echocardiographic Evaluation and Review of the Literature 下载免费PDF全文
Ryan J. Maybrook M.D. Muhammad R. Afzal M.D. Sonya Parashar M.S. Brent Deibert B.S. Mary Chivington R.D.C.S. Jacquelyn Y. Walker R.D.C.S. Buddhadeb Dawn M.D. Deepak Parashara M.D. 《Echocardiography (Mount Kisco, N.Y.)》2016,33(1):117-132
Echocardiography is the most common imaging modality for the assessment of cardiovascular tumors, followed by more advanced imaging modalities, such as cardiac computed tomography or cardiac magnetic resonance imaging. Non‐neoplastic lesions that may simulate a true neoplasm on imaging are termed “cardiac pseudotumors.” As echocardiography is the initial imaging modality where pseudotumors are identified, it is imperative to have a fundamental understanding of pseudotumors evaluation using echocardiography. There is paucity of the literature describing the different kinds of pseudotumors. This review is an attempt to describe common cardiac pseudotumors and to classify them based on their origin. The tumors arising from cardiac structures, such as epicardium, endocardium, or myocardium, were termed as “intrinsic” while the pseudotumors with no cardiac origin were termed as “extrinsic.” The more common pseudotumors are described in detail with pertinent echocardiographic features and examples. 相似文献
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Alberto Bouzas-Mosquera M.D. Victor X. Mosquera M.D. † Francisco Portela M.D. † José J. Cuenca M.D. † Nemesio Álvarez-García M.D. Alfonso Castro-Beiras M.D. 《Echocardiography (Mount Kisco, N.Y.)》2009,26(5):586-588
We present the case of a 63-year-old man who underwent surgical closure of a paravalvular mitral leak. Immediately after surgery, transesophageal echocardiography revealed the appearance of a mediastinal hematoma encroaching on the left atrium and separating the esophageal probe from the posterior left atrial wall. The cause was an inadvertent puncture of the carotid artery, presumably during central venous line insertion prior to surgery. 相似文献
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Kothandam Sivakumar Maruthanayagam Rajan Gnanapragasam Francis Krishnaswami Murali Velayudhan Bashi 《Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital》2010,37(1):95-98
Extrinsic compression of the left main coronary artery by a massively dilated pulmonary artery in patients who have severe pulmonary hypertension can lead to significant myocardial ischemia. A 58-year-old man with a large patent ductus arteriosus and Eisenmenger syndrome presented with angina at rest and worsening heart failure of 3 months'' duration. The new symptoms were recognized to be secondary to extrinsic compression of the left main coronary artery ostium by a dilated main pulmonary artery and were successfully relieved by the placement of a metallic stent in the affected segment of the left main coronary artery. Multislice computed tomographic imaging after 6 months showed stent patency and the intimate relation of the stented vessel to the dilated main pulmonary trunk. We discuss diagnostic and management issues pertaining to this uncommon clinical entity.Key words: Angina pectoris/etiology, angioplasty, transluminal, percutaneous coronary, constriction, patho-logic/etiology, coronary stenosis/etiology, dilatation, pathologic/complications, ductus arteriosus, patent, Eisenmenger complex/ complications, hypertension, pulmonary/complications, stents, tomography, X-ray computedA pulmonary trunk dilated by severe pulmonary artery hypertension (PAH) can compress the aortic ostium of the left main coronary artery (LMCA).1 If the primary disease process causing PAH cannot be reversed, progressive coronary narrowing can lead to left ventricular myocardial dysfunction, angina, and worsening of heart failure.2 We report the case of a 58-year-old patient with a large patent ductus arteriosus and Eisenmenger syndrome who presented with angina at rest and worsening of heart failure due to left ventricular dysfunction. Coronary angiography showed extrinsic compression of the LMCA, at its origin, by a dilated pulmonary trunk. Stenting of the LMCA resulted in immediate relief of angina and led to symptomatic improvement. 相似文献
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Morteza Safi Vahid Eslami Abbas Arjmand Shabestari Habib Saadat Mohammad Hasan Namazi Hosein Vakili Mohammad Reza Movahed 《Clinical cardiology》2009,32(8):426-428
Compression of left main coronary artery (LMCA) secondary to pulmonary trunk dilatation is a newly recognized entity that has been associated with severe pulmonary hypertension. In this paper we present a case of extrinsic compression of LMCA caused by dilated pulmonary trunk secondary to pulmonary hypertension documented using 64‐slice multidetector computed tomography (MDCT) coronary angiography. This case is followed by a review of the literature. Copyright © 2009 Wiley Periodicals, Inc. 相似文献
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ZIAD DAHDOUH M.D. VINCENT ROULE M.D. AUDREY EMMANUELLE DUGUÉ M.D. RÉMI SABATIER M.D. THÉRÈSE LOGNONÉ M.D. GILLES GROLLIER M.D. 《Journal of interventional cardiology》2013,26(2):173-182
Objectives
The aim of this study was to appreciate the safety and effectiveness of transradial percutaneous coronary intervention (PCI) with rotational atherectomy for highly calcified left main coronary artery (LMCA) disease in octogenarians.Background
Conventional surgery is still considered the preferred management for LMCA disease; but, when the lesion is severely calcified, and the patient is unsuitable for surgery, the interventional cardiologist faces a complex PCI traditionally approached by femoral access.Methods
Between June 2004 and December 2010, octogenarians with calcified LMCA disease who were primary denied for surgical revascularization were enrolled. Procedural success and major adverse cerebral and cardiovascular events (MACCE) including death, nonfatal myocardial infarction, target lesion revascularization (TLR), or stroke during long‐term follow‐up were evaluated.Results
Forty‐two consecutive patients≥80 years had undergone stenting for calcified LMCA disease (13 with rotational atherectomy, the “Rota” group, and 29 without rotational atherectomy, the “without Rota” group). Procedural success was good (92.3% vs. 96.6%, respectively, p = NS). Mean follow‐up time was 25.7 ± 21.4 and 28 ± 32.3 months, respectively. There was a TLR in 25% and 11.1%, respectively; p = NS. No difference was detected in terms of overall in‐hospital or long‐term mortality or MACCE.Conclusion
Rotational atherectomy followed by stent implantation by transradial approach, when applied to heavily calcified lesions, appeared to be a safe and effective strategy for the treatment of LMCA disease in octogenarians who were refused for surgery. (J Interven Cardiol 2013;26:173–182)14.
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《Current problems in cardiology》2023,48(1):101424
Coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in revascularization of left main coronary artery (LMCA) disease has been evaluated in previous studies. However, there has been minimal study of the relationship between co-existing non-coronary atherosclerosis (NCA) and LMCA disease revascularization. We aim to examine this relationship. The Gulf-LM study is a retrospective analysis of unprotected LMCA revascularization cases undergoing PCI with second generation drug-eluting stent vs CABG across 14 centers within 3 Gulf countries between January 2015 and December 2019. A total of 2138 patients were included, 381 with coexisting NCA and 1757 without. Outcomes examined included major adverse cardiovascular and cerebrovascular events (MACCE), cardiac and non-cardiac death, and all bleeding. In patients with NCA, preexisting myocardial infarction and congestive heart failure were more common, with PCI being the most common revascularization strategy. A statistically significant reduction in in-hospital MACCE and all bleeding was noted in patients with NCA undergoing PCI as compared to CABG. At a median follow-up of 15 months, MACCE and major bleeding outcomes continued to favor the PCI group, though no such difference was identified between revascularization strategies in patients without NCA.In this multicenter retrospective study of patients with and without NCA who require revascularization (PCI and CABG) for unprotected LMCA disease, PCI demonstrated a better clinical outcome in MACCE both in-hospital and during the short-term follow-up in patients with NCA. However, no such difference was observed in patients without NCA. 相似文献
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Doreen DeFaria Yeh Brian Ghoshhajra Ignacio Inglessis-Azuaje Thomas MacGillivray Richard Liberthson Ami B. Bhatt 《Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital》2015,42(5):465-467
We report the case of a 62-year-old woman who presented with classic symptoms of stable angina. Cardiac images and catheterization results revealed absent pulmonary valve syndrome and compression of the left main coronary artery by a massively dilated pulmonary artery aneurysm. The patient''s anginal symptoms were relieved after pulmonary arterioplasty.Others have described proximal left main coronary artery compression in the presence of a dilated and hypertensive pulmonary artery. To our knowledge, this is the first case in which a pulmonary artery aneurysm caused left main coronary insufficiency in the absence of pulmonary hypertension—a clinically important complication of congenital pulmonary valve-related pulmonary arteriopathy. 相似文献