无顶冠状静脉窦综合征的超声影像学及临床特征分析

目的:分析无顶冠状静脉窦综合征(unroofed coronary sinus syndrome,UCSS)患者超声影像学及临床特征.方法:回顾我院2007年1月至2020年1月临床确诊的140例UCSS患者超声影像资料,对其超声影像特征、合并畸形及继发改变进行分析.结果:140例UCSS患中,女性占62.1％(87/...     

Closure of unroofed coronary sinus with a covered stent in a symptomatic infant.

A covered stent was used for percutaneous closure of an unroofed coronary sinus in an infant with congestive heart failure secondary to increased pulmonary flow. Prior to the stent deployment, the location of the entrance of the coronary vein into the coronary sinus was demonstrated with a selective left coronary artery angiogram to facilitate placement of the stent. The procedure was well tolerated without complications. The infant's symptoms improved significantly after the procedure.     

Interaction of Intraluminal Tissue and Coronary Sinus Lead Stabilized with Stent Placement

Intraluminal Interaction of Tissue and Stented CS Lead . Introduction: The aim of our investigation was to examine the intraluminal interaction of the vascular tissue and the implanted coronary sinus lead stabilized with stent on two human hearts removed before transplantation. Methods and results: The coronary sinus lumen was sectioned under operational microscope and opened carefully. The leads and stents were found separately positioned beside each other completely covered by an intact intimal tissue layer. No sign of occluding proliferative tissue was observed. Conclusion: Stent fixation technique and extraction of the CS lead in our cases did not have any particular damaging effect on the vascular system. (J Cardiovasc Electrophysiol, Vol. 24, pp. 468‐470, April 2013)     

Obliteration of a Coronary Artery Aneurysm With a PTFE-Covered Stent: Endoluminal Graft for Coronary Disease Revisited

This is the first reported use of the JOSTENT stent graft for aneurysm disease in native coronaries. Consideration can be given to using this polytetrafluoroethylene (PTFE)-covered stent in situations such as dissections and restenosis in saphenous vein grafts or in long native coronary arteries without side branches, though further investigation is warranted. Cathet. Cardiovasc. Intervent. 46:113–116, 1999. © 1999 Wiley-Liss, Inc.     

Mapping of the Coronary Sinus and Great Cardiac Vein Using a 2-French Electrode Catheter and a Right Femoral Approach

Coronary Sinus Mapping. Introduction: Local electrogranis recorded from the coronary sinus and great cardiac vein provide important information for the diagnosis of various arrhythmias and identification of target sites for ablation of left-sided accessory pathways. One limitation of present techniques is the inability, in many cases, to probe the great cardiac vein at the anterior mitral annulus. We tested the feasibility of a new technique for catheterization of the coronary sinus and great cardiac vein by means of a small-diameter electrode catheter advanced via a right femoral approach through an angiography catheter. Methods and Results: Of 22 patients (12 men and 10 women; ages 44.5 ± 13.4 years) undergoing radiofrequency ablation of a supraventricular tachycardia, cannulation of the coronary sinus orifice using a 6-French 1L or 2L Amplatz catheter was achieved in 20 patients (91%) within 0.9 ± 0.6 minutes; after cannulation, a 2-French octapolar electrode catheter with a soft radiopaque tip and a 3-mm interelectrode distance could he advanced in all 20 patients through the guiding catheter to the great cardiac vein in the anterior region of the AV sulcus within 0.8 ± 0.7 minutes. Atrial and ventricular local potentials were recorded all along the mitral annulus during sinus rhythm, atrial and ventricular pacing, or supraventricular tachycardia. Variation of local potential amplitude never exceeded 20% of the mean and presented similar stability at all annular regions. The arrhythmogenic substrate was identified in all patients. Of 18 patients with 21 left-sided accessory pathways, an accessory pathway potential could he recorded at the ablation site by one or more adjacent epicardial electrode pairs in 10 pathways. No procedure-related complications were observed. Conclusions: The technique introduced in this study proved feasible in 91% of patients. Its main advantages are the simplicity and rapidity of coronary sinus cannulation and the ability to advance the electrode catheter to the anterior cardiac vein. In addition, closely spaced bipolar electrograms resulted in enhanced atrial, ventricular, and accessory pathway potential resolution.     

Midterm follow‐up results of transcatheter treatment in patients with unroofed coronary sinus

Objective : We present the midterm results of transcatheter treatment of unroofed coronary sinus (CS) using the Amplatzer septal occluder. Background : The unroofed CS is a rare atrial septal defect communicating the left atrium and CS. Surgery has been the mainstay of treatment. Methods : In a 4.5‐year period, nine patients (five males) with ages ranging from 26 to 69 years (median 39 years) diagnosed with an unroofed CS but without a persistent left superior vena cava (LSVC) underwent transcatheter treatment. Computerized tomography (CT) was performed in eight patients. Transesophageal echocardiography (TEE) was used to monitor the procedure. Results : The mean Qp/Qs ratio was 2.4 ± 1 and mean systolic pulmonary artery pressure was 35 ± 19 mm Hg. An Amplatzer septal occluder was deployed in all nine patients. The device was implanted in the defect in one patient and at the CS ostium in the other eight patients. The median device size used was 22 mm (16–28 mm). The left disc herniated into the CS in the single patient in whom the device was implanted within the defect. All patients were available for the 3‐month follow‐up. None had a residual shunt on the 3‐month follow‐up echocardiography. One patient died of a stroke 4.5 months after the procedure. At mean follow‐up of 42.6 ± 18.3 months, symptomatic improvement was documented in the remaining eight patients. All eight patients had an O₂ saturation above 96%. Conclusion : Transcatheter treatment for unroofed CS without persistent LSVC using Amplatzer septal occluder is safe and feasible. © 2013 Wiley Periodicals, Inc.     

Transcatheter therapy of long extreme subatretic aortic coarctations with covered stents.

We report our experience with the transcatheter treatment of long extreme subatretic coarctations in four adult patients by the implantation of covered stents. The minimal narrowing of the stenosis was 0.014' to 2 mm; the hypoplastic distance measured between 21 and 42 mm. Polytetrafluoroethylene-covered stents 39-50 mm long were implanted and 6 months later redilated. Residual pressure gradients ranged from 0 to 10 mm Hg. One stent fracture required the implantation of a second stent after 6 months. The follow-up period ranges from 18 to 4 months and has been uneventful so far. Covered stents seem to have the potential to extend the limits of interventional therapy to extreme forms of aortic coarctations.