19-year patency of a coronary-coronary venous bypass graft.

No data are available on the long-term outcome of coronary-coronary venous bypass grafting. We describe a case in which we successfully stented a discrete, critical stenosis of a coronary-coronary venous graft that had been placed 19 years earlier to minimize manipulation of a severely calcified ascending aorta. Coronary-coronary bypass grafting should be considered in cases involving severe aortic calcification, in situ grafts of inadequate length, and stenosed or occluded subclavian arteries.

Intracoronary ST segment evolution during primary coronary stenting predicts infarct zone recovery.

In patients with acute myocardial infarction (AMI), early ST segment elevation resolution on ECG predicts myocardial reperfusion and LV recovery. Intracoronary ECG is more sensitive than surface ECG to detect regional ischemia. In patients undergoing primary percutaneous coronary intervention (PCI), we investigated if failed myocardial reperfusion, despite successful infarct vessel recanalization, could be rapidly and easily identified by intracoronary ST segment monitoring from guidewire recording.