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Coronary Myocardial Bridge Updates: Anatomy, Pathophysiology, Clinical Manifestations, Diagnosis, and Treatment Options.
Tex Heart Inst J
January 2025
Center for Women's Heart and Vascular Health, The Texas Heart Institute, Houston, Texas.
Myocardial bridging is a frequent anomaly of the heart in humans and other animals. A myocardial bridge is typically characterized by the systolic narrowing seen with traditional catheter angiography, but this abnormality is not by itself a sign of ischemia or the need for intervention. In particular, transient spontaneous angina must be corroborated by reproducible narrowing during acetylcholine testing; this narrowing occurs during resting conditions and is responsive to nitroglycerin administration.
View Article and Find Full Text PDFUnmasking Culprit Complex Infero-Posterior STEMI: Navigating Ad Hoc RCA CTO PCI.
JACC Case Rep
January 2025
Section of Cardiovascular Diseases, White River Health, Batesville, Arkansas, USA.
Patients presenting with acute coronary syndrome with ST-segment elevation myocardial infarction require rapid and decisive interventions to restore blood flow to the affected myocardium, minimizing ischemic damage. This case report is particularly unique because it involves a patient presenting with ST-segment elevation myocardial infarction, where the culprit lesion was an occluded coronary artery graft with an extensive thrombus burden. The complexity of this case necessitated a strategic shift to revascularize the chronically occluded native vessel instead of the graft.
View Article and Find Full Text PDFHybrid repair of aortic aneurysm in a patient with a congenital pelvic kidney.
J Vasc Surg Cases Innov Tech
April 2025
Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
We describe a patient with an asymptomatic infrarenal abdominal aortic aneurysm. Treatment decisions were complicated by the presence of a left congenital pelvic kidney supplied by two renal arteries originating from the proximal common iliac arteries bilaterally and respiratory status that was prohibitive to open repair. A hybrid surgical repair was performed with a bifurcated aortic endograft and parallel grafting to revascularize the pelvic renal arteries.
View Article and Find Full Text PDFAberrant right renal perfusion from right internal mammary artery.
J Vasc Surg Cases Innov Tech
April 2025
Division of Vascular Surgery and Endovascular Therapy, University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University, Cleveland, OH.
Renal artery (RA) anomaly is common and may have significant clinical implications. We present a case of a 29-year-old man in whom the upper two-thirds of the right kidney were supplied by the right internal mammary artery and collateral network. Additionally, the superior left RA had proximal stenosis with a distal aneurysm.
View Article and Find Full Text PDFQuality Improvement Methodologies: An Application in Cardiac Anesthesiology.
J Cardiothorac Vasc Anesth
January 2025
Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Quality improvement (QI) in medicine serves as the cornerstone of best practices. It enhances medical care by maximizing safety and efficiency while minimizing errors and waste. For a QI initiative to succeed it requires careful strategizing and effective change management plans, including the application of established QI methodologies to ensure sustainable success.
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