Introduction: Diffuse coronary artery disease (CAD) has a poor prognosis and many patients are ineligible for conventional coronary artery bypass grafting (CABG). This study evaluated the 12-month outcomes of coronary artery reconstruction and surgical patch angioplasty of the coronary artery for diffuse CAD.
Methods: A retrospective cohort study of patients who underwent CABG with surgical patch angioplasty of the coronary artery (reconstruction group) or standard CABG alone (standard group) at the Cardiovascular Surgery Department of the local Hospital between January 2014 and January 2016. Follow-up was censored at 12 months after surgery.
Results: Cardiopulmonary bypass and aortic cross-clamping durations were longer in the reconstruction group (n=32) than in the standard group (n=125) (<0.05). There were no differences in graft blood flow and postoperative levels of cardiac markers between the two groups (>0.05). In the reconstruction group, one patient died; a vein graft showed occlusion. In the standard group, two patients died; one left internal mammary artery graft and three vein grafts showed occlusion. There were no significant differences in mortality, major adverse cardiovascular and cerebrovascular events, and patency between the two groups (>0.05).
Conclusion: Coronary artery reconstruction and surgical patch angioplasty of the coronary artery can be performed for diffuse CAD. Patient outcomes were not significantly different from those of patients who underwent standard CABG.
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http://dx.doi.org/10.21470/1678-9741-2019-0390 | DOI Listing |
Coron Artery Dis
January 2025
Department of Medicine, Lundquist Institute at Harbor-UCLA Medical Center, Los Angeles.
Background: Coronary artery dominance is determined by the coronary artery emitting the posterior descending artery. In the left dominant system, a greater proportion of coronary flow enters the left coronary artery, potentially influencing calcified plaque development in the left anterior descending artery (LAD).
Methods: This retrospective single-center cohort study analyzed patients who underwent computed tomography angiography from September 2006 to December 2022 at Harbor-UCLA in Los Angeles, California.
Circ Cardiovasc Interv
January 2025
Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (D.M.F.v.d.B., E.M.P., E.W., D.C., E.M., B.F., M.V., J.D., K.A.).
Background: Geographic stent-ostium mismatch is an important predictor of target lesion failure after percutaneous coronary intervention of an aorto-ostial right coronary artery lesion. Optimal visualization of the aorto-ostial plane is crucial for precise stent implantation at the level of the ostium. This study investigates whether preprocedural 3-dimensional computed tomography (3DCT), with determination of the optimal viewing angle, would allow for more precise stent implantation and reduce procedure time, contrast, and radiation dose.
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December 2024
Internal Medicine, Mercy Health St. Vincent Medical Center, Toledo, USA.
We present a case of spontaneous hemorrhage in an emphysematous bulla, complicated by anticoagulation. Bullous emphysema is a well-recognized complication of chronic obstructive pulmonary disease (COPD), and a rare manifestation is hemorrhage into preexisting pulmonary bullae. A 69-year-old male patient presented to the emergency department with hemoptysis, shortness of breath, and productive cough.
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December 2024
General Pediatrics, Al Qassimi Women's and Children's Hospital, Sharjah, ARE.
Kawasaki disease (KD) is an acute vasculitis mainly seen in children, with a specific risk for coronary artery involvement. Atypical symptoms can sometimes result in missed diagnoses, delaying necessary treatment and increasing the chances of serious cardiovascular complications. We report a case of a six-month-old previously healthy girl who had not been vaccinated.
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December 2024
University of Florida Health Congenital Heart Center, University of Florida College of Medicine, Gainesville, USA.
Anomalous aortic origin of a coronary artery (AAOCA) comprises a set of rare congenital abnormalities in the origin or path of the coronary arteries with highly variable clinical implications. This is a pilot feasibility study where we investigated the influence of the anomalous coronary artery inlet architecture on coronary perfusion using coronary blood flow computational simulations to help predict the risk for coronary ischemia in patients with anomalous aortic origin of the right coronary artery (AAORCA) with these types of anomalous coronary artery inlet architectures. We developed a protocol for generating 3D models of patient coronary artery anatomies from an IRB-approved dataset of cardiac CT images of patients with AAORCA at our institution.
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