ABSTRACT
Although drug-eluting stents are increasingly used to treat coronary disease, restenosis remains the major limitation of these devices. We report a case of complete metal jacket using 17 stents for triple-vessel coronary disease in a 73-year-old man, for whom surgery would have been the best choice.
Subject(s)
Coronary Artery Disease/therapy , Coronary Restenosis/therapy , Metals , Percutaneous Coronary Intervention/instrumentation , Stents , Aged , Coronary Angiography , Coronary Artery Bypass , Coronary Artery Disease/diagnostic imaging , Coronary Restenosis/diagnostic imaging , Coronary Restenosis/etiology , Drug-Eluting Stents , Fatal Outcome , Humans , Male , Patient Selection , Percutaneous Coronary Intervention/adverse effects , Prosthesis Design , Retreatment , Risk Factors , Time Factors , Treatment OutcomeABSTRACT
To decrease the risk of traumatic injury or dissection of the aorta in patients with diffuse atherosclerotic disease or calcification of the ascending aorta, we have devised a simple method that uses an Embol-X aortic cannula with a Fogarty occlusion catheter.
Subject(s)
Balloon Occlusion/instrumentation , Balloon Occlusion/methods , Heart Valve Diseases/surgery , Heart Valve Prosthesis Implantation/instrumentation , Heart Valve Prosthesis Implantation/methods , Aortic Diseases/complications , Atherosclerosis/complications , Constriction , Equipment Design , Heart Valve Diseases/complications , HumansABSTRACT
The ideal surgical approach is unclear in adult patients with coarctation of the aorta that is associated with other cardiovascular pathologies that require intervention. Standard median sternotomy allows simultaneous, coronary revascularization surgery, valve replacement and repair of aortic coarctation. However the collateral circulation and the anatomy of the mammary arteries must be determined, to avoid possible complications. We report a case of a 69 year-old man with aortic coarctation, aortic stenosis, coronary artery disease and internal mammary artery dilatation who underwent concomitant surgical procedures through a median sternotomy.
Subject(s)
Aortic Coarctation/surgery , Aortic Valve Stenosis/surgery , Coronary Artery Disease/surgery , Dilatation, Pathologic/surgery , Mammary Arteries/surgery , Aged , Aortic Coarctation/diagnostic imaging , Aortic Valve Stenosis/diagnosis , Coronary Artery Disease/diagnostic imaging , Dilatation, Pathologic/diagnostic imaging , Humans , Male , Sternotomy , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: As the population ages, bioprosthesis are increasingly being used in cardiac valve replacement. Pericardial bioprosthesis combine an excellent hemodynamic performance with low thrombogenicity, but valve failure associated with calcification remains a concern with these valves. We describe distortion of the bioprosthesis ring as a risk factor for early calcification. METHODS: A total of 510 patients over the age of 70 years underwent isolated aortic valve replacement with the Mitroflow (A12) pericardial bioprosthesis. Thirty two patients (6,2%) have undergone a second aortic valve replacement due to structural valve dysfunction resulting from valve calcification. In all patients a chest radiography and coronary angiography was performed before reoperation. A 64 Multidetector Computed Tomography (MDCT) with retrospective ECG gating study was performed in four patients to evaluate the aortic bioprosthesis. RESULTS: Chest radiography showed in all patients an irregular bioprosthesis ring. At preoperative coronary angiography a distorted bioprosthesis ring was detected in all patients. Macroscopic findings of the explanted bioprostheses included extensive calcification in all specimens. CONCLUSION: There was a possible relationship between early bioprosthetic calcification and radiologic distortion of the bioprosthesis ring.
Subject(s)
Aortic Valve/surgery , Bioprosthesis/adverse effects , Calcinosis/etiology , Heart Valve Prosthesis/adverse effects , Aged , Aged, 80 and over , Device Removal , Female , Heart Valve Prosthesis Implantation/adverse effects , Humans , Male , Radiography, Thoracic , Reoperation , Risk FactorsABSTRACT
Absorbable topical hemostatic agents are commonly used in cardiac surgery. In this study, we report an unusual case of an acute ischemic event after coronary revascularization produced by interaction between oxidized cellulose and epsilon aminocaproic acid (EACA). An in vitro study was also performed to test the interaction between oxidized cellulose and EACA.
Subject(s)
Cellulose, Oxidized/adverse effects , Coronary Artery Disease/surgery , Graft Occlusion, Vascular/etiology , Hemostatics/adverse effects , Myocardial Ischemia/etiology , Administration, Topical , Aged , Cellulose, Oxidized/administration & dosage , Coronary Artery Bypass , Hemostatics/administration & dosage , Humans , MaleABSTRACT
This report describes a 41-year-old man who had atypical angina resulting from coronary steal by left atrial myxoma. The tumor was completely excised and the patient was symptoms free after operation.
