ABSTRACT
Coronary artery aneurysm is a rare congenital or acquired anomaly. The commonest location of coronary artery aneurysms is the right coronary artery and they are found slightly more often in males. We report an unusual case of multiple and extremely large aneurysms, therefore potentially at risk of rupture or thrombosis.
Subject(s)
Coronary Aneurysm/diagnosis , Aged , Cardiac Surgical Procedures , Coronary Aneurysm/surgery , Coronary Angiography/methods , Humans , Male , Predictive Value of Tests , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Bicuspid aortic valve is one of the most common congenital cardiac anomalies and it may be accompanied by other cardiovascular anomalies. Sinus of Valsalva aneurysm is a rare anomaly in adult population, but it coexists with bicuspid aortic valve quite often. This report describes a 57 years-old patient who had a bicuspid aortic valve accompanied by unruptured Valsalva sinus aneurysm with significant left anterior narrowing and who underwent successful surgery with ascending aorta and aortic valve replacement as well as coronary by-pass grafting.
Subject(s)
Aortic Aneurysm/surgery , Aortic Valve/surgery , Blood Vessel Prosthesis Implantation , Coronary Artery Bypass , Coronary Stenosis/surgery , Heart Defects, Congenital/surgery , Heart Valve Prosthesis Implantation , Sinus of Valsalva/surgery , Aortic Aneurysm/diagnostic imaging , Aortic Valve/abnormalities , Aortic Valve/diagnostic imaging , Aortography/methods , Coronary Angiography , Coronary Stenosis/complications , Coronary Stenosis/diagnostic imaging , Heart Defects, Congenital/complications , Heart Defects, Congenital/diagnostic imaging , Humans , Male , Middle Aged , Sinus of Valsalva/diagnostic imaging , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
INTRODUCTION: In-stent restenosis still remains a serious clinical problem. Local intramural drug delivery (LDD -- Local Drug Delivery) seems to be an interesting alternative to drug-eluting stents (DES). AIM: The aim of the study was to assess the safety and effectiveness of local intramural paclitaxel administration in the treatment of recurrent in-stent restenosis (ISR). METHODS: Five patients were enrolled in the study (3 men, mean age 50+/-7 years) with at least a second episode of ISR within the same stent. Percutaneous coronary angioplasty was performed on a total of 11 vessel segments. Remedy delivery catheters (Boston Scientific) were used for balloon angioplasty. Inflation pressure was calibrated to obtain a balloon/vessel lumen ratio of 1.1:1. Then the pressure was lowered to 3 atmospheres and 100 microg of paclitaxel diluted in 2 ml of 0.9% NaCl was given over 60 seconds under the pressure of 2-3 atmospheres. This dose was used for each 10 mm of lesions. Control coronary angiography was performed six months after the procedure. RESULTS: In all patients effective target vessel revascularisation was achieved. No adverse events were observed in the periprocedural period or during the 6-month follow-up period. Control angiography revealed ISR in three segments (27.2%) and in-stent late lumen loss of 0.21+/-0.93 mm. CONCLUSIONS: Local intramural paclitaxel delivery is a safe and effective method of ISR treatment. The optimal paclitaxel dose should be established in further studies.
