ABSTRACT
In an attempt to assess the relationship between lipid abnormalities and severity of coronary artery disease, we measured serum levels of cholesterol (SC), triglycerides (TG), phospholipids (SP), low density lipoprotein cholesterol (LDL-C), very low density lipoprotein cholesterol (VLDL-C), high density lipoprotein cholesterol (HDL-C), and high density lipoprotein phospholipids (HDL-P), in 217 men undergoing diagnostic coronary arteriography. We found significantly higher mean values of HDL-P and HDL-C in men with normal coronaries, but no significant differences in the other measured lipids. While there was no significant difference in HDL-C among patients with one, two or three-vessel disease, there was a negative correlation between HDL-P levels and the severity of the disease. These observations suggest that prospective studies would be of merit to establish the relevance of HDL-P in the development of coronary artery disease.
Subject(s)
Coronary Angiography , Coronary Disease/blood , Phospholipids/blood , Cholesterol , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Cholesterol, VLDL/blood , Coronary Disease/diagnostic imaging , Humans , Male , Triglycerides/bloodABSTRACT
A patient with a large saphenous vein graft aneurysm is described. This case illustrates the role of magnetic resonance imaging and cardiac catheterization in patients with a mediastinal mass and history of coronary bypass surgery.
Subject(s)
Aneurysm/diagnosis , Coronary Artery Bypass , Heart Diseases/diagnosis , Mediastinal Diseases/diagnosis , Saphenous Vein/transplantation , Angina Pectoris/diagnosis , Cardiac Catheterization , Cardiac Output, Low/diagnosis , Diagnosis, Differential , Heart Atria , Humans , Magnetic Resonance Imaging , Male , Middle AgedSubject(s)
Angioplasty, Balloon, Coronary/adverse effects , Cardiomyopathies/etiology , Coronary Disease/etiology , Fistula/etiology , Iatrogenic Disease , Atherectomy, Coronary/adverse effects , Cardiomyopathies/diagnostic imaging , Coronary Angiography , Coronary Disease/diagnostic imaging , Fistula/diagnostic imaging , Heart Ventricles/diagnostic imaging , Humans , Male , Middle Aged , Remission, SpontaneousABSTRACT
Coronary angioplasty of tortuous anomalous coronary arteries can be technically challenging. We describe a successful percutaneous transluminal coronary angioplasty (PTCA) of an anomalous right coronary artery after a failed previous attempt. The anatomic limitations of anomalous right coronary arteries and technical considerations for PTCA are discussed.
Subject(s)
Angioplasty, Balloon, Coronary , Coronary Disease/therapy , Coronary Vessel Anomalies/complications , Coronary Disease/complications , Humans , Male , Middle AgedABSTRACT
A patient is reported who underwent cardiac catheterization 4 years following coronary artery bypass grafting. Cardiac catheterization revealed the presence of a fistulous tract in the wall of the ascending aorta, originating at the site of aortic anastomosis of a saphenous vein bypass graft and ending in the superior aspect of the right sinus of Valsalva. This complication was felt to have resulted from a inadvertent localized dissection of the aorta during bypass surgery. The fistula was also imaged by ultrafast cine computerized tomography which proved a useful non-invasive method for follow-up examination.
Subject(s)
Aortic Diseases/etiology , Arterio-Arterial Fistula/etiology , Coronary Artery Bypass/adverse effects , Iatrogenic Disease , Sinus of Valsalva , Aortic Diseases/diagnostic imaging , Aortography , Arterio-Arterial Fistula/diagnostic imaging , Cardiac Catheterization , Humans , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
Iatrogenic aortocoronary vein fistula following coronary artery bypass surgery is a rare complication. We describe the first reported case of inadvertent anastomosis of the left internal mammary artery to cardiac vein. The clinical characteristics and consequences as well as the angiographic characteristics of this fistula are described. Precautions that may be taken to prevent this complication are also addressed.
Subject(s)
Arteriovenous Fistula/etiology , Coronary Artery Bypass/adverse effects , Coronary Vessels , Iatrogenic Disease , Mammary Arteries , Thoracic Arteries , Aged , Arteriovenous Fistula/diagnostic imaging , Arteriovenous Fistula/therapy , Coronary Vessels/surgery , Humans , Male , Mammary Arteries/surgery , Radiography , Saphenous Vein/transplantation , Thoracic Arteries/surgery , VeinsABSTRACT
New balloon-on-a-wire dilation systems allow crossing of severely stenosed coronary arteries owing to their ultra-low profile. However, these systems do not allow for over-the-wire exchange to a larger balloon catheter or insertion of perfusion catheters, should the vessel close abruptly during dilation. Therefore, if the need for such catheters arises, the vessel must be left unprotected during attempts to recross the lesion. We describe a new technique using a combined balloon-on-a-wire system and an exchangeable guidewire, which permits the crossing and dilation of severely stenosed coronary arteries, while at the same time offering vessel protection and balloon catheter exchange.
