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PP-200: TOF IN ADULT PATIENTS: CASE STUDY
Posters / International Journal of Cardiology 147S2 (2011) S131–S175
PP-200 TOF IN ADULT PATIENTS: CASE STUDY K. Yay1 , S. Surer2 , H. Aydin1 , U. Tutun1 . 1 Kalp Ve Damar Cerrahisi, Turkiye Yuksek Ihtisas Hastanesi, Ankara, Turkey; 2 Kalp Ve Damar Cerrahisi, Sami Ulus Children Hospital, Ankara, Turkey Objective: Tetralogy of fallot (TOF) is the most common cyanotic congenital heart disease after 1 year of age. Methods: A 32 year old male was born with tetralogy of fallot and underwent primary surgical repair at age 32, be composed of venticuler septal defect (VSD) patch closure with right ventricular outflow tract (RVOT) transannuler patch. Following operation a statistically in RV/LV pressure ratio 0.9 was not decreased. Results: Functional status was dropped from NYHA III-IV to NYHA I following repair. The patient reported no symptoms. Conclusions: As our case 2 year follow up results show us surgery must be first chose. PP-201 ANOMALIES OF RIGHT CORONARY ARTERIES ARISING FROM LEFT MAIN CORONARY ARTERY. CASE REPORT I.H. Algin. Department of cardiovascular surgery of OSM Ortadogu Hospital, Sanliurfa, Turkey
S145
17.87 ng/mL (reference range 0–0.04 ng/mL), respectively. Other serum biochemical parameters and haemogram were within normal limits. The chest pain relieved after initiation of medical teraphy and ST elevation rezolved. A follow-up echocardiogram 4 weeks later showed normal left ventricular function and size, with a calculated ejection fraction of 68%. Conclusions: ABS was first described in Japan in 1991. It is characterised by transient apical left ventricular ballooning in the absence of significant coronary artery disease. Our patient’s presentation was consistent with a diagnosis of ABS. The pathogenesis of this condition is not well understood but is postulated to be caused by coronary artery vasospasm in association with intense emotional or physical stress, leading to apical myocardial stunning. As a result there is often minimal myocardial necrosis, as reflected by the minor cardiac enzyme rise in this case. Left ventricular function usually returns to normal within 1–4 weeks, as seen in our patient. The role of catecholamines in the pathogenesis of Takotsubo cardiomyopathy has been documented in numerous studies.
Objective: Congenital coronary artery anomalies are rare anomalies which show up asymptomatically if there isn’t an accompanying disease. This is a case of a 71 year old male patient. Patient underwent selective coronary angiography which defined angina after exercises. Methods: Coronary artery anomalies detected in patients after angiography which is right coronary artery arising from left mean coronary artery anomalies and multiple coronary artery stenosis. Results: Multiple coronary artery stenosis identified patient undertaken elective operation for coronary artery bypass grafting. Conclusions: We performed CABG standard hemodynamic condition under cross clamping with CPB. Specialist must be careful in younger patients in whom sudden death may be seen after exercises. PP-202 APICAL BALLOONING SYNDROME (TAKOTSUBO CARDIOMYOPATHY): A CASE REPORT M. Tekinalp1 , H. Akilli1 , A. Aribas1 , C. Duman1 , Y.I. Alihanoglu2 . 1 Cardiology Department of Meram Medical School of Selcuk University, Konya, Turkey; 2 Cardiology Department of Denizli Hospital, Denizli, Turkey Objective: Apical ballooning syndrome (ABS) is a unique acute cardiac syndrome characterized by symptoms and electrocardiographic changes that mimic acute myocardial infarction. It occurs in patients without evidence of significant obstructive coronary artery disease and is associated with transient extensive wall motion abnormalities of the apical and mid portions of the left ventricle. The incidence of ABS is estimated to be 1% to 2% of patients presenting with an acute myocardial infarction. ABS frequently occurs in women in their seventh or eighth decades of life. Methods: A 48 year-old woman presented with acute onset of discomfort in the chest. Her medical history was nat remarkable. She had no modifiable risk factors for coronary artery disease. Examination revealed a heart rate of 90 beats per minute and a blood pressure of 110/65 mmHg, with no evidence of acute pulmonary oedema. At presentation, an electrocardiogram demonstrated 4 mm ST elevation in leads V2–V5. The patient was immediately transferred to the cardiac catheter laboratory, where angiography revealed angiographically normal coronary arteries. Transthoracic echocardiography revealed antero lateral and inferior apical ballooning consistent with ABS (Figure). Ejection fraction was 40%. Her Peak creatinine kinase and troponin I levels were 67.2 ng/mL (reference range 0.6–6.3 ng/mL) and
Figure 1. Apical four-chamber views showing ballooning apical segments (arrows) LV, left ventricle; LA, left atrium; RV, right ventricle; RA, right atrium.
PP-203 LEFT VENTRICULAR NONCOMPACTION ASSOCIATED WITH A SINOATRIAL NODE ARTERY ORIGINATING FROM THE POSTEROLATERAL BRANCH OF THE RIGHT CORONARY ARTERY M. Cetin1 , Z. Guven Cetin2 , O. Ucar2 . 1 Department of Cardiology, Ataturk Chest Disease and Chest Surgery Education and Research Hospital, Ankara, Turkey; 2 Department of Cardiology, Ankara Numune Education and Research Hospital, Ankara, Turkey Objective: Noncompaction of ventricular myocardium (NVM) is a rare unclassified cardiomyopathy characterized by multiple prominent trabeculations and deep intertrabecular recesses, with an incidence of 0.05% in the adult population. This cardiomyopathy can be isolated or in combination with other congenital cardiac disorders, including coronary artery abnormalities. A sinoatrial node (SAN) artery originating from the posterolateral (PL) branch of the right coronary artery (RCA) is a rare coronary artery abnormality.
PP-200 TOF IN ADULT PATIENTS: CASE STUDY K. Yay1 , S. Surer2 , H. Aydin1 , U. Tutun1 . 1 Kalp Ve Damar Cerrahisi, Turkiye Yuksek Ihtisas Hastanesi, Ankara, Turkey; 2 Kalp Ve Damar Cerrahisi, Sami Ulus Children Hospital, Ankara, Turkey Objective: Tetralogy of fallot (TOF) is the most common cyanotic congenital heart disease after 1 year of age. Methods: A 32 year old male was born with tetralogy of fallot and underwent primary surgical repair at age 32, be composed of venticuler septal defect (VSD) patch closure with right ventricular outflow tract (RVOT) transannuler patch. Following operation a statistically in RV/LV pressure ratio 0.9 was not decreased. Results: Functional status was dropped from NYHA III-IV to NYHA I following repair. The patient reported no symptoms. Conclusions: As our case 2 year follow up results show us surgery must be first chose. PP-201 ANOMALIES OF RIGHT CORONARY ARTERIES ARISING FROM LEFT MAIN CORONARY ARTERY. CASE REPORT I.H. Algin. Department of cardiovascular surgery of OSM Ortadogu Hospital, Sanliurfa, Turkey
S145
17.87 ng/mL (reference range 0–0.04 ng/mL), respectively. Other serum biochemical parameters and haemogram were within normal limits. The chest pain relieved after initiation of medical teraphy and ST elevation rezolved. A follow-up echocardiogram 4 weeks later showed normal left ventricular function and size, with a calculated ejection fraction of 68%. Conclusions: ABS was first described in Japan in 1991. It is characterised by transient apical left ventricular ballooning in the absence of significant coronary artery disease. Our patient’s presentation was consistent with a diagnosis of ABS. The pathogenesis of this condition is not well understood but is postulated to be caused by coronary artery vasospasm in association with intense emotional or physical stress, leading to apical myocardial stunning. As a result there is often minimal myocardial necrosis, as reflected by the minor cardiac enzyme rise in this case. Left ventricular function usually returns to normal within 1–4 weeks, as seen in our patient. The role of catecholamines in the pathogenesis of Takotsubo cardiomyopathy has been documented in numerous studies.
Objective: Congenital coronary artery anomalies are rare anomalies which show up asymptomatically if there isn’t an accompanying disease. This is a case of a 71 year old male patient. Patient underwent selective coronary angiography which defined angina after exercises. Methods: Coronary artery anomalies detected in patients after angiography which is right coronary artery arising from left mean coronary artery anomalies and multiple coronary artery stenosis. Results: Multiple coronary artery stenosis identified patient undertaken elective operation for coronary artery bypass grafting. Conclusions: We performed CABG standard hemodynamic condition under cross clamping with CPB. Specialist must be careful in younger patients in whom sudden death may be seen after exercises. PP-202 APICAL BALLOONING SYNDROME (TAKOTSUBO CARDIOMYOPATHY): A CASE REPORT M. Tekinalp1 , H. Akilli1 , A. Aribas1 , C. Duman1 , Y.I. Alihanoglu2 . 1 Cardiology Department of Meram Medical School of Selcuk University, Konya, Turkey; 2 Cardiology Department of Denizli Hospital, Denizli, Turkey Objective: Apical ballooning syndrome (ABS) is a unique acute cardiac syndrome characterized by symptoms and electrocardiographic changes that mimic acute myocardial infarction. It occurs in patients without evidence of significant obstructive coronary artery disease and is associated with transient extensive wall motion abnormalities of the apical and mid portions of the left ventricle. The incidence of ABS is estimated to be 1% to 2% of patients presenting with an acute myocardial infarction. ABS frequently occurs in women in their seventh or eighth decades of life. Methods: A 48 year-old woman presented with acute onset of discomfort in the chest. Her medical history was nat remarkable. She had no modifiable risk factors for coronary artery disease. Examination revealed a heart rate of 90 beats per minute and a blood pressure of 110/65 mmHg, with no evidence of acute pulmonary oedema. At presentation, an electrocardiogram demonstrated 4 mm ST elevation in leads V2–V5. The patient was immediately transferred to the cardiac catheter laboratory, where angiography revealed angiographically normal coronary arteries. Transthoracic echocardiography revealed antero lateral and inferior apical ballooning consistent with ABS (Figure). Ejection fraction was 40%. Her Peak creatinine kinase and troponin I levels were 67.2 ng/mL (reference range 0.6–6.3 ng/mL) and
Figure 1. Apical four-chamber views showing ballooning apical segments (arrows) LV, left ventricle; LA, left atrium; RV, right ventricle; RA, right atrium.
PP-203 LEFT VENTRICULAR NONCOMPACTION ASSOCIATED WITH A SINOATRIAL NODE ARTERY ORIGINATING FROM THE POSTEROLATERAL BRANCH OF THE RIGHT CORONARY ARTERY M. Cetin1 , Z. Guven Cetin2 , O. Ucar2 . 1 Department of Cardiology, Ataturk Chest Disease and Chest Surgery Education and Research Hospital, Ankara, Turkey; 2 Department of Cardiology, Ankara Numune Education and Research Hospital, Ankara, Turkey Objective: Noncompaction of ventricular myocardium (NVM) is a rare unclassified cardiomyopathy characterized by multiple prominent trabeculations and deep intertrabecular recesses, with an incidence of 0.05% in the adult population. This cardiomyopathy can be isolated or in combination with other congenital cardiac disorders, including coronary artery abnormalities. A sinoatrial node (SAN) artery originating from the posterolateral (PL) branch of the right coronary artery (RCA) is a rare coronary artery abnormality.