- Email: [email protected]
PP-231 CORONARY ARTERY AND PULMONARY ARTERY FISTULA ORIGINATED FROM SIGNIFICANT STENOSIS LEFT ANTERIOR DESCENDING ARTERY
S172
Poster Presentations / International Journal of Cardiology 163S1 (2013) S81–S211
Conclusion: The management of coronary artery aneurysms varies significantly due to clinical presentation and potential for myocardial compromise. In symptomatic patients, both percutaneous intervention and surgical treatment have been described. Coronery Artery Surgery Study (CASS), which reported no difference in mortality in patients who had undergone coronary artery bypass graft versus medical therapy in both the aneurysm and stenosis only group.
on pump. After surgery the patient was taken to ICU. He had no problems during follow up. Therefore we planned to monitorize him in cardiovascular clinic. He was externed on the sixth day without any problems. We stil continue to follow-ups of the patient multidisciplinary. In brief, in Takayasu arteritis sometimes a surgeon must decide either cardiac or vasculary or both according to the clinical manifestations of the patient. In the polyclinic follow-ups the surgeon must be aware of restenosis, aneurysm formation in the early period of the surgery.
Figure: Angiography.
Figure: The presence of LAD aneurysm demonstrated by coronary angiography (RAO projection).
PP-230 CORONARY BYPASS IN A PATIENT WITH TAKAYASU ARTERITIS ¨ A. Aksoy, I˙ .F. Ozdomani c, ¸ N. Sirek, S. Durmaz. Department of Cardiovascular Surgery, Dumlupinar University Evliya Celebi Education and Research Hospital, Kutahya, Turkey Takayasu arteritis is an inflamatory disease which involves aorta and great branches of aorta. Its ethiology is unknown. Aortic valve and especially coronary ostiums are involved and this manner potentially creates a fatal complication. Lesions, in many cases, are in coronary ostiums or proximal part of the coronary arteries. In this case, a 44-year-old male consulted us with chest pain, syncope, pain and drowsiness in upper extremity with minimal effort. He describes claducatio under 100 mt. distance. In his story, he told that he had an intervention to his left subclavian artery and has a stent in this artery. He also told us he had a syncope attack 3 months ago. His diagnose was Takayasu arteritis according to ACR 1990 diagnostic criteria pathologically, and radilogically. We could palpate neither upper nor lower extremity pulsations. In his coronary angiography, LAD totally occluded from ostium to proximal part. LAD is filled from midportion to distal part by a collateral artery from circumflex artery. Right axillary, left subclavian, left common iliac arteries were totally occluded. Distal parts are filled with minor collateral arteries. In vertebral doppler USG, right vertebral flow was reduced, left vertebral flow was in opposite direction and had alow velocity. His left subclavian artery was obliterated thus he had subclavian steal syndrome. In laboratory findings, we found that arteritis was not acute. We evaluated the patient and decided that coronary bypass should be done primarily. Periferic vascular intervention might be done if his complaints continues through time despite the medical treatment. He has undergone CABGx1 on pump operation. Arterial monitorisation has been done from right femoral artery. LAD was not suitable for off-pump surgery so we applied LAD-safen bypass
PP-231 CORONARY ARTERY AND PULMONARY ARTERY FISTULA ORIGINATED FROM SIGNIFICANT STENOSIS LEFT ANTERIOR DESCENDING ARTERY ¨ A.S. Kunt. Ozel Yasam Hastanesi, Turkey Coronary artery fistula (CAF) is defined as an rare anomalous connection between a coronary artery and a major vessel or a cardiac chamber. We report a case of a left anterior descending coronary (LAD) stenosis and coronary artery fistula between the LAD coronary artery and the pulmonary artery (PA). CAF are often diagnosed by coronary angiogram. We describe our diagnostic approach and review the literature on the epidemiology, pathophysiology, the diagnostic modalities, and treatment options.
Figure 1. Angiographic view of coronary fistula between left internal thoracic artery and pulmonary artery.
Poster Presentations / International Journal of Cardiology 163S1 (2013) S81–S211
Conclusion: The management of coronary artery aneurysms varies significantly due to clinical presentation and potential for myocardial compromise. In symptomatic patients, both percutaneous intervention and surgical treatment have been described. Coronery Artery Surgery Study (CASS), which reported no difference in mortality in patients who had undergone coronary artery bypass graft versus medical therapy in both the aneurysm and stenosis only group.
on pump. After surgery the patient was taken to ICU. He had no problems during follow up. Therefore we planned to monitorize him in cardiovascular clinic. He was externed on the sixth day without any problems. We stil continue to follow-ups of the patient multidisciplinary. In brief, in Takayasu arteritis sometimes a surgeon must decide either cardiac or vasculary or both according to the clinical manifestations of the patient. In the polyclinic follow-ups the surgeon must be aware of restenosis, aneurysm formation in the early period of the surgery.
Figure: Angiography.
Figure: The presence of LAD aneurysm demonstrated by coronary angiography (RAO projection).
PP-230 CORONARY BYPASS IN A PATIENT WITH TAKAYASU ARTERITIS ¨ A. Aksoy, I˙ .F. Ozdomani c, ¸ N. Sirek, S. Durmaz. Department of Cardiovascular Surgery, Dumlupinar University Evliya Celebi Education and Research Hospital, Kutahya, Turkey Takayasu arteritis is an inflamatory disease which involves aorta and great branches of aorta. Its ethiology is unknown. Aortic valve and especially coronary ostiums are involved and this manner potentially creates a fatal complication. Lesions, in many cases, are in coronary ostiums or proximal part of the coronary arteries. In this case, a 44-year-old male consulted us with chest pain, syncope, pain and drowsiness in upper extremity with minimal effort. He describes claducatio under 100 mt. distance. In his story, he told that he had an intervention to his left subclavian artery and has a stent in this artery. He also told us he had a syncope attack 3 months ago. His diagnose was Takayasu arteritis according to ACR 1990 diagnostic criteria pathologically, and radilogically. We could palpate neither upper nor lower extremity pulsations. In his coronary angiography, LAD totally occluded from ostium to proximal part. LAD is filled from midportion to distal part by a collateral artery from circumflex artery. Right axillary, left subclavian, left common iliac arteries were totally occluded. Distal parts are filled with minor collateral arteries. In vertebral doppler USG, right vertebral flow was reduced, left vertebral flow was in opposite direction and had alow velocity. His left subclavian artery was obliterated thus he had subclavian steal syndrome. In laboratory findings, we found that arteritis was not acute. We evaluated the patient and decided that coronary bypass should be done primarily. Periferic vascular intervention might be done if his complaints continues through time despite the medical treatment. He has undergone CABGx1 on pump operation. Arterial monitorisation has been done from right femoral artery. LAD was not suitable for off-pump surgery so we applied LAD-safen bypass
PP-231 CORONARY ARTERY AND PULMONARY ARTERY FISTULA ORIGINATED FROM SIGNIFICANT STENOSIS LEFT ANTERIOR DESCENDING ARTERY ¨ A.S. Kunt. Ozel Yasam Hastanesi, Turkey Coronary artery fistula (CAF) is defined as an rare anomalous connection between a coronary artery and a major vessel or a cardiac chamber. We report a case of a left anterior descending coronary (LAD) stenosis and coronary artery fistula between the LAD coronary artery and the pulmonary artery (PA). CAF are often diagnosed by coronary angiogram. We describe our diagnostic approach and review the literature on the epidemiology, pathophysiology, the diagnostic modalities, and treatment options.
Figure 1. Angiographic view of coronary fistula between left internal thoracic artery and pulmonary artery.