冠状动脉瘤 coronary artery aneurysm - PubMed 文献(第 2 页)
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冠状动脉瘤 的 PubMed 搜索结果(第 2 页)
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Double giant coronary aneurysm: improved morphological study by computed tomography. 双巨大冠状动脉瘤：通过计算机断层扫描改进的形态学研究
Coronary artery aneurysm may cause coronary artery rupture, thromboembolism or haemodynamic problems related to compression. We report the case of a 68-year old man who was referred to an intensive cardiological care unit for recurrence of ventricular tachycardia. Coronary angiography revealed two large aneurysms of the mid-right coronary artery. A multislice computed tomography (CT) study demonstrated marked underestimation by invasive angiography because of the large thrombus. The patient was referred for cardiac surgery. The right mammary artery was used as a bypass graft to the distal segment of the right coronary artery and the two aneurysms were ligated proximally and distally after removal of their thrombus filling. The postoperative CT confirmed patency of the bypass graft and the vascular exclusion of the aneurysm, with no opacification. Cardiac CT is a promising tool for the comprehensive study of coronary aneurysms, both before and after surgery.
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Recurrent events of acute coronary syndrome in young adult patients after Kawasaki disease. 年轻成人川崎病后急性冠状动脉综合征的复发事件
I encountered three adult patients with major coronary artery occlusion after Kawasaki disease in childhood, who had developed again acute coronary syndrome of adults in the peripheral branches, such as the 4th segments, the atrioventricular node artery, and the posterior descending artery, of the right coronary artery. I reviewed their clinical course and coronary angiograms. Their age at onset of acute coronary syndrome ranged from 29 to 33 years. The male patient with a previous anteroseptal myocardial infarction in children had a symptomatic occlusion of the branch of the 4th posterior descending artery at 32 years of age. Acute coronary syndrome occurred in the area of 4th atrioventricular node artery in two female patients. The collateral arteries from the circumflex artery to the 4th atrioventricular node arteries were not clearly injected. It was suspected that they had developed bilateral giant aneurysms after acute Kawasaki disease. Two patients had an acute myocardial infarction due to thrombotic occlusion in a giant aneurysm of the right coronary artery or the left anterior descending artery, and one patient had an asymptomatic coronary occlusion of the right coronary artery and left anterior descending artery in children. Occlusion of peripheral coronary arteries in adulthood can occur in patients with multi-vessel disease caused by Kawasaki disease. Recurrent events of acute coronary syndrome can occur in adults, although its prevalence may be low. Careful follow-up in adults is also needed in this population.
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Cardiac events in Patients in their forties with Kawasaki disease and regression of coronary artery aneurysms. 四十余岁川崎病且冠状动脉瘤消退患者的心脏事件
Over a 50-year period from the first description of Kawasaki disease, we encountered three male patients with a history of Kawasaki disease, who had their first cardiac events in their forties. They were considered to have almost normal coronary arteries in the coronary angiograms when they were children and adolescents. They had no follow-up examinations after 20 years old. The 1st patient had an acute myocardial infarction, and the 2nd was a new appearance of coronary aneurysm and stenotic lesions with coronary artery calcification. The 3rd patient had unexpected sudden death. The interval from the onset of Kawasaki disease to the cardiac events ranged from 37 to 38 years. In the former two patients, coronary artery lesions could not be evaluated immediately after Kawasaki disease. Although the 3rd patient had bilateral medium-sized coronary artery aneurysms, his coronary aneurysms regressed 1 year after acute Kawasaki disease. The intimal thickening at a previous coronary aneurysm at the age of 19 was mild. The patients with regressed coronary aneurysms were asymptomatic for about 40 years after Kawasaki disease, prior to their cardiac events. Coronary artery calcification of the proximal portion of the major coronary arteries was a predictable marker in such patients. To prevent serious cardiac events in middle-aged adult patients, reevaluation of coronary artery lesions and restarting of anti-thrombotic therapy are needed. We must be aware that there are some differences in the clinical course and time of cardiac events between patients with giant aneurysms and those with medium aneurysms.
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Use of the PK Papyrus covered coronary stent in the treatment of Kawasaki disease-associated giant coronary artery aneurysms. 使用PK Papyrus覆膜冠状动脉支架治疗川崎病相关巨大冠状动脉瘤
Kawasaki disease (KD) is an acute vasculitis that can cause coronary artery inflammation and aneurysm formation leading to early obstructive disease. We describe the use of PK Papyrus covered stents (Biotronic, Inc.) in three pediatric patients to exclude coronary artery aneurysms (CAA) from the circulation and relieve aneurysm associated stenoses. Follow-up angiography at 11-17 months postprocedure demonstrated persistent exclusion of CAA and varying degrees of in-stent restenosis (ISR). Two patients required percutaneous coronary intervention with drug eluting stent (DES) implantation to relieve in-stent stenosis. Our findings suggest that CAA exclusion with the PK Papyrus stent is possible and may be a valuable tool in simultaneously treating stenotic and thrombogenic CAA in pediatric KD patients. ISR of these non-DES remains an issue and may require additional interventions within the short-term to maintain vessel patency.
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A rare and late angiographic presentation of DES fracture. 一例罕见且晚期血管造影表现的药物洗脱支架断裂
The drug-eluting stent (DES) era has seen an increasing number of stent fractures, which is considered one of the mechanisms of restenosis in DES. This increase in recognition could be due to various factors such as increased diagnosis compared to the bare-metal stent era, platform design and strut thickness, higher inflation pressures for DES deployment, and use of DES in more complex lesions (e.g., angulated, diffuse, calcified, bifurcated). The angiographic presentation of DES fracture has been reported as in-stent restenosis (either symptomatic or asymptomatic) in all published cases. We discuss a case of DES fracture presented as an ST-elevation myocardial infarction that was associated with a large coronary artery aneurysm.
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Huge Coronary Aneurysm in a Morbidly Obese Man with Exertional Dyspnea and Chest Pain. 一名病态肥胖男性伴劳力性呼吸困难和胸痛患者的巨大冠状动脉瘤
BACKGROUND Giant coronary artery aneurysm (GCAA) is a rare disease, with an incidence of 0.02% in the general population. GCAA is defined as when the diameter of the coronary artery is more than 4 times the adjacent part or more than 8 mm. There are several causes of GCAA, with atherosclerosis being the most common. Patients with giant coronary artery aneurysms can be asymptomatic or develop chest pain, dyspnea, and palpitations. Complications of GCCA include myocardial infarction, thrombosis, and sudden death, so early treatment is necessary to prevent mortality. There is no standard surgical approach for a giant coronary artery aneurysm. CASE REPORT A 64-year-old man with hypertension, opium addiction, morbid obesity (body weight 151 kg and BMI 46), and benign prostate hyperplasia presented with a giant coronary aneurysm in coronary angiography. The patient underwent cardiac surgery, and a 42-mm coronary aneurysm was detected. The aneurysm had many orifices that opened to the left main coronary artery, left circumflex artery, LAD, the diagonal branch of the LAD, and the septal branch of the LAD. Aneurysmectomy and coronary artery bypass graft were successfully performed. CONCLUSIONS Giant coronary artery aneurysms are rare. Patients with giant coronary artery aneurysms may experience sudden death due to myocardial infarction and other cardiovascular complications due to ischemia. Because it is rare, there is no standard surgical approach for a giant coronary artery aneurysm. Further studies need to focus on standardized surgical management of patients with giant coronary artery aneurysms.
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Sudden death complicating a coronary arteritis: polyarteritis nodosa (case report). 猝死并发冠状动脉炎：结节性多动脉炎（病例报告）
Coronary artery aneurysms are uncommon, are usually associated with atherosclerosis, and rarely involve all three major coronary arteries. Data on the optimal choice of acute myocardial infarction (AMI)´s revascularization in the context of polyarteritis nodosa (PAN) is limited to case reports and is still an open question. The present report describes a rare case of a young male patient followed for PAN presenting with acute myocardial infarction (AMI). Coronary angiography revealed multiple severe aneurysmal and stenotic changes. Based on clinical feature and angiographic findings, it was strongly suspected that the AMI was a complication of his vasculitis. This case indicates that coronary artery involvement should be carefully monitored during the chronic phase of PAN. The pathophysiology of AMI in PAN patients should be kept in mind and the interventional approach must be performed according to the angiographic findings to avoid complications.
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Coronary artery aneurysm formation after drug-eluting stent implantation. 药物洗脱支架植入后冠状动脉瘤形成
Drug-eluting stents (DES) have had a profound impact on the practice of interventional cardiology. Important safety concerns regarding DES have been widely publicized and acknowledged. The primary emphasis has been placed on late stent thrombosis and the adverse sequela which result. Another emerging adverse effect of DES is coronary aneurysm (CAA) formation. We report on a patient who developed CAA formation after DES implantation but not at the site of previous bare-metal stent (BMS) implantation. We also review the current understanding of DES-associated CAA formation.
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A case of giant coronary artery aneurysm after placement of a heparin-coated stent. 肝素涂层支架置入后巨大冠状动脉瘤一例
The formation of coronary aneurysms and pseudoaneurysms are a rare but previously described complication after percutaneous coronary intervention (PCI). We present a unique case of the development of a giant coronary aneurysm after placement of a heparin-coated stent. A 79-year-old female who had PCI to the left anterior descending coronary artery (LAD) using a heparin-coated stent three years previously underwent cardiac catheterization. Coronary angiography revealed a giant aneurysm measuring 19 x 18 mm immediately distal to the previously implanted stent in the LAD. The patient refused any further intervention and was treated with aggressive medical management. Eighteen months have now passed, and the patient has been stable without further cardiac events or complaints.
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Cardiac tamponade due to rupture of coronary artery fistula to the coronary sinus with giant aneurysm of coronary artery: usefulness of transthoracic echocardiography. 冠状动脉瘘入冠状静脉窦伴巨大冠状动脉瘤破裂导致的心脏压塞：经胸超声心动图的应用价值
A 68-year-old woman was admitted to our hospital because of back pain and syncope. Transthoracic echocardiography revealed pericardial effusion, a collapsed right ventricle, a giant aneurysm connected to the coronary sinus, a dilated left main trunk coronary artery, and a dilated left circumflex artery (LCx). Furthermore, there was a coronary artery fistula arising from the LCx that drained into the coronary sinus. We diagnosed cardiac tamponade due to rupture of the coronary artery fistula or giant aneurysm, and successful emergency surgery was performed. Rupture of coronary artery aneurysm or coronary artery fistula is very rare. Transthoracic two-dimensional echocardiography was very useful in our case for the diagnosis of cardiac tamponade, giant coronary aneurysm, and coronary artery fistula.