冠状动脉瘤 coronary artery aneurysm - PubMed 文献(第 5 页)
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冠状动脉瘤 的 PubMed 搜索结果(第 5 页)
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[Diagnosis by two-dimensional and Doppler echocardiography of coronary aneurysm in a Mexican boy with Kawasaki disease].
The mucocutaneous lymph node syndrome or Kawasaki's disease, is a clinical entity consisting of high fever, mucocutaneous involvement and cervical lymphadenopathy that affects infants and young children. Although syndrome is predominantly found in Japan, it has become increasingly recognized in other countries. This disease appears to be benign and self-limited in most instances. However, extensive cardiac involvement may cause sudden death due to myocardial infarction from occlusive coronary artery disease, rupture of a coronary aneurysm or conduction abnormalities. As a result, it has become important to establish a noninvasive diagnostic method for assessing cardiac involvement in this disease. The purpose of this study is to describe the echocardiographic recognition of a left coronary artery aneurysm in a 3 years old mexican boy with Kawasaki's disease.
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Variation in the management and treatment of children with giant coronary artery aneurysm following Kawasaki disease.
Giant coronary artery aneurysms are rare but potentially fatal complications of Kawasaki disease. The lack of evidence-based recommendations on their management and treatment cause guidelines and practices to differ. We aimed to assess these variations. An anonymous online survey regarding surveillance, imaging, pharmacological management, and interventional practices was distributed among 134 physicians attending to Kawasaki disease patients worldwide. A p-value of <0.05 was deemed significant. The majority (60%) of respondents were general paediatric cardiologists, and 29% interventional specialists. The average years in practice was 15 ± 9.6. Physicians from Asia had the most experience with giant coronary artery aneurysms. American practitioners preferred combining anticoagulants with aspirin. Beta-blockers and statins were more likely used in teenagers versus younger children. Cardiac catheterisation was most (52%) chosen for coronary surveillance in patients with echocardiogram anomalies, followed by Coronary CT-angiography. The indications for coronary intervention were split among respondents, regardless of geographic region or experience. The preferred treatment of coronary stenosis was percutaneous intervention (69%) versus bypass surgery. For thrombosis, thrombolytics (50%) were preferred over percutaneous (39%) and surgical (11%) interventions. Most (92%) preferred intervening in young children in a paediatric facility but were split between a paediatric and adult facility for older children. Most chose combined management by adult and paediatric specialists for either age-scenarios (70, 82%). As identified by our study, the lack of large studies and evidence-based recommendations cause uncertainty and ambivalence towards certain treatments. International collaborative efforts are needed to provide more robust evidence in the management of these patients.
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Successful surgical repair of a giant left main coronary artery aneurysm with arteriovenous fistula draining into a persistent left superior vena cava and coronary sinus: role of intraoperative transesophageal echocardiography. 成功手术修复巨大的左主干冠状动脉瘤，并将动静脉瘘引流到持续的左上腔静脉和冠状窦：术中经食管超声心动图的作用
We report the case of a 74-year-old woman with a history of hypertension, hypercholesterolemia, and pacemaker who presented to the hospital with new onset New York Heart Association class IV congestive heart failure. Transthoracic echocardiography revealed a markedly dilated right ventricle with normal right ventricular systolic function. There was moderate pulmonary hypertension with an estimated pulmonary artery systolic pressure of 60 mm Hg. Her echocardiogram 1 year earlier had demonstrated normal right ventricular size and systolic function, and no pulmonary hypertension. Additional transthoracic imaging with saline contrast study through a left peripheral vein demonstrated the presence of a dilated coronary sinus with a persistent left superior vena cava. Color Doppler demonstrated turbulent flow within the coronary sinus with evidence of significant left-to-right shunting. Cardiac catheterization revealed a massively dilated left main coronary artery aneurysm with an arteriovenous fistula into the left superior vena cava and coronary sinus. The calculated Qp/Qs was 2:1. The patient underwent 2 unsuccessful attempts at percutaneous intervention to occlude the arteriovenous fistula. She then underwent successful surgical closure of the coronary arteriovenous fistula. The important role of intraoperative transesophageal echocardiography in guiding this technically challenging surgical case is discussed.
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Immunoglobulin G4-related multiple cardiovascular lesions successfully treated with a combination of open surgery and corticosteroid therapy.
Immunoglobulin G4-related disease, a newly emerging systemic autoimmune disorder, can potentially involve the cardiovascular system. The standard treatment for immunoglobulin G4-related cardiovascular disease has not been established. We encountered a very rare case of an immunoglobulin G4-related inflammatory abdominal aortic aneurysm coexisting with a coronary artery aneurysm and periarteritis. The patient underwent surgical resection for the abdominal aortic aneurysm, followed by successful corticosteroid therapy for the coronary artery lesions. This is the first report of steroid-sensitive immunoglobulin G4-related coronary artery disease. A carefully planned treatment strategy for the multiple cardiovascular lesions was invaluable in the present case.
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Giant coronary aneurysm of Behcet's disease with sudden syncope: a case report.
Behcet's disease(BD) is a chronic inflammatory vasculitis that rarely affects the arteries, making myocardial infarction unlikely. We report a 28-year-old patient who was admitted to our hospital with multiple sudden syncope. Cardiovascular risk factors such as hypertension (HT), diabetes and obesity were not found in her. Preoperatively, imaging examinations suggested thrombosis of the inferior and superior vena cava and right heart combined with coronary artery aneurysm. The patient was finally diagnosed with a huge coronary artery aneurysm proximal to the left anterior descending artery. Syncope is considered to be caused right ventricular outflow tract obstruction. The patient received a successful aneurysm resection and had an uneventful postoperative recovery.
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[A case report of surgical treatment of ruptured coronary artery aneurysm].
A 63-year-old women experienced acute heart failure due to a ruptured aneurysm resulting from the coronary artery fistula which originated from the left anterior descending artery. On surgery, the pericardial cavity was found filled with massive hemorrhagic fluid and perforation was detected on the surface of the aneurysm, sphere-shaped with a approximate diameter of 50 mm. Operation was done by closure of fistula and subsequent aneurysmectomy under extracorporeal circulation. Post operative course had been uneventful. Coronary artery fistula accompanied with aneurysm had been thought to have a high risk of rupture and to be in indication of surgical intervention. This case report was undertaken with bibliographical consideration, since there had been only a few reports of actual ruptures.
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Coronary Artery Aneurysm After Mini-Crush Drug-Eluting Stent Technique in a Chronic Total Occlusion.
A 53-year-old man underwent percutaneous coronary intervention of a chronic total occlusion of the circumflex artery. A mini-crush stent technique with two drug-eluting stents was performed. To the best of our knowledge, this is the first case of coronary artery aneurysm affecting a bifurcated chronic total occlusion treated with a two-stent technique.
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Unexpected Giant Right Coronary Artery Aneurysm Diagnosed by Computed Tomography Angiography in the Emergency Department.
Giant coronary artery aneurysms (GCAA) are usually defined as diameter > 8 mm or > 400% of the adjacent normal segment; they are very rare (reported prevalence ≈0.02%). Though coronary angiography is the diagnostic gold standard, computed tomography angiography (CTA) offers a non-invasive, highly sensitive, and specific alternative. CTA enables detailed visualization of aneurysm morphology and detection of complications. We present the case of a 72-year-old man admitted to the Emergency Department with chest pain, where CTA played a crucial role in diagnosing a GCAA and assessing its potential life-threatening complications, highlighting its value in emergency cardiovascular imaging.
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Coronary artery aneurysm formation following implantation of a bioresorbable vascular scaffold for in-stent restenosis.
Coronary artery aneurysm (CAA) formation is a rare complication of coronary intervention that may develop after implantation of bare-metal or drug-eluting stents. The etiology of this entity appears to be multifactorial and its prognosis is poorly understood, but it has been associated with an increased risk of stent thrombosis. To date few cases of CAAs related to bioresorbable vascular scaffold (BVS) implantation have been reported, and the development of CAA after BVS implantation for the treatment of in-stent restenosis (ISR) has not been previously described. Here we present two cases of CAA formation after BVS, which represent the first demonstration of CAA formation after the use of BVS for ISR.
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Stent Fracture Induced Infected Pseudo Coronary Artery Aneurysm with Massive Abscess Successfully Treated by Coronary Stent Graft.
Infected pseudo coronary artery aneurysm (CAA) is extremely rare, and currently, there is no established treatment. We experienced a rare case of an infected pseudo CAA brought on due to a stent fracture. Following prolonged successful antimicrobial administration, which proved effective in successfully treating the patient, we performed coronary stent graft placement. Although a surgical procedure should fundamentally be the first course of action considered in such cases, when there are concerns as to the degree of invasiveness, our strategy represents a viable option.