Juniper Publishers Journal of Cardiology and Cardiovascular Therapy

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY   Abstract Background: Asymmetric septal hypertrophy is the most prevalent form of hypertrophic cardiomyopathy. The aim of this series of cases is to demonstrate the measures performed by perioperative transesophageal echocardiography (TEE) during myectomy procedures. Methods: A retrospective analysis of the echocardiography exams from patients who underwent myectomy procedure from January 2015 to January 2017 was developed. Were excluded patients who underwent emergency surgeries, combined surgery and patients who had already septal coronary artery alcoholization. Results: A total of 4 patients were evaluated in the period from 2015 to 2017. They were all women, ASA 3 with a mean age of 61±8,7 years old. The left ventricle outflow tract (LVOT) peak gradient pre-CPB was 114,4±50,6mmHg and post-CPB was 42,4 46,3mmHg. The LVOT mean gradient pre-CPB was 52,4±19,9mmHg and post-CPB was 21...

  JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Introduction Coronary arteries of anomalous origin are uncommon and encountered in 0.2-1.2% of patients undergoing percutaneous coronary intervention and represent a marked deviation of the normal anatomic pattern [ 1 , 2 ]. An anomalous origin of the right coronary artery (RCA) from the left sinus of Valsalva (LSOV) has been reported in 6-27% of patients with coronary anomalies.Moreover, the anomalous origin of the RCA from the LSOV is associated with early development of coronary artery disease and it can cause sudden cardiac death [ 3 ]. However, PCIs of anomalous right coronary artery (ARCA) from the LSOV pose considerable technical challenges to the interventionalist due to unusual location and course of this anomaly. Still, CTO-PCIs against ARCA from the LSOV require more technical conditions for appropriate back-up support of guiding catheters to overcome problems such as anato...

  JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Abstract Coronary angiography is the investigation of choice to understand coronary anatomy. Although it is a generally safe procedure, it is not risk free. Coronary artery dissection is a rare condition. It can be either spontaneous or iatrogenic as a complication of angiography, angioplasty or cardiac surgery. We report the case of an iatrogenic dissection of the left main stem coronary artery with extension into the left anterior descending artery (LAD) secondary to an elective coronary angiogram. The complication was treated with emergency coronary artery bypass surgery with a left internal mammary artery to LAD anastamosis and long saphenous vein as graft conduits respectively. We aim to highlight the importance of prompt identification of such complication as well as the challenges in management with regards to coronary artery bypass surgery or bail out stenting. Keywords: Left...

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY   Abstract A 23 year old man presented with anterior ST elevation myocardial infarction while playing football and gave a 3 week history of recreational intravenous steroid abuse. Coronary angiogram showed a large persistent filling defect in left main stem extending into LAD and intermediate arteries. This was felt to be either spontaneous left main dissection precipitated by heavy exertion or left main stem thrombosis facilitated by intravenous steroid abuse over the previous 3 weeks. He was offered immediate surgical revascularisation but elected instead to have delayed surgery after 2 weeks unless symptoms worsened. Repeat coronary angiogram, two weeks later, however, showed considerable improvement with only a small amount of residual thrombus in left anterior descending artery and hence it was elected to continue with medical treatment. Following further 6 weeks, repeat coronary a...

  JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Introduction Coronary arteries of anomalous origin are uncommon and encountered in 0.2-1.2% of patients undergoing percutaneous coronary intervention and represent a marked deviation of the normal anatomic pattern [ 1 , 2 ]. An anomalous origin of the right coronary artery (RCA) from the left sinus of Valsalva (LSOV) has been reported in 6-27% of patients with coronary anomalies. Moreover, the anomalous origin of the RCA from the LSOV is associated with early development of coronary artery disease and it can cause sudden cardiac death [ 3 ]. However, PCIs of anomalous right coronary artery (ARCA) from the LSOV pose considerable technical challenges to the interventionalist due to unusual location and course of this anomaly. Still, CTO-PCIs against ARCA from the LSOV require more technical conditions for appropriate back-up support of guiding catheters to overcome problems such as anat...

JUNIPER PUBLISHERS-OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Present Status of Acute MI Patients in Japan Approximately 40,000 patients die from acute myocardial infarction (MI) in Japan every year according to the data from Vital Statistics 2014 reported by the Ministry of Health, Labor, and Welfare. However, the number of patients hospitalized due to acute MI is about 69,000/year, and the in-hospital mortality of those patients is below 10% according to the data from The Japanese Registry of all cardiac and vascular Disease (JROAD) reported by the Japanese Circulation Society. Therefore, approximately 34,000 patients with acute MI die before hospitalization every year and approximately 40% of acute MI patients die after onset mainly before hospitalization. Judging from these data, we should pay more attention to how to prevent acute MI rather than to how to treat acute MI patients in hospital to save their lives. Process of Acute MI Onset ...

JUNIPER PUBLISHERS-OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Introduction Ischemic heart disease (IHD) is a major cause of mortality and morbidity worldwide. It caused 1 of every 6 deaths in the United States in 2008 [1]. It is also the major contributor to heart failure (HF) which has become a burgeoning disease. According to American Heart Association (AHA) projections, HF prevalence will increase by 46% from 2012 to 2030 [2]. Patients with serious IHD usually, have events such as myocardial infarction (MI) that can result in irreparable loss of viable cardiac mass dramatically affecting their cardiac functions. Despite the important advances achieved in revascularization procedures and medical therapy, many of these patients are left with significant disability [3]. Considering the unclear efficacyof coronary artery bypass grafting (CABG) surgery for these patients and the shortage of donor hearts, a rationale to develop a novel stem cell-bas...

JUNIPER PUBLISHERS-OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Introduction Stent dislodgment is uncommon complication of percutaneous coronary procedures (PCI), mainly due to the improvements in stent design with better diverability, flexibility, and near universal fabrication of premounted stents, as well as increased overall physician/operator knowledge and awareness in performing complex and challenging PCI [1]. Nevertheless, when it occurs it presents a challenge to even most experienced operators, because it is often associated with significant morbidity, including systemic or coronary embolization, acute myocardial infarction (AMI), emergency coronary artery bypass graft surgery (CABG), or even death [2,3]. Here, we present a case of stent dislodgment in left main (LM) with subsequent retrieval of loose stent and unintentional extraction of previously implanted stent causing intimal tearing of distal LM and ostial LAD. Fifty-nine years o...