High anomalous origin of both coronary arteries is extremely rare. We report the case of a patient with a right coronary artery that originated from the left surface of the ascending aorta approximately 25 mm above the sinotubular junction and a left coronary artery that originated from the sinotubular junction ...

The mechanisms underlying the formation of abdominal aortic aneurysms have yet to be fully clarified. To identify key proteins generally involved in aneurysmal formation, proteomic profiles were compared between aneurysmal and non-aneurysmal regions of aortic walls from patients with abdominal aortic aneurysm. Aortic wall specimens were obtained from three patients ...

The present report describes a technique of simultaneous confluent balloon inflation in cases in which conventional subintimal angioplasty failed. Eight patients with peripheral vascular occlusive disease (n = 4 each with iliac arterial lesions and superficial femoral arterial lesions) of clinical category 3-5 received treatment with the confluent two-balloon technique. ...

Pulmonary embolism (PE) is common and the majority of patients survive the acute event. Survivors are at increased risk for adverse outcomes, including persistent thrombi, recurrent embolism, chronic thromboembolic pulmonary hypertension (CTEPH), and death. Anticoagulation protects against recurrence, which has a high mortality rate. The recommended duration of anticoagulation for ...

AIM:The aim of this paper was to evaluate our single-center experience of the management of splenic artery aneurysm (SAA), with particular attention to the long-term results of endovascular treatment. METHODS: Thirty-eight patients with the diagnosis of SAA at the Tokyo University Hospital during the past 23 years were retrospectively reviewed. ...

This case highlights the importance of intra-aortic balloon pump (IABP) during carotid artery stenting (CAS) in patients with severe aortic stenosis. We report the case of a patient with severe carotid artery disease and aortic stenosis who first underwent CAS using IABP and subsequently underwent aortic valve replacement. We conclude ...

We report our experience using transradial access (TRA) for carotid artery stenting (CAS). Eighty-eight patients underwent CAS using a nonfemoral approach, 79 of them by TRA. Carotid artery stenting was performed using standard techniques with a long hydrophilic sheath. Mean age was 69.5 years. A total of 46 patients were ...

To report 2 cases of severe combined aortic and pulmonic valvular stenosis. To find patients with a diagnosis of severe combined aortic and pulmonic valvular stenosis, the authors searched in the patient profile at the cardiology unit, Queen Sirikit National Institute of Child Health (QSNICH) from 1995 to 2010. There ...

Abstract Purpose: To report an initial experience of superficial femoral artery (SFA) recanalization performed with a dual femoral-popliteal approach in the supine patient. Methods: From May 2008 to April 2010, 26 patients (16 men; mean age 68±6.3 years) with intermittent claudication and chronic SFA occlusion (mean length 97.4±3.8 mm, range 35-220) underwent ...

Iron homeostasis influences the development of pulmonary arterial hypertension (PAH) associated with hypoxia or hematologic disorders. To investigate whether severity of idiopathic PAH (IPAH) is impacted by alterations in iron metabolism, we assessed iron metabolic markers, including levels of zinc-protoporphyrin (Zn-pp), transferrin receptor, and red blood cell numbers and morphology ...

Objective: The use of homografts for aortic valve replacement (AVR) is an alternative to mechanical or biological valve prostheses, especially in younger patients. This retrospective comparative study evaluated our single-center long-term results, with a focus on the different origins of the homografts.Methods: Since 1992, 366 adult patients have undergone AVR ...

Combined endovascular interventions on carotid and coronary arteries are rare. Stenting of the unprotected coronary left main stem is a high risk procedure. We presented hemodynamically unstable patient with combined carotid artery and left main stem coronary artery stenting. A 78-year-old female patient was admitted to our institution for right ...

Loeys-Dietz syndrome (LDS) is a recently recognized aggressive aortic disorder characterized by root aneurysm, arterial tortuosity, hypertelorism, and bifid uvula or cleft palate. The results of prophylactic root replacement using valve-sparing procedures (valve-sparing root replacement [VSRR]) in patients with LDS is not known. We reviewed all patients with clinical and ...

Purpose: To report 2 cases of branch retinal artery occlusion (BRAO) associated with Behçet disease (BD). Design: Small case series. Methods: Review of two patients' charts, fluorescein angiography, and optical coherence tomography (OCT). Results: The authors report two young patients, diagnosed with BD, who developed decreased vision secondary to BRAO ...

This study examined a large registry to determine the frequency, predictors, and outcomes of native coronary artery versus bypass graft percutaneous coronary intervention (PCI) in patients with prior coronary artery bypass graft surgery (CABG). The PCI target vessel and corresponding outcomes in prior CABG patients are poorly studied. We analyzed ...

A patient who had previously undergone retrosternal gastric tube reconstruction for esophageal cancer presented with an aortic arch aneurysm. The patient was treated with endovascular stent-graft placement without median sternotomy, followed by revascularization of the brachiocephalic trunk using percutaneous in situ graft fenestration. A 9-month follow-up examination revealed marked regression ...

Purpose: We present the case of a patient who developed an aortoesophageal fistula (AEF) 4 years after thoracic endovascular aortic repair (TEVAR) of a descending thoracic aortic aneurysm rupture.Case Report: A 60-year-old female patient underwent emergency stent graft placement in December 2006 because of rupture of a distal descending aortic ...

The purpose of this study was to review the outcomes of endovascular treatment and open repair of visceral artery aneurysms, and to compare their results. Between January 1995 and January 2009, 42 patients (22 males) underwent surgical or endovascular treatment for visceral artery aneurysms. Mean age was 60 ± 13 ...

Hereditary hemorrhagic telangiectasia (HHT, Osler-Weber-Rendu syndrome) is an autosomal dominant condition which usually presents with recurrent epistaxis, due to the presence of mucocutaneous telangiectasia, and circulatory arteriovenous malformations (pulmonary, hepatic, cerebral and spinal). We present a patient with HHT and coronary artery disease, who underwent coronary artery bypass grafting with ...

: Cerebral venous thrombosis is a rare entity in pregnancy and the postpartum period, with an incidence of 1:10,000 to 1:25,000. : A 19-year-old woman, gravida 1, para 1, presented to the emergency department on postpartum day 7, having experienced seizures. Severe preeclampsia had been diagnosed during the antepartum period. ...

The use of ketorolac, a potent cyclooxygenase-1 inhibitor, for analgesia after cardiac operations has been limited by concerns of increased cardiovascular events. However, a recent study found that its use after coronary artery bypass grafting was associated with improved survival. This was a retrospective study of patients who received coronary ...

Coronary computed tomography angiography (CCTA) is an established modality for ruling out coronary artery disease. However, it has been suggested that CCTA may be a source of non-negligible radiation exposure. To evaluate the potential degradation in coronary image quality when using prospective gated (PG) CCTA as compared with retrospective gated ...

High grade stenoses of both the innominate (IA) or common carotid artery (CCA) and the carotid bifurcation are rare and represent a therapeutic dilemma for the treating physician. A hybrid procedure with concomitant carotid endarterectomy (CEA) and retrograde angioplasty has been proposed as a less invasive treatment option. The aim ...

One of the most common complications of endovascular aneurysm repair (EVAR) is type 2 endoleak. We describe a patient who presented with a recurrent endoleak despite initial intervention and was successfully treated with coil embolization of the inferior mesenteric artery (IMA). A 63-year-old Caucasian male was found to have a ...

The optimal management of the patients requiring cardiac surgery with simultaneous severe carotid disease remains controversial. The traditional approach involves staged or combined carotid endarterectomy and cardiac surgery. This study evaluated the feasibility and safety of angioplasty and stenting for the treatment of carotid stenoses combined with cardiac operations in ...

Objective: We retrospectively evaluated the results of an edge-to-edge repair (Alfieri stitch) of the mitral valve performed via a transaortic approach in patients who were undergoing minimally invasive aortic valve replacement.Methods: From January 2010 to September 2010, 6 patients underwent minimally invasive edge-to-edge repair of the mitral valve via a ...

Cerebral arterial dissections are recognized as a common cause of stroke. However, few studies have reported on the distribution of cerebral arterial dissection and angiographic pattern related to the presenting clinical symptom pattern. We analyzed the distribution of cerebral artery dissection along with angiographic and clinical presenting a pattern as ...

Postoperative coronary arterial spasm is a rare but potentially fatal complication. A 51-year-old male patient with a history of a reactive ergonovine stress test coronary angiogram developed refractory coronary artery spasm after undergoing minimally invasive direct coronary artery bypass grafting of the left anterior descending coronary artery. The patient was ...

Paravalvular abscess is a serious complication of infective endocarditis. The aortic valve and its adjacent ring are more susceptible to abscess formation and paravalvular extension than the mitral valve. A 15-years old patient with bicuspid aortic valve presented with staphylococcal tricuspid valve endocarditis complicated by para-aortic abscess that ruptured into ...

Congenital subaortic stenosis (SAS) has a high recurrence rate after surgical correction. Aortic valve disease frequently coexists with SAS, being its occurrence and progression unpredictable. We aimed to assess predictors of SAS recurrence and aortic valve disease occurrence and progression. Retrospective analysis of 51 patients with SAS followed in a ...

BACKGROUND: Low-flow, low-gradient aortic stenosis is associated with relevant postoperative mortality whereas conservative management results in dismal prognosis. We present the initial experience of low-flow, low-gradient aortic stenosis treated with transcatheter aortic valve implantation (TAVI). METHODS: From June 2008 to December 2010 167 consecutive patients with native severe aortic stenosis ...

OBJECTIVE: To evaluate the procedural safety and filter efficiency of Lumen Biomedical FiberNet® embolic protection system in conjunction with primary stenting of ostial atherosclerotic renal artery lesions. BACKGROUND: There is limited data regarding the utility of distal embolic protection devices in renal artery angioplasty and stenting. METHODS: Patients with angiographically ...

Objectives: The purpose of this study is to verify whether transcatheter aortic valve implantation (TAVI) determined changes in mitral valve (MV) function, in terms of mitral regurgitation (MR) and stenosis. Background: Little data is available regarding the effects of TAVI on global MV function, often derived from analysis primarily focused ...

OBJECTIVES: To report the safety and efficacy of Zotarolimus eluting stents for treatment of unprotected left main coronary artery disease. BACKGROUND: Percutaneous stent insertion is an increasingly popular alternative to bypass surgery for the management of left main (LM) coronary artery disease. While data supports the use of sirolimus and ...

Aortic stenosis in the elderly population is an increasing problem, with many patients being considered too high risk for surgery, and therefore being denied treatment. A percutaneous method of treatment in the form of trans-catheter aortic valve implantation (TAVI) is becoming an increasingly attractive option in this group of patients. ...

Objective: The aim of the study is to evaluate midterm results with regard to false-lumen status of a combined vascular and endovascular approach for the treatment of acute type A aortic dissection. Methods: We performed ascending/hemiarch replacement during hypothermic circulatory arrest with additional open implantation of the Djumbodis Dissection System ...

OBJECTIVES: To determine the incidence, timing and predictors of periprocedural valve dislodgment with the Medtronic Corevalve System (MCS). BACKGROUND: Periprocedural valve dislodgment may occur during transcatheter aortic valve implantation (TAVI). METHODS: Ninety-eight consecutive patients underwent TAVI with the MCS after a comprehensive baseline assessment including invasive angiography, echocardiography and Multi-Slice ...

BACKGROUND: The relationship of aortic valve dysfunction and ascending aortic aneurysm is unclear in adults with bicuspid aortic valve disease. METHODS: We retrospectively studied 134 consecutive out-patients (98 men, 36 women aged 43±18years) with bicuspid aortic valve disease. To investigate the relationship of ascending aortic aneurysm and aortic valve dysfunction ...

Purpose: To retrospectively evaluate computed tomographic (CT) findings of immunoglobulin G4 (IgG4)-related disease involving the vascular system. Materials and Methods: This study was approved by the institutional review board, and all patients included had consented to the use of their medical records for the purpose of research. The study consisted ...

We report a rare case of a congenital left main coronary artery aneurysm in a 2-year-old patient with concomitant intimal hyperplasia and strong intimal apolipoprotein B expression.

OBJECTIVES: To review pulmonary arteritis (PA) complicated by pulmonary arterial hypertension (PAH) in Takayasu's arteritis (TA). METHODS: Two cases of PA and PAH in TA patients and similar cases published in the Medline database from 1975 to 2009 were reviewed. RESULTS: Forty-six cases (females 89.1%, Asians 65%, mean age 34.6 ...

INTRODUCTION: Matrix metalloprotease (MMP) activity is increased in ascending and abdominal aortic aneurysms. Elevated plasma homocysteine (Hc) levels have been reported in patients with abdominal aneurysms. However, there are no published reports correlating, Hc and MMP levels in patients with ascending aortic aneurysms (AAAs). MATERIALS AND METHODS: This study attempts ...

Objectives Coarctation of the aorta (CoA) has been associated with abnormal vascular function, increased blood pressure (BP) and premature cardiovascular disease even after a successful intervention. The objective was to determine the severity of residual cardiovascular abnormalities in youths after CoA repair and their relation to regional BP. Design Cross-sectional ...

BACKGROUND:: Impairment of endothelial function is an independent predictor of coronary events. The aim of this study was to clarify the influence of arterial access and coronary angiography on endothelial function. METHODS:: Eighteen patients with stable angina pectoris who underwent coronary angiography were included in this study. Brachial artery flow-mediated ...

Suitability rate of endovascular aneurysm repair (EVAR) and the anatomic features causing unsuitability have not been well determined in Asian patients who have abdominal aortic aneurysm (AAA). In a single Korean center, a total of 191 patients with abdominal aortic aneurysm (maximal diameter ≥ 4 cm) were identified. Aortoiliac morphologic ...

PURPOSE: Previous studies demonstrated that failure to visualize distal chronic total occlusion in conventional coronary angiography (CCA) does not preclude procedural success of coronary artery bypass grafting (CABG). We assessed the utility of computed tomography angiography (CTA) in guiding CABG to the occluded left anterior descending artery (LAD) incompletely visualized ...

Background: To investigate the causes of paravalvular aortic regurgitation (PAR) after the implantation of the Medtronic CoreValve prosthesis (MCRS). Methods and Results: Fifty-six patients underwent MSCT before TAVI with a MCRS and PAR was assessed with transthoracic echocardiography (TTE) between 5 and 10 days after TAVI. The aortic annulus smallest ...

This report documents the first reported case of transaortic transcatheter aortic valve implantation (TAVI) using the CoreValve ReValving system (Medtronic CoreValve System, Luxembourg), within a previous bioprosthetic aortic valve replacement. TAVI has become a recognized percutaneous treatment for patients with severe native or bioprosthetic aortic valve stenosis. However, as the ...

Cold agglutinin disease although rare, can lead to serious complications for patients undergoing cardio-thoracic surgery, especially when cardiopulmonary bypass is applied under hypothermic circulatory arrest. We describe normothermic total arch replacement without hypothermic circulatory arrest in a patient with cold agglutinin disease. The patient tolerated all procedures well and did ...

BACKGROUND AND IMPORTANCE:: The use of intravenous recombinant tissue plasminogen activator (IV rtPA) has become an integral part of modern acute ischemic stroke management; however, its use has been associated with the development of intracranial hemorrhage (ICH) in 6.4% of patients. It is possible that underlying and unsuspected vascular lesions, ...