| Primary angioplasty in acute inferior myocardial infarction with anomalous-origin right coronary arteries as infarct-related arteries: focus on anatomic and clinical features, outcomes, selection of guiding catheters and management. | |
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MedLine Citation:
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PMID: 11287714 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Inferior wall myocardial infarction caused by obstruction of an anomalous-origin right coronary artery (RCA) is a rare angiographic finding; primary angioplasty to an anomalous-origin RCA has never been reported. METHODS: In 185 patients with acute inferior wall myocardial infarction resulting from RCA occlusion who underwent primary angioplasty, eight patients (4.3%) had anomalous-origin RCAs. RESULTS: Coronary angiography showed that all 8 patients had a dominant RCA. Six patients (75%) had an anomalous-origin RCA arising from the anterior aspect of the ascending aorta above the sinotubular line and the other 2 patients (25%) had an anomalous-origin RCA arising from the left sinus of Valsalva with a separate ostium from the left main coronary artery. The standard Judkins right guiding catheter did not offer adequate support in these patients. In the group of 6 patients, an Amplatz guiding catheter offered good support, while a standard Judkins left guiding catheter was adequate in the other 2 patients. Obstruction of the proximal RCA occurred in 6 patients (75%). Successful reperfusion was achieved in 6 patients (75%), resulting in an uneventful clinical course and long-term survival (mean follow-up, 24.9 +/- 16.5 months). Two patients (25%) had unsuccessful reperfusion and died from cardiogenic shock. CONCLUSIONS: In this small series, anomalous-origin RCAs were the dominant artery and predisposed to atherosclerosis at the proximal portions. We suggest that appropriate guide catheter selection and careful manipulation are essential for the success of revascularization. Complete reperfusion results in an excellent clinical and long-term outcome in patients with anomalous-origin RCAs. |
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Authors:
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H Yip; M C Chen; C J Wu; K H Yeh; M Fu; C L Hang; C Y Fang; K Y Hsieh |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of invasive cardiology Volume: 13 ISSN: 1042-3931 ISO Abbreviation: J Invasive Cardiol Publication Date: 2001 Apr |
Date Detail:
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Created Date: 2001-04-05 Completed Date: 2001-06-14 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8917477 Medline TA: J Invasive Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 290-7 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung, 123, Ta-pei Road, Niao Sung Hsiang, Kaohsiung Hsien, Taiwan, ROC. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Transluminal, Percutaneous Coronary* Coronary Angiography Coronary Disease / therapy* Coronary Vessel Anomalies / complications*, radiography Electrocardiography Female Heart Catheterization / instrumentation Humans Male Middle Aged Myocardial Infarction / complications, therapy* Stents* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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