Coronary-pulmonary artery fistula is an uncommon cardiac anomaly, usually congenital. Most coronary-pulmonary artery fistulas are clinically and haemodynamically insignificant and are usually found incidentally. This report describes a case of complex coronary-pulmonary artery fistula with two feeding vessels of separate origins: one from the proximal part of the left anterior descending artery and another arising from the right aortic cusp. The complex anatomy of the fistula was shown in detail by multidetector computed tomography using multiplanar reconstruction and 3D volume rendering techniques.. ...

A 67-year-old woman was admitted to our hospital for examination of a chest X-ray abnormality. Chest computed tomography and coronary angiography revealed a giant aneurysm and coronary-pulmonary artery fistula originating from both the proximal left anterior descending and the right coronary artery. The fistula was ligated and the aneurysm was resected by means of extracorporeal circulation. The postoperative course was uneventful. Computed tomography and coronary angiography showed that the aneurysm and coronary-pulmonary artery fistula had completely disappeared ...

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Semantic Scholar extracted view of Multiple coronary artery-pulmonary artery-bronchial artery fistulas. by Reiji Hattori et al.

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Coronary artery fistulae (CAF) are rare anomalies. They are vascular communications between the coronary arteries and other cardiac structures, either cardiac chambers or great vessels. There can be considerable variation in the course of a coronary artery fistula. We report a case of a coronary artery fistula between the left circumflex coronary artery and the right and left atria. CAF are often diagnosed by coronary angiogram, however with the advent of new technologies such as Coronary Computed Tomography Angiography (Coronary CTA) the course and communications of these fistulae can be delineated non-invasively and with greater accuracy.

A 60-year-old man with end-stage heart failure underwent orthotopic heart transplantation. Before transplantation, he had elevated pulmonary artery (PA) pressures (60/17 mm Hg, mean PA 35 mm Hg) and pulmonary vascular resistance (PVR) (6.6 Wood units).. Following transplantation, he initially did well, with normalization of PA pressures (27/13 mm Hg, mean PA 20 mm Hg). Several months later, however, he developed overt right heart failure. Invasive hemodynamic evaluation demonstrated severe pulmonary hypertension (92/51 mm Hg, mean PA 66 mm Hg) with a PVR of 10 Wood units. There was no evidence of allograft rejection or pulmonary embolism. Transthoracic echocardiogram demonstrated right ventricular (RV) systolic dysfunction and enlargement. Color flow Doppler imaging demonstrated continuous flow from the ascending aorta into the main PA. The anatomy was confirmed by computed tomographic angiographic imaging (Fig. 1). ...

We present the case of a 74 year old patient, hypertensive, dyslipidemic, with a personal history of angina going back several years, with an acute coronary syndrome without ST elevation which occurred in the past year, complicated with residual angina and heart failure symptoms. She is admitted accusing chest pain at rest, ceasing spon-taneously after 10 minutes and dyspnea occurring during medium intensity efforts ...

Coronary artery fistulas are rare congenital or acquired coronary artery anomalies that can originate from any of the three major coronary arteries & drain in all the cardiac chambers & great vessels. A combination like the one described in the present case, patient presented with myocardial infarction, is unusual since fistulas originate from left coronary artery in about 35% cases & drain into the pulmonary artery occurs in only 17%. Keywords: Coronary artery fistula, Myocardial infarction, ACS, Congenital malformation

Coronary artery fistulas are rare and vary widely in their morphological appearance and presentation. This paper presents experience of catheter closure of coronary artery fistulas in 40 patients. Catheter closure was performed with a variety of tech

The LAD fistula to the MPA was ligated after constructing the left internal mammary artery to the LAD graft. However, the RCA fistula was left alone due to its unfavorable location for exposure or ligation, and postoperative transcatheter embolization was planned.. Although various imaging modalities have been used, intraoperative 2D TEE has been used for diagnosis and evaluation of coronary artery fistulae.1-3 However, the limitations of 2D TEE make angiography the preferred method of visualizing this pathology.4 Manipulating the TEE probe to acquire appropriate 2D images and interpreting the images accurately are challenging in complex fistula pathology. Even under favorable conditions, greater effort may be required to obtain and combine multiple 2D images. The X-plane mode may partly overcome the limitation of 2D TEE imaging; it instantaneously produces an additional 2D image and multiplane angle, and angulation of the additional image to the original can be changed by adjusting knob and ...

Souto, Rafael Mansur, Santos, Alair Augusto Sarmet Moreira Damas dos and Nacif, Marcelo Souto Persistent Primitive Hypoglossal Artery Associated with Brain Stem Ischemia in an Elderly Patient. Int. J. Cardiovasc. Sci., Oct 2018, vol.31, no.5, p.548-550. ISSN 2359- ...

A 78-year-old woman presented with an abrupt onset of chest pain and dyspnea. Fourteen years before admission, she had undergone aortic root and valve replacement with the Bentall-de Bono continuous-suture wrap-inclusion technique because of an aneurysm of the ascending aorta and severe aortic valve regurgitation. Physical examination revealed signs of congestive heart failure and poor peripheral perfusion. The admission radiograph (Figure 1) showed lung congestion predominantly in the right lung, bilateral pleural effusion, elevation of the left hemidiaphragm, tracheal shift to the right side, and aortic arch calcification. The ECG (Figure 2) revealed sinus tachycardia at 111 bpm, frequent premature atrial beats, and repolarization abnormalities that consisted of T-wave inversion in the inferolateral leads. Transthoracic echocardiography showed a hypertrophied left ventricle with normal systolic function. Computed tomography disclosed a huge pseudoaneurysm of the ascending aorta (maximum ...

We report the case of a 54-year-old man, waitlisted for lung transplantation with a diagnosis of end-stage diffuse bronchiectasis. On arrival at the catheterization laboratory for coronary angiography prior to transplantation, the patient developed a hypertensive crisis (BP 200/110mmHg), at which stage he reported habitually uncontrolled blood pressure. Coronary angiography revealed coronary arteries free of lesions and a coronary artery fistula emerging from the left common trunk (LCT), 3mm in caliber at the proximal end and 2mm at the most distal end (Video 1, Appendix), with drainage to the left pulmonary artery, causing hemodynamic alterations in the form of high cardiac output (thermodilution 7.86l/min). Increased pulmonary pressures (mPAP 71mmHg, PVR 5.5 Wood units [WU]) associated with pulmonary hyperflow and significant diastolic dysfunction due to hypertensive heart disease evidenced in the rest of the study data (mean PCP 35mmHg and left ventricular end-diastolic pressure [LVEDP] ...

THE ROLE OFMULTIDETECTOR COMPUTED TOMOGRAPHY CORONARY ANGIOGRAPHY IN THE FOLLOW UP OF CORONARY ARTERY FISTULA AFTER CLOSURE BY PERCUTANEOUS INTERVENTION ...

Christmann, Martin; Hoop, Ricarda; Dave, Hitendu; Quandt, Daniel; Knirsch, Walter; Kretschmar, Oliver (2017). Closure of coronary artery fistula in childhood: treatment techniques and long-term follow-up. Clinical Research in Cardiology, 106(3):211-218. ...

Coronary artery fistulae (CAF) represent an abnormal communication bypassing the myocardial capillary bed between a coronary artery and either a cardiac chamber (coronary-cameral CAF) or a vascular structure from systemic or pulmonary circulation (coronary-vascular CAF). CAF represent a congenital anomaly in 0.2% of the population, but are more frequently found in heart transplant recipients (8%), mostly as coronary-right ventricle (RV) CAF caused by endomyocardial biopsy used for monitoring of rejection1,2. Other complications of myocardial biopsy include perforation of the RV wall and tricuspid valve damage2. Several case reports have shown successful transcatheter closure of CAF3,4. We aimed to analyse .... ...

Systemic artery-pulmonary artery shunts have been made in dogs and the relation between pulmonary artery pressure and blood flow and the development of vascular lesions has been studied. Arteriolar medial hypertrophy and intimal proliferation are not necessarily incited by a large blood flow, but such lesions are more readily induced by an end-to-end than by an end-to-side type of shunt. Intimal proliferation is not associated with stainable alterations in elastic tissue or lipid infiltration. Vascular lesions do not readily regress when the inciting factor is removed.. ...

2 Departments of Cardiovascular Surgery, Başkent University Faculty of Medicine, Ankara, Turkey. DOI : 10.24953/turkjped.2020.04.011 Background and objectives. In this study, we aimed to review the treatment options and long-term problems of patients who were diagnosed with coronary artery fistulae (CAF) in our institution. We also tried to determine the most appropriate time for treatment of this condition.. Method. From 2000 to 2018, the medical records of 56 patients (33 males and 23 females) who had CAF diagnoses were retrospectively reviewed.. Results. The mean age of the patients at the time of diagnosis was 3.9 ± 4.6 years (range, 1 month to 18 years) and the mean duration of the follow-up period was 7.4 ± 4.5 years (range, 1 year to 17.5 years). The right coronary artery (RCA) was the most common origin site for CAF, the left main coronary artery (LMCA) was the second most common origin site whereas the left anterior descending coronary artery (LAD) was the third most common origin ...

Coronary artery fistulas (CAFs) are infrequent congenital malformations, although some may be acquired: iatrogenic (during thoracic surgery or PCI) or traumatic. The incidence of CAFs has not been well defined but it is found in less than 0.2% of angiographic examinations. CAFs, even if rarely, may cause heart failure, spontaneous intrapericardial rupture or myocardial ischemia due to coronary steal phenomenon. The literature reports very few cases of patients where a CAF was associated with a coronary artery disease (CAD). The consequences of this association on coronary haemodynamics and myocardial blood flow (BF) was poorly investigated ...

OBJECTIVE: To investigate the utility of interlocking detachable coils (IDC) for transcatheter occlusion of vascular communications in congenital heart disease. BACKGROUND: The IDC can be delivered in a retractable fashion through hydrophilic Renegad

Coronary-to-cardiac chamber fistulae and coronary aneurysms are potential complications after heart transplantation. In the setting of exercise intolerance and large fistulae at major coronary vessels, covered stents may provide an effective interventional strategy.

Case Reports in Vascular Medicine is a peer-reviewed, Open Access journal that publishes case reports in all areas of vascular medicine.

Multiple coronary artery fistulae arising from all 3 major coronary arteries emptying into the LV are extremely rare. There are case reports and small series that have demonstrated inducible ischemia on myocardial nuclear studies.1 There are no reports that demonstrate the subendocardial nature of inducible ischemia as observed in this case by cardiovascular magnetic resonance imaging. It is commonly believed that the perfusion defect corresponds to the region of myocardium that is bypassed by the intramyocardial fistulae. Adenosine-induced hyperemia decreases the diastolic perfusion gradient, increasing shunting by the fistulae and hence causing a coronary steal phenomenon. This steal phenomenon explains the clinical finding that sublingual nitrates exacerbate ischemic symptoms. In the present case, symptoms were abolished by β-blockade.. ...

TY - JOUR. T1 - Congenital coronary artery fistula presenting later in life. AU - Abusaid, Ghassan H.. AU - Hughes, Douglas. AU - Khalife, Wissam I.. AU - Parto, Parham. AU - Gilani, Syed A.. AU - Fujise, Ken. PY - 2011/8/1. Y1 - 2011/8/1. N2 - A 53-year-old male presented to our tertiary medical center with complaints of dyspnea and exertional chest pain with mild left ventricular dysfunction and right ventricular enlargement on echocardiography. Cardiac catheterization showed a congenital right coronary artery fistula communicating with the right sided chambers. Using contrast enhanced multi-detector computed tomography scan, the fistula was clearly draining into the coronary sinus. We describe briefly the etiology of coronary artery fistula, its clinical presentation, and the common tests used to confirm diagnosis. We further discuss the types of treatment modalities that are currently available.. AB - A 53-year-old male presented to our tertiary medical center with complaints of dyspnea and ...

BACKGROUND AND PURPOSE Congenital coronary artery fistula (CAF) is an uncommon anomaly. It can become symptomatic, associated with significant morbidity and mortality. We report our experience in percutaneous treatment of CAF. METHODS AND RESULTS Four patients with five CAFs were treated. All were symptomatic at admission. Four fistulas rose from the left anterior descending coronary artery. The fifth originated from the right coronary sinus. All drained into the pulmonary artery. Percutaneous treatment was performed using microcoils in two cases and Hydrocoils in the last two patients (three fistulas). A complete occlusion was achieved in all. There was no complication related with the procedure, and all were asymptomatic at the follow-up. CONCLUSIONS Transcatheter closure of CAFs with microcoils/Hydrocoils is feasible and safe in the anatomically suitable vessels, with low rates of complications. Percutaneous treatment with microcoils/Hydrocoils is a valid option in symptomatic patients.

TY - JOUR. T1 - Bronchial-pulmonary artery fistula with fatal massive hemoptysis caused by anastomotic bronchial aspergillus infection in a lung transplant recipient. AU - Slatore, Christopher G.. AU - Yank, Veronica. AU - Jewell, Kim D.. AU - Fligner, Corinne L.. PY - 2007/11/1. Y1 - 2007/11/1. UR - http://www.scopus.com/inward/record.url?scp=38549119640&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=38549119640&partnerID=8YFLogxK. M3 - Article. C2 - 17971258. AN - SCOPUS:38549119640. VL - 52. SP - 1542. EP - 1545. JO - Respiratory Care. JF - Respiratory Care. SN - 0020-1324. IS - 11. ER - ...

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Continued experience confirms the suitability of electrovitreotomy for dividing pathogenically taut proliferative and non-proliferative vitreous forms with a minimum of bleeding, and an inability to cut vitreous of ordinary consistency and tension. It differs directly with electrovitrectomy in these regards. To use effectively with a minimum of complications it is mandatory to have a vitrectomy capability immediately at hand and to respect a wide variety of interrelated factors that include: current density, electrical resistance of tissues, duration of electrical action: dimension, insulation, and configuration of the electrode: configuration, tension, location, and morphological content of dissectable structures. Mobile and dispersed blood in the liquid of the retrovitreal space often surrounds cuttable vitreous lesions. Frequently rest causes it to sediment and improves viewing sufficiently to permit effective electrovitreotomy without vitrectomy. ...

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We report an interesting case of a 66-year-old man with acute myocardial infarction (AMI) with bilateral coronary ostial stenosis cardiovascular syphilis complicated by aortic regurgitation (AR). A 12-lead electrocardiogram and blood tests on arrival suggested AMI, and echocardiography showed moderate AR. Emergency coronary angiography showed bilateral coronary ostial stenosis. The patient underwent emergency surgical treatment, coronary artery bypass grafting, and aortic valve replacement with a bioprosthetic valve. On arrival, rapid plasma reagin and Treponema pallidum hemagglutination tests were 172.2- and 1187.5-fold, respectively. These results suggested cardiovascular syphilis, which was confirmed by pathological findings. The postoperative course was uneventful and the patient was transferred to another hospital on postoperative day 25. This patient received intravenous penicillin for 2 weeks and subsequently oral amoxicillin. When both AR and coronary ostial stenosis are found, it is necessary

AIM. To assess the functionality of congenital coronary artery fistulas (CAFs) using adenosine stress N-13-ammonia positron emission tomography computed tomography (PET-CT).. METHODS. Congenital CAFs were incidentally detected during coronary angiography (CAG) procedures in 11 adult patients (six males and five females) with a mean age of 64.3 years (range 41-81). Patients were collected from three institutes in the Netherlands. The characteristics of the fistulas (origin, pathway and termination), multiplicity of the origins and pathways of the fistulous vessels were assessed by CAG. Five patients underwent adenosine pharmacologic stress N-13-ammonia PET-CT to assess myocardial perfusion and the functional behavior of the fistula.. RESULTS. Eleven patients with 12 CAFs, 10 unilateral and one bilateral, originating from the left anterior descending coronary artery (n = 8), right coronary artery (n = 2) and circumflex (n = 2). All fistulas were of the vascular type, terminating into either the ...

Roughly 10% to 32% of the population has a fetal origin PCA supplying their parieto-occipital lobes in which the P1 segment is hypoplastic and the PCA is supplied primarily by a larger diameter homolateral posterior communicating artery [5, 10]. Other potentially persistent primitive carotid basilar anastomoses include the primitive trigeminal artery, the primitive acoustic (otic) artery, the primitive hypoglossal artery, and the primitive proatlantic artery. The fetal origin PCA anatomic variant provides a potential conduit for emboli from ipsilateral ICA disease [6-9]. To the best of our knowledge, artery-to-artery embolism from cervical ICA pseudoaneurysm to fetal PCA has not been previously reported. Pseudoaneurysm usually develops as a result of trauma, with rupture of the affected artery through the intima and media into the subadventitial plane. The resulting tear is contained by the adventitia forming a pseudoaneurysm. Unlike true aneurysms, pseudoaneurysms do not involve dilatation of ...

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This rate is substantially slower than the average replication rates estimated for murine (once per 2.5 weeks) and feline (once per 8.3-10 weeks) HSC in vivo. A microscopic film of the movements of bull sperm cells in generic cialis available dark-field illumination. Some of this pheromone is probably produced by cells whose precursors are very close to, or identical with, the precursors of the sternites and thorax. Herein, we provide genetic and biochemical evidence to definitively demonstrate that a C-terminal loop structure, formed by residues 652-678, is the critical region of CBD for both TLRs and integrins. This response was followed 30 min later by evidence of increased protein synthesis. In many cases roentgen examination was performed with the patient in both the erect and the left lateral decubitus positions.. A case of coronary recanalization, complicated by coronary fistula created by an angioplasty guidewire, buy viagra is reported. Baseline levels of three adrenal androgens ...

ICD-10-PCS code B241ZZZ for Ultrasonography of Multiple Coronary Arteries is a medical classification as listed by WHO under the range - Heart.

Revision: 10766 http://supertuxkart.svn.sourceforge.net/supertuxkart/?rev=10766&view=rev Author: hikerstk Date: 2012-01-30 22:20:31 +0000 (Mon, 30 Jan 2012) Log Message: ----------- Moved terrain particle effectrs from kart into kart_gfx. Modified Paths: -------------- main/trunk/src/karts/kart.cpp main/trunk/src/karts/kart.hpp main/trunk/src/karts/kart_gfx.cpp main/trunk/src/karts/kart_gfx.hpp Modified: main/trunk/src/karts/kart.cpp =================================================================== --- main/trunk/src/karts/kart.cpp 2012-01-30 22:14:34 UTC (rev 10765) +++ main/trunk/src/karts/kart.cpp 2012-01-30 22:20:31 UTC (rev 10766) @@ -93,14 +93,12 @@ m_race_position = position; m_collected_energy = 0; m_finished_race = false; - m_wheel_toggle = 1; m_finish_time = 0.0f; m_bubblegum_time = 0.0f; m_invulnerable_time = 0.0f; m_squash_time = 0.0f; m_shadow_enabled = false; m_shadow = NULL; - m_terrain_particles = NULL; m_collision_particles = NULL; m_slipstream = NULL; m_skidmarks = NULL; @@ ...

Cardiology Research and Practice is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies that focus on the diagnosis and treatment of cardiovascular disease. The journal welcomes submissions related to systemic hypertension, arrhythmia, congestive heart failure, valvular heart disease, vascular disease, congenital heart disease, and cardiomyopathy.

TY - JOUR. T1 - Accuracy of cross-sectional echocardiography in diagnosis of aortopulmonary window. AU - Balaji, Seshadri. AU - Burch, Michael. AU - Sullivan, Ian D.. PY - 1991/3/15. Y1 - 1991/3/15. N2 - The first echocardiographic descriptions of the aortopulmonary window (APW) were case reports.1,2 These observations were extended by Smallhorn et al,3 who described appearances of an isolated APW in 4 infants and compared these with appearances in 14 patients with a common arterial trunk and in 6 with a single pulmonary artery originating at the ascending aorta. In these reports,1-3 diagnosis was also established by invasive investigation and did not include any patient who had APW with associated cardiac abnormalities. The publication of case reports as late as 1988 suggests that the echocardiographic diagnosis of even an isolated APW is not always straightforward,4 perhaps because the lesion may be confused with other structural abnormalities.5 There have been no reports of the accuracy of ...

TY - JOUR. T1 - Persistent hypoglossal artery with hypoplasia of the vertebral and posterior communicating arteries. AU - Terayama, Ryuji. AU - Toyokuni, Yuka. AU - Nakagawa, Shinsuke. AU - Nakatsuji, Kazuki. AU - Nakama, Hitomi. AU - Yamaai, Tomoichiro. AU - Ichikawa, Hiroyuki. AU - Sugimoto, Tomosada. PY - 2011/3. Y1 - 2011/3. N2 - We observed a rare case of the right persistent hypoglossal artery (PHA) in the posterior cranial fossa of a deceased 74-year-old Japanese man who did not have any clinical manifestations related to this anomaly when alive. The large-sized PHA originating from the cervical internal carotid artery passed through the hypoglossal canal together with the hypoglossal nerve and reached the posterior cranial fossa to anastomose the basilar artery. In addition, the ipsilateral vertebral artery and bilateral posterior communicating arteries were hypoplastic. Here, we discuss the developmental mechanisms underlying the formation of the PHA and the spectrum of diseases related ...

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