RESUMEN
No-reflow is a serious condition, and is associated with substantial morbidity and mortality after percutaneous coronary intervention. The most feared complication of no-reflow is a case of no-reflow that is resistant to multiple drug therapy. This condition usually occurs in patients with distal coronary disease or high thrombus burden. In the present case, a patient with resistant no-reflow that could be reversed by distal intracoronary administration of very high doses of adenosine (1 mg) is described. Administration of very high doses of adenosine via a balloon catheter was safe and did not cause any changes in the heart rate or blood pressure. The present case is the first to be reported in the literature.
Asunto(s)
Braquiterapia/efectos adversos , Vasos Coronarios , Angina Inestable/terapia , Angioplastia Coronaria con Balón , Implantación de Prótesis Vascular , Angiografía Coronaria , Reestenosis Coronaria/diagnóstico por imagen , Reestenosis Coronaria/etiología , Reestenosis Coronaria/terapia , Femenino , Humanos , Persona de Mediana Edad , StentsRESUMEN
This study examined the changes in brachial artery diameter and flow velocity in response to intravenous adenosine and compared the results to cuff occlusion and single-photon emission computed tomographic (SPECT) images. The change in diameter was less with adenosine than with cuff occlusion. There was no correlation between the presence of abnormal SPECT images and the responses to adenosine or cuff occlusion in either diameter or flow velocity.
Asunto(s)
Adenosina/farmacología , Arteria Braquial/efectos de los fármacos , Arteria Braquial/fisiología , Enfermedad de la Arteria Coronaria/fisiopatología , Vasodilatadores/farmacología , Adenosina/administración & dosificación , Velocidad del Flujo Sanguíneo , Femenino , Humanos , Infusiones Intravenosas , Masculino , Persona de Mediana Edad , Flujo Pulsátil , Tomografía Computarizada de Emisión de Fotón Único , Vasodilatadores/administración & dosificaciónRESUMEN
Right coronary artery to coronary sinus fistula is a rare anomaly. We present a unique case of an adult patient with multiple fistulae from the right coronary artery draining into the coronary sinus near the posterior left atrium-left ventricle junction, first suspected by transthoracic two-dimensional echocardiography. The multiple openings were not seen by any invasive or noninvasive techniques and were noted only at the time of surgery. To our knowledge, this is the first case of multiple fistulae connecting the right coronary artery to the coronary sinus that has been reported in the English literature.