Sinus Node Dysfunction due to Occlusion of the Sinus Node Artery during Percutaneous Coronary Intervention.

BACKGROUND: Sinus node artery occlusion (SNO) is a rare complication of percutaneous coronary intervention (PCI). We analyze both the short- and long-term consequences of SNO. METHODS: We retrospectively reviewed 1379 consecutive PCI's involving RCA and Cx arteries performed in our heart institute from 2016 to 2019. Median follow-up was 44 ± 5 months. RESULTS: Among the 4844 PCIs performed during the study period, 284 involved the RCA and the circumflex's proximal segment. Periprocedural SNO was estimated by angiography observed in 15 patients (5.3%), all originated from RCA. The majority of SNO occurred during urgent and primary PCIs following acute coronary syndrome (ACS). Sinus node dysfunction (SND) appeared in 12 (80%) of patients. Four (26.6%) patients had sinus bradycardia, which resolved spontaneously, and 8 (53.3%) patients had sinus arrest with an escaped nodal rhythm, which mostly responded to medical treatment during the first 24 hours. There was no association between PCI technique and outcome. Three patients (20%) required urgent temporary ventricular pacing. One patient had permanent pacemaker implantation. Pacemaker interrogation during follow-up revealed a recovery of the sinus node function after one month. CONCLUSION: SNO is rare and seen mostly during angioplasty to the proximal segment of the RCA during ACS. The risk of developing sinus node dysfunction following SNO is high. SND usually appears during the first 24 h of PCI. The majority of SND patients responded to medical treatment, and only in rare cases were permanent pacemakers required.

Effect of weaning age on the small intestine mucosa of rats.

Weaning of mammalian progeny is associated with a change in food composition and mother-offspring separation. Weaning results in a critical period of low voluntary feed intake, during which the animal is adapting to the starter diet. To evaluate the effects of weaning age on morphological changes that occur in the intestines of rats, we assessed intestinal histomorphometry and somatic growth in 21-days-old pups and 90-days-old mature rats that had been weaned early (day 16), normally (day 21), or late (day 26). Early weaning resulted in deeper crypts, lower villous/crypt ratio, and a smaller villous area on day 21. Crown-tail length correlated positively with the crypt depth and negatively with the villous/crypt ratio. At age 90 days, early weaned animals had shallower crypts, a greater villous/crypt ratio, and a smaller villous area compared with their normally weaned counterparts. The rats' crown-tail length correlated negatively with the crypt depth and positively with the villous/crypt ratio. Early weaning significantly affects the intestinal mucosa, which may impact food absorption and lead to differences in somatic growth compared with late weaning. Over time there may be a phase of compensation with increased villus height and crypt depth.