RESUMEN
BACKGROUND: An increasing number of patients undergoing percutaneous interventions (PI) have experienced previous coronary artery bypass graft surgery (CABG). However, the impact of PI on outcomes in such patients is currently unclear. We evaluated the immediate and 1-year clinical outcomes of post-CABG patients who underwent PI in a tertiary center. METHODS: From January-2005 to September-2006, 91 consecutive post-CABG patients underwent 197 stent implantations (84% drug-eluting stents) for 154 lesions. 58% were treated in the native coronary arteries, 34% in the grafts and 8% in both type of vessels. Major adverse cardiac events (MACE) were recorded in-hospital and at 1-year follow-up. RESULTS: Procedural success rate was 95.6%. In-hospital MACE rate was 3.3%. At 1 year, the incidence of MACE was 18.6%: death occurred in 5.4% of the patients, myocardial infarction in 2.2%, and 10.9% of the patients underwent repeat revascularization (target lesion revascularization was required in 5.4%). Multivariate analysis revealed left ventricular ejection fraction <50% (OR 4.6, 95% CI 1.8 to 7.5, p=0.01) and multivessel intervention (OR 2.7, 95% CI 1.2 to 4.5, p=0.03) to be independent predictors of MACE at 1 year. CONCLUSIONS: Immediate results showed the safety and efficacy of percutaneous revascularization in post-CABG patients. The relatively low risk need for target lesion revascularization obtained is encouraging. Independent predictors of MACE at 1 year were left ventricular disfunction and multivessel intervention.
Asunto(s)
Angioplastia Coronaria con Balón/estadística & datos numéricos , Puente de Arteria Coronaria/estadística & datos numéricos , Reestenosis Coronaria , Oclusión de Injerto Vascular/epidemiología , Oclusión de Injerto Vascular/terapia , Anciano , Angina de Pecho/epidemiología , Angina de Pecho/cirugía , Angina de Pecho/terapia , Comorbilidad , Reestenosis Coronaria/epidemiología , Reestenosis Coronaria/cirugía , Reestenosis Coronaria/terapia , Bases de Datos Factuales , Stents Liberadores de Fármacos/estadística & datos numéricos , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Análisis Multivariante , Valor Predictivo de las Pruebas , Estudios Prospectivos , Factores de Riesgo , Resultado del TratamientoRESUMEN
A 56-year-old man presented with acute pancreatitis and electrocardiographic abnormalities, suggesting acute inferior myocardial infarction. An emergent coronary angiogram showed normal coronary arteries. The clinical significance and therapeutic implications of this rare finding are discussed.
Asunto(s)
Sistema de Conducción Cardíaco/fisiopatología , Infarto del Miocardio/diagnóstico , Pancreatitis/diagnóstico , Enfermedad Aguda , Cateterismo Cardíaco , Angiografía Coronaria , Diagnóstico Diferencial , Electrocardiografía , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/diagnóstico por imagen , Infarto del Miocardio/fisiopatología , Pancreatitis/diagnóstico por imagen , Pancreatitis/fisiopatología , Pancreatitis/terapia , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
The first septal perforating artery can anomalously originate from the aortic root. This finding is rare, benign and usually associated with other congenital coronary anomalies. We describe a patient with an isolated anomaly, a septal perforating artery which originated separately from the right sinus of Valsalva.
Asunto(s)
Anomalías de los Vasos Coronarios/diagnóstico por imagen , Defectos de los Tabiques Cardíacos/diagnóstico por imagen , Seno Aórtico/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , RadiografíaRESUMEN
Anomalous origin of left and right coronary arteries from a single coronary ostium in the right sinus of Valsalva is rare. Accordingly, few reports have described percutaneous coronary interventions in this anomaly. We report a case of a 75-year-old woman with a severe lesion in the anomalous left main coronary artery arising from a single ostium in the right sinus of Valsalva. The patient was successfully treated with direct stenting.
Asunto(s)
Anomalías de los Vasos Coronarios/terapia , Seno Aórtico/anomalías , Stents , Anciano , Angiografía Coronaria , Anomalías de los Vasos Coronarios/diagnóstico por imagen , Femenino , HumanosRESUMEN
A patient with postinfarction angina was referred for coronary angiography. In addition to severe atherosclerotic coronary disease, which was responsible for clinical presentation, a single coronary artery arising from the left sinus of Valsalva was found. The authors report the use of direct coronary stent deployment without predilation to treat disease in this rare anomaly.