Coronary Ostial Stenosis in a Young Patient (original) (raw)
Related papers
Circulation, 1975
Symptomatic, nonsyphilitic, acquired coronary ostial stenosis is a rare angiographic finding and was found in 0.13% of 3000 coronary angiograms. Three females with this lesion have been treated surgically. Two had left coronary ostial involvement. Coronary angiography may result in catheter tip occulsion of the ostium with chest pain, dyspnea, diaphoresis, systemic hypotension and abrupt fall in pressure at the catheter tip. Recognition of this entity is necessary for safe coronary angiography. Involvement of the left ostium carries the same serious prognosis as does left main coronary disease.
American Heart Journal, 1992
%roo?dyn, N. Y. Coronary ostial stenosis rarely occurs in the absence of other coronary artery disease. Fewer than 50 cases of nonsyphilitic isolated coronary ostial stenosis have been reported according to a review of the literature.lm4 The vast majority of patients in these reported cases were prememopausal women. There are a few reports of it occurring in young male patientss4 The majority of the reported cases of isolated coronary ostial stenosis were corrected by coronary artery bypass surgery.l-" Recent studies have shown angioplasty to have disappointing results in the correction of coronary ostial stenosis.5-6 Two cases of an isolated coronary ostial stenosis in elderly patients are reported here: stenosis was corrected by directional coronary atherectomy. Case 1. An 81-year-old woman with no previous history of cardiac disease suddenly experienced severe retrosternal From the Departments of Medicine and Cardiology, Maimonides Medical Center. Brooklyn.
International Journal of Angiology, 2011
This study was designed to evaluate ostial left main coronary artery (LMCA) stenosis and investigate concomitant stenotic lesions of LMCA and right coronary arteries (RCA) and their demographic and angiographic features. We evaluated 11,283 patients who underwent coronary angiography. Patients were placed into four groups according to having ostial or nonostial LMCA or RCA stenosis. Significant LMCA stenosis was observed in 242 (8.3%) of the patients, and only 68 (28.1%) of them had significant ostial LMCA stenosis. There was a significant correlation between ostial stenosis of LMCA and RCA (p ¼ 0.03). The frequency of female gender was greater in ostial LMCA and ostial RCA stenosis groups compared with the other groups (p ¼ 0.01). Ostial LMCA and RCA stenosis were related significantly. Both female predominance and coexistence of ostial LMCA and RCA stenosis might have suggest a different pathological ground for this disease.
Isolated Left Main Ostial Coronary Stenosis in a Young Woman
… HEART JOURNAL (IHJ), 2007
Coronary arteritis is a rare but potentially fatal condition either by itself or in conjunction with other diseases in all age groups. Coronary arteritis is most closely associated with the polyarteritis syndromes and other collagen vascular diseases, immune system dysfunction, Mediterranean fever, Kawasaki disease, fibrous pericarditis and staphylococcal septicemia. Isolated left main coronary arteritis may be associated with specific and non-specific aortoarteritis or in some cases after mediastinal irradiation. In this young woman, with regard to her age of 22 years old, sex, absence of familial and personal risk factors, and elevated CRP and ESR and the report of severe left main stem inflammation at open heart surgery and negative response to intracoronary injection of nitrate during angiography, the diagnosis of isolated left main stem coronary arteritis is very high in probability (
Isolated Congenital Coronary Ostial Stenosis in a Young Infant: A Case Report
World Journal for Pediatric and Congenital Heart Surgery, 2020
Coronary ostial stenosis is a rare congenital cardiac anomaly, frequently associated with hypoplasia of the proximal coronary artery. This condition is potentially life-threatening, as it may present with myocardial ischemia and sudden death. We present a case of left coronary ostial stenosis in a 48-day-old infant symptomatic for sudden cardiac arrest, who successfully underwent surgical angioplasty. Any cardiac arrest in a neonate or young infant should raise suspicion of coronary ostial stenosis/atresia, considering the difficulty in diagnosing this congenital heart defect.
Advances in Interventional Cardiology, 2013
Ostial stenosis of the left main coronary artery as the result of the previous percutaneous coronary intervention on the left coronary artery G Gr rz ze eg go or rz z M Me en nc ce el l, , J Ja ac ce ek k K Ko ow wa al lc cz zy yk k, , M Ma ar rc ci in n S Sw wi ie er ra ad d, , A An nd dr rz ze ej j S Sw wi ia at tk ko ow ws sk ki i, , G Gr rz ze eg go or rz z H Ho on ni is sz z, , Z Zb bi ig gn ni ie ew w K Ka al la ar ru us s, , B Be ea at ta a S Sr re ed dn ni ia aw wa a A b s t r a c t A 76-year-old patient was admitted to hospital due to recurrent chest pain. Angiography revealed multivessel coronary artery disease with significant stenosis in medial and distal parts of the left main coronary artery (LMCA). Two drug-eluting stents (DES) were implanted from the medial part of the LMCA to the proximal part of the left anterior descending (LAD) artery. An excellent angiographic result was achieved. After 20 days the patient returned to our clinic because of acute coronary syndrome (ACS). Angiography showed 80% stenosis in the ostial LMCA. The lesion was stented with DES, obtaining a good angiographic result. K Ke ey y w wo or rd ds s: : left main coronary artery, restenosis. R Re ec ce ei iv ve ed d: : 30.04.2013, a ac cc ce ep pt te ed d: : 28.06.2013.
Iatrogenic left main coronary ostial stenosis after a Bentall procedure in an asymptomatic young man
Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2012
Coronary ostial stenosis is a rare but potentially fatal sequela of aortic surgery. The clinical presentation can include acute coronary syndromes, ventricular arrhythmias, congestive heart failure, or sudden death. Herein, we present what we believe is the first reported case of asymptomatic iatrogenic left main coronary ostial stenosis. The patient was an active 34-year-old man who had undergone a modified Bentall procedure and was asymptomatic thereafter. Seven months after that operation, exercise stress testing showed electrocardiographic signs of asymptomatic myocardial ischemia at high workload, and coronary angiography revealed severe nonatherosclerotic left main ostial stenosis. Percutaneous coronary intervention and stenting of the unprotected left main stenosis was successful, and patency at 8 months was apparent on coronary angiography.The conventional treatment for coronary ostial stenosis, coronary artery bypass grafting, carries a high risk of perioperative infarction...
Surgical angioplasty for isolated coronary ostial stenosis
Texas Heart Institute …, 1997
Patch angioplasty has been reported as a suitable surgical option for patients with isolated coronary ostial stenosis, but controversy still exists concerning its effectiveness. We report the cases of 4 additional patients in whom this procedure was performed, including that of a patient with bilateral ostial stenosis; and we review the literature pertaining to bilateral ostial stenosis. Four patients, 3 with isolated stenosis of the left main coronary ostium and 1 with bilateral ostial stenosis, had direct surgical ostioplasty from January through November 1994. We considered the cause of ostial stenosis to be aortitis (of suspected syphilitic origin) in 1 patient, atherosclerotic plaque in 2 patients, and a fibrous membrane in the 4th. Ostioplasty was performed with a patch of autologous pericardium in 3 patients (fresh pericardium in 2 and glutaraldehyde-fixed in 1) and a patch of saphenous vein in 1. There were no operative deaths. One patient underwent successful reoperation for left main coronary artery restenosis after 3 months. All other patients are asymptomatic at 16, 18, and 24 months postoperatively. In the patient who underwent bilateral ostioplasty, coronary angiography showed patent ostia at 1 year. Surgical ostioplasty should be considered in the treatment of patients who have isolated ostial stenosis but no distal coronary disease. Careful patient selection seems to be a prerequisite for surgical success.