RESUMO
We reported two cases of patients that underwent left internal mammary (LIMA)-coronary bypass graft and developed recurrent myocardial ischemia in the follow-up period caused by stenosis in the subclavian artery. The angiography showed retrograde flow from the left anterior descending artery to subclavian artery. After initial dilatation with a conventional angioplasty balloon catheter, we implanted Palmaz-Schatz Stents, achieving an excellent final result. Our finding suggest that Stent implantation is a safe and effective procedure, and provides an alternative to other forms of revascularization for the treatment of this disorder.
Assuntos
Arteriopatias Oclusivas/terapia , Anastomose de Artéria Torácica Interna-Coronária/efeitos adversos , Stents , Artéria Subclávia , Idoso , Angioplastia Coronária com Balão , Constrição Patológica/diagnóstico por imagem , Constrição Patológica/etiologia , Constrição Patológica/terapia , Angiografia Coronária , Feminino , Humanos , Masculino , Artéria Subclávia/diagnóstico por imagemRESUMO
Descrevemos dois casos de pacientes que haviam sido submetidos a revascularizaçäo do miocárdio com a utilizaçäo da artéria mamária interna esquerda e que desenvolveram na evoluçäo, quadro de insuficiência coronária por estenose da artéria subclávia esquerda. A cinecoronariografia evidenciou fluxo retrógrado da artéria descendente anterior para artéria mamária com enchimento da artéria subclávia distal à estenose que se localizava na sua origem. Após dilataçäo inicial com catater baläo de angioplastia coronária, foram implantados stents de Palmaz-Schantz, obtendo-se excelente aspecto angiográfico, sem complicaçöes e regressäo dos sintomas. Nossos resultados demonstram que a implantaçäo de stents nestes pacientes pode ser realizada com eficácia e segurança, mostrando ser um tratamento alternativo a outras formas de revascularizaçäo cirúrgica ou percutânea para esta doença.
We reported two cases of patients that underwent leftinternal mammary (LIMA) - coronary bypass graft and developed recurrent myocardial ischemia in the follow-up period caused by stenosis in the subclavian artery. The angiography showed retrograde flow from the left anterior descending artery to subclavian artery. After initial dilatation with a conventional angioplasty balloon catheter, we implanted Palmaz-Schatz Stents, achieving an excellent final result. Our finding suggest that Stent implantation is a safe and effective procedure, and provides an alternative to other forms of revascularization for the treatment of this disorder
Assuntos
Humanos , Masculino , Idoso , Arteriopatias Oclusivas/cirurgia , Artéria Subclávia/cirurgia , Stents , Anastomose de Artéria Torácica Interna-Coronária/efeitos adversos , Arteriopatias Oclusivas/etiologiaRESUMO
We describe the rare angiographic finding of the right coronary artery arising from the middle portion of the left anterior descending coronary artery in a patient with atherosclerotic coronary artery disease and acute myocardial infarction. This anatomic variation has been previously described only four times in the modern literature.
Assuntos
Anomalias dos Vasos Coronários/diagnóstico , Infarto do Miocárdio/etiologia , Adulto , Angiografia Coronária , Anomalias dos Vasos Coronários/complicações , Eletrocardiografia , Humanos , MasculinoRESUMO
A 43 year-old female patient with angina pectoris and vasospasm demonstrated in the anomalous left circumflex (Cx) and right coronary (RCD) arteries by coronary angiograph. Origin of the left Cx from the RCD is the most common coronary anomaly and generally, is considered to be benign. Nevertheless, myocardial ischemia in patient with this anomaly has been described. To our knowledge, this is the first reported case of coronary vasospasm occurring simultaneously in the anomalous left Cx and RCD arteries. The diagnostic troubles and the potential danger of this association were emphasized.