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Start Over Descriptor "left main coronary" Topic coronary angiography
5 results on '"left main coronary"'

1. Left main coronary artery stenosis: severity evaluation and implications for management.

Author

Habibi SE, Shah R, Berzingi CO, Melchior R, Sumption KF, and Jovin IS

Subjects
Computed Tomography Angiography, Coronary Stenosis diagnostic imaging, Coronary Vessels diagnostic imaging, Fractional Flow Reserve, Myocardial, Humans, Severity of Illness Index, Tomography, Optical Coherence, Coronary Angiography methods, Coronary Stenosis pathology, Coronary Vessels pathology
Abstract

Introduction: The significant stenosis of the left main coronary artery is associated with poor outcomes and is considered a strong indication for revascularization. However, deciding whether the stenosis is significant can sometimes be challenging, especially when the degree of stenosis is intermediate, and can necessitate additional tests and imaging modalities. Areas covered: We did a literature search using keywords like 'left main', 'imaging', 'intravascular ultrasound', 'fractional flow reserve', 'computed tomographic angiography' and 'magnetic resonance imaging'. The most commonly used methods for better characterizing intermediate left main coronary stenoses are intravascular ultrasound and fractional flow reserve, while optical coherence tomography is the newer technique that provides better images, but for which not as much data is available. The noninvasive techniques are coronary computed tomographic angiography and, to a lesser degree, coronary magnetic resonance imaging. Expert commentary: Accurately determining the severity of left main coronary stenosis can mean the difference between a major intervention and conservative therapy. The reviewed newer imaging modalities give us greater confidence that patients with left main stenosis are assigned to the right treatment modality.

Published
2017
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2. Long-term outcomes following left main bifurcation stenting in Indian population—Analysis based on SYNTAX I and II scores

Author

Ajith Ananthakrishna Pillai, Balachander Jayaraman, Harichandrakumar Kottyath, Santhosh Satheesh, Saranya Gousy, and Raja J. Selvaraj

Subjects
Male, Time Factors, medicine.medical_treatment, Coronary Artery Disease, 030204 cardiovascular system & hematology, Coronary Angiography, Syntax score, 0302 clinical medicine, Long term outcomes, Prevalence, Medicine, Bifurcation stenting, 030212 general & internal medicine, Ejection fraction, Incidence, Indian population, Middle Aged, Coronary Vessels, Interventional Cardiology, Fractional Flow Reserve, Myocardial, Treatment Outcome, Cardiology, Female, Stents, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, RD1-811, Decision Making, India, Outcomes, 03 medical and health sciences, Percutaneous Coronary Intervention, Internal medicine, Diseases of the circulatory (Cardiovascular) system, Humans, cardiovascular diseases, Ultrasonography, Interventional, Retrospective Studies, business.industry, Stent, Percutaneous coronary intervention, Left main coronary, ROC Curve, RC666-701, Conventional PCI, Observational study, Surgery, business, Mace, Follow-Up Studies
Abstract

Background: Syntax 1 and recently Syntax 2 (SS2) scores are validated risk prediction models in coronary disease. Objectives: To find out the long term outcomes following stenting for unprotected left main bifurcation disease (LMD) and to validate and compare the performance of the SYNTAX scores 1 and 2 (SS1 and SS2 PCI) for predicting major adverse cardiac events (MACE) in Indian population. Methods: Single-center, retrospective, observational study involving patients who underwent percutaneous coronary intervention (PCI) with at least one stent implanted for the LMD. Discrimination and calibration models were assessed by ROC curve and the Hosmer-Lemeshow test. Results: Data of 103 patients were analyzed. The mean SS1 and SS2 scores were 27.9 and 30.7 and MACE was 16.5% at 4 years. The target lesion revascularization (TLR) rate at 4 years was 11(10.7%). There were 4 deaths (3.8%). The mean left ventricular ejection fraction (LVEF) was the only variable in SS2, which predicted cardiac events. ROC curve analysis showed both models to be accurate in predicting TLR and mortality following LM PCI. SS2 score showed a better risk prediction than SSI with AUC for TLR (SSI 0.560 and SS2PCI 0.625) and AUC for mortality (SS1 0.674 and SS2PCI 0.833). Hosmer-Lemeshow test validated the accuracy of both the risk models in predicting the events. Conclusions: Both risk models were applicable for Indian patients. The SS2 score was a better predictor for mortality and TLR. In the SS2 score, the LVEF was the most useful predictor of events after LM PCI. Keywords: Left main coronary, Bifurcation stenting, Syntax score, Outcomes

Published
2017

3. Prediction of Left Main Coronary Artery Obstruction by 12‐Lead Electrocardiography: ST Segment Deviation in Lead V 6 Greater than or Equal to ST Segment Deviation in Lead V 1

Author

Edgar Lichstein, Sunil Abrol, Bilal Malik, David Yens, Jacob Shani, Nitin Mahajan, Brian Temple, Gerald Hollander, and Deepak Thekkoott

Subjects
Male, medicine.medical_specialty, Acute coronary syndrome, medicine.medical_treatment, Hemodynamics, left main coronary, Coronary Angiography, Revascularization, Culprit, acute coronary syndrome, Lesion, Electrocardiography, Predictive Value of Tests, Risk Factors, Physiology (medical), Internal medicine, medicine, Humans, Diseases of the circulatory (Cardiovascular) system, ST segment, Aged, Retrospective Studies, medicine.diagnostic_test, business.industry, Coronary Stenosis, Reproducibility of Results, Original Articles, General Medicine, Middle Aged, medicine.disease, Surgery, Logistic Models, Case-Control Studies, RC666-701, Predictive value of tests, Cardiology, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, reciprocal electrocardiographic changes
Abstract

Background: Acute coronary syndrome (ACS) resulting from culprit lesion in left main coronary artery (LMCA) can cause rapid hemodynamic deterioration. It is important to identify these patients early to facilitate timely revascularization. ST segment elevation in aVR greater than or equal to V 1 (aVR-V 1 ≥ 0) has been suggested as a sensitive predictor of LMCA disease. As a result of balanced forces, we hypothesized that ST deviation in V 6 greater than or equal to ST deviation in V 1 (V 6 -V 1 ≥ 0) might be a good determinant of LMCA disease. Methods: We compared admission 12-lead ECGs of ACS resulting from culprit LMCA lesion (n = 75, group I) with ACS resulting from culprit left anterior descending lesion (n = 81, group II). Group I was selected over a period of 10 years. We compared V 6 -V 1 ≥ 0 to aVR-V 1 ≥ 0 in both groups. We also looked at ratios of ST deviations in V 6 ,V 1 (V 6 /V 1 ≥ 1) and aVR,V 1 (aVR/V 1 ≥ 1) in patients where ST segment in V 1 was not isoelectric (group I = 54 and group II = 55). Results: ST deviation in V 6 was significantly greater in group I as compared to group II (P < 0.001). The reliabilities of V 6 -V 1 ≥ 0, V 6 /V 1 ≥ 1, aVR-V 1 ≥ 0, and aVR/V 1 ≥ 1 in predicting LMCA disease were determined. Conclusion: This is the largest series of ECG analysis on ACS resulting from culprit LMCA lesion. V 6 -V 1 ≥ 0 and V 6 /V 1 ≥ 1 were more sensitive in predicting LMCA as culprit vessel in comparison to previously reported greater ST segment elevation in aVR than V 1 .

Published
2006
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4. Assessment of left main coronary artery atherosclerotic burden using 64-slice CT coronary angiography: correlation between dimensions and presence of plaques

Author

F. Alberghina, Nico R. Mollet, Francesca Pugliese, Massimo Midiri, Erica Maffei, Alessandro Palumbo, Giuseppe Runza, Manuel Belgrano, W. Bob Meeijboom, Ludovico La Grutta, Annachiara Aldrovandi, Annick C. Weustink, Filippo Cademartiri, Roberto Malago, Cademartiri, F, La Grutta, L, Malagò, R, Alberghina, F, Palumbo, A, Belgrano, M, Maffei, E, Aldrovandi, A, Pugliese, F, Runza, G, Weustink, A, Bob Meeijboom, W, Mollet, NR, Midiri, M, Cademartiri, F., La Grutta, L., Malago, R., Alberghina, F., Palumbo, A., Belgrano, MANUEL GIANVALERIO, Maffei, E., Aldrovandi, A., Pugliese, F., Runza, G., Weustink, A., Bob Meeijboom, W., Mollet, N. R., Midiri, M., and Radiology & Nuclear Medicine

Subjects
Coronary angiography, Male, medicine.medical_specialty, left main coronary, medicine.disease_cause, Coronary Angiography, Coronary artery disease, Internal medicine, medicine, atherosclerotic burden, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, Vulnerable plaque, Neuroradiology, medicine.diagnostic_test, business.industry, Ultrasound, Coronary artery disease, Left main coronary artery, Multidetector-row computed tomography, 64-slice CT, Vulnerable plaque, Interventional radiology, General Medicine, Left main coronary artery, Middle Aged, Multidetector-row computed tomography, medicine.disease, medicine.anatomical_structure, Semiquantitative Method, cardiovascular system, Cardiology, Female, 64-slice CT, Radiology, business, Tomography, X-Ray Computed, Artery
Abstract

PURPOSE: The aim of this study was to correlate left main (LM) coronary artery dimensions with the presence of atherosclerosis by multidetector-row computed tomography (MDCT) coronary angiography (CA) and to assess coronary atherosclerotic plaques with a semiquantitative method. MATERIALS AND METHODS: Sixty-two consecutive patients (41 men, mean age 60+/-11) with suspected coronary artery disease underwent 64-MDCT coronary angiography. LM dimensions (length, ostial and bifurcation diameters), quantitative [location, Hounsfield unit (HU) attenuation] and qualitative (composition, shape) analysis of plaques within the LM were performed. All patients underwent conventional CA. RESULTS: Thirty patients (mean age 55+/-10) without plaques in the LM presented the following average dimensions: length 10.6+/-6.1 mm, ostial diameter 5.5+/-0.7 mm, bifurcation diameter 4.9+/-0.9 mm. LM plaques (n=36) were detected in 32 patients (mean age 64+/-10) with the following LM average dimensions: length 11.3+/-4.0 mm, ostial diameter 6.0+/-1.2 mm and bifurcation diameter 6.0+/-1.2 mm. Plaques were calcified (40%, mean attenuation 742+/-191 HU), mixed (43%, mean attenuation 387+/-94 HU) or noncalcified (17%, mean attenuation 56+/-14 HU) and were frequently eccentric (77%). Age was significantly different in the two groups (p

5. Left Main Coronary Artery Occlusion Due to Thrombus Embolization From a Prosthetic Mitral Valve

Author

Ronen Jaffe, Ronen Rubinshtein, and Avinoam Shiran

Subjects
medicine.medical_specialty, Cardiac Catheterization, Heart disease, thrombotic lesion, medicine.medical_treatment, Suction, left main coronary, Coronary Angiography, Prosthesis, embolism, Aortic valve replacement, Internal medicine, Thromboembolism, medicine, Humans, Embolization, Myocardial infarction, cardiovascular diseases, Thrombus, Thrombectomy, Heart Valve Prosthesis Implantation, business.industry, Cardiogenic shock, cardiogenic shock, Anticoagulants, Middle Aged, medicine.disease, Treatment Outcome, Embolism, Coronary Occlusion, primary angioplasty, Heart Valve Prosthesis, Cardiology, cardiovascular system, Mitral Valve, Female, Warfarin, business, Cardiology and Cardiovascular Medicine, Echocardiography, Transesophageal
Abstract

A 46-year-old woman with a history of rheumatic heart disease and mitral and aortic valve replacement with mechanical bileaflet prosthesis was admitted with acute anterior wall ST-segment elevation myocardial infarction and cardiogenic shock after discontinuation of anticoagulant therapy. She

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