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Objective: This study aims to evaluate the clinical implications of radial artery graft stenosis and the performance of percutaneous intervention (PCI) of radial artery (RA) grafts., Methods: Out of 291 patients, 18 (6.2%) underwent PCI of an RA graft. The indications for PCI were acute myocardial infraction (n=1), angina (n=10) and scintigraphic abnormality (n=5). Two patients were asymptomatic and underwent PCI prior to major extracardiac surgery. The location of the RA stenosis was proximal (n=2) or distal anastomosis (n=5) and body of the conduit (n=11). From 1992 to 2001, balloon dilatation alone was performed on nine RA grafts at 1.7 years after surgery. Since 1999, stenting of nine RA grafts was achieved at 9.2 years after surgery. Three bare-metal and six drug-eluting stents were implanted. Stent mean diameter and length were 2.75 mm and 16 mm, respectively. Simultaneous PCI of other coronaries was achieved in five cases., Results: At 5.8 years, clinical follow-up showed heart failure (n=2) and recurrent angina (n=3), all after balloon dilatation. Control angiogram was performed in 14 cases at 4.5 years by conventional angiography (n=8) and 64-slice CT scan (n=6). One RA graft was occluded due to competitive flow from the native coronary vessel. Two RA restenoses following balloon dilatation were treated by stenting with long-term success (n=1) and secondary occlusion (n=1). Intra-stent RA stenosis was noted in one asymptomatic patient. All patients survived at long term except for one non-cardiac death at 5.9 years., Conclusion: Focal stenosis of radial artery graft is a rare angiographic finding and its meaning is unequivocal. PCI with balloon alone should be restricted to the early postoperative period during which spasm is difficult to exclude. Stenting offers excellent and durable results and shall be preferred in most cases., (Copyright (c) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.)

Left ventricular aneurysms most often occur in the course of myocardial infarction. In rare cases they can be detected when the coronary network is devoid of any lesions. The aetiology is therefore multiple and dependent on the context. One aetiology seems less exceptional and concerns idiopathic aneurysms encountered in the African population, where the role of a "debilitating condition" such as tuberculosis has been evoked. We report the case history of a young patient from Zaire with a left ventricular aneurysm discovered in association with ganglionic tuberculosis complicated by AA amyloidosis. Histological analysis allowed the aetiological diagnosis to be established. Aneurysmal dilatation of the left ventricle was reported in the presence of amyloid deposits at the intra-myocardial arteriole level, whereas the context suggested a tubercular role. In spite of the difficulty of establishing a precise aetiological diagnosis, there seems to exist a consensus for surgical management.