Objectives. Coronary collateral circulation (CCC) may limit the size of right ventricular (RV) infarcts but does not fully explain the relationship between CCC and clinical adverse events in patients with inferior STEMI. In this study, it was aimed to assess the relationship between preintervention angiographic evidence of CCC and clinical outcomes in patients with inferior STEMI who have undergone percutaneous coronary intervention. Methods. A total of 235 inferior STEMI patients who presented within the first 12 hours from the symptom onset were included. CCC to the right coronary artery (RCA) before angioplasty were angiographically assessed, establishing two groups: 147 (63%) patients without CCC and 88 (37%) with CCC according to presence of CCC. Results. RV infarction, complete atrioventricular block, VT/VF, cardiogenic shock, and in-hospital death were noted less frequently in patients with CCC than in those without CCC. Absence of CCC to RCA was found to be the independent predictor for in-hospital death among them (odds ratio 4.0, 95% CI 1.8–12.6; p = 0.03). Conclusion. Presence of angiographically detectable CCC was associated with better in-hospital outcomes including RV infarction, complete AV block, cardiogenic shock, and VT/VF in patients with inferior STEMI.

Presence of RRVFP is associated with in-hospital mortality in patients presenting with their first IWMI complicated by RVMI.

Hypertrophic cardiomyopathy is a genetic myocardial disorder. In such patients, myocardial bridging is the most frequent encountered coronary arterial anomaly. Patients may, however, on occasion, present with other much rarer malformations of the coronary arteries. Duplication of the right coronary artery is a very rare anomaly. We have now encountered a patient with hypertrophic cardiomyopathy in whom we found myocardial bridging of the anterior interventricular coronary artery and duplication of the right coronary artery. To the best of our knowledge, this association has not previously been described.

Covered stent graft by entrapping the thrombus between the vessel wall and stent might be helpful in preventing distal embolization and "no reflow" in a high-risk patient cohort. We here present a case with successful restoration of coronary flow in a highly thrombogenic milieu (acute myocardial infarction) with implantation of two covered stent grafts which by entrapping the thrombus avoided the distal embolization and "no reflow" in a totally occluded saphenous vein graft (SVG). However, stent length should be longer than the measured lesion length since choosing the exact diameter will not cover the plaque elongification secondary to the dilation process which is specifically significant in SVGs because of the softness of the plaque.

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