We present the clinical and angiographic profile of three patients with class I stable angina pectoris. All had strong coronary risk factors, and stress testing was positive in stage one of the Bruce protocol. Coronary angiography revealed total occlusion of the left main coronary artery (LMCA), and aortocoronary bypass surgery was performed. Thus, total LMCA occlusion may be an unexpected angiographic finding in patients with class I angina.
Summary:Hemodynamic data and angiograms of 15 adult patients with pulmonary atresia and ventricular septal defect were reviewed to assess the pulmonary circulation and other associated features. The most common variety of pulmonary atresia was that of pulmonary valve, main pulmonary artery, and the confluence of pulmonary arteries (6 cases, 40%). The collateral vessels to the lungs were well developed in all cases; selective injections into the collateral vessels were of great value in their delineation. The left ventricle was well developed in 11 cases (73.3%). Congestive heart failure was seen in 8 (53.3%), tricuspid regurgitation in 10 (66.7%), and aortic regurgitation in 7 (46.7%) cases. The long survival in these patients was related to the favorable anatomy of central pulmonary arteries (12 cases, 80%) and adequate pulmonary collateral circulation.
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