Clinical outcome of various management strategies in coronary artery ectasia

Vasu, Nandhakumar; Narayanan, Sheshadri; Ajit, Mullasari S.

doi:10.1016/j.ihj.2017.04.013

Cited by 7 publications

(6 citation statements)

References 6 publications

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“…A few clinicians recommend IVUS for an accurate assessment of percentage vessel narrowing and to differentiate true aneurysms 15 . Percutaneous coronary intervention and coronary artery bypass grafting have similar results for CAE in a recent study 16 .…”

Section: S879mentioning

confidence: 78%

Incidence and Characteristics of Coronary Artery Ectasia in Patients Undergoing Coronary Angiography at Army Cardiac Center Lahore

Shafiq

Usman

Sultan

et al. 2021

PAFMJ

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Objective: To estimate the incidence and characteristics of coronary artery ectasia in patients undergoing coronary angiography. Study Design: A prospective analysis. Place and Duration of Study: This study was conducted at Army Cardiac Center, Lahore over a period of two years from Jan 2018 to Dec 2019. Methodology: Its prospective analysis of all coronary angiograms performed in our catheterization laboratory during study period. Markis classification was the basis to define and classify coronary artery ectasia. Demographical, clinical, and laboratory data were collected for each patient in this study. Results: A total of 172 (3.9%) out of 4,372 coronary angiograms showed coronary artery ectasia. Among coronary artery ectasia group, mean age 58 ± 10 years, 90% were male, 47% were current smokers, 32% were hypertensive, 15% had diabetes Mellitus and 37% had dyslipidemia. The most common clinical presentation was Non STsegment elevation myocardial infarction (31%), followed by Stable ischemic heart disease in 28%. Right coronary artery was the most frequent coronary artery involved (57%) while Markis Class 3 pattern was seen as most common type of coronary artery ectasia. Conclusion: The frequency of coronary artery ectasia among our patients undergoing coronary angiography was about 4%. Right coronary artery remained the most common affected artery.

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Section: S879mentioning

confidence: 78%

Incidence and Characteristics of Coronary Artery Ectasia in Patients Undergoing Coronary Angiography at Army Cardiac Center Lahore

Shafiq

Usman

Sultan

et al. 2021

PAFMJ

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“… 3 Additionally, CABG can be selected for giant CAE if myocardial perfusion is compromised and the distal branch is of reasonable size. 2 , 6 , 7 Although medication treatments have provided benefits in some cases, 7 medications cannot reverse the structural changes of the heart and vessels. Furthermore, antiplatelet and anticoagulant therapy may increase the risk of bleeding and should be used cautiously in patients who have a risk of CAE rupture.…”

Section: Discussionmentioning

confidence: 99%

Right coronary artery–left ventricular fistula with giant right coronary artery of diffuse ectasia: a case report

Zhang

Chen

Hou

et al. 2021

European Heart Journal - Case Reports

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Background Coronary artery fistula complicated with giant coronary artery ectasia (CAE) is a rare cardiac malformation, and its surgical indications and treatment strategies still need further discussion. Case summary In this case, a 41-year-old man had complained of occasional dizziness for 2 years, but he did not seek medical attention until he started to feel palpitations. A right coronary artery (RCA)–left ventricular (LV) fistula with giant RCA of diffuse ectasia was firstly revealed by transthoracic echocardiography. A widened left ventricle and significantly constricted right atrium and right ventricle were also detected by three-dimensional coronary artery computed tomography. Surgical treatment, including the repair of the RCA-LV fistula, the resection and reconstruction of the dilated RCA and coronary artery bypass grafting (CABG) under hypothermic cardiopulmonary bypass, were performed to correct the malformation. The patient presented a favourable health condition without any discomfort at the 1-year follow-up. Discussion CAE can be caused by various congenital or acquired factors. Surgical treatment, such as transcatheter embolization excision, surgical ligation or resection for symptomatic patients with CAE three times or larger than the reference diameter, has been reported to have satisfactory results. Additionally, CABG can be selected if myocardial perfusion is compromised and the distal branch is of reasonable size. In this case, the giant ectasia of the RCA may have been a consequence of the congenital RCA-LV fistula. Atherosclerosis, with calcified plaques in the RCA, and the patient’s long-term history of smoking may have contributed to the development of giant ectasia of the RCA.

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“…Besides the pharmacologic management of CAE, there are other invasive revascularization options such as percutaneous coronary intervention and coronary artery bypass graft [46]. The types, challenges, and outcomes of different interventional strategies have been reviewed extensively in other articles [47,48].…”

Section: Indications Of Interventional Managementmentioning

confidence: 99%

“…These invasive options are usually indicated in CAE patients with concomitant obstructive lesions or patients exhibiting symptoms or signs of myocardial ischemia despite adequate pharmacologic treatment. However, patients with isolated CAE can be managed with optimal medical therapy alone [46,49]. Thrombus formation is another complication that may happen in CAE.…”

Section: Indications Of Interventional Managementmentioning

confidence: 99%

Pharmacologic Management of Coronary Artery Ectasia

Khedr

Neupane

Proskuriakova

et al. 2021

Cureus

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Coronary artery ectasia (CAE) is a rare form of aneurysmal coronary heart disease. It is defined as a dilatation of the coronary artery by more than one-third of its length and with a diameter 1.5 times of a normal coronary artery adjacent to it. This condition increases the risk of angina pectoris and acute coronary syndrome. Hence, we discuss the pharmacologic options for primary and secondary prevention of CAE complications. Antiplatelets such as aspirin are considered the mainstay of treatment in patients with CAE. Anticoagulants such as warfarin are warranted on a case-by-case basis to prevent thrombus formation depending on the presence of concomitant obstructive coronary artery disease and the patient's risk of bleeding. Since atherosclerosis is the most common cause of CAE, statins are indicated in all patients for primary prevention. Angiotensin-converting enzyme (ACE) inhibitors may be indicated, especially in hypertensive patients, due to their anti-inflammatory properties. Beta-blockers may be indicated due to their antihypertensive and anti-ischemic effects. Calcium (Ca) channel blockers may be needed to prevent coronary vasospasm. Nitrates are generally contraindicated as they may lead to worsening of symptoms.Other antianginal medications such as trimetazidine can improve exercise tolerance with no reported adverse events in these patients.

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Clinical outcome of various management strategies in coronary artery ectasia

Cited by 7 publications

References 6 publications

Incidence and Characteristics of Coronary Artery Ectasia in Patients Undergoing Coronary Angiography at Army Cardiac Center Lahore

Incidence and Characteristics of Coronary Artery Ectasia in Patients Undergoing Coronary Angiography at Army Cardiac Center Lahore

Right coronary artery–left ventricular fistula with giant right coronary artery of diffuse ectasia: a case report

Pharmacologic Management of Coronary Artery Ectasia

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