Coronary Artery Steal via a Large Anastomosis between the Coronary and Bronchial Arteries Successfully Treated by Surgical Division

Kawasuji, Michio; Murakami, S; Watanabe, Yoh; Igarashi, Takashi

doi:10.1055/s-2007-1023365

Cited by 10 publications

(9 citation statements)

References 3 publications

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“…) supplying the apical segment of the right upper lobe. The anastomotic vessel of 3 mm diameter between the bronchial and coronary arteries already discussed was found in a patient with aortitis syndrome (Kawasuji et al, 1984). In this patient, in whom the segmental pulmonary artery to the right upper lobe was obstructed, all cardiac symptoms were relieved following surgical division of the anastomotic vessel.…”

Section: Pathologymentioning

confidence: 54%

“…He also noted that, in pathologic conditions, the anastomotic arteries became tortuous and of larger caliber, albeit that the largest measured communications had diameters of no >1 mm (Moberg, 1967a, b). In this respect, Bjork (1966) reported the existence of communications with diameters of 2 mm, whereas Kawasuji et al (1984) measured an artery of 3 mm. Although conventional wisdom had suggested that the benefit of the anastomoses became evident only when both coronary arteries were obstructed, Sanerkin (1968) reported an instance in which extracardiac anastomoses of considerable caliber were formed in the setting of occlusion of a single coronary artery.…”

Section: Morphology Of the Anastomosesmentioning

confidence: 99%

“…Flow from the coronary arteries to the bronchial arteries occurs in situations when the coronary arterial pressure is increased, as in the setting of supravalvular aortic stenosis (Do Valle et al, 1969). Flow in the opposite direction is seen in the setting of increased bronchial arterial pressure, such as in tetralogy of Fallot with pulmonary stenosis (Bjork, 1966) or atresia (Jefferson et al, 1972), chronic obstructive pulmonary disease (Smith et al, 1970), or Takayasu's arteritis (Kawasuji et al, 1984).…”

Section: Anastomoses From the Bronchial Arteriesmentioning

confidence: 99%

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Extracardiac coronary arterial anastomoses

et al. 2010

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The collateral arterial circulation of the heart has been extensively studied. However, less attention has been paid to extracardiac anastomoses, which may also be of significant clinical importance. In this review, we will describe the most common types of these anastomoses, which include bronchial to coronary arteries and internal thoracic to coronary arteries. In a much lesser degree, anastomoses between coronary arteries and pericardiacophrenic branches of the internal thoracic arteries, anterior mediastinal arteries, intercostal arteries, and esophageal arterial branches have also been described. Knowledge of the likely morphology and function of the anastomoses, therefore, could prove helpful in the clinical evaluation of patients with myocardial ischemia, particularly when selecting candidates for myocardial revascularization.

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Section: Pathologymentioning

confidence: 54%

Section: Morphology Of the Anastomosesmentioning

confidence: 99%

Section: Anastomoses From the Bronchial Arteriesmentioning

confidence: 99%

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Extracardiac coronary arterial anastomoses

et al. 2010

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“…Vessels can increase in caliber and become tortuous [ 10 ]. The diameters range from less than 1 mm up to 3 mm [ 25 - 30 ]. Vessels may reach a diameter of 2 mm in one out of eight patients [ 28 , 29 ]-Kawasuji reported a vessel that reached 3 mm in diameter [ 30 ].…”

Section: The Nature Of Nccmbfmentioning

confidence: 99%

Noncoronary Collateral Myocardial Blood Flow: The Human Heart’s Forgotten Blood Supply

Picichè

2015

TOCMJ

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The “noncoronary collateral circulation” (NCCC) or “noncoronary collateral myocardial blood flow” (NCCMBF), reaches the heart through a micro-vascular network arising from the bronchial, esophageal, pericardial, diaphragmatic, and aortic arteries. The left and right internal thoracic arteries (ITAs) along with their collateral branches also serve as a source of NCCMBF-a feature seen in other mammals. Under certain circumstances the ITAs have a high potential for developing collateral branches. In the case of severe Leriche syndrome or with chronic obstruction of the abdominal aorta, the ITAs can serve as the main or even sole source of blood supply to the lower limbs. It is also possible for the ITAs to develop angiographically visible branches that directly connect with the coronary arteries. In ischemic conditions there is a functional, ischemia-reducing extracardiac coronary artery supply via natural ipsilateral ITA anastomosis. To date we know little about NCCMBF and its potential benefits in clinical applications, which makes this a challenging and intriguing field of research. This paper reviews all available data on noncoronary collateral blood supply to the human heart.

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“…In addition to our previous report [40], where we analyzed the coronary artery lesions documented in the literature from findings by angiography, surgery, and autopsy, there are many possible pathophysiological mechanisms in the development of coronary artery involvement: (1) coronary ostial stenosis secondary to proliferation of the aortic intima and contraction of the fibrotic media and adventitia that occur in the aorta, (2) stenosis due to extension of the aortic inflammation into the coronary artery, (3) stenosis at skip lesions due to inflammation of the coronary artery itself (eoronary arteritis), (4) coronary artery stenosis due to extrinsic constriction caused by periarteritis of the aorta or pulmonary artery, or associated pericarditis, (5) coronary artery thrombosis secondary to coronary arteritis [41], (6) coronary aneurysm with or without thrombus formation [41][42][43], (7) coronary steal syndrome due to coronary fistula communicating to the bronchial or pulmonary artery [44][45][46][47][48], and (8) compression of the coronary artery by aneurysm of the aortic sinus [49] (Fig. 4).…”

Section: Cardiac Involvementmentioning

confidence: 99%

Surgical treatment of cardiac involvement in Takayasu arteritis

Amano

Suzuki

1992

Heart Vessels

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Cardiac involvement is a serious disorder in Takayasu arteritis. Surgical treatment of aortic root and coronary artery lesions due to Takayasu arteritis has many potential difficulties due to its inflammatory nature. We operated on 15 patients with cardiac involvement stemming from Takayasu arteritis. These patients are classified into 3 groups depending on the clinical diagnosis and surgical procedures employed: coronary artery involvement alone--coronary artery bypass grafting (CABG), three patients (group A), aortic regurgitation with intact coronary artery--Aortic valve replacement or modified Bentall's operation, eight patients (group B), and aortic regurgitation with coronary artery involvement g aortic valve replacement or modified Bentall's operation with CABG, (4 patients) (group C). CABG was performed using saphenous vein graft. For aortic valve replacement or replacement of both the aortic valve and ascending aorta, a prosthetic valve or composite graft with Teflon felt flange was fabricated during surgery and treated with fibrin glue before insertion. A double fixation method with reinforcement by a Teflon felt strip was employed for proximal anastomosis of the flanged prosthesis. A button-shaped coronary ostium was directly anastomosed to the composite graft. There was no operative or hospital mortality. One patient died of brain abscess at 6 months after surgery and another patient with CABG required a second operation due to graft failure. Steroid therapy is recommended in cases diagnosed as being in an active stage until the inflammatory signs disappear.

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Coronary Artery Steal via a Large Anastomosis between the Coronary and Bronchial Arteries Successfully Treated by Surgical Division

Cited by 10 publications

References 3 publications

Extracardiac coronary arterial anastomoses

Extracardiac coronary arterial anastomoses

Noncoronary Collateral Myocardial Blood Flow: The Human Heart’s Forgotten Blood Supply

Surgical treatment of cardiac involvement in Takayasu arteritis

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