Syncope in a child owing to intramural course of the left coronary artery

Daehnert, Ingo; Rotzsch, Claudius; Krause, Stefanie; Dorszewski, Anja; Kostelka, Martin

doi:10.1111/j.1651-2227.2003.tb00506.x

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…2,5-7 Symptoms include chest pain, nausea, vomiting, syncope, and dyspnea. 2,3,6 Unfortunately, these symptoms also indicate other potentially less lethal conditions, including musculoskeletal injury, vasovagal syncope, and seizure. Accordingly, the patient’s presenting constellation of symptoms rarely leads to a definitive diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…8 In concerning cases with negative standard ED workup (chest X-ray, EKG, and cardiac enzymes), additional imaging tests should be performed. 2,5,6,9 Although echocardiography typically leads to the correct diagnosis, 2,7 echocardiograms may be falsely read as normal, especially in cases where the artery’s intramural course is relatively short. 1,2,6,9 Better imaging options for diagnosis and preoperative planning include coronary angiography, cardiac CTA, and cardiac magnetic resonance imaging, although it remains unclear which of these tests best detects anomalous arteries and/or intramural segments.…”

Section: Discussionmentioning

confidence: 99%

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Needle in a Haystack

Fishe

2016

Clin Pediatr (Phila)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Needle in a Haystack

Fishe

2016

Clin Pediatr (Phila)

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“…Various incision lines in minimally invasive coronary artery bypass grafting. Reimplantation technique of Left coronary artery to left coronary sinus(26). Unroofing of intramural right coronary artery in the aorta.…”

mentioning

confidence: 99%

Coronary Artery Disease and Coronary Artery Bypass Surgery in Patients of Middle Age

Lee

Kim

2008

J Korean Med Assoc

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C oronary artery disease in young patients (< 40 years) is not common. However, when it occurs it has symptoms that are more frequent and a more rapid progression when compared to older affected patients. Younger patients are more likely to have normal coronary arteries and have nonobstructive disease < 70%, single vessel disease and less extensive coronary artery atherosclerosis. Therefore, it is likely that there are differences in the cardiac risk factors in young patients undergoing coronary artery bypass surgery. Smoking, hypercholesterolemia, unstable angina, and myocardial infarction were more frequent in the young age group, and diabetes and hypertension were more common in older patients. The need for repeated interventions, additional surgery andlate myocardial infarction were more common in younger patients. Favorable factors associated with increased survival included the absence of unstable angina, a left ventricle ejection fraction of =45% and the use of the internal thoracic artery for procedures. The patency of saphenous vein grafts in younger patients was inferior to vein graft patency in the older patients. Risk factors such as hyperlipidemia, smoking and a family history of coronary artery disease may be related to the early graft failure in young patients. The patency of the internal thoracic artery to the left anterior descending artery was above 90% over 10 years; however, it was around 50% for the saphenous vein. Therefore, the aggressive use of internal thoracic arteries, for coronary artery bypass surgery in young patients, was essential for improved late survival and the event free survival (reduced additional interventions, surgeries and hospital admissions). The Y composite graft technique or sequential anastomosis, improves the coronary artery anastomosis with fewer arterial grafts. Other arterial grafts such as the gastroepiploic artery, radial artery and inferior epigastric artery could be used for coronary artery bypass surgery in young patients for free grafts, in situ grafts or Y composite grafts. Young patients that have coronary artery bypass surgery have a favorable prognosis when the internal thoracic arteries or other arterial grafts are used. In addition, such as the Y composite graft technique and sequential anastomosis can also be used with a high success rate.

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Ross procedure for congenital aortic insufficiency and an associated right intramural coronary artery

Takabayashi

Shimpo

Miyake

2005

Jpn J Thorac Caridovasc Surg

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A 7-year-old boy diagnosed with aortic insufficiency was treated with a Ross procedure and he had an associated right intramural coronary artery. Although preoperative angiocardiography showed that the right and left coronary artery orifices were close together, a right intramural coronary artery could not be diagnosed by transthoracic echocardiography. Intraoperative findings showed that the right coronary artery was intramural for a distance of 7 mm. As a result, a longer single coronary button was harvested and transplanted to the pulmonary autograft. The postoperative course was uneventful; coronary ischemia did not occur and aortic valve function was preserved.

show abstract

Syncope in a child owing to intramural course of the left coronary artery

Cited by 4 publications

References 14 publications

Needle in a Haystack

Needle in a Haystack

Coronary Artery Disease and Coronary Artery Bypass Surgery in Patients of Middle Age

Ross procedure for congenital aortic insufficiency and an associated right intramural coronary artery

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