Pub Date : 2021-04-10DOI: 10.22541/AU.161801918.85821829/V1
Sho Kusadokoro, M. Shiraishi, D. Hori, A. Yamaguchi
A 71-year-old woman who was resuscitated from cardiac arrest after pericardial drainage, was admitted to our hospital. Enhanced computed tomography demonstrated pericardial effusion due to rupture of posterior ventricular myocardium. She underwent emergent surgical repair. A 20-mm tear in the extensively necrotic left ventricular posterior wall and active hemorrhage were identified. Sutureless repair using three sheets of TachoSil (CSL Behring, Tokyo, Japan) and fibrin glue was performed. To reduce ventricular pressure to avoid re-rupture and formation of ventricular aneurysm, deep sedation was followed in the intensive care unit for 2 weeks. The patient returned to her normal daily life and is progressing well for more than 5 months after the surgery.
{"title":"Sutureless repair and deep sedation for a blow-out type post-infarction left ventricular free wall rupture","authors":"Sho Kusadokoro, M. Shiraishi, D. Hori, A. Yamaguchi","doi":"10.22541/AU.161801918.85821829/V1","DOIUrl":"https://doi.org/10.22541/AU.161801918.85821829/V1","url":null,"abstract":"A 71-year-old woman who was resuscitated from cardiac arrest after\u0000pericardial drainage, was admitted to our hospital. Enhanced computed\u0000tomography demonstrated pericardial effusion due to rupture of posterior\u0000ventricular myocardium. She underwent emergent surgical repair. A 20-mm\u0000tear in the extensively necrotic left ventricular posterior wall and\u0000active hemorrhage were identified. Sutureless repair using three sheets\u0000of TachoSil (CSL Behring, Tokyo, Japan) and fibrin glue was performed.\u0000To reduce ventricular pressure to avoid re-rupture and formation of\u0000ventricular aneurysm, deep sedation was followed in the intensive care\u0000unit for 2 weeks. The patient returned to her normal daily life and is\u0000progressing well for more than 5 months after the surgery.","PeriodicalId":73692,"journal":{"name":"Journal of coronary artery disease","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44264962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.7793/JCAD.27.20-00019
H. Yokoi, Yutaro Ota, Tsubasa Komai, S. Yamazaki, Takashi Yanagiuchi, Shunpei Ushimaru, Taku Kato
Intravascular ultrasound (IVUS) catheter is a user-friendly imaging device widely used during percutaneous coronary intervention (PCI). However, IVUS catheter entrapment is an infrequent but serious complication associated with PCI. Case 1 was an 87-year-old woman on hemodialysis who had non-ST elevation myocardial infarction with total occlusion in the middle left anterior descending artery (LAD). PCI was performed with two drug-eluting stents (DESs) under IVUS guidance, but the IVUS catheter was entrapped at the implanted stent, leading to stent deformation. Case 2 was an 86-year-old woman on hemodialysis who had stable angina with severe calcified stenosis in the middle LAD. IVUS-guided rotational atherectomy was performed, but the IVUS catheter was stuck in the implanted DES with stent deformation. In both patients, we attempted to use a 0.010-inch guidewire and compatible balloon catheter system that can pass through a 6-Fr guide catheter simultaneously with the IVUS catheter, and the entrapped IVUS catheters were successfully removed from the implanted stents. This retrieval method is very convenient to apply during bailout and should be recommended especially in PCI using a 6-Fr guide catheter.
{"title":"Successful Removal of an Entrapped Intravascular Ultrasound Catheter Using a 0.010-inch Guidewire and Compatible Balloon Catheter System","authors":"H. Yokoi, Yutaro Ota, Tsubasa Komai, S. Yamazaki, Takashi Yanagiuchi, Shunpei Ushimaru, Taku Kato","doi":"10.7793/JCAD.27.20-00019","DOIUrl":"https://doi.org/10.7793/JCAD.27.20-00019","url":null,"abstract":"Intravascular ultrasound (IVUS) catheter is a user-friendly imaging device widely used during percutaneous coronary intervention (PCI). However, IVUS catheter entrapment is an infrequent but serious complication associated with PCI. Case 1 was an 87-year-old woman on hemodialysis who had non-ST elevation myocardial infarction with total occlusion in the middle left anterior descending artery (LAD). PCI was performed with two drug-eluting stents (DESs) under IVUS guidance, but the IVUS catheter was entrapped at the implanted stent, leading to stent deformation. Case 2 was an 86-year-old woman on hemodialysis who had stable angina with severe calcified stenosis in the middle LAD. IVUS-guided rotational atherectomy was performed, but the IVUS catheter was stuck in the implanted DES with stent deformation. In both patients, we attempted to use a 0.010-inch guidewire and compatible balloon catheter system that can pass through a 6-Fr guide catheter simultaneously with the IVUS catheter, and the entrapped IVUS catheters were successfully removed from the implanted stents. This retrieval method is very convenient to apply during bailout and should be recommended especially in PCI using a 6-Fr guide catheter.","PeriodicalId":73692,"journal":{"name":"Journal of coronary artery disease","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71175495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.7793/JCAD.27.20-00020
S. Doi, Y. Tanabe, Y. Ishibashi, Y. Akashi
a large thrombus (Fig. 2A). Immediately after angiography, she developed ventricular fi brillation (VF) resistant to defi brillation. VA-ECMO was immediately inserted to get away from collapsed circulation. Then Impella CP was inserted before PCI for LV unloading and reducing myocardial damage. PCI was performed under mechanical supports using VA-ECMO and Impella CP via the left radial artery. Thrombus aspiration and the simultaneous kissing balloon dilatation were performed in the LMT with a 3.0-mm balloon (Sapphire NC, OrbusNeich Medical, Inc., Fort Lauderdale, FL, USA) from the LMT to LAD and a 2.5-mm balloon (Ryurei, Terumo Medical Corporation, Tokyo, Japan) from Acute myocardial infarction (AMI) with cardiogenic shock (CS) has poor prognosis, despite using mechanical circulatory support devices. An 85-year-old woman with ST-elevation myocardial infarction (STEMI) was transferred to our hospital. STEMI was caused by plaque rupture of the left main trunk (LMT) along with CS and aborted myocardial damage. She suffered cardiopulmonary arrest despite intra-aortic balloon pumping (IABP) support. Veno-arterial extra corporeal membrane oxygenation (VA-ECMO) and Impella CP were immediately inserted to support the circulation and left ventricular unloading. Then she underwent percutaneous coronary intervention (PCI) and managed to survive. Transthoracic echocardiogram in the subacute phase revealed a preserved left ventricular systolic function though the culprit lesion was in LMT and the area at risk for myocardial infarction was extremely large. Left ventricular unloading using Impella CP could contribute to preservation of cardiac function and diminishing of myocardial damage. balloon pumping, myocardial percutaneous coronary percutaneous ventricular assist device
大血栓(图2A)。在血管造影后，她立即出现心室颤动(VF)，抵抗心室颤动。立即插入VA-ECMO以摆脱循环衰竭。PCI前置入Impella CP，实现左室卸荷，减轻心肌损伤。在机械支持下使用VA-ECMO和Impella CP经左桡动脉行PCI。在LMT中使用3.0 mm球囊(Sapphire NC, OrbusNeich Medical, Inc.， Fort Lauderdale, FL, USA)从LMT到LAD和2.5 mm球囊(Ryurei, Terumo Medical Corporation, Tokyo, Japan)进行血栓抽吸和同时的吻合球囊扩张，急性心肌梗死(AMI)合并心源性冲击(CS)预后较差，尽管使用机械循环支持装置。一位85岁女性st段抬高型心肌梗死(STEMI)被转至我院。STEMI是由左主干(LMT)斑块破裂合并CS和流产心肌损伤引起的。尽管有主动脉内气囊泵送(IABP)支持，她还是出现了心肺骤停。立即插入静脉-动脉体外膜氧合(VA-ECMO)和Impella CP以支持循环和左心室卸载。随后，她接受了经皮冠状动脉介入治疗(PCI)，并得以生存。亚急性期经胸超声心动图显示左心室收缩功能保留，虽然罪魁祸首病变在LMT，心肌梗死的危险区域极大。使用Impella CP卸载左心室，可以保护心功能，减轻心肌损伤。球囊泵血，心肌经皮冠状动脉经皮心室辅助装置
{"title":"Diminishing of Myocardial Damage Using Impella CP for ST-Elevation Myocardial Infarction Involving the Left Main Trunk","authors":"S. Doi, Y. Tanabe, Y. Ishibashi, Y. Akashi","doi":"10.7793/JCAD.27.20-00020","DOIUrl":"https://doi.org/10.7793/JCAD.27.20-00020","url":null,"abstract":"a large thrombus (Fig. 2A). Immediately after angiography, she developed ventricular fi brillation (VF) resistant to defi brillation. VA-ECMO was immediately inserted to get away from collapsed circulation. Then Impella CP was inserted before PCI for LV unloading and reducing myocardial damage. PCI was performed under mechanical supports using VA-ECMO and Impella CP via the left radial artery. Thrombus aspiration and the simultaneous kissing balloon dilatation were performed in the LMT with a 3.0-mm balloon (Sapphire NC, OrbusNeich Medical, Inc., Fort Lauderdale, FL, USA) from the LMT to LAD and a 2.5-mm balloon (Ryurei, Terumo Medical Corporation, Tokyo, Japan) from Acute myocardial infarction (AMI) with cardiogenic shock (CS) has poor prognosis, despite using mechanical circulatory support devices. An 85-year-old woman with ST-elevation myocardial infarction (STEMI) was transferred to our hospital. STEMI was caused by plaque rupture of the left main trunk (LMT) along with CS and aborted myocardial damage. She suffered cardiopulmonary arrest despite intra-aortic balloon pumping (IABP) support. Veno-arterial extra corporeal membrane oxygenation (VA-ECMO) and Impella CP were immediately inserted to support the circulation and left ventricular unloading. Then she underwent percutaneous coronary intervention (PCI) and managed to survive. Transthoracic echocardiogram in the subacute phase revealed a preserved left ventricular systolic function though the culprit lesion was in LMT and the area at risk for myocardial infarction was extremely large. Left ventricular unloading using Impella CP could contribute to preservation of cardiac function and diminishing of myocardial damage. balloon pumping, myocardial percutaneous coronary percutaneous ventricular assist device","PeriodicalId":73692,"journal":{"name":"Journal of coronary artery disease","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71175769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.7793/jcad.27.20-00035
K. Tamura, T. Maruyama, S. Sakurai
Objective: We assessed the safety of Suvorexant, an orexin receptor antagonist, on cardiac and respiratory function in patients who underwent off-pump coronary artery bypass grafting (OPCAB) retrospectively. Materials and methods: We investigated 66 patients including 16 women (mean age 71.6±8.1 years) who underwent OPCAB alone at our hospital. Patients were categorized as those received orexin receptor antagonist after OPCAB (S-group, n=35) or without orexin receptor antagonist (N-group, n=31), and the following data were analyzed between both groups. Results: The incidence of postoperative delirium was significantly lesser in the S-group than in the N-group (N vs. S =32.3 % vs. 8.6 %, p=0.004). Intensive care unit stay was also significantly shorter in the S-group compared with the N-group (N vs. S=4.6±1.1 vs. 4.1±0.8 days, p=0.040). No significant intergroup difference was observed in arterial blood gas measurement (mean the potential of hydrogen, partial pressure of oxygen, the partial pressure of carbon dioxide, base excess, and respiratory rate) and circulation statement (systolic arterial blood pressure, pulmonary artery wedge pressure, heart rate, cardiac index, and mixed venous oxygen saturation) before and after the administration of Suvorexant. Conclusion: Orexin receptor antagonists didn’t worsen the cardiac function and the respiratory function in patients who underwent OPCAB.
{"title":"Safety of Orexin Receptor Antagonist on Cardiac and Respiratory Function in Patients who Underwent Off-pump Coronary Artery Bypass Grafting","authors":"K. Tamura, T. Maruyama, S. Sakurai","doi":"10.7793/jcad.27.20-00035","DOIUrl":"https://doi.org/10.7793/jcad.27.20-00035","url":null,"abstract":"Objective: We assessed the safety of Suvorexant, an orexin receptor antagonist, on cardiac and respiratory function in patients who underwent off-pump coronary artery bypass grafting (OPCAB) retrospectively. Materials and methods: We investigated 66 patients including 16 women (mean age 71.6±8.1 years) who underwent OPCAB alone at our hospital. Patients were categorized as those received orexin receptor antagonist after OPCAB (S-group, n=35) or without orexin receptor antagonist (N-group, n=31), and the following data were analyzed between both groups. Results: The incidence of postoperative delirium was significantly lesser in the S-group than in the N-group (N vs. S =32.3 % vs. 8.6 %, p=0.004). Intensive care unit stay was also significantly shorter in the S-group compared with the N-group (N vs. S=4.6±1.1 vs. 4.1±0.8 days, p=0.040). No significant intergroup difference was observed in arterial blood gas measurement (mean the potential of hydrogen, partial pressure of oxygen, the partial pressure of carbon dioxide, base excess, and respiratory rate) and circulation statement (systolic arterial blood pressure, pulmonary artery wedge pressure, heart rate, cardiac index, and mixed venous oxygen saturation) before and after the administration of Suvorexant. Conclusion: Orexin receptor antagonists didn’t worsen the cardiac function and the respiratory function in patients who underwent OPCAB.","PeriodicalId":73692,"journal":{"name":"Journal of coronary artery disease","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71175906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.7793/jcad.27.21-00012
S. Ito, Y. Shimizu
{"title":"Potential Treatments for Refractory Vasospastic Angina","authors":"S. Ito, Y. Shimizu","doi":"10.7793/jcad.27.21-00012","DOIUrl":"https://doi.org/10.7793/jcad.27.21-00012","url":null,"abstract":"","PeriodicalId":73692,"journal":{"name":"Journal of coronary artery disease","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71176256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.7793/jcad.27.21-00004
Y. Tahara, T. Noguchi, K. Nishimura, Kenji Narikawa, H. Ogawa, S. Yasuda
{"title":"Rationale and Design of the Kento Heart Safe City Project","authors":"Y. Tahara, T. Noguchi, K. Nishimura, Kenji Narikawa, H. Ogawa, S. Yasuda","doi":"10.7793/jcad.27.21-00004","DOIUrl":"https://doi.org/10.7793/jcad.27.21-00004","url":null,"abstract":"","PeriodicalId":73692,"journal":{"name":"Journal of coronary artery disease","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71176097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.7793/jcad.27.21-00013
Masaki Yamamoto, Hitoshi Ninomiya, Tokio Yamaguchi, K. Kidawara, K. Orihashi, Takayuki Sato, Keiji Inoue, K. Hanazaki
Coronary artery disease (CAD) is a common cause of death in Japan, causing about 200,000 deaths each year . The use of percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) have reportedly improved patient outcomes since their introduction . Thus, early detection and treatment for CAD may further reduce the mortality rate. Asymptomatic CAD occurs in 15% of patients aged <70 years and in 28% of those aged >70 years . Therefore, a highly sensitive screening method is required to detect CAD in these individuals. Some studies report that stress testing with electrocardiography, echocardiography, and scintigraphy monitoring, and the use of coronary computed tomography (CT) to measure the coronary calcium level are useful for CAD screening . However, these tests are expensive and time-consuming in some clinical settings, which reduces their feasibility. Repeated myocardial ischemia-reperfusion (MIR) occurs in patients with CAD, wherein intermittent blood fl ow restriction is followed by re-canalization . Reperfusion and reoxygenation after myocardial ischemia cause the release of a large number of reactive oxygen species (ROS) . We have focused on the oxidative stress that occurs in MIR. Serum bilirubin is part of the biological defense system that is activated in response to the presence of ROS . After reoxygenation, ROS rapidly oxidize Original Article
{"title":"Investigation of the Use of Bilirubin Oxidation as a Screening Test for Coronary Artery Disease","authors":"Masaki Yamamoto, Hitoshi Ninomiya, Tokio Yamaguchi, K. Kidawara, K. Orihashi, Takayuki Sato, Keiji Inoue, K. Hanazaki","doi":"10.7793/jcad.27.21-00013","DOIUrl":"https://doi.org/10.7793/jcad.27.21-00013","url":null,"abstract":"Coronary artery disease (CAD) is a common cause of death in Japan, causing about 200,000 deaths each year . The use of percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) have reportedly improved patient outcomes since their introduction . Thus, early detection and treatment for CAD may further reduce the mortality rate. Asymptomatic CAD occurs in 15% of patients aged <70 years and in 28% of those aged >70 years . Therefore, a highly sensitive screening method is required to detect CAD in these individuals. Some studies report that stress testing with electrocardiography, echocardiography, and scintigraphy monitoring, and the use of coronary computed tomography (CT) to measure the coronary calcium level are useful for CAD screening . However, these tests are expensive and time-consuming in some clinical settings, which reduces their feasibility. Repeated myocardial ischemia-reperfusion (MIR) occurs in patients with CAD, wherein intermittent blood fl ow restriction is followed by re-canalization . Reperfusion and reoxygenation after myocardial ischemia cause the release of a large number of reactive oxygen species (ROS) . We have focused on the oxidative stress that occurs in MIR. Serum bilirubin is part of the biological defense system that is activated in response to the presence of ROS . After reoxygenation, ROS rapidly oxidize Original Article","PeriodicalId":73692,"journal":{"name":"Journal of coronary artery disease","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71176449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.7793/JCAD.27.20-00033
Ryota Akazawa, K. Maeda, Y. Yoshitomi, T. Fujiwara, Yoshikazu Watanabe, Tomoki Shokawa, S. Tsujiyama, T. Fujii
Selecting an appropriate therapeutic strategy for severe aortic stenosis (AS) is challenging in presence of ST-elevation myocardial infarction (STEMI). We report a case in which antegrade balloon aortic valvuloplasty (A-BAV) played an important role in temporizing a patient with severe AS and reduced left ventricular ejection fraction (LVEF) due to STEMI. Our patient was an 85-year-old man who experienced anterior STEMI (peak creatine kinase = 5286 U/L) and fulfilled the criteria of classical LFLG-AS (aortic valve area = 0.68 cm 2 , LVEF = 16%, and MPG = 20 mmHg). He had heart failure symptoms refractory to optimized therapy, including intra-aortic balloon pump (IABP) counterpulsation, even after successful recanalization of the coronary artery. Intervention for severe AS was required; however, the patient was identified to be at high risk for surgery (Society of Thoracic Surgeons score = 16.56%), and our hospital is not a transcatheter aortic valve replacement-capable facility. We performed A-BAV for hemodynamic restoration. A few days after successful A-BAV, tapering of norepinephrine and weaning of IABP were initiated. A cardiac rehabilitation program was initiated during the intensive care period, and which facilitated the patient to be discharged. A-BAV achieved convalescence with no recurrence of heart failure hospitalization at 510 days of follow-up.
{"title":"The Role of Antegrade Balloon Aortic Valvuloplasty in a Patient with Low-flow, Low-gradient Aortic Stenosis and ST-elevation Myocardial Infarction","authors":"Ryota Akazawa, K. Maeda, Y. Yoshitomi, T. Fujiwara, Yoshikazu Watanabe, Tomoki Shokawa, S. Tsujiyama, T. Fujii","doi":"10.7793/JCAD.27.20-00033","DOIUrl":"https://doi.org/10.7793/JCAD.27.20-00033","url":null,"abstract":"Selecting an appropriate therapeutic strategy for severe aortic stenosis (AS) is challenging in presence of ST-elevation myocardial infarction (STEMI). We report a case in which antegrade balloon aortic valvuloplasty (A-BAV) played an important role in temporizing a patient with severe AS and reduced left ventricular ejection fraction (LVEF) due to STEMI. Our patient was an 85-year-old man who experienced anterior STEMI (peak creatine kinase = 5286 U/L) and fulfilled the criteria of classical LFLG-AS (aortic valve area = 0.68 cm 2 , LVEF = 16%, and MPG = 20 mmHg). He had heart failure symptoms refractory to optimized therapy, including intra-aortic balloon pump (IABP) counterpulsation, even after successful recanalization of the coronary artery. Intervention for severe AS was required; however, the patient was identified to be at high risk for surgery (Society of Thoracic Surgeons score = 16.56%), and our hospital is not a transcatheter aortic valve replacement-capable facility. We performed A-BAV for hemodynamic restoration. A few days after successful A-BAV, tapering of norepinephrine and weaning of IABP were initiated. A cardiac rehabilitation program was initiated during the intensive care period, and which facilitated the patient to be discharged. A-BAV achieved convalescence with no recurrence of heart failure hospitalization at 510 days of follow-up.","PeriodicalId":73692,"journal":{"name":"Journal of coronary artery disease","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71175968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.7793/JCAD.27.19-00018
M. Fujii, D. Nishina, R. Bessho
Atrial fi brillation (AF) is one of the most frequent complications following cardiac surgery, with incidence ranging from 30% to 60%-. Postoperative AF is associated with complications including an increased risk of stroke and a need for additional treatment, as well as a prolonged intensive care unit or hospital stay and increased hospitalization costs. The incidence of postoperative AF in off-pump coronary artery bypass grafting (CABG) is similar to conventional CABG with cardiopulmonary bypass. β-blockers are widely used during the perioperative periods in cardiac surgery. The ACCF/AHA guidelines recommend that β-blockers should be administered for at least 24 hours before CABG in all patients without contraindications, should be reinstituted as soon as possible after CABG, and should be prescribed to all CABG patients at the time of hospital discharge. Landiolol hydrochloride (Onoact ® ; Ono Pharmaceutical Co., Osaka, Japan), is an ultrashort acting β-blocker, with a halflife of 4 minutes and a higher β-selectivity than any currently available β-blocker. Recently, some meta-analyses have shown that landiolol administration signifi cantly reduces the incidence of postoperative AF following cardiac surgery-. The effectiveness of landiolol was similar for both valvular surgery and CABG, even with off-pump CABG. High right atrial overdrive pacing for patients with paroxysmal AF reduces the recurrence of AF when compared with ventricular demand pacing in observational and controlled clinical trials . Several randomized controlled studies of either right, left, or biatrial pacing to prevent postoperative AF following CABG or valve surgery and to reduce the length of the hospital stay were performed-. Although the role of postoperative β-blockers in combination with atrial pacing has been pointed out as benefi cial, the effi cacy of this combination therapy is still a matter of debate. This Original Article
{"title":"Does the Temporary Right Atrial Overdrive Pacing Enhance an Effect on Landiolol to Prevent Atrial Fibrillation after Off-pump Coronary Artery Bypass Grafting?","authors":"M. Fujii, D. Nishina, R. Bessho","doi":"10.7793/JCAD.27.19-00018","DOIUrl":"https://doi.org/10.7793/JCAD.27.19-00018","url":null,"abstract":"Atrial fi brillation (AF) is one of the most frequent complications following cardiac surgery, with incidence ranging from 30% to 60%-. Postoperative AF is associated with complications including an increased risk of stroke and a need for additional treatment, as well as a prolonged intensive care unit or hospital stay and increased hospitalization costs. The incidence of postoperative AF in off-pump coronary artery bypass grafting (CABG) is similar to conventional CABG with cardiopulmonary bypass. β-blockers are widely used during the perioperative periods in cardiac surgery. The ACCF/AHA guidelines recommend that β-blockers should be administered for at least 24 hours before CABG in all patients without contraindications, should be reinstituted as soon as possible after CABG, and should be prescribed to all CABG patients at the time of hospital discharge. Landiolol hydrochloride (Onoact ® ; Ono Pharmaceutical Co., Osaka, Japan), is an ultrashort acting β-blocker, with a halflife of 4 minutes and a higher β-selectivity than any currently available β-blocker. Recently, some meta-analyses have shown that landiolol administration signifi cantly reduces the incidence of postoperative AF following cardiac surgery-. The effectiveness of landiolol was similar for both valvular surgery and CABG, even with off-pump CABG. High right atrial overdrive pacing for patients with paroxysmal AF reduces the recurrence of AF when compared with ventricular demand pacing in observational and controlled clinical trials . Several randomized controlled studies of either right, left, or biatrial pacing to prevent postoperative AF following CABG or valve surgery and to reduce the length of the hospital stay were performed-. Although the role of postoperative β-blockers in combination with atrial pacing has been pointed out as benefi cial, the effi cacy of this combination therapy is still a matter of debate. This Original Article","PeriodicalId":73692,"journal":{"name":"Journal of coronary artery disease","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71175686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.7793/jcad.27.20-00013
T. Shigematsu, H. Okayama, S. Kido, K. Matsuda, T. Aono, Yuta Tanaka, T. Kosaki, S. Hosokawa, G. Kawamura, Y. Kawada, G. Hiasa, Tadakatsu Yamada
pericardial effusion. Other fi ndings were an ejec-tion fraction was 40%, a mild aortic regurgitation without dilation. Emergency coronary angiography was carried out on suspi-cion of ST elevation myocardial infarction through a right radial approach. Right coronary angiography showed no significant stenosis. Left coronary angiography revealed 99% stenosis at the proximal part of the left anterior descending artery (LAD). Left coronary angiography revealed collapse or dilation, which de-pended on the timing of the injection of contrast medium, or Although acute type A aortic dissection with obstruction of the coronary artery is frequently fatal, some case reports have shown the effectiveness of stenting as a bridge to definitive surgery. We report a case of a 72-year-old woman referred to our hospital with acute onset chest pain. Her history included stent grafting for an abdominal aortic aneurysm three months before surgery, and percutaneous coronary intervention for the left circumflex artery and right coronary artery one year prior to admission. Electrocardiogram findings indicated ST-segment elevation. Emergency coronary angiography showed a 99% stenosis at the proximal part of the left anterior descending artery. Intravascular ultrasound study revealed a hematoma located from the proximal part of the left anterior descending artery to the left main trunk. After implanting a drug eluting stent from the left main trunk to the left anterior descending artery, computed tomography revealed an acute type A aortic dissection. Ascending aortic replacement and coronary artery bypass grafting were performed. Successful implantation of the stent at the left coronary artery was a bridge to surgery for the patient.
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