1/67. Left coronary artery-left ventricular fistula with acute myocardial infarction, representing the coronary steal phenomenon: a case report.A 59-year-old man presented with a left anterior descending coronary artery to left ventricular fistula manifesting as myocardial infarction, representing the coronary steal phenomenon. electrocardiography showed poor R progression in leads V1 through V3. The biochemical markers of myocardial injury were elevated. creatine kinase level was 509 IU/l, creatine kinase MB isoenzyme (CK-MB)47 IU/l, cardiac troponin t 0.62 ng/ml, myosin light chain 6.1 ng/ml, and myoglobin 142 ng/ml. thallium-201 myocardial perfusion imaging with dobutamine stress showed a dobutamine-induced perfusion deficit of the anteroseptal wall of the left ventricle with 0.1 mV ST-segment depression in II, III, aVF, V5, and V6. The mean left anterior descending blood flow measured with the Doppler guidewire was increased from 211 to 378 ml/min. Selective coronary arteriography showed dominant left coronary artery with the contrast medium streaming into the left ventricle via a maze of fine vessels from the distal left anterior descending coronary artery. No critical stenosis of the left anterior descending coronary artery was observed. Administration of acetylcholine 100 micrograms into the left coronary artery did not induce vasoconstriction of that artery. The fistula terminating in the left ventricle was ligated surgically and the patient became free of chest pain. thallium-201 myocardial perfusion imaging with dobutamine stress revealed no perfusion deficit of the anteroseptal wall of the left ventricle. The presence of coronary steal phenomenon was detected by dobutamine stress myocardial imaging.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/67. Tracheocarotid artery fistula infected with methicillin-resistant staphylococcus aureus.Massive life-threatening haemorrhage from a fistula between the trachea and a major blood vessel of the neck is a rare complication of the tracheostomy procedure, well-recognized by anaesthetists and otolaryngologists. Although the lesion is likely to be encountered at autopsy, it is not described in histopathological literature. The possible causes are discussed together with the macroscopic and microscopic appearances of the lesion. Suitable procedures for its identification and for obtaining appropriate histopathological blocks are suggested. Presence of methicillin-resistant staphylococcus aureus (MRSA) has not been documented before and might have contributed to the genesis of the fistula in this case.- - - - - - - - - - ranking = 3.048483414526keywords = blood vessel, vessel (Clic here for more details about this article) |
3/67. Single coronary arteries: two cases with distinct and previously undescribed angiographic patterns.Single coronary artery is a rare congenital anomaly, sometimes associated with myocardial ischemia. We present the clinical and angiographic features of two symptomatic patients with documented myocardial ischemia and with distinct and previously undescribed patterns of single right coronary arteries. These cases are new variants of the types R-I and R-II-A, in which the most probable mechanisms of ischemia are the insufficient blood supply, due to the long trajectories of the single arteries and the presence of underdeveloped vessels. Also, our second case presented with a fistulae from the LCX to the left ventricle, which is another determinant of myocardial ischemia.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/67. Lymphocutaneous fistula as a long-term complication of multiple central venous catheter placement.We report a case of a lymphocutaneous fistula in a 19-month-old boy who had been a premature neonate, born in the 23rd week of gestation. The fistula, an apparent complication of central venous line placement during the patient's first 5 months of life, was composed of a distinct lymphatic vessel bundle in the right supraclavicular region, with its exit point at the posterior aspect of the right shoulder. The drainage ceased immediately after resection and repair of a 1-cm obstruction in the superior vena cava.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/67. The use of subatmospheric pressure dressing therapy to close lymphocutaneous fistulas of the groin.groin lymphorrhea is an uncommon but serious complication of vascular and cardiac surgery as well as interventional procedures that cannulate the femoral vessels. Treatment options are somewhat controversial. For lymphocutaneous fistulas, a commonly used current modality is early surgical ligation with the assistance of blue-dye staining of the lymphatic anatomy. The purpose of this case series is to give the first description of a new, less invasive, approach using subatmospheric pressure dressing therapy for the treatment of the challenging problem of lymphocutaneous fistulas of the groin.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/67. trachea--innominate artery fistula following tracheostomy. Successful repair using an innominate vein graft.This report discusses the first recorded patient in whom a trachea--innominate artery fistula after tracheostomy was treated successfully by resection of the eroded segment of artery followed by graft replacement using the patient's left innominate vein. The mechanism of vessel erosion and its prevention are discussed. Also, suitable methods are presented for obtaining temporary control of the severe hemorrhage associated with a tracheoarterial fistula while simultaneously maintaining an adequate airway.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/67. An unusual case of dual coronary artery fistulas to main pulmonary artery.Coronary artery fistula is an anomaly in which a coronary artery directly connects to a cardiac chamber or great vessel. Its incidence is around 0.1 to 1% in the adult population. Dual coronary artery fistulas are far less common and their incidence is estimated to be around 5% in patients with this anomaly. Closure of the fistulas is indicated in patients with myocardial ischemia, large left to right shunt, congestive heart failure or other complications. Herein, we report a 64 year-old man with dual coronary artery fistulas presenting with exertional chest pain. The fistulas were initially suspected on transesophageal echocardiogram because of abnormal flow with a mosaic pattern between the left anterior descending and main pulmonary arteries. Selective coronary angiogram confirmed the diagnosis and revealed fistulous connections from the proximal left anterior descending and ostial right coronary arteries to the main pulmonary artery. The patient became symptom-free after surgical closure of the fistulas.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/67. Transparasternal transpericardial operation in the treatment of chronic empyema with bronchopleural fistula.A 78-year-old man with a lung destroyed by chronic empyema underwent pleuropneumonectomy, 4 months after open-window thoracostomy, via a transparasternal transpericardial approach. This approach is safe and effective in great vessel and bronchus dissection and applicable to cases of persistent chronic empyema such as our.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/67. Imaging of multiple coronary artery fistulas to right ventricle by transthoracic and transesophageal echocardiography.A 20-year-old woman presented with extremely rare multiple coronary artery fistulas with left circumflex and right coronary arteries as the feeding vessels and two distinct sites of drainage into the posterior wall of the right ventricle near the apex in close proximity. The large left fistula was well depicted by transthoracic echocardiography, whereas the transesophageal approach better delineated part of the smaller right fistula.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/67. Right coronary artery-right atrium fistula in primary angiosarcoma of the heart.We report a case of angiosarcoma of the heart, manifested as a continuous murmur. Right coronary arteriography disclosed a paracardiac mass with fistulas from the coronary vessel to the right atrium. Histologic study revealed this to be an angiosarcoma with sinusoidal pattern. To our knowledge, this is the first case of this kind of cardiac tumor presenting as a fistula from a coronary artery to the right atrium.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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