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1. Orazi A, Chiu R, O'Malley DP, Czader M, Allen SL, An C, Vance GH: Chronic myelomonocytic leukemia: The role of bone marrow biopsy immunohistology. Mod Pathol; 2006 Dec;19(12):1536-45
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Chronic myelomonocytic leukemia: The role of bone marrow biopsy immunohistology.
  • The World Health Organization criteria for diagnosing chronic myelomonocytic leukemia (CMML) are largely based on findings observed in the peripheral blood and bone marrow aspirate.
  • We examined whether bone marrow biopsy supplemented by immunohistochemistry may be helpful in distinguishing CMML from cases of chronic myelogenous leukemia and atypical chronic myeloid leukemia (aCML).
  • We immunostained 25 cases of CMML with paraffin reactive antibodies which included CD68 (KP1), CD68R (PG-M1), and CD163, and compared the results with those observed in six cases of chronic myelogenous leukemia and in three cases of atypical CML.
  • In addition, we examined whether CD34 immunohistochemistry could be useful in separating cases of CMML with less than 10% blasts (type-1) from cases of CMML with blasts accounting for 10-19% (type-2), and cases of CMML in acute transformation to acute myeloid leukemia (blasts > or = 20%).
  • CD123-positive plasmacytoid monocyte nodules were found only in CMML and not in the other two disease groups.
  • CD68R was more restricted to bone marrow macrophages and monocytes than CD68, but the differences between CMML and chronic myelogenous leukemia or atypical CML were still not significant.
  • Although CD42b immunostaining facilitated the detection of dwarf megakaryocytes often present in CMML, the distinction between those and the small forms seen in chronic myelogenous leukemia was still problematic.
  • [MeSH-major] Biopsy, Needle. Bone Marrow / pathology. Immunoenzyme Techniques / methods. Leukemia, Myelomonocytic, Chronic / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antigens, CD / metabolism. Biomarkers, Tumor / metabolism. Bone Marrow Cells / metabolism. Bone Marrow Cells / pathology. Diagnosis, Differential. Female. Humans. Karyotyping. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / genetics. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / metabolism. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology. Male. Megakaryocytes / metabolism. Megakaryocytes / pathology. Middle Aged

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  • (PMID = 17041567.001).
  • [ISSN] 0893-3952
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, CD; 0 / Biomarkers, Tumor
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2. Kim HW, Lee SS, Ryu MH, Lee JL, Chang HM, Kim TW, Chi HS, Kim WK, Lee JS, Kang YK: A case of leukemic pleural infiltration in atypical chronic myeloid leukemia. J Korean Med Sci; 2006 Oct;21(5):936-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A case of leukemic pleural infiltration in atypical chronic myeloid leukemia.
  • Pleural effusion in chronic myeloid leukemia (CML) is poorly understood and rarely reported in the literature.
  • We report here a case of bilateral pleural involvement of atypical CML in an 83-yr old male diagnosed with pancreatic cancer with abdominal wall metastasis and incidental peripheral leukocytosis.
  • Based on bone marrow examination, chromosome analysis and polymerase chain reaction he was diagnosed with Philadelphia chromosome negative, BCR/ABL gene rearrangement negative CML.
  • [MeSH-major] Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology. Leukemic Infiltration / pathology. Pleural Effusion / etiology


3. Tatli E: Thrombotic occlusion of the ostial left main coronary artery in a patient with acute coronary syndrome. Neth Heart J; 2009 Aug;17(7-8):295-6

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Thrombotic occlusion of the ostial left main coronary artery in a patient with acute coronary syndrome.
  • Ostial left main coronary artery (LMCA) occlusion is rarely seen in patients with acute coronary syndrome.
  • Acute coronary syndrome resulting from an LMCA occlusion is associated with a significant morbidity and mortality rate, if it is managed with fibrinolysis.
  • Electrocardiography can predict LMCA occlusion in patients with acute coronary syndrome.
  • We report a 52-year-old male who presented with acute coronary syndrome and ostial LMCA occlusion. (Neth Heart J 2009;17:295-6.).

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  • [Cites] Int J Cardiol. 2007 Apr 4;116(3):e83-4 [17126932.001]
  • [Cites] Jpn Heart J. 2000 Sep;41(5):571-81 [11132164.001]
  • [Cites] J Am Coll Cardiol. 2001 Nov 1;38(5):1348-54 [11691506.001]
  • [Cites] Int Heart J. 2006 Jan;47(1):13-20 [16479036.001]
  • (PMID = 19789699.001).
  • [ISSN] 1568-5888
  • [Journal-full-title] Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation
  • [ISO-abbreviation] Neth Heart J
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
  • [Other-IDs] NLM/ PMC2743820
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4. Prieto-Solís JA, Benito N, Martín-Durán R: [Electrocardiographic diagnosis of left main coronary artery obstruction using ST-segment and QRS-complex vector analysis]. Rev Esp Cardiol; 2008 Feb;61(2):137-45

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Electrocardiographic diagnosis of left main coronary artery obstruction using ST-segment and QRS-complex vector analysis].
  • [Transliterated title] Diagnóstico electrocardiográfico de la obstrucción del tronco coronario izquierdo mediante el análisis vectorial del segmento ST y el complejo QRS.
  • INTRODUCTION AND OBJECTIVES: It is vital that obstruction of the left main coronary artery (LMCA) is diagnosed early.
  • We investigated the value of ST-segment and QRS-complex vector analysis in identifying LMCA obstruction in acute coronary syndrome.
  • METHODS: The study involved 57 consecutive patients with electrocardiographic features suggestive of LMCA obstruction.
  • RESULTS: Coronary angiography showed that the obstructed vessel was the LMCA in 20 patients, the left circumflex artery in 19, the right coronary artery in 10, and the left anterior descending artery in three.
  • Five patients had three-vessel disease.
  • An ST vector that was directed between -90 degrees and 180 degrees in the frontal plane was observed in 100% of patients with an LMCA obstruction (P< .001).
  • An ST vector directed anteriorly or parallel to the horizontal plane was present in 95% of patients (19/20) with an LMCA obstruction (P< .001; specificity 92%).
  • A QRS vector with a left shift é-30 degrees was observed in 75% (15/20) with LMCA disease (P< .001; specificity 95%).
  • An ST vector directed between -90 degrees and 180 degrees and anteriorly had a sensitivity of 95% and specificity of 100% for LMCA obstruction.
  • An ST vector directed between -90 degrees and 180 degrees combined with a left QRS vector shift > or =-30 degrees had a sensitivity of 75% and a specificity of 100% for LMCA obstruction.
  • A simple algorithm combining these observation was able to predict LMCA obstruction in 100% of patients.
  • CONCLUSIONS: In acute coronary syndrome, ST-segment and QRS-complex vector analysis can predict the presence of LMCA obstruction.
  • [MeSH-major] Coronary Stenosis / diagnosis. Electrocardiography

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  • [CommentIn] Rev Esp Cardiol. 2009 Jan;62(1):105-6; author reply 106-8 [19150026.001]
  • (PMID = 18364182.001).
  • [ISSN] 1579-2242
  • [Journal-full-title] Revista española de cardiología
  • [ISO-abbreviation] Rev Esp Cardiol
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Spain
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5. Breccia M, Biondo F, Latagliata R, Carmosino I, Mandelli F, Alimena G: Identification of risk factors in atypical chronic myeloid leukemia. Haematologica; 2006 Nov;91(11):1566-8
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  • [Title] Identification of risk factors in atypical chronic myeloid leukemia.
  • In the WHO classification atypical chronic myeloid leukemia (CML) has been considered as a new distinct clinical entity included in the category of mixed myeloproliferative/myelodysplastic disorders.
  • Little is known about this uncommon disease, whose incidence is about of one-two cases every 100 cases of Ph-positive CML.
  • We analyzed our series of 55 patients diagnosed as having aCML, with the aim of identifying clinical factors of possible prognostic value on survival and acute transformation.
  • [MeSH-major] Leukemia, Myelogenous, Chronic, BCR-ABL Positive / diagnosis

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  • (PMID = 17043019.001).
  • [ISSN] 1592-8721
  • [Journal-full-title] Haematologica
  • [ISO-abbreviation] Haematologica
  • [Language] eng
  • [Publication-type] Letter
  • [Publication-country] Italy
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6. Macdonald D, Cross NC: Chronic myeloproliferative disorders: the role of tyrosine kinases in pathogenesis, diagnosis and therapy. Pathobiology; 2007;74(2):81-8
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  • [Title] Chronic myeloproliferative disorders: the role of tyrosine kinases in pathogenesis, diagnosis and therapy.
  • The term chronic myeloproliferative disorders was originally used by Damashek to describe the link amongst a group of acquired blood diseases.
  • These may be chromosomal translocations resulting in the creation of a fusion kinase gene, examples of which include ABL, FGFR, and PDGFR as seen in disorders CML, 8p11 myeloproliferative syndrome, atypical CML and chronic eosinophilic leukaemia.
  • This abnormality is seen in 30-97% of cases of MPD with the phenotype PV, ET or CIMF.
  • [MeSH-major] Gene Expression Regulation, Enzymologic. Gene Expression Regulation, Neoplastic. Hypereosinophilic Syndrome / diagnosis. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / diagnosis. Myeloproliferative Disorders / diagnosis. Myeloproliferative Disorders / therapy. Protein-Tyrosine Kinases / genetics
  • [MeSH-minor] Chronic Disease. Hematopoiesis / genetics. Humans. Janus Kinase 2 / genetics. Molecular Diagnostic Techniques. Mutant Chimeric Proteins / genetics. Oncogene Proteins, Fusion / genetics. Point Mutation. Polycythemia Vera / diagnosis. Polycythemia Vera / genetics. Polycythemia Vera / therapy. Primary Myelofibrosis / diagnosis. Primary Myelofibrosis / genetics. Primary Myelofibrosis / therapy. Receptor, Fibroblast Growth Factor, Type 1 / genetics. Receptor, Platelet-Derived Growth Factor alpha / genetics. Receptor, Platelet-Derived Growth Factor beta / genetics. Thrombocythemia, Essential / diagnosis. Thrombocythemia, Essential / genetics. Thrombocythemia, Essential / therapy. mRNA Cleavage and Polyadenylation Factors / genetics

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  • (PMID = 17587879.001).
  • [ISSN] 1015-2008
  • [Journal-full-title] Pathobiology : journal of immunopathology, molecular and cellular biology
  • [ISO-abbreviation] Pathobiology
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / FIP1L1-PDGFRA fusion protein, human; 0 / Mutant Chimeric Proteins; 0 / Oncogene Proteins, Fusion; 0 / mRNA Cleavage and Polyadenylation Factors; EC 2.7.10.1 / FGFR1 protein, human; EC 2.7.10.1 / Protein-Tyrosine Kinases; EC 2.7.10.1 / Receptor, Fibroblast Growth Factor, Type 1; EC 2.7.10.1 / Receptor, Platelet-Derived Growth Factor alpha; EC 2.7.10.1 / Receptor, Platelet-Derived Growth Factor beta; EC 2.7.10.2 / JAK2 protein, human; EC 2.7.10.2 / Janus Kinase 2
  • [Number-of-references] 29
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7. Shimizu T, Miyakawa Y, Mitsuhashi T, Kakimoto T, Ikeda Y, Kizaki M, Hagiwara T: [Persistent neutrophilia occurring after pneumonia: a differential diagnosis of neutrophilia based on the WHO classification]. Rinsho Ketsueki; 2005 Jul;46(7):532-5
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  • [Title] [Persistent neutrophilia occurring after pneumonia: a differential diagnosis of neutrophilia based on the WHO classification].
  • Bone marrow examination revealed hypercellularity without excess of blasts and hiatus leukemia, accompanied by mild dysplasia in myeloid cells and megakaryocytes.
  • Major/minor BCR-ABL fusion genes were negative by RT-PCR.
  • As previously reported by several investigators, we often experience difficulties in distinguishing atypical CML from CNL and CMML.
  • [MeSH-major] Leukocytosis / classification. Leukocytosis / diagnosis. Neutrophils. Pneumonia, Bacterial / complications
  • [MeSH-minor] Aged, 80 and over. Diagnosis, Differential. Female. Humans. World Health Organization

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  • (PMID = 16440748.001).
  • [ISSN] 0485-1439
  • [Journal-full-title] [Rinshō ketsueki] The Japanese journal of clinical hematology
  • [ISO-abbreviation] Rinsho Ketsueki
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
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8. Kamakari S, Roussou A, Jefferson A, Ragoussis I, Anagnou NP: Structural analysis and expression profile of a novel gene on chromosome 5q23 encoding a Golgi-associated protein with six splice variants, and involved within the 5q deletion of a Ph(-) CML patient. Leuk Res; 2005 Jan;29(1):17-31
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  • [Title] Structural analysis and expression profile of a novel gene on chromosome 5q23 encoding a Golgi-associated protein with six splice variants, and involved within the 5q deletion of a Ph(-) CML patient.
  • In addition, the novel gene and other key regulatory genes of the region, such IL3, Ril, AF5q31 and TCF-1, were found to be deleted in an atypical CML case, thus underscoring the significance of this subregion in the leukemogenesis process.
  • [MeSH-major] Alternative Splicing. Carrier Proteins / genetics. Chromosomes, Human, Pair 5. Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative / genetics
  • [MeSH-minor] Adaptor Proteins, Signal Transducing. Amino Acid Sequence. Base Sequence. Chromosome Deletion. Gene Expression. Humans. Microfilament Proteins. Molecular Sequence Data

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  • (PMID = 15541471.001).
  • [ISSN] 0145-2126
  • [Journal-full-title] Leukemia research
  • [ISO-abbreviation] Leuk. Res.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Adaptor Proteins, Signal Transducing; 0 / Carrier Proteins; 0 / GABARAPL2 protein, human; 0 / Microfilament Proteins
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9. Fend F, Horn T, Koch I, Vela T, Orazi A: Atypical chronic myeloid leukemia as defined in the WHO classification is a JAK2 V617F negative neoplasm. Leuk Res; 2008 Dec;32(12):1931-5
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  • [Title] Atypical chronic myeloid leukemia as defined in the WHO classification is a JAK2 V617F negative neoplasm.
  • Atypical chronic myeloid leukemia (aCML) as defined by the WHO classification is a rare hematopoietic stem cell disorder, which shows both myeloproliferative as well as myelodysplastic features.
  • Because of the presence of neutrophilic leukocytosis, aCML may resemble chronic myelogenous leukemia.
  • However, in contrast with the latter, aCML lacks a Philadelphia chromosome or the BCR/ABL fusion gene.
  • The molecular pathogenesis of aCML and its relationship to other myeloproliferative neoplasms is unknown.
  • Fifty-nine cases of Philadelphia (Ph) chromosome negative chronic myeloproliferative neoplasms (CMPN) and normal bone marrows (BM) served as controls.
  • None of the nine amplifiable cases of aCML and none of the normal BM controls showed a JAK2 V617F mutation, in contrast to 45/59 (76%) of the Ph chromosome negative CMPN cases.
  • Atypical CML should therefore be considered as a JAK2 negative chronic myeloid neoplasm that remains properly categorized, alongside chronic myelomonocytic leukemia and juvenile myelomonocytic leukemia, within the WHO group of myelodysplastic/myeloproliferative neoplasms.
  • [MeSH-major] Amino Acid Substitution. Janus Kinase 2 / genetics. Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative / classification. Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative / genetics
  • [MeSH-minor] Blast Crisis / blood. Blast Crisis / pathology. Blood Cell Count. Fusion Proteins, bcr-abl / genetics. Humans. Mastocytosis / pathology. Neutrophils / pathology. Philadelphia Chromosome. World Health Organization


10. Fukuhara T, Kakinoki Y: [Clinical features of a new category, myelodysplastic/myeloproliferative diseases, defined by WHO classification]. Rinsho Byori; 2006 Mar;54(3):243-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The WHO classification published in 2001 defined a new category of hematological disease, myelodysplastic/myeloproliferative diseases (MDS/MPD), that have both myelodysplasia and myeloproliferation at the time of initial presentation.
  • This category consists of four subclasses, chronic myelomonocytic leukemia (CMML), atypical CML(aCML), juvenile chronic myelogenous leukemia and MDS/MPD-unclassifiable (MDS/MPD-u).
  • By reviewing the data of each case according to the criteria, we diagnosed 31 cases of MDS/MPD, including 22 cases of CMML, 5 cases of aCML and 4 cases of MDS/MPD-u.
  • It is noteworthy that blast crisis in CMML exclusively occurred within one year after diagnosis.
  • Young age, a high percentage of blasts in the peripheral blood, splenomegaly, lymphadenopathy and clonal cytogenetic abnormality were associated with blast crisis.
  • It is suggested that there are two subgroups in CMML which differ in disease progression.

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  • (PMID = 16637572.001).
  • [ISSN] 0047-1860
  • [Journal-full-title] Rinsho byori. The Japanese journal of clinical pathology
  • [ISO-abbreviation] Rinsho Byori
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Advanced Glycosylation End Product-Specific Receptor; 0 / Receptors, Immunologic
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11. Park SJ, Kim YH: Percutaneous coronary intervention as an alternative to bypass surgery for unprotected LMCA stenosis. Expert Rev Cardiovasc Ther; 2008 Sep;6(8):1107-14
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  • [Title] Percutaneous coronary intervention as an alternative to bypass surgery for unprotected LMCA stenosis.
  • Hemodynamically significant left main coronary artery (LMCA) stenosis is found in approximately 4% of diagnostic coronary angiograms and is known as unprotected LMCA stenosis if the left coronary artery and left circumflex artery have no patent previous grafts.
  • Previous randomized studies have demonstrated a significant reduction in mortality when revascularization by coronary artery bypass graft (CABG) surgery was undertaken compared with medical treatment.
  • However, with the advent of drug-eluting stents (DES), the long-term outcomes of PCI with DES to treat unprotected LMCA stenoses have been reported to be acceptable.
  • Therefore, apart from the current guidelines, PCI for unprotected LMCA stenosis in many countries is often undertaken in individuals who are at very high risk of CABG or refuse to undergo a sternotomy.
  • Future randomized studies comparing CABG versus PCI using DES for treatment of unprotected LMCA stenosis would be a great advance in the clinical knowledge of adopting appropriate treatments.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Coronary Artery Bypass. Coronary Stenosis / therapy. Stents

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  • (PMID = 18793113.001).
  • [ISSN] 1744-8344
  • [Journal-full-title] Expert review of cardiovascular therapy
  • [ISO-abbreviation] Expert Rev Cardiovasc Ther
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Platelet Aggregation Inhibitors
  • [Number-of-references] 39
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12. Shirai S, Doijiri T, Iwabuchi M: Treatment for LMCA ostial stenosis using a bifurcation technique with a retrograde approach. Catheter Cardiovasc Interv; 2010 Apr 1;75(5):748-52
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  • [Title] Treatment for LMCA ostial stenosis using a bifurcation technique with a retrograde approach.
  • A 69-year-old man who underwent coronary artery bypass surgery in February 2008.
  • The surgery included grafting of the left internal thoracic artery (LITA) to the diagonal branch (D1) and a saphenous vein graft (SVG) to the left circumflex artery (LCX) due to ostial stenosis of the left main coronary artery (LMCA).
  • Coronary CT revealed that the LITA-D1 graft was patent, the SVG-LCX graft was occluded, and there was severe ostial stenosis of the LMCA.
  • After crossing the LMCA ostial lesion the retrograde wire was snared through antegradely for insertion of the guiding catheter via the right brachial artery.
  • We were able to engage the guiding catheter in the left coronary artery and implant the stent successfully using the antegrade approach.
  • [MeSH-major] Angioplasty, Balloon, Coronary / methods. Coronary Artery Bypass / adverse effects. Coronary Restenosis / therapy. Coronary Stenosis / surgery. Graft Occlusion, Vascular / therapy

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  • [Copyright] (c) 2009 Wiley-Liss, Inc.
  • (PMID = 20088018.001).
  • [ISSN] 1522-726X
  • [Journal-full-title] Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
  • [ISO-abbreviation] Catheter Cardiovasc Interv
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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13. Bousquet M, Quelen C, De Mas V, Duchayne E, Roquefeuil B, Delsol G, Laurent G, Dastugue N, Brousset P: The t(8;9)(p22;p24) translocation in atypical chronic myeloid leukaemia yields a new PCM1-JAK2 fusion gene. Oncogene; 2005 Nov 3;24(48):7248-52
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  • [Title] The t(8;9)(p22;p24) translocation in atypical chronic myeloid leukaemia yields a new PCM1-JAK2 fusion gene.
  • Several tyrosine kinase genes are involved in chromosomal translocations in chronic myeloproliferative disorders, but there are still uncharacterized translocations in some cases.
  • We report two such cases corresponding to atypical chronic myeloid leukaemia with a t(8;9)(p22;p24) translocation.
  • By fluorescence in situ hybridisation (FISH) on the corresponding metaphases with a bacterial artificial chromosome probe encompassing the janus kinase 2 (JAK2) gene at 9p24, we observed a split for both patients, suggesting that this gene was rearranged.
  • [MeSH-major] Cell Cycle Proteins / genetics. Chromosomes, Human, Pair 8. Chromosomes, Human, Pair 9. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / genetics. Oncogene Proteins, Fusion / genetics. Protein-Tyrosine Kinases / genetics. Proto-Oncogene Proteins / genetics. Translocation, Genetic

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  • [Copyright] Oncogene (2005) 24, 7248-7252. doi:10.1038/sj.onc.1208850; published online 8 August 2005.
  • [CommentIn] Oncogene. 2005 Nov 3;24(48):7125-6 [16007127.001]
  • (PMID = 16091753.001).
  • [ISSN] 0950-9232
  • [Journal-full-title] Oncogene
  • [ISO-abbreviation] Oncogene
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents; 0 / Autoantigens; 0 / Cell Cycle Proteins; 0 / Oncogene Proteins, Fusion; 0 / PCM1 protein, human; 0 / Proto-Oncogene Proteins; 0 / RNA, Messenger; 04079A1RDZ / Cytarabine; EC 2.7.10.1 / Protein-Tyrosine Kinases; EC 2.7.10.2 / JAK2 protein, human; EC 2.7.10.2 / Janus Kinase 2; X6Q56QN5QC / Hydroxyurea; ZRP63D75JW / Idarubicin
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14. Aoki J, Hoye A, Staferov AV, Alekyan BG, Serruys PW: Sirolimus-eluting stent implantation for chronic total occlusion of the left main coronary artery. J Interv Cardiol; 2005 Feb;18(1):65-9; discussion 69
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  • [Title] Sirolimus-eluting stent implantation for chronic total occlusion of the left main coronary artery.
  • Chronic total occlusion of the left main coronary artery (LMCA) is rare.
  • Recently, percutaneous coronary intervention has been increasingly applied to unprotected LMCA lesions.
  • We describe a patient with chronic total occlusion of the LMCA who was successfully treated with bifurcation stenting with sirolimus-eluting stents.

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  • (PMID = 15788057.001).
  • [ISSN] 0896-4327
  • [Journal-full-title] Journal of interventional cardiology
  • [ISO-abbreviation] J Interv Cardiol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] W36ZG6FT64 / Sirolimus
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15. Elder PT, McMullin MF, Humphreys MW, Hamilton J, McGrattan P: The finding of a reciprocal whole-arm translocation t(X;12)(p10;p10) in association with atypical chronic myeloid leukaemia. Med Oncol; 2010 Sep;27(3):760-2
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The finding of a reciprocal whole-arm translocation t(X;12)(p10;p10) in association with atypical chronic myeloid leukaemia.
  • Atypical chronic myeloid leukaemia (aCML) belongs to the myeloproliferative/myelodysplastic category of haematological disease.
  • Main characteristics are marked dysgranulopoiesis, bone marrow dysfunction and the failure to demonstrate the presence of the Philadelphia chromosome or BCR/ABL fusion gene normally associated with CML t(9;22)(q34;q11).
  • Most cases of aCML have one or more karyotypic abnormalities.
  • We highlight a clinical presentation of aCML associated with an acquired reciprocal whole-arm translocation (WAT), t(X;12)(p10;p10), which to our knowledge has not yet been described.
  • [MeSH-major] Chromosomes, Human, Pair 12 / ultrastructure. Chromosomes, Human, X / ultrastructure. Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative / genetics. Translocation, Genetic

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  • [Cites] J Clin Pathol. 2008 Aug;61(8):903-8 [18474541.001]
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  • (PMID = 19657750.001).
  • [ISSN] 1559-131X
  • [Journal-full-title] Medical oncology (Northwood, London, England)
  • [ISO-abbreviation] Med. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] RWM8CCW8GP / Octreotide
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16. Guerrero RR, Wilkinson JL, Brizard CP: Reconstruction of left main coronary artery with subclavian artery free graft in an infant. Eur J Cardiothorac Surg; 2005 May;27(5):927-9

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Reconstruction of left main coronary artery with subclavian artery free graft in an infant.
  • We report the case of a 3-month-old infant with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) with absent left main coronary artery (LMCA).
  • She underwent repair by reimplantation technique with the construction of a short LMCA using two opposite flaps.
  • Occlusion of the reconstructed LMCA was found by angiogram.
  • At reoperation the right subclavian artery was used as a free interposition graft to reconstruct the LMCA.
  • At 8 months she was asymptomatic and LMCA patency was demonstrated by angiogram.
  • [MeSH-major] Coronary Vessel Anomalies / surgery. Coronary Vessels. Subclavian Artery / transplantation

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  • (PMID = 15848342.001).
  • [ISSN] 1010-7940
  • [Journal-full-title] European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • [ISO-abbreviation] Eur J Cardiothorac Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
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17. Bhatia V, Parida AK, Pandey AK, Kaul U: 12 lead ECG in the detection of left main coronary artery occlusion during acute coronary syndromes. Int J Cardiol; 2007 Apr 4;116(3):e83-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] 12 lead ECG in the detection of left main coronary artery occlusion during acute coronary syndromes.
  • A careful evaluation of the 12 Lead surface ECG may help detect Left Main Coronary artery (LMCA) occlusion.
  • Since LMCA occlusion can cause rapid hemodynamic and electrical deterioration, early identification may help the treating team to plan out timely revascularization.
  • We describe a 61 years old male who presented with acute anterior wall myocardial infarction and where LMCA occlusion was suspected on the basis of surface ECG.
  • [MeSH-major] Coronary Disease / diagnosis. Coronary Disease / surgery. Electrocardiography. Myocardial Infarction / diagnosis
  • [MeSH-minor] Coronary Angiography. Coronary Artery Bypass. Coronary Vessels. Humans. Intra-Aortic Balloon Pumping. Male. Middle Aged

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  • (PMID = 17126932.001).
  • [ISSN] 1874-1754
  • [Journal-full-title] International journal of cardiology
  • [ISO-abbreviation] Int. J. Cardiol.
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] Netherlands
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18. Klein AJ, Hudson PA, Kim MS, Cleveland JC Jr, Messenger JC: Spontaneous left main coronary artery dissection and the role of intravascular ultrasonography. J Ultrasound Med; 2010 Jun;29(6):981-8

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Spontaneous left main coronary artery dissection and the role of intravascular ultrasonography.
  • OBJECTIVE: Spontaneous left main coronary artery (LMCA) dissection is a rare event with an unknown incidence and high risk of sudden cardiac death.
  • The diagnosis of LMCA dissection is often challenging given the limitations of 2-dimensional angiography.
  • The 3-dimensional perspective of intravascular ultrasonography (IVUS) is often indispensable in confirming or excluding the diagnosis of spontaneous LMCA dissection.
  • We report 2 cases of spontaneous LMCA dissection with unique angiographic presentations wherein IVUS was essential in defining the extent of LMCA involvement and facilitated the subsequent referral for emergent coronary artery bypass grafting.
  • METHODS: Two patients presented to our facility with acute coronary syndrome prompting coronary angiography, which was notable for an unusual angiographic appearance of the LMCA.
  • Intravascular ultrasonography was performed in each case, revealing spontaneous LMCA dissection.
  • RESULTS: Intravascular ultrasonography permitted the prompt diagnosis and aided in definitive surgical intervention in our 2 cases of spontaneous LMCA dissection.
  • CONCLUSIONS: Intravascular ultrasonography is a useful adjunctive imaging modality in the diagnosis and management of spontaneous LMCA dissection.
  • [MeSH-minor] Adult. Aged. Coronary Angiography. Diagnosis, Differential. Female. Humans

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  • (PMID = 20498472.001).
  • [ISSN] 1550-9613
  • [Journal-full-title] Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
  • [ISO-abbreviation] J Ultrasound Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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19. Micci F, Panagopoulos I, Haugom L, Andersen HK, Tjønnfjord GE, Beiske K, Heim S: t(3;21)(q22;q22) leading to truncation of the RYK gene in atypical chronic myeloid leukemia. Cancer Lett; 2009 May 18;277(2):205-11
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] t(3;21)(q22;q22) leading to truncation of the RYK gene in atypical chronic myeloid leukemia.
  • The analysis of a small number of patients with atypical chronic myeloid leukemia showing balanced chromosomal translocations has revealed diverse tyrosine kinase fusion genes, most commonly involving FGFR1, PDGFRA, PDGFRB, JAK2, and ABL.
  • We present a case of aCML with a 3q22;21q22-translocation that led to truncation of the receptor-like tyrosine kinase (RYK) gene and its juxtaposition with sequences from chromosome 21 including the ATP5O gene coding for a mitochondrial ATP synthase.
  • [MeSH-major] Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative / genetics. Receptor Protein-Tyrosine Kinases / genetics. Translocation, Genetic


20. Miura T, Yamazaki K, Kihara S, Miyagishima M, Kobayashi K, Sugimoto K, Kurosawa H: Extensive patch angioplasty of the left main ostial stenosis using a rhombic-shaped pulmonary autograft. Ann Thorac Cardiovasc Surg; 2008 Aug;14(4):263-6
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  • [Title] Extensive patch angioplasty of the left main ostial stenosis using a rhombic-shaped pulmonary autograft.
  • A rhombic shaped pulmonary autograft patch was applied to enlarge an ostial stenosis of the left main coronary artery (LMCA) in a 25-year-old woman diagnosed with vasculitis syndrome.
  • At eighteen months of follow-up, a coronary angiogram by computed tomography showed no restenosis at the LMCA.
  • The rhombic-shaped pulmonary autograft patch might be an ideal shape and material for angioplasty of the ostial stenosis of the LMCA.
  • [MeSH-major] Angioplasty. Coronary Stenosis / surgery. Pulmonary Artery / transplantation. Vasculitis / complications. Vasculitis / surgery

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  • (PMID = 18818580.001).
  • [ISSN] 1341-1098
  • [Journal-full-title] Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
  • [ISO-abbreviation] Ann Thorac Cardiovasc Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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21. Boztosun B, Aung SM, Olcay A, Kirma C: The longest documented left main coronary artery. Int J Cardiol; 2008 May 7;126(1):e17-8

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The longest documented left main coronary artery.
  • The left main coronary angiography (LMCA) ranges from 3 to 6 mm in diameter and may be up to 10 to 15 mm in length in humans.
  • We here report a case of the longest LMCA (38 mm) in a 60-year-old woman with subacute anterior myocardial infarction.
  • In coronary angiography and coronary computerized tomography LMCA was measured to be 38 mm long.
  • [MeSH-minor] Coronary Stenosis / diagnosis. Coronary Stenosis / pathology. Documentation / methods. Female. Humans. Middle Aged. Myocardial Infarction / diagnosis. Myocardial Infarction / pathology. Tomography, Emission-Computed, Single-Photon

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  • (PMID = 17434626.001).
  • [ISSN] 1874-1754
  • [Journal-full-title] International journal of cardiology
  • [ISO-abbreviation] Int. J. Cardiol.
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] Netherlands
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22. de Jesus Perez VA, Haddad F, Vagelos RH, Fearon W, Feinstein J, Zamanian RT: Angina associated with left main coronary artery compression in pulmonary hypertension. J Heart Lung Transplant; 2009 May;28(5):527-30
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Angina associated with left main coronary artery compression in pulmonary hypertension.
  • Left main coronary artery (LMCA) compression by an enlarged pulmonary artery trunk (PAT) has been associated with angina, but appropriate diagnostic and treatment approaches remain poorly defined.
  • We present two cases of angina caused by LMCA compression from an enlarged pulmonary artery, one of which also presented with new, severe left ventricular systolic dysfunction attributed to myocardial ischemia.
  • Diagnosis of LMCA stenosis was made via coronary angiography followed by computed tomography-gated coronary angiography (CT-CA), which confirmed pulmonary artery enlargement as the source of extrinsic compression.
  • Restoring LMCA patency with percutaneous intervention and/or aggressive treatment of pulmonary hypertension led to significant improvement in angina, cardiac function and quality of life.
  • Given the negative impact on cardiac function, prompt diagnosis and treatment of extrinsic LMCA compression should be considered a priority.
  • [MeSH-major] Angina Pectoris / etiology. Coronary Stenosis / etiology. Hypertension, Pulmonary / complications. Pulmonary Artery
  • [MeSH-minor] Adult. Angioplasty, Balloon, Coronary. Coronary Angiography. Echocardiography. Epoprostenol / therapeutic use. Humans. Male. Middle Aged. Myocardial Ischemia / diagnosis. Myocardial Ischemia / etiology. Myocardial Ischemia / therapy. Piperazines / therapeutic use. Purines / therapeutic use. Sildenafil Citrate. Stents. Sulfones / therapeutic use. Tomography, X-Ray Computed. Ultrasonography, Interventional. Vasodilator Agents / therapeutic use

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  • (PMID = 19416787.001).
  • [ISSN] 1557-3117
  • [Journal-full-title] The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
  • [ISO-abbreviation] J. Heart Lung Transplant.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Piperazines; 0 / Purines; 0 / Sulfones; 0 / Vasodilator Agents; BW9B0ZE037 / Sildenafil Citrate; DCR9Z582X0 / Epoprostenol
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23. Polewczyk A, Janion M, Gutkowski W, Sielski J, Dudek D, Sadowski J, Sledź J, Jedrzejczak-Misiek M, Buda S: [Clinical evaluation, diagnostic and therapeutic approach to patients with left main coronary artery stenosis]. Pol Arch Med Wewn; 2006 Sep;116(3):861-7

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Clinical evaluation, diagnostic and therapeutic approach to patients with left main coronary artery stenosis].
  • BACKGROUND: A critical stenosis of the left main coronary artery (LMCA) needs immediate diagnosis and therapy because of poor prognosis due to significant decrease of myocardial perfusion.
  • AIM: To identify patients with a critical stenosis of LMCA using clinical, biochemical electrocardiographic and echocardiographic data.
  • METHODS: Consecutive 75 subjects with angiographic result of culprit lesion in LMCA were selected.
  • Coronary artery disease risk factors, resting and exercise ECG changes, regional contractility defects in echocardiography and applied therapy were analysed.
  • RESULTS: A coexistence of critical LMCA narrowing and sclerotic changes in remaining coronary arteries were present in 93.3% of patients with predilection to the left anterior descending artery (65.3%).
  • An ST segment elevation in aVR lead in resting ECG was correlated with LMCA stenosis in 54.7% of patients.
  • Coronary artery by-pass grafting and resulted in good 1.5-years clinical outcome.
  • Patients with LMCA stenosis usually have disseminated sclerotic changes in coronary arteries.
  • 2. Evaluation of resting ECG with emphasis on ST elevation in aVR lead may be useful to predict LMCA stenosis.
  • 3. Further studies are required to define factors identifying patients with LMCA disease.
  • [MeSH-major] Coronary Stenosis / diagnosis

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  • (PMID = 18652279.001).
  • [Journal-full-title] Polskie Archiwum Medycyny Wewnetrznej
  • [ISO-abbreviation] Pol. Arch. Med. Wewn.
  • [Language] pol
  • [Publication-type] Journal Article
  • [Publication-country] Poland
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24. Price MJ, Cristea E, Sawhney N, Kao JA, Moses JW, Leon MB, Costa RA, Lansky AJ, Teirstein PS: Serial angiographic follow-up of sirolimus-eluting stents for unprotected left main coronary artery revascularization. J Am Coll Cardiol; 2006 Feb 21;47(4):871-7
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  • [Title] Serial angiographic follow-up of sirolimus-eluting stents for unprotected left main coronary artery revascularization.
  • OBJECTIVES: This study was performed to evaluate the clinical and serial angiographic outcomes of patients undergoing sirolimus-eluting stent (SES) implantation for unprotected left main coronary artery (LMCA) stenosis.
  • BACKGROUND: The efficacy of SES has led to their expanded use for off-label indications, including LMCA disease.
  • METHODS: Unprotected LMCA intervention with SES was attempted in 50 patients.
  • RESULTS: The target lesion involved the distal LMCA in 47 patients (94%).
  • In-lesion restenosis occurred in 21 patients (42%), was focal in 85% of cases, and in 82% involved the branch ostia, sparing the LMCA itself.
  • Late loss was significantly greater within the left circumflex (LCX) ostium compared to the parent vessel (PV) of the LMCA bifurcation (0.83 +/- 0.89 mm vs. 0.49 +/- 0.72 mm, p = 0.04).
  • CONCLUSIONS: Restenosis is a frequent finding when serial angiographic follow-up is performed after SES implantation for unprotected distal LMCA lesions.

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  • [CommentIn] J Am Coll Cardiol. 2006 Feb 21;47(4):878-81 [16487859.001]
  • [CommentIn] J Am Coll Cardiol. 2006 Oct 17;48(8):1727-8; author reply 1728-9 [17045913.001]
  • (PMID = 16487858.001).
  • [ISSN] 1558-3597
  • [Journal-full-title] Journal of the American College of Cardiology
  • [ISO-abbreviation] J. Am. Coll. Cardiol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] W36ZG6FT64 / Sirolimus
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25. Grand FH, Iqbal S, Zhang L, Russell NH, Chase A, Cross NC: A constitutively active SPTBN1-FLT3 fusion in atypical chronic myeloid leukemia is sensitive to tyrosine kinase inhibitors and immunotherapy. Exp Hematol; 2007 Nov;35(11):1723-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A constitutively active SPTBN1-FLT3 fusion in atypical chronic myeloid leukemia is sensitive to tyrosine kinase inhibitors and immunotherapy.
  • OBJECTIVES: To determine the consequences and significance of an acquired 46XX,t(2;13;2;21)(p13;q12;q33;q11.2) in atypical chronic myeloid leukemia (aCML).
  • RESULTS: Fluorescence in situ hybridization indicated that FLT3 at 13q12 was disrupted and 5'-rapid amplification of cDNA ends polymerase chain reaction identified a novel in-frame mRNA fusion between exon 3 of SPTBN1 (spectrin, beta, nonerythrocytic 1) at chromosome 2p16 and exon 13 of FLT3.
  • To determine if FLT3 might be involved more widely in BCR-ABL-negative aCML, we analyzed 40 cases and found two were internal tandem duplication-positive, but D835 mutations were not observed.
  • CONCLUSION: Although FLT3 abnormalities are uncommon in aCML, SPTBN1-FLT3 is a novel constitutively active tyrosine kinase that appears to responsive to both targeted signal transduction therapy and immunotherapy.
  • [MeSH-major] Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative / genetics. Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative / therapy. Oncogene Proteins, Fusion / analysis. Spectrin / genetics. fms-Like Tyrosine Kinase 3 / genetics


26. Paç FA, Cağdaş DN, Ulaş M, Ozatik MA, Paç M: Left main coronary artery and aortic root compression associated with atrial septal defect and pulmonary hypertension. Int J Cardiol; 2007 May 31;118(2):e41-3
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  • [Title] Left main coronary artery and aortic root compression associated with atrial septal defect and pulmonary hypertension.
  • The extrinsic compression of left main coronary artery (LMCA) by dilated pulmonary artery is rarely reported.
  • Various congenital and acquired diseases were shown to cause extrinsic LMCA compression.
  • Here we present a child with aortic root and LMCA compression due to dilated pulmonary trunk and causing angina like chest pain.
  • This case report will be a guide for the evaluation and surgical treatment of the patients with pulmonary hypertension and LMCA compression.
  • [MeSH-minor] Chest Pain / etiology. Child. Dyspnea / etiology. Female. Humans. Pulmonary Artery / surgery

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  • (PMID = 17395318.001).
  • [ISSN] 1874-1754
  • [Journal-full-title] International journal of cardiology
  • [ISO-abbreviation] Int. J. Cardiol.
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] Netherlands
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27. Moral S, Cardenas M, Puigfel M, Bassaganyas J: Subacute total occlusion of the left main coronary artery. Acta Cardiol; 2009 Jun;64(3):411
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Subacute total occlusion of the left main coronary artery.
  • Total occlusion of left main coronary artery (LMCA) is a rare manifestation of coronary atherosclerotic disease.
  • We report a patient with subacute total occlusion of the LMCA.
  • [MeSH-major] Coronary Artery Disease / diagnosis. Coronary Occlusion / diagnosis. Coronary Vessels / pathology

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  • (PMID = 19593955.001).
  • [ISSN] 0001-5385
  • [Journal-full-title] Acta cardiologica
  • [ISO-abbreviation] Acta Cardiol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
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28. Matsumoto N, Sato Y, Kunimasa T, Yoda S, Yokoyama S, Takayama T, Komatsu S, Achenbach S, Saito S, Hirayama A: MDCT detection of anomalous origins of the left main coronary artery: report of 2 cases. Int J Cardiol; 2008 Nov 28;130(3):485-7
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  • [Title] MDCT detection of anomalous origins of the left main coronary artery: report of 2 cases.
  • The left main coronary artery (LMCA) arising either from the right sinus of Valsalva, separately from the right coronary artery (RCA), or from the RCA as a single coronary artery is an extremely rare coronary artery anomaly.
  • We report 2 cases of anomalous origins of the LMCA detected by multidetector-row computed tomography.
  • [MeSH-major] Coronary Angiography. Coronary Artery Disease / radiography. Coronary Vessel Anomalies / radiography. Tomography, X-Ray Computed

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  • (PMID = 17707930.001).
  • [ISSN] 1874-1754
  • [Journal-full-title] International journal of cardiology
  • [ISO-abbreviation] Int. J. Cardiol.
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] Netherlands
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29. Ionescu CN, Donohue TJ: ECG findings in acute left main coronary artery thrombosis: a case report and review of the literature. Conn Med; 2009 Jun-Jul;73(6):333-5
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  • [Title] ECG findings in acute left main coronary artery thrombosis: a case report and review of the literature.
  • Acute coronary syndrome due to left main coronary artery (LMCA) thrombosis is a catastrophic event associated with poor prognosis and high in-hospital mortality.
  • Unfortunately, the electrocardiographic manifestations of LMCA thrombosis are nonspecific.
  • This report describes the electrocardiogram (ECG) findings in a patient with LMCA thrombosis.
  • A new right bundle branch block (RBBB) pattern, especially when associated with ST elevation in aVR and V1, should raise suspicion of this diagnosis.
  • [MeSH-major] Coronary Thrombosis / diagnosis. Electrocardiography. Myocardial Infarction / diagnosis
  • [MeSH-minor] Acute Coronary Syndrome / etiology. Acute Coronary Syndrome / therapy. Coronary Artery Bypass. Fatal Outcome. Humans. Male. Middle Aged

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  • (PMID = 19637662.001).
  • [ISSN] 0010-6178
  • [Journal-full-title] Connecticut medicine
  • [ISO-abbreviation] Conn Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 6
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30. Lee JH, Kim EM, Ahn KT, Kim MS, Kim KS, Jung IS, Park JH, Choi SW, Seong IW, Jeong JO: Significant left main coronary artery disease from iatrogenic dissection during coronary angiography. Int J Cardiol; 2010 Jan 21;138(2):e35-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Significant left main coronary artery disease from iatrogenic dissection during coronary angiography.
  • Though atherosclerotic obstruction is the major cause of the obstructive left main coronary artery (LMCA) disease, it can be associated with iatrogenic dissection during coronary angiography.
  • Here we report a case with severe LMCA stenosis due to catheter induced dissection in a 77-year-old man which was detected 9 months later.
  • By careful review of the angiogram had taken at 9 months ago, the LMCA was injured by the diagnostic left Judkin's catheter during the first coronary angiography.
  • [MeSH-major] Coronary Angiography / adverse effects. Coronary Artery Disease / etiology. Coronary Artery Disease / radiography. Coronary Vessels / injuries. Iatrogenic Disease

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  • [Copyright] Copyright (c) 2008 Elsevier Ireland Ltd. All rights reserved.
  • [CommentIn] Int J Cardiol. 2010 Oct 8;144(2):334-7 [19332358.001]
  • (PMID = 18723232.001).
  • [ISSN] 1874-1754
  • [Journal-full-title] International journal of cardiology
  • [ISO-abbreviation] Int. J. Cardiol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Netherlands
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31. Jönsson A, Ivert T, Nordqvist T, Hammar N: Grade of left main coronary artery stenosis does not influence long-term mortality after coronary artery bypass surgery. Scand Cardiovasc J; 2008 Oct;42(5):323-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Grade of left main coronary artery stenosis does not influence long-term mortality after coronary artery bypass surgery.
  • OBJECTIVE: To assess if grade of left main coronary artery (LMCA) stenosis influences early or long-term mortality after coronary artery bypass grafting (CABG).
  • DESIGN: Among all 1 384 patients with LMCA stenosis at Karolinska Hospital, Stockholm, Sweden during 1990-1999, 131 deaths occurred within 5 years of surgery (cases).
  • Matched controls (n=146) were randomly selected from all surviving LMCA patients taking gender, age and year of surgery into account.
  • Angiographies were classified for grade of LMCA stenosis before the operation.
  • RESULTS: High-grade LMCA stenosis was equally common among cases and controls (50 vs. 45%).
  • The odds ratio (OR) of mortality 5 years after the operation in patients with high-grade versus low-grade LMCA stenosis based on the matched pairs was 1.2 (95% confidence interval (CI) 0.7-2.0) and after multivariable adjustment using information on all subjects the OR was 1.0 (95% CI 0.6-1.7).
  • CONCLUSIONS: Grade of LMCA stenosis does not appear to influence early or long-term mortality after CABG performed during 1990-1999.
  • [MeSH-major] Coronary Artery Bypass / mortality. Coronary Stenosis / mortality. Coronary Stenosis / surgery

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  • (PMID = 18609052.001).
  • [ISSN] 1651-2006
  • [Journal-full-title] Scandinavian cardiovascular journal : SCJ
  • [ISO-abbreviation] Scand. Cardiovasc. J.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] England
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32. Xubo G, Xingguo L, Xianguo W, Rongzhen X, Xibin X, Lin W, Lei Z, Xiaohong Z, Genbo X, Xiaoying Z: The role of peripheral blood, bone marrow aspirate and especially bone marrow trephine biopsy in distinguishing atypical chronic myeloid leukemia from chronic granulocytic leukemia and chronic myelomonocytic leukemia. Eur J Haematol; 2009 Oct;83(4):292-301
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The role of peripheral blood, bone marrow aspirate and especially bone marrow trephine biopsy in distinguishing atypical chronic myeloid leukemia from chronic granulocytic leukemia and chronic myelomonocytic leukemia.
  • OBJECTIVES: To better realize the features of peripheral blood (PB), bone marrow (BM) aspirate and especially BM trephine biopsy in atypical chronic myeloid leukemia (aCML).
  • METHODS: We studied PB, BM smears in 35 cases of aCML and compared with 84 cases of chronic granulocytic leukemia chronic phase (CGL-CP), 39 cases of chronic myelomonocytic leukemia (CMML).
  • In addition, we evaluated characteristics of BM trephine biopsies in 21 cases of aCML and compared with 68 cases of CGL-CP, 20 cases of CMML.
  • RESULTS: All aCML patients presented with leukocytosis (median WBC 17.3 x 10(9)/L), 48% had moderate anemia, and 85% had thrombocytopenia.
  • Values of monocytes, eosinophils, basophils, percentage of immature granulocytes and monocytes (0.63 +/- 0.41 x 10(9)/L, 0.18 +/- 0.16 x 10(9)/L, 0.09 +/-0.08 x 10(9)/L, 6.27 +/- 3.09%, and 2.46 +/- 1.75%, respectively) were useful in distinguishing aCML from CGL-CP and CMML groups.
  • The BM smears showed that striking dysgranulopoieis (100%), dyserythropoiesis (48.6%), percentage of blasts, nucleated erythrocytes, monocytes, eosinophils, and basophils (2.45 +/- 2.06%, 7.76 +/- 2.89%, 1.30 +/- 1.21%, 1.47 +/- 1.60%, and 1.15 +/- 1.08%, respectively) were all important parameters for a diagnosis of aCML.
  • On BM trephine sections, aCML was characterized as hypercellularity, a moderate degree of reticulin fibrosis (71.4%), lymphocytopenia (76.2%), plasmacytopenia (90.5%), abnormal localization of immature precursors (28.5%), and absence of eosinophilia, basophilia, monocytosis.
  • CONCLUSIONS: Besides the findings observed in PB and BM aspirate, features of BM trephine biopsy (including BM trephine section, BM imprint, immunohistochemical, and cytochemical staining) can also aid in the diagnosis of aCML.
  • [MeSH-major] Blood Cells / pathology. Bone Marrow / pathology. Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative / diagnosis
  • [MeSH-minor] Aged. Aged, 80 and over. Biopsy. Bone Marrow Examination. Diagnosis, Differential. Female. Histocytochemistry. Humans. Immunohistochemistry. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / diagnosis. Leukemia, Myelomonocytic, Chronic / diagnosis. Male. Middle Aged


33. Imamaki M, Matsuura K, Sakurai M, Shimura H, Ishida A, Miyazaki M: Evaluation of early and midterm results of offpump coronary artery bypass in patients with left main disease. J Card Surg; 2009 Mar-Apr;24(2):162-6

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Evaluation of early and midterm results of offpump coronary artery bypass in patients with left main disease.
  • PURPOSE: This study evaluated the early and midterm results of offpump coronary artery bypass (OPCAB) for left main coronary artery (LMCA) stenosis.
  • METHODS: Patients treated between November 2001 and December 2006, during which isolated coronary artery bypass grafting (CABG) was performed without cardiopulmonary bypass in principle, were included.
  • Isolated CABG was performed in 206 patients, of whom 62 (30.1%) had LMCA stenosis >50%.
  • RESULTS: The in-hospital mortality rate (LMCA stenosis > 50%, 1.6%; LMCA stenosis <or=50%, 0.7%, p = 0.512), the incidence of postoperative complications, and the midterm survival rate (LMCA stenosis succeeds50%, 86.7 +/- 5.2%/5 years, LMCA stenosis<or=50%, 89.6 +/- 3.8%/5 years, p = 0.21) did not significantly differ between the two groups.
  • Conversion was significantly frequent in patients with LMCA stenosis >75% and severe stenosis >90% in the right coronary artery (RCA) trunk.
  • CONCLUSIONS: Patients with LMCA stenosis can undergo OPCAB safely and the midterm results are good.
  • As conversion was significantly frequent in patients with severe LMCA and RCA trunk stenosis, adequate preparation for pump application is necessary.
  • [MeSH-major] Coronary Artery Bypass, Off-Pump / statistics & numerical data. Coronary Stenosis / surgery

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  • (PMID = 19267825.001).
  • [ISSN] 1540-8191
  • [Journal-full-title] Journal of cardiac surgery
  • [ISO-abbreviation] J Card Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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34. Jong GP, Ma T, Chou P, Shyu MY, Tseng WK, Chang TC: Reciprocal changes in 12-lead electrocardiography can predict left main coronary artery lesion in patients with acute myocardial infarction. Int Heart J; 2006 Jan;47(1):13-20
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Reciprocal changes in 12-lead electrocardiography can predict left main coronary artery lesion in patients with acute myocardial infarction.
  • Acute left main coronary artery (LMCA) occlusion may result in acute myocardial infarction (AMI) or sudden death.
  • ST elevation in the aVR and V1 leads is reported to be valuable in recognizing LMCA occlusion.
  • This study aimed to determine the reciprocal ST segment depression of 12-lead ECGs associated with acute LMCA occlusion.
  • From January 2000 to December 2004, 61 patients who underwent emergency percutaneous coronary intervention in 3 hospitals due to AMI associated with LMCA (n = 18) and a left anterior descending coronary artery (LADCA) (n = 43) proximal lesion were selected.
  • Reciprocal ST segment depression occurred in leads aVF, V(2), V(3), V(4), V(5), and V(6) with significantly higher incidence in the LMCA group than in the LADCA group.
  • Stepwise linear multivariate discriminant analysis indicated that ST segment depression in leads aVF, V(2), and V(4) could distinguish the LMCA group from the LADCA group.
  • We concluded that reciprocal ST segment depression in leads V(2), V(4), and aVF of a 12-lead ECG is an important predictor of acute LMCA occlusion.
  • [MeSH-major] Coronary Occlusion / diagnosis. Electrocardiography. Myocardial Infarction / diagnosis

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  • (PMID = 16479036.001).
  • [ISSN] 1349-2365
  • [Journal-full-title] International heart journal
  • [ISO-abbreviation] Int Heart J
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Japan
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35. Edris A, Patel PM, Kern MJ: Early recognition of catheter-induced left main coronary artery vasospasm: implications for revascularization. Catheter Cardiovasc Interv; 2010 Aug 1;76(2):304-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Early recognition of catheter-induced left main coronary artery vasospasm: implications for revascularization.
  • Catheter-induced left main coronary artery (LMCA) vasospasm is a rare complication of coronary angiography that confounds the decision for coronary artery bypass graft (CABG) surgery.
  • We report two cases of catheter-induced LMCA vasospasm.
  • The first case was a 68-year-old woman who presented 6 years after CABG for presumed severe LMCA atherosclerotic disease.
  • Coronary angiography demonstrated totally occluded CABGs and normal native coronary arteries, including a normal LMCA.
  • The second case was a 56-year-old man with severe LMCA stenosis, who was scheduled for unprotected LM percutaneous coronary intervention (PCI).
  • These cases emphasize the need for meticulous technique and a high index of suspicion of LMCA vasospasm.
  • Intravascular ultrasound (IVUS) at the time of angiography may help to identify minimal atherosclerotic disease suggesting vasospasm.
  • [MeSH-major] Coronary Angiography / adverse effects. Coronary Artery Bypass. Coronary Stenosis / radiography. Coronary Vasospasm / etiology. Diagnostic Errors / prevention & control. Unnecessary Procedures
  • [MeSH-minor] Aged. Early Diagnosis. Electrocardiography. Female. Humans. Male. Middle Aged. Predictive Value of Tests. Vasodilator Agents / administration & dosage

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  • [Copyright] (c) 2010 Wiley-Liss, Inc.
  • (PMID = 20665882.001).
  • [ISSN] 1522-726X
  • [Journal-full-title] Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
  • [ISO-abbreviation] Catheter Cardiovasc Interv
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Vasodilator Agents
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36. Zeina AR, Rosenschein U, Barmeir E: Dimensions and anatomic variations of left main coronary artery in normal population: multidetector computed tomography assessment. Coron Artery Dis; 2007 Sep;18(6):477-82
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Dimensions and anatomic variations of left main coronary artery in normal population: multidetector computed tomography assessment.
  • OBJECTIVES: The aim of our study was to determine the dimensions, morphology and anatomic variations of the left main coronary artery (LMCA) in normal participants, on multidetector computed tomography.
  • BACKGROUND: Accurate imaging of LMCA dimensions and configuration is crucial to avoid misdiagnosis of LMCA disease.
  • MATERIALS AND METHODS: Seventy morphologically normal LMCAs of 70 participants were carefully selected from among 600 consecutive coronary computed tomography angiography studies performed in our institute.
  • LMCA cross-sectional diameters and areas were obtained at three points of each vessel: ostium, midvessel and distal.
  • Influences of age, body weight, height and body surface area (BSA) on LMCA dimensions were evaluated.
  • RESULTS: Different dimensions in each measured point of the LMCA were detected.
  • Cross-sectional elliptic shape at ostium, mid-LMCA and distal LMCA was found in 66/70 (94%), 51/70 (73%) and 54/70 (77%) of the participants, respectively.
  • On the basis of the 3D presentation, four types of LMCA were identified: biconcave-shape appearance (type 1), tapering morphology (type 2), combined morphology (type 3) and funnel-shape appearance (type 4).
  • Fifty-two of the 70 participants had an LMCA orifice originating in the middle third of the aortic sinus, 15/70 in the posterior third and 3/70 in the anterior third.
  • In men, significant correlation was found between LMCA cross-sectional area and body weight, height and BSA.
  • CONCLUSION: LMCA is not a simple straight tube but usually has various anatomical configurations, variable dimensions and cross-sectional shapes.
  • Ostial angulation is a normal variant usually associated with the posterior position of the LMCA orifice of origin in the aortic sinus.
  • [MeSH-minor] Adult. Anatomy, Cross-Sectional. Coronary Artery Disease / pathology. Coronary Artery Disease / radiography. Female. Humans. Imaging, Three-Dimensional / methods. Male. Middle Aged

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  • (PMID = 17700220.001).
  • [ISSN] 0954-6928
  • [Journal-full-title] Coronary artery disease
  • [ISO-abbreviation] Coron. Artery Dis.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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37. Leesar MA, Mintz GS: Hemodynamic and intravascular ultrasound assessment of an ambiguous left main coronary artery stenosis. Catheter Cardiovasc Interv; 2007 Nov 1;70(5):721-30
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Hemodynamic and intravascular ultrasound assessment of an ambiguous left main coronary artery stenosis.
  • The assessment of the left main coronary artery (LMCA) stenosis by angiography is not reliable, and noninvasive tests are incapable of discriminating ischemia caused by LMCA versus other stenoses.
  • Among patients with LMCA stenosis, both fractional flow reserve and intravascular ultrasound parameters would determine the severity of stenosis and predict the event rates.
  • This review outlines the evidence in support of their routine use for the assessment of an ambiguous LMCA stenosis.

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  • [Copyright] (c) 2007 Wiley-Liss, Inc.
  • (PMID = 17960644.001).
  • [ISSN] 1522-1946
  • [Journal-full-title] Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
  • [ISO-abbreviation] Catheter Cardiovasc Interv
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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38. Gao RL, Xu B, Chen JL, Han YL, Li ZQ, Lü SZ, Qi XY, Huo Y, Wang LF, Chen JZ, Shen WF, Fang WY, Jia SQ, Chinese Registry of Unprotected Left Main Coronary Artery Stenting investigators: Prognosis of unprotected left main coronary artery stenting and the factors affecting the outcomes in Chinese. Chin Med J (Engl); 2006 Jan 5;119(1):14-20

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prognosis of unprotected left main coronary artery stenting and the factors affecting the outcomes in Chinese.
  • BACKGROUND: The long term prognosis of unprotected left main coronary artery (LMCA) stenting is controversial.
  • This study was conducted to evaluate the immediate and long term outcomes of LMCA stenting in Chinese patients and to determine which factors affect the outcomes.
  • METHODS: From May 1997 to March 2003, 224 patients in 23 hospitals underwent elective unprotected LMCA stenting with bare metal stents.
  • Their clinical records were analysed to ascertain immediate and long term outcomes of LMCA stenting as well as factors influencing the prognosis.
  • RESULTS: Stents were implanted into LMCA successfully in 223 cases (99.6 %).
  • Cardiac death developed in 10 cases (4.5%), noncardiac death in 2 cases (0.9%), nonfatal MI in 4 cases (1.8%), target lesion revascularization (TLR) of LMCA in 26 cases (11.7%) and TLR of nonLMCA in 37 cases (16.5%).
  • Univariate analysis showed that cardiac death correlated with left ventricular ejection fraction (LVEF < 40%), female gender and LMCA combined with multivessel disease; that major adverse cardiac events (MACE) correlated with LVEF < 40%, bifurcation lesion and incomplete revascularization.
  • CONCLUSIONS: Long-term outcomes of stenting for selected patients with unprotected LMCA stenosis is acceptable.
  • It should be performed in inoperable or low risk patients with LVEF > or = 40% and isolated LMCA disease or LMCA combined with multivessel diseases in whom complete revascularization can be obtained.
  • [MeSH-major] Coronary Disease / therapy. Stents

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  • (PMID = 16454976.001).
  • [ISSN] 0366-6999
  • [Journal-full-title] Chinese medical journal
  • [ISO-abbreviation] Chin. Med. J.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China
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39. Inan BK, Ucak A, Gullu AU, Temizkan V, Ugur M, Yilmaz AT: Left main coronary artery and supravalvular aortic stenosis in adult: treatment with ostial patchplasty and modified Brom procedure. J Card Surg; 2009 May-Jun;24(3):299-300
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  • [Title] Left main coronary artery and supravalvular aortic stenosis in adult: treatment with ostial patchplasty and modified Brom procedure.
  • Left main coronary artery (LMCA) stenosis accompanying to supravalvular aortic stenosis is a very uncommon, serious congenital abnormality.
  • Aortic valve leaflet fusions and intimal thickening of the aortic valve leaflets and coronary artery are the underlying pathologies for the LMCA stenosis.
  • We operated on a 21-year-old male patient for supravalvar aortic stenosis with LMCA ostial stenosis.
  • We enlarged the LMCA with a pericardial patch (ostial plasty) and reconstructed the aortic root with a modified Brom procedure.
  • Postoperative course was uneventful; echocardiographic evaluation revealed a normal functioning aortic valve with a normal left ventricular function.
  • Gradient at left ventricular outflow tract was decreased a great deal.
  • Although supravalvular aortic stenosis with LMCA stenosis is a very rare congenital abnormality, this clinical entity can be successfully corrected with detailed and selected surgical procedures.

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  • (PMID = 19438785.001).
  • [ISSN] 1540-8191
  • [Journal-full-title] Journal of cardiac surgery
  • [ISO-abbreviation] J Card Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Polyethylene Terephthalates
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40. Vaseghi M, Lee MS, Currier J, Tobis J, Shapiro S, Aboulhosn J: Percutaneous intervention of left main coronary artery compression by pulmonary artery aneurysm. Catheter Cardiovasc Interv; 2010 Sep 1;76(3):352-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Percutaneous intervention of left main coronary artery compression by pulmonary artery aneurysm.
  • BACKGROUND: Extrinsic compression of the left main coronary artery (LMCA) by a pulmonary artery aneurysm (PAA) has become increasingly recognized as an etiology of angina in patients with pulmonary arterial hypertension (PAH).
  • The purpose of this study was to assess the feasibility and efficacy of LMCA stenting in the treatment LMCA stenosis because of PAA.
  • METHODS: Retrospective analysis of data on patients with PAH who presented with angina and underwent percutaneous intervention of their LMCA compression because of PAA was performed.
  • RESULTS: Five patients (age 51 ± 16 years, all female) with PAH presented with angina and underwent LMCA stenting between 2007 and 2009.
  • LMCA compression because of a PAA was diagnosed in all patients with cardiac CT angiography after echocardiography demonstrated an enlarged pulmonary artery.
  • LMCA stenting was successfully performed in all patients with resolution of angina and electrocardiographic abnormalities.
  • CONCLUSIONS: LMCA stenting appears to be a feasible and durable option in patients who present with angina because of compression by PAA.
  • [MeSH-major] Aneurysm / etiology. Angioplasty, Balloon, Coronary. Coronary Stenosis / therapy. Hypertension, Pulmonary / complications. Pulmonary Artery

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  • [CommentIn] Catheter Cardiovasc Interv. 2010 Sep 1;76(3):357-8 [20839347.001]
  • (PMID = 20552652.001).
  • [ISSN] 1522-726X
  • [Journal-full-title] Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
  • [ISO-abbreviation] Catheter Cardiovasc Interv
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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41. Jönsson A, Hammar N, Liska J, Nordqvist T, Ivert T: High mortality after coronary bypass surgery in patients with high-grade left main coronary artery stenosis. Scand Cardiovasc J; 2006 Jun;40(3):179-85

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] High mortality after coronary bypass surgery in patients with high-grade left main coronary artery stenosis.
  • OBJECTIVE: To determine mortality after coronary artery bypass grafting (CABG) in relation to degree of left main coronary artery (LMCA) obstruction.
  • DESIGN: All patients without LMCA stenosis (n=3370), with low-grade stenosis (n = 261), high-grade stenosis (n = 224) or total occlusion of the LMCA (n = 15) were followed for ten years after CABG performed during 1970-1989.
  • RESULTS: Early mortality was 1.9% and 2.3%, respectively, if there was no or a low-grade LMCA stenosis vs. 6.3% if the stenosis was high-grade.
  • Ten-year survival was 76% if no LMCA obstruction, 74% if low-grade stenosis and 64% if the stenosis was high-grade.
  • Risk of early death (odds ratio 2.6, 95% CI 1.4-4.8) and mortality at ten years (relative risk 1.5, 95% CI 1.1-2.0) was higher in patients with high-grade stenosis than in those without LMCA stenosis.
  • There was no increased long-term mortality in patients with low-grade stenosis or among the few patients with occlusion of the LMCA.
  • CONCLUSIONS: High-grade LMCA stenosis was associated with a three-fold increased risk of early and fifty percent higher risk of late death than in patients without LMCA stenosis.
  • [MeSH-minor] Aged. Coronary Artery Bypass. Female. Humans. Male. Middle Aged. Time Factors

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  • (PMID = 16798666.001).
  • [ISSN] 1401-7431
  • [Journal-full-title] Scandinavian cardiovascular journal : SCJ
  • [ISO-abbreviation] Scand. Cardiovasc. J.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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42. Boztosun B, Dundar C, Aung SM, Kirma C: Left main coronary artery stenting in a patient with acute myocardial infarction and cardiogenic shock. Int J Cardiol; 2009 Feb 20;132(2):e88-90
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  • [Title] Left main coronary artery stenting in a patient with acute myocardial infarction and cardiogenic shock.
  • Acute total occlusion of left main coronary artery (LMCA) is rarely found in patients presenting with acute coronary syndromes.
  • We present a case of successful stenting of a LMCA lesion in a patient presenting with acute myocardial infarct and cardiogenic shock.

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  • [CommentIn] Int J Cardiol. 2009 Jun 12;135(1):141-2 [18562024.001]
  • (PMID = 18035439.001).
  • [ISSN] 1874-1754
  • [Journal-full-title] International journal of cardiology
  • [ISO-abbreviation] Int. J. Cardiol.
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] Netherlands
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43. Tuncer C, Sokmen G, Sokmen A, Guven A: Aneurysm involving bifurcation of left main coronary artery presenting with transient ischemic attack, paroxysmal atrial fibrillation and ventricular tachycardia. Int J Cardiovasc Imaging; 2006 Jun-Aug;22(3-4):317-20
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  • [Title] Aneurysm involving bifurcation of left main coronary artery presenting with transient ischemic attack, paroxysmal atrial fibrillation and ventricular tachycardia.
  • Coronary artery aneurysm, especially left main coronary artery (LMCA) aneurysm is a rare phenomenon.
  • The disease may be congenital or acquired.
  • The most common cause of coronary artery aneurysm is atherosclerosis.
  • We presented a man with a large LMCA aneurysm presenting with unstable angina, transient ischemic attack, ventricular tachycardia and paroxysmal atrial fibrillation.
  • [MeSH-minor] Adult. Angina, Unstable / etiology. Coronary Angiography. Disease Progression. Electrocardiography. Heart Conduction System / physiopathology. Humans. Male


44. Christensen KN, Harris SR, Froemming AT, Brinjikji W, Araoz P, Asirvatham SJ, Lachman N: Anatomic assessment of the bifurcation of the left main coronary artery using multidetector computed tomography. Surg Radiol Anat; 2010 Dec;32(10):903-9

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Anatomic assessment of the bifurcation of the left main coronary artery using multidetector computed tomography.
  • PURPOSE: Multiple techniques for stenting left main coronary artery (LMCA) bifurcation lesions exist, and an accurate understanding of normal LMCA anatomy is essential for proper diagnosis and therapeutic intervention for these lesions.
  • The purpose of this paper is to identify various anatomic LMCA characteristics at the point of bifurcation and draw relevant clinical lessons from these characteristics.
  • METHODS: Two independent observers analyzed 105 cardiac dual-source computed tomography images recording LMCA length, angle of bifurcation, and cross-sectional area of the LMCA, left circumflex artery (LCX), and anterior interventricular artery (AIVA) at the point of LMCA bifurcation.
  • Frequency of left dominance, right dominance, and codominance, as well as LMCA trifurcation was also noted.
  • RESULTS: Average LMCA length was 9.9 ± 4.15 (range 2-21 mm).
  • The most frequent division of the LMCA is a bifurcation into the terminal LCX and AIVA.
  • Average cross-sectional areas at point of LMCA bifurcation were as follows for LMCA, LCX, and AIVA respectively: 12.4 ± 4.4 mm(2) (range 2.3-25.9 mm(2)), 7.4 ± 3.5 mm(2) (range 1.2-23 mm(2)), 8.5 ± 3.5 mm(2) (range 1.3-25.9 mm(2)).
  • Frequency of heart dominance was as follows for right dominant, left dominant, and codominant 85.7, 9.5, and 4.8%, respectively.
  • CONCLUSION: Accurate knowledge of the in vivo anatomy of the area of bifurcation of the LMCA is essential for avoiding the misdiagnoses of diseases and for proper stent placement during percutaneous intervention in the area of bifurcation.

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  • [Cites] Am Heart J. 1977 Dec;94(6):705-9 [920579.001]
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  • (PMID = 20191272.001).
  • [ISSN] 1279-8517
  • [Journal-full-title] Surgical and radiologic anatomy : SRA
  • [ISO-abbreviation] Surg Radiol Anat
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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45. Ng MK, Yeung AC: Left main coronary artery disease: is CABG still the gold standard? Rev Cardiovasc Med; 2005;6(4):187-93
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Left main coronary artery disease: is CABG still the gold standard?
  • Severe stenosis of the left main coronary artery (LMCA) is a coronary artery-disease manifestation of critical prognostic importance.
  • As a consequence of the survival advantage conferred by coronary artery bypass grafting (CABG) over medical therapy, lesions in the LMCA have been considered a standard indication for CABG for nearly 3 decades.
  • Initial attempts to treat LMCA disease percutaneously by balloon angioplasty resulted in poor clinical outcomes, leading many to regard significant LMCA disease as a contraindication for percutaneous coronary intervention (PCI).
  • However, the development and refinement of coronary stenting over the last 15 years, followed by the recent introduction of drug-eluting stents, has fueled renewed interest in percutaneous treatment of LMCA disease.
  • Outcomes of recent studies using sirolimus- and/or paclitaxel-eluting stents for treatment of LMCA disease have yielded rates of in-hospital and 1-year mortality that compare favorably with those of surgery.
  • This article will review the natural history of LMCA disease, the outcomes of CABG for LMCA disease, and the history and recent developments regarding PCI for LMCA disease.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Coronary Artery Bypass. Coronary Artery Disease / therapy. Coronary Stenosis / therapy. Stents

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  • (PMID = 16379014.001).
  • [ISSN] 1530-6550
  • [Journal-full-title] Reviews in cardiovascular medicine
  • [ISO-abbreviation] Rev Cardiovasc Med
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 35
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46. Karimi M, Murdison K, Blackwood W, Davis W: Reimplantation of anomalous right coronary artery from left main coronary artery: a surgical option. Interact Cardiovasc Thorac Surg; 2010 Apr;10(4):642-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Reimplantation of anomalous right coronary artery from left main coronary artery: a surgical option.
  • Anomalous right coronary artery (ARCA) from left sinus of Valsalva could present in several forms either being intramural or extramural, and most occurring with separate ostium from left coronary system.
  • ARCA originating from the left main coronary artery (LMCA) is very rare and treatments proposed for this type of anomaly are pulmonary artery translocation or coronary artery bypass grafting (CABG) of the right coronary system.
  • There has not been any report in the literature of successful reimplantation of ARCA from LMCA, to the best of our knowledge, as another surgical option for this anomaly.
  • We are reporting a case of successful surgical reimplantation of an ARCA from LMCA.

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  • (PMID = 20061336.001).
  • [ISSN] 1569-9285
  • [Journal-full-title] Interactive cardiovascular and thoracic surgery
  • [ISO-abbreviation] Interact Cardiovasc Thorac Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
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47. Jönsson A, Jensen J, Olsson A, Holm P, Liska J: Follow-up of patients operated on with arterial patch angioplasty of the left main coronary artery. Ann Thorac Surg; 2006 Apr;81(4):1249-55
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  • [Title] Follow-up of patients operated on with arterial patch angioplasty of the left main coronary artery.
  • BACKGROUND: Surgical angioplasty of the left main coronary artery (LMCA) can be performed with good results in selected patients.
  • It restores the native antegrade blood flow in the LMCA and does not leave the patient with a graft-dependent retrograde perfusion.
  • By using a proximal segment of the right internal mammary artery as patch material, we assumed that this would minimize the risk of restenosis of the LMCA.
  • METHODS: Forty-three patients were operated on with LMCA angioplasty from 1997 to 2003.
  • Follow-up at a mean of 45 months (range, 7 to 79) included a stress test, echocardiography, and angiography with intravascular ultrasound (IVUS) of the LMCA.
  • All patients included in the follow-up had preserved preoperative left ventricular function, and there was no aortic incompetence.
  • The dimensions of the LMCA after angioplasty was in diameter 4.8 mm (3.35 to 6.75 mm) and 5.6 mm (4 to 7.6 mm), and in area 18.9 mm2 (12.3 to 31.9 mm2) and 24.8 mm2 (14.5 to 37 mm2) in the distal and proximal parts, respectively.
  • CONCLUSIONS: Surgical angioplasty of the left main coronary artery using a proximal segment of the right internal mammary artery as an onlay patch is safe, with good long-term results.
  • [MeSH-major] Angioplasty / methods. Coronary Stenosis / surgery. Coronary Vessels / surgery. Mammary Arteries / transplantation

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  • [CommentIn] Ann Thorac Surg. 2006 Apr;81(4):1255 [16564253.001]
  • (PMID = 16564252.001).
  • [ISSN] 1552-6259
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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48. Oviedo C, Maehara A, Mintz GS, Araki H, Choi SY, Tsujita K, Kubo T, Doi H, Templin B, Lansky AJ, Dangas G, Leon MB, Mehran R, Tahk SJ, Stone GW, Ochiai M, Moses JW: Intravascular ultrasound classification of plaque distribution in left main coronary artery bifurcations: where is the plaque really located? Circ Cardiovasc Interv; 2010 Apr;3(2):105-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intravascular ultrasound classification of plaque distribution in left main coronary artery bifurcations: where is the plaque really located?
  • BACKGROUND: Angiographic classifications of the location and severity of disease in the main vessel and side branch of coronary artery bifurcations have been proposed and applied to distal left main coronary artery (LMCA) bifurcation.
  • METHODS AND RESULTS: We reviewed 140 angiograms of distal LMCA and ostial left anterior descending (LAD) and left circumflex (LCX) artery lesions with preintervention intravascular ultrasound (IVUS) of both the LAD and LCX arteries as well as the LMCA.
  • Contrary to angiographic classifications, IVUS showed that bifurcation disease was rarely focal and that both sides of the flow divider were always disease-free.
  • Continuous plaque from the LMCA into the proximal LAD artery was seen in 90%, from the LMCA into the LCX artery in 66.4%, and from the LMCA into both the LAD and LCX arteries in 62%.
  • Plaque localized to either the LAD or LCX ostium and not involving the distal LMCA was seen in only 9.3% of LAD arteries and 17.1% of LCX arteries.
  • Plaque distribution was not influenced by the LAD/LCX angiographic angle, lesion severity, LMCA length, or remodeling.
  • CONCLUSIONS: Angiographic classification of LMCA bifurcation lesions is rarely accurate.
  • IVUS shows that the carina is always spared and that the disease is diffuse rather than focal.

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  • [CommentIn] Circ Cardiovasc Interv. 2010 Apr;3(2):94-6 [20407110.001]
  • (PMID = 20197513.001).
  • [ISSN] 1941-7632
  • [Journal-full-title] Circulation. Cardiovascular interventions
  • [ISO-abbreviation] Circ Cardiovasc Interv
  • [Language] eng
  • [Databank-accession-numbers] ClinicalTrials.gov/ NCT00180466
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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49. Ozcan O, Canbay A, Vural M, Diker E, Aydogdu S: Left main coronary artery aneurysm: report of three cases. Cardiovasc Revasc Med; 2007 Oct-Dec;8(4):278-80
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  • [Title] Left main coronary artery aneurysm: report of three cases.
  • Left main coronary artery (LMCA) aneurysm is a rare coronary abnormality defined as localized coronary artery dilatations>1.5 to 2 times the diameter of the adjacent segments.
  • The incidence of coronary artery aneurysm varies between 0.15% and 4.9%.
  • Here, we present three cases of LMCA aneuryms, of one which firstly diagnosed by multidetected computed tomography.
  • [MeSH-minor] Adult. Coronary Angiography. Diagnosis, Differential. Electrocardiography. Female. Humans. Imaging, Three-Dimensional. Male. Middle Aged. Tomography, X-Ray Computed

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  • (PMID = 18053950.001).
  • [ISSN] 1553-8389
  • [Journal-full-title] Cardiovascular revascularization medicine : including molecular interventions
  • [ISO-abbreviation] Cardiovasc Revasc Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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50. Aygul N, Salamov E, Dogan U, Tokac M: Acute occlusion of the left main trunk presenting as ST-elevation acute coronary syndrome. J Electrocardiol; 2010 Jan-Feb;43(1):76-8

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Acute occlusion of the left main trunk presenting as ST-elevation acute coronary syndrome.
  • Acute obstruction of the left main coronary artery (LMCA) is not frequently encountered.
  • Electrocardiographic findings are important to early diagnosis in determining an acute obstruction of the LMCA, which requires immediate aggressive treatment, in this extremely unstable condition.
  • However, there is no single typical electrocardiographic pattern representing acute occlusion of the LMCA.
  • We describe a rare electrocardiographic finding that suggested ST-elevation acute coronary syndrome of the anterior zone due to left main trunk total occlusion.
  • [MeSH-major] Acute Coronary Syndrome / diagnosis. Acute Coronary Syndrome / etiology. Coronary Stenosis / complications. Coronary Stenosis / diagnosis. Electrocardiography / methods
  • [MeSH-minor] Adult. Diagnosis, Differential. Humans. Male

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  • (PMID = 19698952.001).
  • [ISSN] 1532-8430
  • [Journal-full-title] Journal of electrocardiology
  • [ISO-abbreviation] J Electrocardiol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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51. Batyraliev TA, Fetser DV, Preobrazhenskiĭ DV, Pershukov IV, Sidorenko BA: [Percutaneous coronary interventions on unprotected left main coronary artery: contemporary outlook of the problem]. Kardiologiia; 2009;49(5):81-92
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Percutaneous coronary interventions on unprotected left main coronary artery: contemporary outlook of the problem].
  • Coronary bypass surgery in patients with lesions in unprotected left main coronary artery (LMCA) remains gold standard of treatment.
  • Is PCI of LMCA justified, what is complication rate of PCI of LMCA?
  • In order to answer these questions we analyzed modern studies in which PCI with the use of standard metal and drug eluting stents were carried out in patients with lesions in unprotected LMCA.
  • [MeSH-major] Angioplasty, Balloon, Coronary / methods. Coronary Disease / therapy

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  • (PMID = 19463146.001).
  • [ISSN] 0022-9040
  • [Journal-full-title] Kardiologiia
  • [ISO-abbreviation] Kardiologiia
  • [Language] rus
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Russia (Federation)
  • [Number-of-references] 39
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52. Caldera AE, Cruz-Gonzalez I, Bezerra HG, Cury RC, Palacios IF, Cockrill BA, Inglessis-Azuaje I: Endovascular therapy for left main compression syndrome. Case report and literature review. Chest; 2009 Jun;135(6):1648-1650
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Endovascular therapy for left main compression syndrome. Case report and literature review.
  • Extrinsic compression of the left main coronary artery (LMCA) can occur in patients with severe pulmonary hypertension and enlarged pulmonary artery trunk.
  • We report a case of extrinsic compression of the LMCA in a symptomatic patient with Eisenmenger syndrome who underwent unprotected LMCA stent implantation.
  • We also performed a literature review of the reported cases concerning patients treated with LMCA stent implantation for the management of this condition.
  • [MeSH-minor] Cardiac Surgical Procedures / methods. Coronary Angiography. Ductus Arteriosus, Patent / complications. Ductus Arteriosus, Patent / diagnosis. Ductus Arteriosus, Patent / surgery. Female. Follow-Up Studies. Heart-Lung Transplantation. Humans. Middle Aged. Radiography, Thoracic. Risk Assessment. Severity of Illness Index. Stents. Tomography, X-Ray Computed. Treatment Outcome. Waiting Lists

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  • (PMID = 19497900.001).
  • [ISSN] 1931-3543
  • [Journal-full-title] Chest
  • [ISO-abbreviation] Chest
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 9
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53. Morita S, Yasaka M, Yasumori K, Oishi Y, Takaseya T, Sonoda H, Kawara T: Transcranial Doppler study to assess intracranial arterial communication before aortic arch operation. Ann Thorac Surg; 2008 Aug;86(2):448-51

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Bilateral axillary artery perfusion was used with the left common carotid artery perfusion for selective cerebral perfusion.
  • A preoperative left carotid artery compression test with measurement of the left middle cerebral artery (LMCA) flow was performed to determine how safe it was to interrupt the perfusion to the left common carotid artery.
  • Before surgery, the LMCA flow was detected using transcranial Doppler ultrasonography.
  • During manual compression of the left carotid artery, the flow velocity of the LMCA was measured and expressed as a percent in comparison to the precompression value.
  • RESULTS: During carotid artery compression, flow velocity of the LMCA was reduced to 56% +/- 36% (median, 63%; range, 0% to 100%) of the precompression value.
  • The communication to the LMCA assessed with magnetic resonance angiography showed a weak relationship to the functional flow reserve of the LMCA based on a transcranial Doppler study.
  • The results indicated that morphologic observation with magnetic resonance angiography did not reflect the dynamic nature of the intracranial collaterals.
  • CONCLUSIONS: A preoperative left carotid artery compression test with a measurement of the flow of the LMCA is useful to assess the feasibility of interrupting perfusion to the left carotid artery during aortic arch surgery with bilateral axillary artery perfusion.
  • [MeSH-major] Cerebrovascular Circulation / physiology. Circle of Willis / physiology. Circle of Willis / ultrasonography. Middle Cerebral Artery / physiology. Middle Cerebral Artery / ultrasonography. Ultrasonography, Doppler, Transcranial
  • [MeSH-minor] Aged. Aged, 80 and over. Aorta, Thoracic. Blood Flow Velocity. Carotid Artery, Common / physiology. Collateral Circulation / physiology. Female. Humans. Hypoxia, Brain / prevention & control. Male. Middle Aged. Perfusion / methods. Regional Blood Flow

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  • [CommentIn] Ann Thorac Surg. 2008 Aug;86(2):452 [18640314.001]
  • (PMID = 18640313.001).
  • [ISSN] 1552-6259
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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54. Suemaru S, Iwasaki K, Yamamoto K, Kusachi S, Hina K, Hirohata S, Hirota M, Murakami M, Kamikawa S, Murakami T, Shiratori Y: Coronary pressure measurement to determine treatment strategy for equivocal left main coronary artery lesions. Heart Vessels; 2005 Nov;20(6):271-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Coronary pressure measurement to determine treatment strategy for equivocal left main coronary artery lesions.
  • It is often hard to select a treatment strategy for equivocal left main coronary artery (LMCA) disease.
  • We investigated the usefulness of coronary pressure (CP) measurement for determining the treatment strategy in intermediate LMCA disease.
  • We measured CP in 15 consecutive patients with equivocal LMCA disease (age 67.6 +/- 7.5 years, 14 males).
  • Patients with FFRmyo > or = 0.75 and <0.75 received medical therapy and coronary artery bypass grafting (CABG), respectively, and were followed up for 32.5 +/- 9.7 (20-47) months.
  • FFRmyo of the LMCA was 0.91 +/- 0.01 and 0.61 +/- 0.03 in patients who received medical and surgical therapy, respectively.
  • During the follow-up period, no patients with medical therapy showed symptoms due to the LMCA lesion.
  • In conclusion, the present results clearly demonstrated that CP is clinically useful for determining the treatment strategy for equivocal LMCA lesions but coronary angiography is not.
  • [MeSH-major] Blood Pressure / physiology. Coronary Artery Disease / diagnosis. Coronary Circulation / physiology. Coronary Stenosis / diagnosis. Myocardial Infarction / diagnosis
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Blood Flow Velocity / physiology. Cardiac Catheterization. Coronary Artery Bypass. Coronary Vessels / physiopathology. Female. Follow-Up Studies. Humans. Male. Middle Aged. Postoperative Complications / diagnosis. Postoperative Complications / physiopathology. Regional Blood Flow / physiology

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  • (PMID = 16314909.001).
  • [ISSN] 0910-8327
  • [Journal-full-title] Heart and vessels
  • [ISO-abbreviation] Heart Vessels
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
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55. Murasato Y, Suzuka H, Suzuki Y: Incomplete stent apposition in a left main bifurcated lesion after kissing stent implantation. J Invasive Cardiol; 2006 Nov;18(11):E279-84
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Incomplete stent apposition in a left main bifurcated lesion after kissing stent implantation.
  • We present the case of a 75-year-old female who developed restenosis after the deployment of kissing sirolimus-eluting stents at the left main coronary artery (LMCA) bifurcation.
  • Restenosis occurred at the left circumflex (LCx) artery ostium, where a stent deployed from the LMCA to the LCx arteries overlapped another stent deployed from the LMCA to the left anterior descending (LAD) artery.
  • We investigated the stent expansion and deformation after kissing stent implantation using a phantom three-dimensional model depicting a LMCA bifurcation.
  • Stent overlap was detected at the distal LMCA whether the LAD stent was positioned over the left circumflex (LCx) stent or vice versa.
  • Thus, we found that kissing stent implantation using different-sized stents produced compression of the LCx stent at the distal LMCA.
  • Incomplete stent apposition caused by stent overlap and stent deformation is thought to be the main mechanism for restenosis after kissing stent implantation procedures.

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  • (PMID = 17090830.001).
  • [ISSN] 1557-2501
  • [Journal-full-title] The Journal of invasive cardiology
  • [ISO-abbreviation] J Invasive Cardiol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] W36ZG6FT64 / Sirolimus
  • [Number-of-references] 17
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56. Godino C, Parodi G, Furuichi S, Latib A, Barbagallo R, Goktekin O, Cera M, Mueller R, Tamburino C, Grube E, Di Mario C, Reimers B, Chieffo A, Antoniucci D, Colombo A, Sangiorgi GM: Long-term follow-up (four years) of unprotected left main coronary artery disease treated with paclitaxel-eluting stents (from the TRUE Registry). EuroIntervention; 2010 Apr;5(8):906-16
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term follow-up (four years) of unprotected left main coronary artery disease treated with paclitaxel-eluting stents (from the TRUE Registry).
  • AIMS: Limited data are available on the long-term outcome following PCI with paclitaxel-eluting stent (PES) implantation in patients with unprotected left main coronary artery (LMCA).
  • The objective of this study was to evaluate "real world" long-term outcome following paclitaxel-eluting stent (PES) implantation for unprotected LMCA disease in patients enrolled in the TRUE registry.
  • METHODS AND RESULTS: From March 2003 to October 2004, 93 consecutive patients (81.7% male) underwent PCI for unprotected LMCA disease.
  • The target lesion involved the distal LMCA in 68 (73.1%) patients.
  • Double stenting techniques were performed in 46 (67.6%) distal LMCA, of these 50% were stented using the Crush technique.
  • In-segment restenosis occurred in 16 (20.3%) patients and was focal in 72.4% of cases and significantly higher in patients with distal LMCA (36.8% vs. 13.6%, p<0.04).
  • At a median follow-up of 1,450 days (IQR 1281-1595), the overall incidence of MACE was 35.5% and the TLR rate was 25.8% and significantly higher in patients with bifurcation stenting (32.3% vs. 8%, p<0.02).
  • CONCLUSIONS: Treatment of unprotected LMCA disease with PES, after four years follow-up, appears to be safe and effective with a low rate of cardiac mortality and overall risk of ST.
  • The need for target lesion revascularisation in 25.8% of patients highlights the need for more effective PCI especially in patients with distal LMCA disease.
  • [MeSH-major] Angioplasty, Balloon, Coronary / instrumentation. Cardiovascular Agents / administration & dosage. Coronary Artery Disease / therapy. Drug-Eluting Stents. Paclitaxel / administration & dosage
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Chi-Square Distribution. Coronary Angiography. Coronary Restenosis / etiology. Disease-Free Survival. Europe / epidemiology. Female. Follow-Up Studies. Hospital Mortality. Humans. Kaplan-Meier Estimate. Logistic Models. Male. Middle Aged. Myocardial Infarction / etiology. Prosthesis Design. Registries. Risk Assessment. Risk Factors. Severity of Illness Index. Thrombosis / etiology. Time Factors. Treatment Outcome

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  • Hazardous Substances Data Bank. TAXOL .
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  • [CommentIn] EuroIntervention. 2011 Feb;6(7):904-5 [21252030.001]
  • (PMID = 20542775.001).
  • [ISSN] 1969-6213
  • [Journal-full-title] EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
  • [ISO-abbreviation] EuroIntervention
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Cardiovascular Agents; P88XT4IS4D / Paclitaxel
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57. Rostoff P, Piwowarska W, Konduracka E, Libionka A, Bobrowska-Juszczuk M, Stopyra K, Gackowski A, Kubinyi A, Nessler B, Mroczek-Czernecka D: Value of lead aVR in the detection of significant left main coronary artery stenosis in acute coronary syndrome. Kardiol Pol; 2005 Feb;62(2):128-35; discussion 136-7

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Value of lead aVR in the detection of significant left main coronary artery stenosis in acute coronary syndrome.
  • ST segment elevation in aVR may have diagnostic value in patients with acute coronary syndrome (ACS) and significant stenosis or obstruction of the left main coronary artery (LMCAS), especially when accompanied by ST segment elevation in lead V(1).
  • AIM: To asses the value of lead aVR and V1 for the detection of LMCAS in patients with ACS.
  • METHODS: The study group consisted of 150 patients (mean age 60.6+/-9.5 years, range 33-78 years) with ACS, including 46 with LMCAS and 104 without LMCAS.
  • RESULTS: In patients with LMCAS, ST segment elevation in lead aVR was two times more frequent than in remaining patients (69.6% vs 34.6% p=0.0001) whereas there were no differences in lead V(1).
  • Sensitivity of ST elevation in aVR in detection of LMCAS was 69.6%, specificity - 65.4%, positive predictive value - 47.1%, and negative predictive value - 82.9%.
  • In patients with LMCAS, ST segment depression was significantly more often present in ECG leads other than aVR (45.6% vs 23.1% p<0.01).
  • Patients with LMCAS more often had hypertension (95.6% vs 77.9% p<0.05) and three-vessel disease (78.3% vs 31.8%, p<0.0001).
  • CONCLUSIONS: The assessment of lead aVR in patients with ACS may indicate LMCAS.
  • [MeSH-major] Coronary Stenosis / diagnosis. Coronary Vessels / pathology. Electrocardiography. Heart Conduction System / physiopathology
  • [MeSH-minor] Acute Disease. Adult. Aged. Case-Control Studies. Female. Humans. Male. Middle Aged. Predictive Value of Tests. Sensitivity and Specificity

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  • (PMID = 15815796.001).
  • [ISSN] 0022-9032
  • [Journal-full-title] Kardiologia polska
  • [ISO-abbreviation] Kardiol Pol
  • [Language] eng; pol
  • [Publication-type] Journal Article
  • [Publication-country] Poland
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58. Sokmen G, Tuncer C, Sokmen A, Suner A: Clinical and angiographic features of large left main coronary artery aneurysms. Int J Cardiol; 2008 Jan 11;123(2):79-83

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinical and angiographic features of large left main coronary artery aneurysms.
  • Coronary artery aneurysms are defined as coronary dilatations which exceed the diameter of normal adjacent segments by 1.5 times.
  • Left main coronary artery (LMCA) is the least frequently involved artery with a prevalence of 0.1%.
  • Majority of coronary artery aneurysms are atherosclerotic in origin.
  • A number of complications have been reported to occur during the course of the disease including thrombosis and distal embolization, myocardial ischemia and/or infarction, dissection, vasospasm, calcification, fistulization and very rarely rupture.
  • Large aneurysms of LMCA represent a potentially fatal condition even without concomitant atherosclerotic coronary disease.
  • Because of rarity of coronary artery aneurysms, it is difficult to standardize treatment.
  • In this article, we presented 4 cases of large LMCA aneurysms with various clinical and angiographic features.
  • [MeSH-major] Coronary Aneurysm / diagnosis. Coronary Angiography

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  • (PMID = 17407794.001).
  • [ISSN] 1874-1754
  • [Journal-full-title] International journal of cardiology
  • [ISO-abbreviation] Int. J. Cardiol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Netherlands
  • [Number-of-references] 34
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59. Park SJ, Kim YH: Percutaneous coronary intervention for unprotected left main coronary artery stenosis. Cardiol Clin; 2010 Feb;28(1):81-95
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Percutaneous coronary intervention for unprotected left main coronary artery stenosis.
  • Because of the long-term benefit of coronary artery bypass graft (CABG) surgery in medical therapy, CABG has been the standard treatment of unprotected left main coronary artery (LMCA) stenosis.
  • However, with the advancement of techniques and equipment, the percutaneous interventional approach for implantation of coronary stents has been shown to be feasible for patients with unprotected LMCA stenosis.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Coronary Artery Disease / therapy. Coronary Stenosis / therapy

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  • (PMID = 19962051.001).
  • [ISSN] 1558-2264
  • [Journal-full-title] Cardiology clinics
  • [ISO-abbreviation] Cardiol Clin
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Netherlands
  • [Number-of-references] 69
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60. Duygu H, Yavuzgil O, Erturk U, Zoghi M, Ozerkan F: ST-segment elevation in lead augmented vector right may also be caused by diffuse left main coronary artery vasospasm without fixed stenosis. Clin Cardiol; 2008 Apr;31(4):179-82

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] ST-segment elevation in lead augmented vector right may also be caused by diffuse left main coronary artery vasospasm without fixed stenosis.
  • The ST-segment elevation in this aVR in the patient with clinically suspected acute coronary syndrome suggests a strong possibility of left main coronary artery (LMCA) obstruction due to fixed stenosis.
  • In this article, we report the first case, to our knowledge, of ST-segment elevation in lead aVR due to diffuse LMCA spasm.
  • [MeSH-major] Coronary Vasospasm / diagnosis. Electrocardiography
  • [MeSH-minor] Acute Coronary Syndrome / diagnosis. Angina Pectoris. Coronary Angiography. Coronary Stenosis / complications. Humans. Male. Middle Aged

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  • [Copyright] Copyright (c) 2008 Wiley Periodicals, Inc.
  • (PMID = 18404728.001).
  • [ISSN] 0160-9289
  • [Journal-full-title] Clinical cardiology
  • [ISO-abbreviation] Clin Cardiol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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61. Tsupryk A, Gorbovitski M, Kabotyanski EA, Gorfinkel V: Novel design of multicapillary arrays for high-throughput DNA sequencing. Electrophoresis; 2006 Jul;27(14):2869-79
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • A novel approach to design and optimize linear multicapillary arrays (LMCAs) for high-throughput DNA sequencing is proposed.
  • Theoretical and experimental studies showed that in conjunction with a dual-side laser illumination scheme, the proposed LMCA design allows a simultaneous uniform irradiation of as many as 550 working capillaries.

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  • (PMID = 16800025.001).
  • [ISSN] 0173-0835
  • [Journal-full-title] Electrophoresis
  • [ISO-abbreviation] Electrophoresis
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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62. Qiu JY, Zhang Y, Lu DP, Lai YY, He Q, Shi Y: [Clinical and cytogenetical study on subacute myeloid leukemia in myelodysplastic syndromes]. Zhonghua Nei Ke Za Zhi; 2005 Jun;44(6):407-10
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Clinical and cytogenetical study on subacute myeloid leukemia in myelodysplastic syndromes].
  • OBJECTIVE: To discuss from the clinical and cytogenetic aspect that part of patients now diagnosed as myelodysplastic syndromes (MDS) could be diagnosed early as leukemia and be classified as subacute myeloid leukemia (Sub-AML).
  • Among them 42 had +8 chromosome aberration, 16 had -7/7q-, and 55 had normal karyotypes and more than 0.10 blast cells in the bone marrow.
  • Short term culture and G-banding techniques and in some specimens fluorescence in situ hybridization (FISH) method were used to do chromosome analysis.
  • RESULTS: Among the detected chromosome aberrations, +8 was the most frequent (42.8%) and then -7/7q-(15.0%); 42 patients with +8 had median blast cell count of 0.08, within a median of 18 months follow-up period 40.0% of the patients evolved to frank leukemia (FL) and the median overall survival was 20 months.
  • CONCLUSIONS: Both the +8 and -7/7q- groups have malignant leukemic cell clone, and run a subacute and progressive clinical course; it is suggested they might be classified into Sub-AML.
  • [MeSH-major] Leukemia, Myeloid, Acute / genetics. Myelodysplastic Syndromes / genetics
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Chromosome Aberrations. Cytogenetic Analysis. Female. Follow-Up Studies. Humans. Male. Middle Aged


63. Hamzeh RK, El-Said HG, Moore JW: Left main coronary artery compression from right pulmonary artery stenting. Catheter Cardiovasc Interv; 2009 Feb 1;73(2):197-202
MedlinePlus Health Information. consumer health - Congenital Heart Defects.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Left main coronary artery compression from right pulmonary artery stenting.
  • Complications related to pulmonary artery stenting include stent migration, jailing of vessels, vessel rupture, and compression of surrounding structures.
  • Compression of the left main coronary artery (LMCA) as a result of stent placement in the right pulmonary artery (RPA) is extremely rare.
  • We present two patients post repair of congenital heart disease who suffered LMCA compression following RPA stenting.
  • The first patient experienced acute coronary insufficiency in the cardiac catheterization laboratory, whereas the second patient had a more chronic course.
  • We also present a third patient who had a CT angiogram that demonstrated a close spatial relationship between the RPA and the LMCA.
  • Based on our previous experiences, we felt that this patient was at significant risk for LMCA compression if the RPA were stented.
  • Coronary compression is rare complication of pulmonary artery stenting but should be considered in cases with history of repaired congenital heart disease.
  • [MeSH-major] Angioplasty, Balloon. Coronary Stenosis / etiology. Heart Defects, Congenital / therapy. Pulmonary Artery. Stents

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  • [Copyright] (c) 2009 Wiley-Liss, Inc.
  • [CommentIn] Catheter Cardiovasc Interv. 2009 Feb 1;73(2):203-4 [19156880.001]
  • (PMID = 19156890.001).
  • [ISSN] 1522-726X
  • [Journal-full-title] Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
  • [ISO-abbreviation] Catheter Cardiovasc Interv
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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64. Tyczynski P, Pregowski J, Mintz GS, Witkowski A, Kim SW, Waksman R, Satler L, Pichard A, Kalinczuk L, Maehara A, Weissman NJ: Intravascular ultrasound assessment of ruptured atherosclerotic plaques in left main coronary arteries. Am J Cardiol; 2005 Sep 15;96(6):794-8
MedlinePlus Health Information. consumer health - Coronary Artery Disease.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intravascular ultrasound assessment of ruptured atherosclerotic plaques in left main coronary arteries.
  • Atherosclerotic plaque rupture is the main cause of acute coronary syndromes.
  • There is no systematic description of ruptured plaques located in the left main coronary artery (LMCA).
  • The aim of our study was to describe ruptured plaques in the LMCA with intravascular ultrasound.
  • We identified 17 LMCA plaque ruptures in 16 patients.
  • Two left main ruptures were clinically considered to be incidental findings and were left untreated; the remaining 14 were culprit lesions that were treated with emergency coronary artery bypass grafting (n = 3) or LMCA stenting (n = 11).
  • One patient died in the hospital after left main stenting for unstable angina; all other patients who underwent stenting or surgical bypass did well.
  • All ruptures were located in the distal half of the LMCA; 6 ruptures involved bifurcation and 11 were confined to the LMCA proper.
  • The angle between the maximum plaque cavity and the left anterior descending/left circumflex artery flow divider was 162.3 degrees +/- 15.6 degrees in bifurcation versus 71.3 degrees +/- 41.6 degrees in nonbifurcation lesions (p <0.0001).
  • The LMCA minimum lumen area measured 6.0 +/- 3.3 mm2 in nonbifurcation lesions and 7.4 +/- 4.7 mm2 in bifurcation lesions (p = 0.5).
  • LMCA plaque ruptures mostly present as unstable angina, are located in the distal portion and/or bifurcation of the LMCA, often do not compromise the lumen, and have an angiographic complex appearance.
  • [MeSH-major] Coronary Artery Disease / complications. Coronary Artery Disease / ultrasonography. Coronary Vessels / ultrasonography. Ultrasonography, Interventional

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  • (PMID = 16169363.001).
  • [ISSN] 0002-9149
  • [Journal-full-title] The American journal of cardiology
  • [ISO-abbreviation] Am. J. Cardiol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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65. Levisman J, Budoff M, Karlsberg R: Congenital atresia of the left main coronary artery: cardiac CT. Catheter Cardiovasc Interv; 2009 Sep 1;74(3):465-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Congenital atresia of the left main coronary artery: cardiac CT.
  • Congenital coronary artery disease is a rare occurrence, and atresia of the left main is one of the least frequently observed variations.
  • In a recent review of 1,950 angiograms, 110 congenital coronary anomalies were seen, and of those, only 13 cases represented an absent left main coronary artery (LMCA).
  • This case is of a 53-year-old male who initially presented 2 years prior for atypical chest pain.
  • The anatomy described in this case is typical for LMCA atresia.

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  • [Copyright] 2009 Wiley-Liss, Inc.
  • (PMID = 19472349.001).
  • [ISSN] 1522-726X
  • [Journal-full-title] Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
  • [ISO-abbreviation] Catheter Cardiovasc Interv
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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66. Madias JE: Exercise-attenuation of Q-waves in II, III, and aVF, and R-Waves in V1 and V2 in a patient with an inferior infarction and anterior wall ischemia. Pacing Clin Electrophysiol; 2008 Nov;31(11):1508-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Myocardial scintigraphy disclosed ischemia of the anterior wall and coronary arteriography, a 90% stenosis of the left main coronary artery (LMCA).
  • This electrocardiogram sign is diagnostic of severe anterior wall ischemia due to left anterior descending or LMCA stenosis.
  • [MeSH-major] Coronary Stenosis / diagnosis. Coronary Stenosis / etiology. Electrocardiography / methods. Myocardial Infarction / complications. Myocardial Infarction / diagnosis. Ventricular Dysfunction, Left / complications. Ventricular Dysfunction, Left / diagnosis

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  • (PMID = 18950310.001).
  • [ISSN] 1540-8159
  • [Journal-full-title] Pacing and clinical electrophysiology : PACE
  • [ISO-abbreviation] Pacing Clin Electrophysiol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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67. Gotzmann M, Bojara W, Germing A, Mügge A, Laczkovics A, Thiessen C, Tannapfel A, Lindstaedt M: Differential diagnosis of non-atherosclerotic left main coronary artery stenosis. BMJ Case Rep; 2009;2009:bcr0820080776

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Differential diagnosis of non-atherosclerotic left main coronary artery stenosis.
  • A left main coronary artery (LMCA) stenosis without any atherosclerotic changes elsewhere in the coronary artery tree is a rare finding, and some uncommon reasons for luminal narrowing should be considered.
  • An unusual case of non-atherosclerotic LMCA stenosis is reported.A middle-aged patient presented with acute myocardial infarction.
  • An immediate coronary angiography was ordered and revealed a subtotal mid LMCA stenosis.
  • A drug-eluting stent was successfully implanted in the LMCA.Operative revascularisation was recommended.
  • Five years after the first admission to our hospital, the patient died as a result of ventricular fibrillation.The differential diagnosis of non-atherosclerotic LMCA stenoses is discussed.

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  • (PMID = 21687045.001).
  • [ISSN] 1757-790X
  • [Journal-full-title] BMJ case reports
  • [ISO-abbreviation] BMJ Case Rep
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC3027375
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68. Motreff P, Rioufol G, Gilard M, Caussin C, Ouchchane L, Souteyrand G, Finet G: Diffuse atherosclerotic left main coronary artery disease unmasked by fractal geometric law applied to quantitative coronary angiography: an angiographic and intravascular ultrasound study. EuroIntervention; 2010 Jan;5(6):709-15
MedlinePlus Health Information. consumer health - Coronary Artery Disease.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Diffuse atherosclerotic left main coronary artery disease unmasked by fractal geometric law applied to quantitative coronary angiography: an angiographic and intravascular ultrasound study.
  • AIMS: Angiographic analysis of left main coronary artery (LMCA) stenosis can be hindered by the lack of any reference segment when the LMCA is short or there is diffuse atheroma.
  • Applied to the LMCA, the FGL can help the quantification of stenoses.
  • METHODS AND RESULTS: Fifty-two patients with angiographically mild focal LMCA disease (n=14) or normal to nearly normal LMCA (n=38) who had undergone intravascular ultrasound (IVUS) were included.
  • IVUS analysis confirmed all 14 focal stenoses (group C); of the 38 angiographically normal patients, however, 10 were found to present diffuse LMCA disease (group B), the remaining 28 showing a truly healthy LMCA (group A).
  • LMCA stenosis in groups A,B and C was respectively 3%,4% and 42% on usual quantitative coronary angiography(QCA) and 5%, 31% and 43% on QCAfractal applying the FGL.
  • In cases of diffuse atheroma, the FGL corrected the underestimation of LMCA diameter, which averaged 1.2 mm. conclusions: Angiographic underestimation of LMCA stenosis can be corrected by applying the FGL to obtain a theoretic LMCA diameter, thereby unmasking any diffuse atherosclerotic LMCA disease, or to quantify focal stenosis more precisely where the adjacent segments are also pathological.
  • [MeSH-major] Coronary Angiography / methods. Coronary Artery Disease / diagnosis. Fractals. Ultrasonography, Interventional / methods
  • [MeSH-minor] Aged. Diagnosis, Differential. Female. Follow-Up Studies. Humans. Male. Middle Aged. Reproducibility of Results. Severity of Illness Index

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  • (PMID = 20142223.001).
  • [ISSN] 1969-6213
  • [Journal-full-title] EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
  • [ISO-abbreviation] EuroIntervention
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] France
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69. Murasato Y: Impact of three-dimensional characteristics of the left main coronary artery bifurcation on outcome of crush stenting. Catheter Cardiovasc Interv; 2007 Feb 1;69(2):248-56

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Impact of three-dimensional characteristics of the left main coronary artery bifurcation on outcome of crush stenting.
  • BACKGROUND: Crush stenting with drug-eluting stents is used to treat left main coronary artery (LMCA) bifurcations.
  • However, the rate of restenosis at the left circumflex (LCX) artery ostium is high.
  • The impact of the three-dimensional (3D) structure of LMCA bifurcation on the outcome of crush stenting with respect to restenosis has not been described.
  • OBJECTIVES: This study examined the stent expansion, deformity, overlapping, and apposition after crush stenting of LMCA bifurcations.
  • METHODS: Bare metal stents were crushed at LMCA bifurcations in a 3D model that reproduced actual angles, such that the stent deployed from the LMCA to the left anterior descending (LAD) artery crushed the stent deployed from the LMCA to the LCX, followed by kissing balloon inflation.
  • RESULTS: In the 3D model, one stent overlapped the other in the distal LMCA, in contrast to the nearly parallel position of the stents observed in a separate two-dimensional model.
  • A narrow LMCA-LCX angle was associated with less expansion of the LCX stent at the ostium than more distally, and with a higher likelihood of incomplete stent apposition.
  • CONCLUSIONS: Overlap of the LAD stent over, as opposed to under, the LCX stent was associated with close apposition of the stent to the vessel on the myocardial side, at the ostium of the LCX artery, where atherosclerotic plaques are likely to be present.
  • The spatial plaque burden and bifurcation angle should be closely examined before crush stenting, and segments should not be left unstented over large plaques.

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  • [Copyright] (c) 2006 Wiley-Liss, Inc.
  • (PMID = 17211894.001).
  • [ISSN] 1522-1946
  • [Journal-full-title] Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
  • [ISO-abbreviation] Catheter Cardiovasc Interv
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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70. Soleimani A, Abbasi A, Kazzazi EH, Hosseini K, Salirifar M, Darabian S, Sadeghian S, Sheikhfathol-Lahi M: Prevalence of left main coronary artery disease among patients with ischemic heart disease: insights from the Tehran Angiography Registry. Minerva Cardioangiol; 2009 Apr;57(2):175-83
MedlinePlus Health Information. consumer health - Coronary Artery Disease.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prevalence of left main coronary artery disease among patients with ischemic heart disease: insights from the Tehran Angiography Registry.
  • AIM: This study was designed to investigate the prevalence of left main coronary artery (LMCA) significant stenosis among patients with stable angina (SA) or acute coronary syndromes (ACSs) and to assess the influence of demographic and clinical profiles on these findings.
  • The patients' characteristics were compared in subgroups with and without LMCA disease.
  • RESULTS: Significant and minimal LMCA stenoses were found in 659 (3.6%) and 1157 (6.4%) patients, respectively.
  • An unprotected LMCA disease was estimated in 609 (3.4%) subjects.
  • A cumulative Logit Model analysis revealed the male gender (odds ratio [OR]=1.480, 95% confidence interval [CI]=1.287 to 1.703; P<0.001), diabetes mellitus (OR=1.158, 95% CI=1.029 to 1.303; P=0.015), dyslipidemia (OR=1.125, 95% CI=1.001 to 1.265; P=0.048), and aging (OR=1.028, 95% CI=1.022 to 1.034; P<0.001) as the independent predictors of LMCA stenosis with coexistent diseases in the rest of the coronary arteries.
  • In the patients with normal or minimal stenoses of the other coronary arteries, cigarette smoking (OR=3.749, 95% CI=1.698 to 8.070) was found to be the independent risk factor of isolated LMCA disease.
  • Luminal stenosis >50% in the right coronary artery, the left circumflex artery, and the left anterior descending artery was significantly more frequent in association with LMCA disease.
  • CONCLUSIONS: The patients with LMCA disease were more likely to be male, older, and have diabetes mellitus or dyslipidemia, whereas cigarette smoking was found as an independent predictor of isolated LMCA.
  • There was a strong correlation between the severity of LMCA stenosis and coexistent diseases in the rest of the coronary arteries.
  • [MeSH-major] Coronary Artery Disease / epidemiology. Medical Records / statistics & numerical data. Myocardial Ischemia / complications

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  • (PMID = 19274028.001).
  • [ISSN] 0026-4725
  • [Journal-full-title] Minerva cardioangiologica
  • [ISO-abbreviation] Minerva Cardioangiol
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Italy
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71. Park SJ, Kim YH: Percutaneous coronary intervention for unprotected left main coronary artery stenosis. World J Cardiol; 2010 Apr 26;2(4):78-88
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  • [Title] Percutaneous coronary intervention for unprotected left main coronary artery stenosis.
  • Hemodynamically significant left main coronary artery stenosis (LMCA) is found in around 4% of diagnostic coronary angiograms and is known as unprotected LMCA stenosis if the left coronary artery and left circumflex artery has no previous patent grafts.
  • Previous randomized studies have demonstrated a significant reduction in mortality when revascularization by coronary artery bypass graft (CABG) surgery was undertaken compared with medical treatment.
  • However, with the advent of drug-eluting stents (DES), the long term outcomes of PCI with DES to treat unprotected LMCA stenoses have been acceptable.
  • Therefore, apart from the current guidelines, PCI for treatment of unprotected LMCA stenosis is often undertaken in individuals who are at a very high risk of CABG or refuse to undergo a sternotomy.
  • Future randomized studies comparing CABG vs PCI using DES for treatment of unprotected LMCA stenosis would be a great advance in clinical knowledge for the adoption of appropriate treatment.

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  • (PMID = 21160702.001).
  • [ISSN] 1949-8462
  • [Journal-full-title] World journal of cardiology
  • [ISO-abbreviation] World J Cardiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China
  • [Other-IDs] NLM/ PMC2998877
  • [Keywords] NOTNLM ; Bypass surgery / Left main / Prognosis / Restenosis / Stent
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72. Tyczyński P, Witkowski A, Chojnowska L, Litwiński P, Dabrowski M, Ryzyłło W: [Angioplasty of the unprotected left main coronary artery stenosis with standby cardiopulmonary support--a case report]. Kardiol Pol; 2007 Mar;65(3):286-8
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  • [Title] [Angioplasty of the unprotected left main coronary artery stenosis with standby cardiopulmonary support--a case report].
  • Stenosis of the unprotected left main coronary artery (LMCA) is a classical indication for coronary artery bypass graft surgery (CABG).
  • Percutaneous coronary intervention (PCI) of LMCA may be an alternative to surgical treatment if atherosclerosis of distal segments is very advanced.
  • The ongoing Syntax trial will clarify whether angioplasty of LMCA with drug-eluting stents can be equivalent to CABG.
  • We present a case of a patient with occluded right coronary artery, severe stenoses of the LMCA, left anterior descending artery and left circumflex artery, and poor left ventricular ejection fraction in whom PCI for stenosis of unprotected LMCA with standby cardiopulmonary support was performed.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Cardiopulmonary Bypass. Coronary Artery Bypass. Coronary Artery Disease / therapy. Coronary Stenosis / therapy

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  • (PMID = 17436158.001).
  • [ISSN] 0022-9032
  • [Journal-full-title] Kardiologia polska
  • [ISO-abbreviation] Kardiol Pol
  • [Language] pol
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Poland
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73. Chikwe J, Kim M, Goldstone AB, Fallahi A, Athanasiou T: Current diagnosis and management of left main coronary disease. Eur J Cardiothorac Surg; 2010 Oct;38(4):420-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Current diagnosis and management of left main coronary disease.
  • Left main coronary artery (LMCA) disease remains an important risk factor for increased mortality and morbidity at all stages of diagnosis and treatment of coronary artery disease.
  • Left main stem pathology is often silent, with unpredictable presentation: as such it poses diagnostic and management challenges.
  • This article reviews the anatomy, epidemiology and diagnosis of left main stem disease, as well as advances in multidisciplinary concepts of diagnosis and management, and summarises the outcomes of recent prospective studies comparing percutaneous and surgical revascularisation in LMCA disease.
  • [MeSH-major] Coronary Disease / diagnosis

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  • [Copyright] Copyright © 2010. Published by Elsevier B.V.
  • [CommentIn] Eur J Cardiothorac Surg. 2010 Oct;38(4):428-30 [20627754.001]
  • (PMID = 20643559.001).
  • [ISSN] 1873-734X
  • [Journal-full-title] European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • [ISO-abbreviation] Eur J Cardiothorac Surg
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
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74. Cohenpour M, Tourovski A, Zyssman I, Friedensohn A, Gayer G, Horne T: Anomalous origin of left main coronary artery: the value of myocardial scintigraphic and spiral computed tomography scans. Nucl Med Rev Cent East Eur; 2006;9(1):69-71
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  • [Title] Anomalous origin of left main coronary artery: the value of myocardial scintigraphic and spiral computed tomography scans.
  • Anomalous origin of the left main coronary artery (LMCA) from the right sinus of the Valsalva or the proximal right coronary artery (RCA) is one of the most clinically important anomalies of coronary circulation.
  • The exact anatomic course of anomalous LMCA was confirmed using contrast enhanced computed tomography.
  • [MeSH-minor] Adult. Coronary Angiography. Coronary Vessel Anomalies / diagnosis. Coronary Vessel Anomalies / pathology. Female. Humans. Perfusion. Thallium / pharmacology. Tomography, Emission-Computed, Single-Photon / methods

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  • (PMID = 16791809.001).
  • [ISSN] 1506-9680
  • [Journal-full-title] Nuclear medicine review. Central & Eastern Europe
  • [ISO-abbreviation] Nucl Med Rev Cent East Eur
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Poland
  • [Chemical-registry-number] AD84R52XLF / Thallium
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75. Hong YJ, Mintz GS, Kim SW, Lu L, Bui AB, Pichard AD, Satler LF, Waksman R, Kent KM, Suddath WO, Weissman NJ: Impact of remodeling on cardiac events in patients with angiographically mild left main coronary artery disease. J Invasive Cardiol; 2007 Dec;19(12):500-5

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Impact of remodeling on cardiac events in patients with angiographically mild left main coronary artery disease.
  • BACKGROUND: The clinical significance of intravascular ultrasound (IVUS) assessed remodeling in left main coronary artery (LMCA) lesions has not been studied.
  • Thus, we evaluated the impact of coronary arterial remodeling on cardiac events in patients with angiographically mild LMCA disease.
  • METHODS: Two hundred thirty-six patients who underwent IVUS evaluation to determine the severity of angiographically mild LMCA lesions (diameter stenosis < 50%) were included.
  • Negative remodeling (NR) was defined as a remodeling index (lesion/reference external elastic membrane crosssectional area [CSA]) < 0.95, intermediate remodeling (IR) as between 0.95-1.05, and positive remodeling (PR) as > 1.05.
  • At 1-year follow up, LMCA-related cardiac events occurred in 15 patients (6.3%).
  • NR was less frequently associated with LMCA-related cardiac events than IR/PR [6/156 (3.8%) vs. 9/80 (11.3%); p = 0.027].
  • In lesions associated with LMCA-related events, lumen CSA was smaller, plaque burden was larger, and the remodeling index was greater than in lesions not associated with cardiac events, but only non-NR was an independent predictor of LMCA-related events in patients with mild LMCA disease (hazard ratio 4.095; 95% CI, 1.275-13.149; p = 0.018).
  • CONCLUSIONS: Angiographically mild LMCA disease was more frequently associated with NR, and NR was associated with fewer LMCA-related cardiac events in patients with mild LMCA lesions.
  • [MeSH-major] Coronary Angiography / methods. Coronary Disease / radiography. Coronary Vessels / physiopathology
  • [MeSH-minor] Disease Progression. Female. Follow-Up Studies. Humans. Male. Middle Aged. Prognosis. Retrospective Studies. Ultrasonography, Interventional

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  • (PMID = 18180518.001).
  • [ISSN] 1557-2501
  • [Journal-full-title] The Journal of invasive cardiology
  • [ISO-abbreviation] J Invasive Cardiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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76. Kim HS, Kim YH, Lee SW, Park DW, Lee CW, Hong MK, Kim JJ, Park SW, Park SJ: Safety and effectiveness of sirolimus-eluting stent implantation for in-stent restenosis of the unprotected left main coronary artery. Int J Cardiol; 2008 Feb 20;124(1):118-20
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Safety and effectiveness of sirolimus-eluting stent implantation for in-stent restenosis of the unprotected left main coronary artery.
  • The present study examined the alternative treatment of sirolimus-eluting stent (SES) implantation for in-stent restenosis (ISR) of the unprotected left main coronary artery (LMCA).
  • Twelve patients underwent SES deployment for bare-metal ISR in the LMCA.
  • ISR were 24+/-11 mm in length and located at the ostial (n=1) and distal (n=11) portion of LMCA.
  • Bifurcation lesions were treated with one of three techniques: the stent crossing the left circumflex artery (n=7), kissing stenting (n=2) or the Crush technique (n=2).
  • There were no cases of significant narrowing in the left circumflex artery after the procedure.
  • The present study suggests that SES implantation may be a feasible therapeutic option for treating ISR in unprotected LMCA.

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  • (PMID = 17383034.001).
  • [ISSN] 1874-1754
  • [Journal-full-title] International journal of cardiology
  • [ISO-abbreviation] Int. J. Cardiol.
  • [Language] eng
  • [Publication-type] Letter; Research Support, Non-U.S. Gov't
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Immunosuppressive Agents; W36ZG6FT64 / Sirolimus
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77. Park SJ, Park DW: Left main stenting: is it a different animal? EuroIntervention; 2010 Dec;6 Suppl J:J112-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Left main stenting: is it a different animal?
  • For several decades, coronary-artery bypass grafting (CABG) has been regarded as the treatment of choice for patients with unprotected left main coronary artery (LMCA) disease.
  • However, because of marked advancements in techniques of percutaneous coronary intervention (PCI) with stenting and CABG, as well as adjunctive pharmacologic therapy, a new evaluation and review of current indications for optimal revascularisation therapy for LMCA disease may be required to determine the standard of care for these patients.
  • The available current evidence suggests that the composite outcome of death, myocardial infarction and stroke is similar in patients with LMCA disease who are treated with PCI with stenting or CABG, the only difference was the rate of repeat revascularisation.
  • Although PCI can be performed successfully in most LMCA lesions, "high-risk" anatomic subsets, especially involving distal LMCA bifurcation lesions, continue to present unique technical challenges to interventional cardiologists, and, therefore, an integrated approach combing advanced devices, tailored techniques, adjunctive support of physiologic and morphologic evaluation, and adjunctive pharmacologic agents should be reinforced to improve clinical outcomes.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Coronary Artery Disease / therapy. Stents

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  • (PMID = 21930474.001).
  • [ISSN] 1969-6213
  • [Journal-full-title] EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
  • [ISO-abbreviation] EuroIntervention
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Metals
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78. Lindstaedt M, Spiecker M, Lawo T, Yazar A, Mügge A, Bojara W, Germing A: [Angiographic assessment of functionally insignificant left main coronary artery stenoses: reliability compared to intracoronary pressure measurement]. Dtsch Med Wochenschr; 2006 Sep 29;131(39):2134-8

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Angiographic assessment of functionally insignificant left main coronary artery stenoses: reliability compared to intracoronary pressure measurement].
  • BACKGROUND AND OBJECTIVE: Left main coronary artery disease (LMCA) is still a widely accepted indication for coronary artery bypass surgery.
  • Intermediate LMCA disease, however, often cannot be evaluated reliably on the basis of clinical and angiographic information alone.
  • This study was performed to compare the accuracy of visual angiographic assessment of intermediate LMCA stenoses by experienced interventional cardiologists with functional assessment by FFR in a patient population with excellent long-term outcome after deferral of surgery on the basis of FFR measurements.
  • PATIENTS AND METHODS: 24 of 51 consecutive patients with intermediate LMCA disease were deferred from surgery based on an FFR value of > or = 0.75.
  • CONCLUSION: The functional significance of intermediate or equivocal LMCA lesions should not be based on visual assessment alone, even when performed by experienced interventional cardiologists.
  • [MeSH-major] Blood Pressure / physiology. Blood Pressure Determination / standards. Coronary Angiography / standards. Coronary Circulation / physiology. Coronary Stenosis / diagnosis. Coronary Vessels / physiology

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  • (PMID = 16991027.001).
  • [ISSN] 0012-0472
  • [Journal-full-title] Deutsche medizinische Wochenschrift (1946)
  • [ISO-abbreviation] Dtsch. Med. Wochenschr.
  • [Language] ger
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] Germany
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79. Gupta R, Rahman MA, Uretsky BF, Schwarz ER: Left main coronary artery thrombus: a case series with different outcomes. J Thromb Thrombolysis; 2005 Apr;19(2):125-31

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Left main coronary artery thrombus: a case series with different outcomes.
  • Left main coronary artery (LMCA) thrombosis with acute myocardial infarction is an uncommon condition with an extremely high mortality.
  • We describe our experience with six patients who presented with LMCA thrombosis and discuss the epidemiology, etiology and management options available for this high-risk subgroup.
  • [MeSH-minor] Aged. Disease Management. Female. Humans. Male. Middle Aged. Myocardial Infarction / etiology. Myocardial Infarction / therapy. Risk Factors. Treatment Outcome

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  • (PMID = 16052304.001).
  • [ISSN] 0929-5305
  • [Journal-full-title] Journal of thrombosis and thrombolysis
  • [ISO-abbreviation] J. Thromb. Thrombolysis
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Netherlands
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80. Park SJ: Is stenting a preferred option for unprotected left main coronary artery disease in the drug-eluting stent era? Indian Heart J; 2007 Mar-Apr;59(2 Suppl B):B105-12

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Is stenting a preferred option for unprotected left main coronary artery disease in the drug-eluting stent era?
  • Coronary artery bypass graft (CABG) has been the established treatment for left main coronary artery (LMCA) disease.
  • LMCA disease has been considered to be a challenge for interventional cardiologist for more than 25 years.
  • The early experience with drug-eluting stent (DES) in unprotected LMCA reveals reduced rates of restenosis and associated clinical outcomes when compared with patients who were treated with BMS.
  • However, up to now, effectiveness of DES is not enough to replace CABG in LMCA revascularization.
  • Based on these trials, it is likely that, for selected patients, DES may be regarded as a preferred revascularization strategy for LMCA disease.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Coronary Disease / therapy. Coronary Restenosis / prevention & control. Drug-Eluting Stents
  • [MeSH-minor] Coronary Artery Bypass. Hospital Mortality. Humans. Randomized Controlled Trials as Topic

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  • (PMID = 19153426.001).
  • [ISSN] 0019-4832
  • [Journal-full-title] Indian heart journal
  • [ISO-abbreviation] Indian Heart J
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] India
  • [Number-of-references] 39
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81. Karavolias GK, Georgiadou P, Iliodromitis EK, Cokkinos P, Adamopoulos S, Theodorakis GN, Kremastinos DT: Primary stenting of an unprotected left main coronary artery total occlusion in a patient with acute myocardial infraction and cardiogenic shock. Acute Card Care; 2006;8(3):172-6
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  • [Title] Primary stenting of an unprotected left main coronary artery total occlusion in a patient with acute myocardial infraction and cardiogenic shock.
  • Acute total occlusion of the left main coronary artery (LMCA) is a rare angiographic finding with very poor prognosis.
  • Coronary angiography, which was performed under the support of an intra-aortic balloon pump, revealed total occlusion of the LMCA.
  • Prompt and successful percutaneous transluminal coronary angioplasty with sirolimus-stent deployment in the LMCA allowed for an uneventful recovery and discharge of the patient.
  • [MeSH-major] Coronary Stenosis / diagnosis. Myocardial Infarction / diagnosis. Shock, Cardiogenic / diagnosis
  • [MeSH-minor] Adult. Angioplasty, Balloon, Coronary. Coronary Angiography. Diagnosis, Differential. Electrocardiography. Humans. Male. Stents

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  • (PMID = 17012133.001).
  • [ISSN] 1748-2941
  • [Journal-full-title] Acute cardiac care
  • [ISO-abbreviation] Acute Card Care
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] Sweden
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82. Murasato Y, Horiuchi M, Otsuji Y: Three-dimensional modeling of double-stent techniques at the left main coronary artery bifurcation using micro-focus X-ray computed tomography. Catheter Cardiovasc Interv; 2007 Aug 1;70(2):211-20
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Three-dimensional modeling of double-stent techniques at the left main coronary artery bifurcation using micro-focus X-ray computed tomography.
  • BACKGROUND: Various double-stent techniques using drug-eluting stents have been proposed to treat the left main coronary artery (LMCA) bifurcation.
  • However, use of these techniques is frequently associated with focal restenosis at the ostium of the left circumflex coronary artery (LCX).
  • OBJECTIVES: To examine the results of double-stent techniques, using a silicon model of the LMCA bifurcation and three-dimensional (3D) reconstruction images created with micro-focus X-ray computed tomography (MFCT).
  • METHODS: Crush, kissing, and modified T stentings were performed with bare metal stents in a LMCA bifurcation model.
  • The stents were then inspected using MFCT at a minimal resolution of 0.06 mm.
  • RESULTS: Gaps in stent apposition to the vessel were observed at the site of stent overlap in the distal LMCA with all stenting techniques.
  • In crush stenting, when the left anterior descending artery stent overlapped the LCX stent, the latter was crushed on the myocardial side of the vessel, and a gap was observed on the nonmyocardial side, at the LCX ostium.
  • CONCLUSIONS: Close apposition of the stent to the vessel at the ostium of the LCX is difficult to achieve at the LMCA bifurcation, regardless of which double-stent technique is employed, due to the site's wide bifurcation angle and complex 3D structure.
  • [MeSH-major] Blood Vessel Prosthesis. Blood Vessel Prosthesis Implantation / instrumentation. Coronary Angiography / methods. Coronary Artery Disease / radiography. Imaging, Three-Dimensional. Radiographic Image Interpretation, Computer-Assisted. Stents. Tomography, X-Ray Computed

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  • [Copyright] Copyright (c) 2007 Wiley-Liss, Inc.
  • (PMID = 17421017.001).
  • [ISSN] 1522-1946
  • [Journal-full-title] Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
  • [ISO-abbreviation] Catheter Cardiovasc Interv
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Metals
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83. Huang HC, Kao HL, Wu XM, Wang SS, Hsu RB, Ho YL, Chen MF: Long-term prognosis in ethnic Chinese patients with unprotected left main coronary artery disease. Clin Res Cardiol; 2010 Jul;99(7):437-43
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term prognosis in ethnic Chinese patients with unprotected left main coronary artery disease.
  • OBJECTIVE: The aim of this study was to investigate the long-term outcome of unprotected left main coronary artery disease (LMCA) with different therapeutic modalities in Chinese patients.
  • BACKGROUND: Coronary artery bypass graft (CABG) has been considered standard therapy for patients with LMCA disease.
  • Percutaneous coronary intervention (PCI) has recently been alternative choice for unprotected LMCA.
  • Nevertheless, the effects on the long-term outcome of unprotected LMCA by the above-mentioned management in Chinese remains unknown.
  • METHODS: Patients with unprotected LMCA were enrolled at National Taiwan University Hospital from January 1996 to June 2006.
  • In high-risk left ventricular dysfunction, the elderly and renal insufficiency patients, the long-term survival was statistically significantly better in the CABG group.
  • CONCLUSION: For Chinese patients with unprotected left main coronary artery disease, a significant higher risk of cardiovascular death was noted in the medical therapy group.
  • Overall the long-term cardiovascular survival was similar in LMCA patients treated with either PCI or CABG, but CABG provided better survival outcome in high-risk subgroup patients.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Asian Continental Ancestry Group / statistics & numerical data. Coronary Artery Bypass. Coronary Artery Disease / therapy

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  • (PMID = 20229255.001).
  • [ISSN] 1861-0692
  • [Journal-full-title] Clinical research in cardiology : official journal of the German Cardiac Society
  • [ISO-abbreviation] Clin Res Cardiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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84. Khattab AA, Hamm CW, Senges J, Toelg R, Geist V, Bonzel T, Kelm M, Levenson B, Neumann FJ, Nienaber CA, Pfannebecker T, Sabin G, Schneider S, Tebbe U, Richardt G, German Cypher Registry: Sirolimus-eluting stent treatment for unprotected versus protected left main coronary artery disease in widespread clinical routine: 6-month and 3-year clinical follow-up results from the prospective multicentre German Cypher Registry. Heart; 2007 Oct;93(10):1251-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Sirolimus-eluting stent treatment for unprotected versus protected left main coronary artery disease in widespread clinical routine: 6-month and 3-year clinical follow-up results from the prospective multicentre German Cypher Registry.
  • BACKGROUND: Percutaneous coronary intervention (PCI) of left main coronary artery (LMCA) disease in the bare stent era was limited by high restenosis rates which eventually resulted in sudden death in unprotected cases.
  • Clinical and angiographic restenosis has been substantially reduced by drug-eluting stents, reviving therefore this indication for PCI despite the absence of direct comparative studies with coronary artery bypass graft surgery.
  • OBJECTIVE: To assess the acute, mid- and long-term outcomes of patients treated with sirolimus-eluting stents for unprotected LMCA stenoses and to compare them with those treated for protected LMCA disease in the same time period from the German Cypher Registry.
  • Eighty-two patients treated for unprotected LMCA disease were compared with 118 patients treated for protected LMCA stenoses.
  • RESULTS: One-third of the patients in both groups were treated for the distal left main bifurcation.
  • The cumulative combined incidence of all-cause death, non-fatal MI and target vessel revascularisation at 6 months was 14.1% in the unprotected LMCA group and 13.1% in the protected group (hazard ratio = 0.81 (95% CI 0.37 to 1.74), p = 0.8).
  • CONCLUSION: Sirolimus-eluting stent treatment of unprotected and protected LMCA stenoses is technically feasible in widespread routine clinical use.
  • Acceptable long-term clinical results can be achieved, with no particular safety concerns about treatment of unprotected LMCA disease.
  • [MeSH-minor] Aged. Disease-Free Survival. Drug Implants. Female. Follow-Up Studies. Humans. Male. Prospective Studies. Registries. Treatment Outcome

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  • (PMID = 17890701.001).
  • [ISSN] 1468-201X
  • [Journal-full-title] Heart (British Cardiac Society)
  • [ISO-abbreviation] Heart
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Drug Implants; 0 / Tubulin Modulators; W36ZG6FT64 / Sirolimus
  • [Other-IDs] NLM/ PMC2000930
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85. Van Mieghem CA, Cademartiri F, Mollet NR, Malagutti P, Valgimigli M, Meijboom WB, Pugliese F, McFadden EP, Ligthart J, Runza G, Bruining N, Smits PC, Regar E, van der Giessen WJ, Sianos G, van Domburg R, de Jaegere P, Krestin GP, Serruys PW, de Feyter PJ: Multislice spiral computed tomography for the evaluation of stent patency after left main coronary artery stenting: a comparison with conventional coronary angiography and intravascular ultrasound. Circulation; 2006 Aug 15;114(7):645-53

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Multislice spiral computed tomography for the evaluation of stent patency after left main coronary artery stenting: a comparison with conventional coronary angiography and intravascular ultrasound.
  • BACKGROUND: Surveillance conventional coronary angiography (CCA) is recommended 2 to 6 months after stent-supported left main coronary artery (LMCA) percutaneous coronary intervention due to the unpredictable occurrence of in-stent restenosis (ISR), with its attendant risks.
  • We evaluated the diagnostic performance of high-resolution MSCT to detect ISR after stenting of the LMCA.
  • METHODS AND RESULTS: Seventy-four patients were prospectively identified from a consecutive patient population scheduled for follow-up CCA after LMCA stenting and underwent MSCT before CCA.
  • The sensitivity, specificity, and positive and negative predictive values were 100%, 91%, 67%, and 100%, respectively.
  • When analysis was restricted to patients with stenting of the LMCA with or without extension into a single major side branch, accuracy was 98%.
  • When both branches of the LMCA bifurcation were stented, accuracy was 83%.
  • CONCLUSIONS: Current MSCT technology, in combination with optimal heart rate control, allows reliable noninvasive evaluation of selected patients after LMCA stenting.
  • MSCT is safe to exclude left main ISR and may therefore be an acceptable first-line alternative to CCA.
  • [MeSH-minor] Adrenergic beta-Antagonists / pharmacology. Aged. Coronary Artery Disease / physiopathology. Coronary Artery Disease / therapy. Coronary Vessels / physiopathology. Coronary Vessels / ultrasonography. Female. Heart Rate / drug effects. Heart Rate / physiology. Humans. Male. Middle Aged. Predictive Value of Tests. Prospective Studies. Risk Factors. Sensitivity and Specificity. Ultrasonography, Interventional

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  • [CommentIn] Circulation. 2006 Aug 15;114(7):616-9 [16908783.001]
  • (PMID = 16894038.001).
  • [ISSN] 1524-4539
  • [Journal-full-title] Circulation
  • [ISO-abbreviation] Circulation
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adrenergic beta-Antagonists
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86. Tanigawa J, Sutaria N, Goktekin O, Di Mario C: Treatment of unprotected left main coronary artery stenosis in the drug-eluting stent era. J Interv Cardiol; 2005 Dec;18(6):455-65
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment of unprotected left main coronary artery stenosis in the drug-eluting stent era.
  • Coronary angiography is often inadequate for estimating the severity of ambiguous left main coronary artery (LMCA) stenoses.
  • For patients requiring LMCA revascularization, coronary artery bypass graft (CABG) surgery has been gold standard for decades.
  • LMCA stenosis remains one of the few serious challenges for the interventional cardiologists and, in the bare metal stent era, the long-term results were not sufficient to replace CABG surgery, mainly because of the high restenosis rate.
  • Drug-eluting stents (DES) have dramatically reduced the restenosis rate and early results in small series (approximately 300 patients in total) treated with DES in LMCA have been encouraging, especially for lesions at the ostium and in the left main shaft.
  • Before changes are made in the guidelines for treatment, we must wait for a refinement in the technique and stent design used for bifurcational left main lesion and the results of randomized, specific multicenter studies (SYNTAX trial).
  • It is likely that, for selected patients, LMCA stenosis will be regarded as an indication for PCI.
  • [MeSH-minor] Angioplasty, Balloon, Coronary. Atherectomy, Coronary. Coronary Artery Bypass. Coronary Restenosis / prevention & control. Humans. Immunosuppressive Agents / administration & dosage. Sirolimus / administration & dosage

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  • [Copyright] (J Interven Cardiol 2005;18:455-465).
  • (PMID = 16336426.001).
  • [ISSN] 0896-4327
  • [Journal-full-title] Journal of interventional cardiology
  • [ISO-abbreviation] J Interv Cardiol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Immunosuppressive Agents; W36ZG6FT64 / Sirolimus
  • [Number-of-references] 60
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87. Kim SW, Mintz GS, Escolar E, Ohlmann P, Pregowski J, Tyczynski P, Pichard AD, Satler LF, Kent KM, Suddath WO, Waksman R, Weissman NJ: The impact of cardiovascular risk factors on subclinical left main coronary artery disease: an intravascular ultrasound study. Am Heart J; 2006 Oct;152(4):693.e7-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The impact of cardiovascular risk factors on subclinical left main coronary artery disease: an intravascular ultrasound study.
  • BACKGROUND: The impact of cardiovascular risk factors on subclinical but measurable left main coronary artery (LMCA) atherosclerosis is not well known.
  • METHODS: We analyzed 150 consecutive patients with first-time coronary artery disease presentation undergoing intervention of a left anterior descending coronary artery or left circumflex lesion with motorized intravascular ultrasound transducer pullback that included a nonstenotic LMCA.
  • The mean arc of LMCA calcium (12 degrees +/- 25 degrees overall) correlated with plaque volume (51 +/- 28 mm3, r = 0.30, P = .0001) and with the number of coronary risk factors (P = .048) and ranged from 0.28 degrees +/- 0.74 degrees in patients with 0 to 1 risk factors to 9.95 degrees +/- 21.55 degrees in patients with 2 to 4 risk factors to 19.38 degrees +/- 32.51 degrees in patients with 5 to 7 risk factors.
  • Regression analysis showed obesity and age were the most important factors contributing to LMCA calcium.
  • CONCLUSION: Intravascular ultrasound measurable atherosclerosis in nonstenotic LMCA correlates with conventional primary coronary risk scores.
  • Left main coronary artery calcium correlates both with LMCA plaque volume and risk factors.
  • Thus, subclinical LMCA atherosclerosis may be a marker for events that are predicted by commonly used primary risk-assessment algorithms.
  • [MeSH-major] Cardiovascular Diseases / etiology. Coronary Artery Disease / ultrasonography. Ultrasonography, Interventional

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  • (PMID = 16996839.001).
  • [ISSN] 1097-6744
  • [Journal-full-title] American heart journal
  • [ISO-abbreviation] Am. Heart J.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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88. Suzuki T, Asai T, Matsubayashi K, Kambara A, Hiramatsu N, Kinoshita T, Nishimura O: Left main coronary artery disease does not affect the outcome of off-pump coronary artery bypass grafting. Ann Thorac Surg; 2010 Nov;90(5):1501-6

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Left main coronary artery disease does not affect the outcome of off-pump coronary artery bypass grafting.
  • BACKGROUND: Left main coronary artery (LMCA) stenosis (≥50%) has historically been recognized as a risk factor among patients undergoing coronary artery bypass grafting.
  • METHODS: From January 2002 to December 2008, a total of 665 patients, 268 of whom had significant LMCA disease, underwent isolated off-pump coronary artery bypass surgery at Shiga Medical University Hospital.
  • We compared the clinical results in the 237 patients with LMCA stenosis (LMCA group) with those in the propensity score-matched 237 patients without LMCA stenosis (non-LMCA group).
  • We performed off-pump surgery in all coronary artery bypass grafting cases with no exclusion criteria.
  • Two patients in the LMCA group (2 of 237; 0.8%) and four in the non-LMCA group (4 of 237; 1.7%) died within 30 days after surgery.
  • The rates of six-year freedom from all cause death were 87.3% and 60.7% in the LMCA group and non-LMCA group, respectively (p = 0.17), and the corresponding rates for the combined endpoint of cardiac death, myocardial infarction, angina pectoris, repeat coronary intervention, and heart failure were 80.4% and 70.4% (p = 0.98).
  • Multivariate Cox regression analysis revealed chronic renal failure as a statistically significant predictor for late cardiac event.
  • CONCLUSIONS: Off-pump coronary artery bypass grafting is feasible and safe in patients with critical LMCA stenosis and LMCA disease is not recognized as a risk factor after off-pump coronary artery bypass grafting in either the short or the long term.
  • [MeSH-major] Coronary Artery Bypass, Off-Pump / adverse effects. Coronary Stenosis / complications
  • [MeSH-minor] Aged. Female. Humans. Kidney Failure, Chronic / etiology. Male. Middle Aged. Proportional Hazards Models. Treatment Outcome

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  • [Copyright] Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
  • [CommentIn] Ann Thorac Surg. 2010 Nov;90(5):1506 [20971249.001]
  • (PMID = 20971248.001).
  • [ISSN] 1552-6259
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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89. Sari I, Acar Z, Nurkalem Z, Uslu N, Davutoglu V, Ates M, Ozer O, Eren M, Aksoy M: Preoperative clinical status but not waiting time predicts in-hospital outcomes of surgery in patients with left main coronary artery stenosis. Tohoku J Exp Med; 2007 Oct;213(2):173-80

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Preoperative clinical status but not waiting time predicts in-hospital outcomes of surgery in patients with left main coronary artery stenosis.
  • Contoversy exists about the optimal operation time of the patients with left main coronary artery (LMCA) stenosis.
  • We therefore, aimed to investigate the effect of waiting time on in-hospital morbidity and mortality in patients with LMCA stenosis and identify the risk factors associated with adverse cardiovascular events before and during surgery.
  • One hundred seventy six patients with LMCA stenosis were divided into two groups according to the time period between coronary angiography and coronary artery bypass surgery (group 1: <or= 7 days, 94 patients; and group 2: > 7 days, 82 patients).
  • When we analyzed the differences between the patients with and without MACE, the patients who experienced MACE were older (p = 0.001), and had higher degree of LMCA stenosis (p = 0.01), higher degree of right coronary artery stenosis (p = 0.02), higher blood urea level (p = 0.003), and higher incidence of unstable angina or myocardial infarction within 2 weeks (p = 0.001).
  • Independent risk factors for MACE were unstable angina or myocardial infarction within 2 weeks, age more than 70 years and stenosis more than 75% in the LMCA.
  • These results suggest that preoperative clinical status but not waiting time predicts in-hospital surgical outcomes in LMCA stenosis.
  • [MeSH-minor] Aged. Coronary Angiography. Coronary Artery Bypass / statistics & numerical data. Female. Humans. Logistic Models. Male. Middle Aged. Multivariate Analysis. Predictive Value of Tests. Preoperative Care. Time Factors. Treatment Outcome

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  • (PMID = 17917411.001).
  • [ISSN] 0040-8727
  • [Journal-full-title] The Tohoku journal of experimental medicine
  • [ISO-abbreviation] Tohoku J. Exp. Med.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Japan
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90. Botsios S, Maatz W, Sprengel U, Heuer H, Walterbusch G: Patch angioplasty for isolated ostial stenosis of the left main coronary artery. J Card Surg; 2008 Nov-Dec;23(6):743-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Patch angioplasty for isolated ostial stenosis of the left main coronary artery.
  • BACKGROUND: Conventional coronary artery bypass grafting (CABG) is recognized as the treatment of choice for left main coronary artery stenosis (LMCA) with excellent results.
  • Patch angioplasty is an alternative method in selected cases for ostial stenosis of the LMCA.
  • Therefore, the aim of this study was to evaluate the long-term outcome of patients treated by patch angioplasty using saphenous vein for ostial stenosis of the LMCA.
  • METHODS: Nineteen patients underwent vein patch angioplasty for ostial LMCA stenosis between 1995 and 2005 at our institution.
  • On three of them simultaneous aortic valve replacement was carried out and on one patient concomitant coronary artery bypass grafting of the right coronary artery was performed.
  • CONCLUSIONS: Surgical patch angioplasty with saphenous vein for isolated ostial LMCA stenosis is a safe operative technique with good long-term results.
  • MRI is able to adequately depict the operative result of left main coronary ostium reconstruction.

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  • (PMID = 19017004.001).
  • [ISSN] 1540-8191
  • [Journal-full-title] Journal of cardiac surgery
  • [ISO-abbreviation] J Card Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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91. de la Torre Hernández JM, Ruiz-Lera M, Fernández-Friera L, Ruisanchez C, Sainz-Laso F, Zueco J, Figueroa A, Colman T: [Prospective use of an intravascular ultrasound-derived minimum lumen area cut-off value in the assessment of intermediate left main coronary artery lesions]. Rev Esp Cardiol; 2007 Aug;60(8):811-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Prospective use of an intravascular ultrasound-derived minimum lumen area cut-off value in the assessment of intermediate left main coronary artery lesions].
  • [Transliterated title] Aplicación prospectiva de un valor de corte de área luminal mínima por ecografía intravascular en la evaluación de lesiones intermedias del tronco.
  • BACKGROUND AND OBJECTIVES: Angiographic assessment of the severity of intermediate lesions in the left main coronary artery (LMCA) is subject to significant limitations.
  • Intravascular ultrasound (IVUS) can provide accurate measurement, but there is no agreement on the minimum lumen cross-sectional area (MLA) that indicates significant disease.
  • The aim of this study was to determine the long-term safety of applying a cut-off value of 6 mm2 for the MLA in the LMCA.
  • METHODS: The study included patients with intermediate lesions (i.e., 25-50%) in unprotected LMCAs, with no previous evidence of associated ischemia.
  • In 31 (39%), the MLA was < or =6 mm2, and they underwent LMCA revascularization; in the remaining 48 (61%), the MLA was >6 mm2, and patients either underwent angioplasty for other lesions (n=37) or continued medical treatment (n=11).
  • In a follow-up period of 40 [17] months, four patients (8.3%) died from heart disease, all of whom had an MLA between 9-10 mm2 in the baseline study.
  • Revascularization of the LMCA was necessary in only two patients (4.2%), both of whom had elective surgery more than 2 years after the initial study.
  • CONCLUSIONS: Intravascular ultrasound assessment of intermediate LMCA lesions using an MLA cut-off value of 6 mm2 appears safe over the long term provided the clinical and angiographic criteria applied to patient selection are similar to those used in this study.
  • [MeSH-major] Coronary Artery Disease / ultrasonography. Ultrasonography, Interventional

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  • [CommentIn] Rev Esp Cardiol. 2008 Aug;61(8):893-4; author reply 894 [18684375.001]
  • [CommentIn] Rev Esp Cardiol. 2007 Aug;60(8):794-6 [17688846.001]
  • (PMID = 17688849.001).
  • [ISSN] 1579-2242
  • [Journal-full-title] Revista española de cardiología
  • [ISO-abbreviation] Rev Esp Cardiol
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Spain
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92. Wu XM, Liu CP, Lin WC, Kao HL: Long-term outcome of percutaneous coronary intervention for unprotected left main coronary artery disease. Int J Cardiol; 2010 Feb 4;138(3):272-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term outcome of percutaneous coronary intervention for unprotected left main coronary artery disease.
  • OBJECTIVES: The aim of this study is to evaluate the in-hospital, 30 day and long-term outcomes after percutaneous coronary intervention for unprotected left main coronary artery disease.
  • BACKGROUNDS: Left main coronary artery (LMCA) diseases stenosis is a strong indication for coronary artery bypass grafting (CABG).
  • With improved device technology, percutaneous coronary intervention (PCI) with drug-eluting stent (DES) stents had been recently advocated as an alternative procedure for the unprotected LMCA disease.
  • METHODS: Between January 2003 and February 2007, all unprotected LMCA PCI procedures were retrospectively collected.
  • RESULTS: Fifty five consecutive patients with >50% diameter stenosis of LMCA undergoing PCI were analyzed.
  • CONCLUSIONS: Our results showed that PCI with stenting was an acceptable treatment option for patients with LMCA stenosis.
  • Involvement of the LMCA bifurcation remains a predictor for unfavorable outcome.
  • [MeSH-major] Angioplasty, Balloon, Coronary / mortality. Coronary Artery Disease / mortality. Coronary Artery Disease / therapy. Drug-Eluting Stents / statistics & numerical data

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  • [Copyright] Copyright 2008 Elsevier Ireland Ltd. All rights reserved.
  • [CommentIn] Int J Cardiol. 2010 Sep 24;144(1):90-1 [19157586.001]
  • (PMID = 18804295.001).
  • [ISSN] 1874-1754
  • [Journal-full-title] International journal of cardiology
  • [ISO-abbreviation] Int. J. Cardiol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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93. Vecchio S, Chechi T, Vittori G, Biondi Zoccai GG, Lilli A, Spaziani G, Giuliani G, Falchetti E, Margheri M: Outlook of drug-eluting stent implantation for unprotected left main disease: insights on long-term clinical predictors. J Invasive Cardiol; 2007 Sep;19(9):381-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Outlook of drug-eluting stent implantation for unprotected left main disease: insights on long-term clinical predictors.
  • BACKGROUND: Percutaneous coronary intervention (PCI) has been increasingly employed to treat unprotected left main coronary artery (LMCA) stenosis, with variable success.
  • This strategy has been applied to patients undergoing drug-eluting stent (DES) implantation for unprotected LMCA stenosis.
  • METHODS: From April 2003 to June 2006, 114 consecutive patients with de novo unprotected LMCA stenosis underwent PCI with DES, and were followed over a mean period of 17.1 +/- 9.1 months.
  • RESULTS: LMCA stenting was successfully performed in all patients.
  • In-hospital mortality was 3.5%, with no in-hospital non-fatal MI or emergency coronary artery bypass grafts.
  • Acute coronary syndromes, as clinical presentation, and non-ostial LMCA disease were also significantly more common within non-surviving patients (100% vs. 67%; p < 0.05, and 92.3% vs. 66.3%; p = 0.05, respectively).
  • CONCLUSIONS: Stenting of unprotected LMCA appears to be associated with a favorable mid-term outlook, especially in selected patients.
  • [MeSH-major] Angioplasty, Balloon, Coronary / mortality. Coronary Artery Disease / therapy. Coronary Restenosis / prevention & control. Immunosuppressive Agents / administration & dosage. Sirolimus / administration & dosage. Stents

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  • [CommentIn] J Invasive Cardiol. 2007 Sep;19(9):388-9 [17827508.001]
  • (PMID = 17827507.001).
  • [ISSN] 1557-2501
  • [Journal-full-title] The Journal of invasive cardiology
  • [ISO-abbreviation] J Invasive Cardiol
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 0 / Immunosuppressive Agents; P88XT4IS4D / Paclitaxel; W36ZG6FT64 / Sirolimus
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94. Cheng CI, Wu CJ, Hsieh YK, Chen YH, Chen CJ, Chen SM, Yang CH, Hung WC, Yip HK, Chen MC, Fu M, Fang CY: Percutaneous coronary intervention for iatrogenic left main coronary artery dissection. Int J Cardiol; 2008 May 23;126(2):177-82

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Percutaneous coronary intervention for iatrogenic left main coronary artery dissection.
  • BACKGROUND: Although catheter-induced left main coronary artery (LMCA) dissection is a rare complication of coronary catheterization, it is a common cause of periprocedural mortality.
  • Emergent coronary artery bypass surgery (CABG) is the mainstay for managing this acute complication.
  • Although the number of cases was small, prompt bail-out stenting for iatrogenic LMCA dissection had reportedly reversed this complication with favorable clinical outcomes.
  • METHODS: This study included 13 cases of attempted stenting for iatrogenic LMCA dissection classified as grades C-F based on the National Heart, Lung and Blood Institute (NHLBI) classification system.
  • Follow-up angiogram of eight patients with a mean interval of 5.2+/-2.3 months after initial event demonstrated restenosis in three patients occurring either at the ostiums of the left anterior descending artery or left circumflex artery.
  • CONCLUSIONS: Successful bail-out stenting resulted in good long-term survival and should be considered for initial management of iatrogenic LMCA dissection.
  • [MeSH-major] Aneurysm, Dissecting / therapy. Angioplasty, Balloon, Coronary. Coronary Aneurysm / therapy. Iatrogenic Disease

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  • (PMID = 17490760.001).
  • [ISSN] 1874-1754
  • [Journal-full-title] International journal of cardiology
  • [ISO-abbreviation] Int. J. Cardiol.
  • [Language] eng
  • [Publication-type] Case Reports; Comparative Study; Journal Article; Review
  • [Publication-country] Netherlands
  • [Number-of-references] 17
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95. Kim SW, Mintz GS, Ohlmann P, Hassani SE, Michalek A, Escolar E, Bui AB, Pichard AD, Satler LF, Kent KM, Suddath WO, Waksman R, Weissman NJ: Comparative intravascular ultrasound analysis of ostial disease in the left main versus the right coronary artery. J Invasive Cardiol; 2007 Sep;19(9):377-80

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Comparative intravascular ultrasound analysis of ostial disease in the left main versus the right coronary artery.
  • BACKGROUND: Significant aorto-ostial disease is difficult to evaluate with angiography and sometimes even with intravascular ultrasound (IVUS).
  • METHODS: We used IVUS to compare ostial lesions in the left main coronary (LMCA, n = 45) versus the right coronary artery (RCA, n = 50).
  • Negative remodeling was defined as a remodeling index (lesion/distal reference arterial area) < 0.95.
  • RESULTS: Patient age was 66 +/- 11 years in the LMCA group and 66 +/- 11 years in the RCA group; 56% of the LMCA ostial lesions and 46% of RCA ostial lesions were in males, and 35% of the LMCA ostial lesions and 20% of the RCA ostial lesions were in diabetics.
  • With the exception of a smaller minimum lumen area (p < 0.0001) and distal reference plaque burden (p = 0.002) in ostial RCA lesions and a larger eccentricity index in ostial LMCA lesions (p = 0.001), both sites were remarkably similar.
  • Both ostial LMCA and RCA lesions were short, had modest amounts of calcium, had modest plaque burdens, but had a marked frequency of negative remodeling (84% in LMCA and 86% in RCA; p = 1.0).
  • CONCLUSION: IVUS morphometry is similar in ostial LMCA and RCA lesions; negative remodeling is the dominant contributor to lumen compromise in both locations.

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  • (PMID = 17827506.001).
  • [ISSN] 1557-2501
  • [Journal-full-title] The Journal of invasive cardiology
  • [ISO-abbreviation] J Invasive Cardiol
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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96. Arkowski J, Derkacz A, Negrusz-Kawecka M, Poczatek K, Nowicki P, Obremska M, Sciborski R, Mazurek W: [Life saving angioplasty of left main coronary artery in a high risk patient]. Kardiol Pol; 2006 Oct;64(10):1121-4; discussion 1125
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Life saving angioplasty of left main coronary artery in a high risk patient].
  • A case a of a life-saving angioplasty of left main coronary artery (LMCA) is presented.
  • Coronary angiography revealed significant stenosis of LMCA, in addition to previously known multi-vessel diffuse CAD.
  • In 9 month follow-up angiography there was no restenosis in LMCA.
  • In patients to whom cardiac surgery presents very high risk, an angioplasty of LMCA can be life-saving, with good long term effects.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Coronary Artery Disease / therapy
  • [MeSH-minor] Aged. Coronary Angiography. Coronary Artery Bypass. Coronary Vessels / surgery. Critical Care / methods. Humans. Male. Stents. Treatment Outcome

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  • (PMID = 17089246.001).
  • [ISSN] 0022-9032
  • [Journal-full-title] Kardiologia polska
  • [ISO-abbreviation] Kardiol Pol
  • [Language] pol
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Poland
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97. Ozmen N, Yiginer O, Uz O, Kardesoglu E, Aparci M, Isilak Z, Cingozbay BY, Cebeci BS, Kocum HT: ST elevation in the lead aVR during exercise treadmill testing may indicate left main coronary artery disease. Kardiol Pol; 2010 Oct;68(10):1107-11

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] ST elevation in the lead aVR during exercise treadmill testing may indicate left main coronary artery disease.
  • BACKGROUND: exercise treadmill testing (ETT) is the most widely used method for evaluating patients with coronary artery disease.
  • Predicting the left main coronary artery (LMCA) disease before invasive procedures is very important in risk assessment because of its severe clinical outcome.
  • AIM: To examine whether ST elevation in lead aVR during ETT may suggest LMCA disease since the lead aVR is the reciprocal lead of LMCA.
  • RESULTS: coronary angiography in the study group revealed significant LMCA stenosis in 16 (76%) patients, whereas LMCA disease was present in only 3 (8%) patients from the control group.
  • There was no significant coronary artery stenosis in 5 patients in the study group and 12 patients in the control group.
  • Of the 16 patients who had LMCA stenosis, 9 had isolated LMCA disease and 7 had additional stenotic lesions in LAD or circumflex coronary arteries.
  • The values of positive and negative predictive value of this finding in diagnosing the presence of LMCA were 76% and 93%, respectively.
  • CONCLUSIONS: ST segment elevation in lead aVR during ETT may point to a high probability of the presence of LMCA disease.
  • [MeSH-major] Coronary Stenosis / diagnosis. Coronary Vessels / pathology. Electrocardiography. Exercise Test

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  • [CommentIn] Kardiol Pol. 2010 Oct;68(10):1112-4 [20967705.001]
  • (PMID = 20967704.001).
  • [ISSN] 0022-9032
  • [Journal-full-title] Kardiologia polska
  • [ISO-abbreviation] Kardiol Pol
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Poland
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98. Namboodiri N, Ajitkumar V, Tharakan J: A rare type of dual left anterior descending artery distribution demonstrated by multislice cardiac computerized tomography in a patient with anterior wall infarction. J Invasive Cardiol; 2008 Jul;20(7):367-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A rare type of dual left anterior descending artery distribution demonstrated by multislice cardiac computerized tomography in a patient with anterior wall infarction.
  • Dual left anterior descending coronary artery (LAD) distribution with either of the vessels originating from the left main coronary artery (LMCA) and the right aortic sinus of Valsalva is an extremely rare coronary artery anomaly.
  • Here we discuss a 45-year-old male who presented with non-ST-elevation anterior wall myocardial infarction due to near-total occlusion of the LAD immediately after its origin from the LMCA.

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  • (PMID = 18599898.001).
  • [ISSN] 1557-2501
  • [Journal-full-title] The Journal of invasive cardiology
  • [ISO-abbreviation] J Invasive Cardiol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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99. Safi M, Eslami V, Shabestari AA, Saadat H, Namazi MH, Vakili H, Movahed MR: Extrinsic compression of left main coronary artery by the pulmonary trunk secondary to pulmonary hypertension documented using 64-slice multidetector computed tomography coronary angiography. Clin Cardiol; 2009 Aug;32(8):426-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Extrinsic compression of left main coronary artery by the pulmonary trunk secondary to pulmonary hypertension documented using 64-slice multidetector computed tomography coronary angiography.
  • Compression of left main coronary artery (LMCA) secondary to pulmonary trunk dilatation is a newly recognized entity that has been associated with severe pulmonary hypertension.
  • In this paper we present a case of extrinsic compression of LMCA caused by dilated pulmonary trunk secondary to pulmonary hypertension documented using 64-slice multidetector computed tomography (MDCT) coronary angiography.
  • [MeSH-major] Coronary Angiography / methods. Coronary Stenosis / radiography. Coronary Thrombosis / complications. Hypertension, Pulmonary / complications. Pulmonary Artery / radiography. Sarcoidosis, Pulmonary / complications. Tomography, X-Ray Computed


100. Piña Y, Exaire JE, Sandoval J: Left main coronary artery extrinsic compression syndrome: a combined intravascular ultrasound and pressure wire. J Invasive Cardiol; 2006 Mar;18(3):E102-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Left main coronary artery extrinsic compression syndrome: a combined intravascular ultrasound and pressure wire.
  • The compression of the left main coronary artery (LMCA) secondary to pulmonary artery trunk dilatation is a relatively new entity that has been associated with severe pulmonary hypertension.
  • We report a case of a woman with severe pulmonary arterial hypertension due to an atrial septal defect with extrinsic compression of the LMCA and a physiopathologic approach to guide its treatment.

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  • (PMID = 16495602.001).
  • [ISSN] 1557-2501
  • [Journal-full-title] The Journal of invasive cardiology
  • [ISO-abbreviation] J Invasive Cardiol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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