Common origin of both right and left coronary arteries from the right sinus of Valsalva

Anomalous origin of the left main coronary artery (LMCA) from the right sinus of Valsalva (RSOV) represents in about 2 per 10,000 patients undergoing diagnostic cardiac catheterization. This rare anomaly correlates with sudden cardiac death after exercise and angina. We describe the case of a middle-aged woman, suffering from typical angina pectoris, with an anomalous common origin of all coronary arteries from the RSOV. We also provide the variations of the anomaly and discuss briefly on pathophysiology and treatment. © 2007 Elsevier Ireland Ltd. All rights reserved

Perforation of a saphenous vein graft during percutaneous angioplasty: Demonstration by means of intravascular ultrasound and consequent treatment with a polytetrafluoroethylene-covered stent

We present a case of a perforation of the saphenous vein graft during percutaneous angioplasty and its subsequent implantation with a polytetrafluoroethylene-covered stent. Angiographic as well as intravascular images of the site of perforation are provided. © 2008 Elsevier Ireland Ltd. All rights reserved

ASCENDING AORTA DISTENSIBILITY ABNORMALITIES IN HYPERTENSIVE PATIENTS AND RESPONSE TO NIFEDIPINE ADMINISTRATION

PURPOSE: The purpose of the present investigation was to study the distensibility of the ascending aorta in patients with arterial hypertension and normal subjects before and after administration of a calcium antagonist, nifedipine. PATIENTS AND METHODs: The distensibility of the ascending aorta was measured before and after nifedipine administration in 22 male hypertensive patients and 12 age-matched male normotensive subjects. Aortic distensibility was calculated as a function of changes in aortic diameter and pulse pressure, using the formula: 2 X (pulsatile change in aortic diameter)/[(diastolic aortic diameter) X (aortic pulse pressure)]. Aortic diameters were measured by echocardiography and aortic pressures were obtained by catheterization of the ascending aorta. RESULTS, In the basal state, the distensibility of the ascending aorta and aortic strain were lower in hypertensive patients than in normotensive subjects (p <0.001); the lower aortic distensibility, however, was associated with a greater distending pressure. A good inverse correlation (r = -0.81) was found between mean aortic pressure and aortic distensibility. The aortic distensibility was increased after nifedipine administration in both groups; this increase in aortic distensibility, however, was lower in the patients with hypertension compared with normotensive subjects (p <0.001). CONCLUSIONS: Aortic distensibility is decreased in patients with arterial hypertension. Nifedipine administration increased the distensibility of the ascending aorta both in patients with arterial hypertension and in normotensive subjects. The increase of aortic distensibility after nifedipine administration was lower in hypertensive patients