Giant right coronary artery aneurysm presenting with non-ST elevation myocardial infarction and severe mitral regurgitation: a case report

<p>Abstract</p> <p>Introduction</p> <p>Coronary artery aneurysms are seen in 1.5-5% of patients presenting for coronary angiography, but giant aneurysms, defined as being greater than 2 cm in diameter, are rare. Given the paucity of cases and limited experience in diagnosis and management of the disease, each case is a learning tool in itself.</p> <p>Case presentation</p> <p>We report the rare case of a 78-year-old Caucasian man who presented to a peripheral emergency department with chest pain and was subsequently found to have a giant right coronary artery aneurysm. Following initial investigation and treatment he was referred to our hospital for definitive management.</p> <p>Conclusion</p> <p>The case described illustrates one of the varied presentations and subsequent management of an ill-defined and heterogeneous disease process. Given the limited experience with giant aneurysms in the coronary circulation, this case provides valuable insight into the clinical presentation of the disease and gives an example of the management of the most recent such case at our hospital.</p

Single-stage repair of adult aortic coarctation and concomitant cardiovascular pathologies: a new alternative surgical approach

BACKGROUND: Coarctation of the aorta in the adulthood is sometimes associated with additional cardiovascular pathologies that require intervention. Ideal approach in such patients is uncertain. Anatomic left-sided short aortic bypass from the arcus aorta to descending aorta via median sternotomy allows simultaneuos repair of both complex aortic coarctation and concomitant cardiac operation. MATERIALS: Four adult patients were underwent Anatomic left-sided short aortic bypass operation for complex aortic coarctation through median sternotomy using deep hypothermic circulatory arrest. Concomitant cardiac operations were Bentall procedure for annuloaortic ectasia in one patient, coronary artery bypass grafting for three vessel disease in two patient, and patch closure of ventricular septal defect in one patient. RESULTS: All patients survived the operation and were alive with patent bypass at a mean follow-up of 36 months. No graft-related complications occurred, and there were no instances of stroke or paraplegia. CONCLUSION: We conclude that single-stage repair of adult aortic coarctation with concomitant cardiovascular lesions can be performed safely using this newest technique

Internal mammary artery dilatation in a patient with aortic coarctation, aortic stenosis, and coronary disease. Case report

The ideal surgical approach is unclear in adult patients with coarctation of the aorta that is associated with other cardiovascular pathologies that require intervention. Standard median sternotomy allows simultaneous, coronary revascularization surgery, valve replacement and repair of aortic coarctation. However the collateral circulation and the anatomy of the mammary arteries must be determined, to avoid possible complications. We report a case of a 69 year-old man with aortic coarctation, aortic stenosis, coronary artery disease and internal mammary artery dilatation who underwent concomitant surgical procedures through a median sternotomy

Two stage hybrid approach for complex aortic coarctation repair

<p>Abstract</p> <p>Background</p> <p>Management of an adult patient with aortic coarctation and an associated cardiac pathology poses a great surgical challenge since there are no standard guidelines for the therapy of such complex pathology. Debate exists not only on which lesion should be corrected first, but also upon the type and timing of the procedure. Surgery can be one- or two-staged. Both of these strategies are accomplice with elevate morbidity and mortality.</p> <p>Case report</p> <p>In the face of such an extended surgical approach, balloon dilatation seems preferable for treatment of severe aortic coarctation.</p> <p>We present an adult male patient with aortic coarctation combined with ascending aorta aneurysm and concomitant aortic valve regurgitation. The aortic coarctation was corrected first, using percutaneous balloon dilatation; and in a second stage the aortic regurgitation and ascending aorta aneurysm was treated by Bentall procedure. The patients' postoperative period was uneventful. Three years after the operation he continues to do well.</p

Novel insights into an old controversy: Is coronary artery ectasia a variant of coronary atherosclerosis?

Coronary artery ectasia (CAE) is defined as a localized or diffuse non-obstructive lesion of the epicardial coronary arteries with a luminal dilation exceeding 1.5-fold the diameter of the normal adjacent arterial segment. The incidence of CAE has been reported to range between 2% and 4%, which might be an overestimation of the true frequency. The coincidence of CAE with other systemic vascular dilatations has suggested that the mechanism underlying CAE is not only localized to coronary arteries, but also to other vascular compartments such as aorta or peripheral veins. Although the pathophysiology of CAE remains largely unknown, it was supposed to represent a variant of coronary atherosclerosis. This review focuses on this controversy of whether CAE and coronary artery disease (CAD) are two manifestations of the same underlying process. There are clear differences between CAD and CAE with respect to cardiovascular risk factors such as diabetes mellitus, and pathogenic steps in disease progress such as inflammation or extracellular matrix remodeling. As this review will underscore, the current knowledge of the field is insufficient to finally clarify the causative interrelation between CAE and CAD. The clinical course and treatment of CAE mainly depends on its coexistence with CAD. When coexisting with CAD, the prognosis and treatment of CAE are the same as for CAD alone. In isolated CAE, prognosis is better and anti-platelet drugs are the mainstay of treatment. Surgical treatment can be considered in selected patients. For clarifying the mechanism underlying CAE, additional clinical, histopathological and pathophysiological investigations are required. In fact, every patient with CAE should be evaluated systematically for pathological changes in other vascular territories, both in the arterial system as well as in the venous system, which might occur in the disease process

DEPTH MAP PROCESSING FOR MULTI-VIEW VIDEO PLUS DEPTH

The world of multimedia and visual entertainment has grown in leaps and bounds in the past decade with 3-D television being one of the biggest technologies. Amongst several formats proposed for representing 3-D content, multi- view video plus depth (MVD) format has gained a lot of interest in the past few years. MVD requires that each view of a particular scene be accompanied by a per-pixel depth. This introduces new problems for compression and transmission of MVD content because a depth map has di erent characteristics from a color image. Keeping the MVD format and depth map characteristics in mind, we highlight three majors problems that plague the MVD format, namely, 1. depth map re nement. 2. depth map compression. 3. novel view synthesis using the depth map at the decoder side. In order to re ne a depth map, we propose a multi-resolution anisotropic di usion algorithm that is optimized to run in real-time thus ensuring that the encoder does not su er from additional latency. Next, we propose two unique solutions for compressing them. We rst propose a solution using the Layered Depth Video (LDV) concept using a rate-distortion optimized quadtree decomposition of the LDV using a novel two-mode block truncation code with improved prediction. We also propose a compression solution using compressive sensing (CS) concepts by creating a hybrid rate-optimized CS codec. This codec achieves two goals:- rstly, block classi cation to ensure lower decoder complexity and secondly, rate-distortion optimization of the measurement rate for each block that is to be compressively sensed. We then look at the view synthesis component of the MVD tool-chain which x is a time-sensitive process. Keeping decoding latency in mind, we propose a lookup- table based approach to the 3-D warping process with a simpli ed hole- lling algorithm that is not only competitive quality-wise with other schemes but is several times faster too. It is hopeful that the presented techniques can be used successfully to create MVD architectures for applications that need low-complexity encoding solutions.PH.D in Electrical Engineering, May 201

Side Information Generation for Distributed Video Coding Using Spatiotemporal Joint Bilinear Upsampling

Distributed video coding presents a viable solution for power-constrained multimedia communication. However, its relatively low coding efficiency compared to the conventional video coding schemes remains a challenging issue. The rate-distortion performance of distributed video coding is highly dependent on the quality of side information generated at the decoder and various techniques have been proposed to improve the side information quality in block-based and frame-based distributed video coding architectures. In this paper, a robust spatiotemporal joint bilateral upsampling based side information generation method is proposed. The proposed side information generation method is based on a block-based low-complexity distributed video coding architecture with adaptive block coding mode classification. A partially reconstructed Wyner-Ziv (WZ) frame with skip and key blocks is downsampled and spatiotemporal error concealment and joint bilateral upsampling are used to generate the side information. Simulation results show that the proposed method improves the quality of side information significantly while keeping low computational complexity