September 2004

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Volume 16 Issue 9
Intravascular Ultrasound Findings in “Pseudostenosis” During Coronary Angioplasty
The “pseudostenosis” is a well-known angiographic finding observed when the guidewire crosses markedly angulated coronary segments, most commonly in right coronary arteries.1–9 This phenomenon is produced by the straightening of angulated segments by…
Device Closure of Fenestrated Atrial Septal Aneurysm:
Difficulties and Complications with Implantation of Two Devices
Atrial septal aneurysm is a cardiac malformation defined as a localized thinning and bulging of the atrial septum into either atrium. It appears to be acquired as the result of abnormal atrial hemodynamics with resultant pressure deformity and mobili…
Use of Bivalirudin Instead of Heparin During a Percutaneous Coronary Intervention in a Patient with Severe Thrombocytopenia
Heparin has been the standard anticoagulation for percutaneous cardiovascular procedures (PCI). Its low cost and the lack of a better therapeutic alternative have accounted for its widespread adoption in the cardiac catheterization laboratory over th…
Left coronary angiogram in a right anterior oblique cranial angulation showing a large proximal septal perforator arising from the left anterior descending artery. There is a temporary pacer wire at the RV apex.
Intracoronary Myocardial Contrast Echocardiography in a Patient with Drug Refractory Hypertrophic Obstructive Cardiomyopathy Rev
Case Study. A 49-year-old female was investigated for a 2-year history of dyspnea, angina on exertion, and exertional presyncope. Physical examination revealed a 2/6 mid-systolic murmur at rest, increasing in intensity to 3/6 following the Valsalva m…
Coronary Artery Dissection and Perforation Complicating Percutaneous Coronary Intervention
Percutaneous coronary intervention (PCI) is increasingly utilized in the treatment of coronary artery disease. Despite its numerous benefits, serious and potentially life-threatening complications of PCI can occur, including iatrogenic coronary disse…
The Evolving Role of Glycoprotein (GP) IIb/IIIa Receptor Blockade During Percutaneous Coronary Intervention of Saphenous Vein By
Percutaneous coronary intervention (PCI) has improved the treatment of coronary artery disease. However, unlike native coronary arteries, progress in the percutaneous intervention of saphenous vein bypass grafts (SVBG) has been disappointing, often c…
Electrocardiogram three hours post-AVNRT ablation demonstrating inferior ST elevation.
Asymptomatic Acute Inferior ST Elevation Myocardial Infarction from Thermal Injury Complicating Radiofrequency Ablation for Atri
Catheter-based radiofrequency ablation (RFA) is an increasingly utilized modality for the treatment of symptomatic tachyarrhythmias. It is both safe and effective, but complications do infrequently occur. We present a case of asymptomatic acute infer…
Figure 1. Coronary angiogram in the 45° right anterior oblique position shows an intermediate lesion in the left circumflex coronary artery. Arrow points to the lesion. Figure 2. Coronary angiogram demonstrates an image of long dissection extending from t
An Image of Coronary Thrombus Mimicking Dissection Detected by Intravascular Ultrasound During Functional Evaluation of an Inter
During functional evaluation of an intermediate lesion in the circumflex coronary artery by pressure wire, an angiographically false image of long dissection extending from the left main coronary artery (LMCA) to the second obtuse marginal branch of…
1: Complete occlusion of the mid right coronary artery at the site of the previously implanted stent. 2: Angiographic results of balloon dilation at the segment with instent restenosis (ISR) and after a new stent implantation in the most proximal segment
Iatrogenic Subtle Acute Aortic Dissection During Coronary Angioplasty for In-Stent Restenosis. Value of Intravascular
Ultrasoun
Acute aortic dissection (AD) constitutes a life-threatening entity that requires early recognition and management.1–3 AD is a dynamic process with a broad clinical spectrum of presentation. In most patients AD occurs spontaneously as the result of cy…
Figure 1. Right anterior oblique projection shows flow through the left internal thoracic artery. After its insertion to the anterior coronary vein, the flow is back toward the base of the heart, through the iatrogenic shunt, and to the coronary sinus.
Unintended Iatrogenic Creation of an Internal Thoracic Artery to Anterior Coronary Vein Bypass Graft with Subsequent Reoperation
Coronary artery bypass surgery is now a common operation in major tertiary centers with over 300,000 surgeries performed annually in the United States. Despite the refinement of the procedure and high volume experience of most surgeons, mistakes are…