Rarities in the catheterization Lab. A strange type of single coronary artery

The single coronary artery, a rare but well described coronary artery anomaly, is considered potentially dangerous. A case of a 71-year old woman, suffering from a moderate arterial hypertension and frequent episodes of atypical chest pain is described. The woman was found to have a strange type of single coronary with hypoplastic circumflex coronary artery, difficulty classifiable as a Lipton R-II A single coronary artery. The anatomical features and classification criteria of the case are also described.

New hopes for dynamic cardiomyoplasty from use of Doppler flow wire in evaluation of demand stimulation

BACKGROUND

There are no data regarding real cardiac assistance in demand dynamic cardiomyoplasty (DDCMP). A test of the use of Doppler flow wire is presented to demonstrate cardiac assistance in DDCMP.

METHODS

Comparative study in hospitalized care. A peripheral Flex Doppler flow wire of 0.018 inch was advanced through a 4F introducer femoral arterial in seven DDCMP patients (age=57.1+/-6.2 years; NYHA= 1.4+/-0.5). A short period of 10 sec with stimulator off and a following period of 15 sec with clinical stimulation were recorded. We measured the maximum peak aortic flow velocity (MPAV) in all beats. Latissimus dorsi (LD) mechanogram was simultaneously recorded.

RESULTS

Statistical analysis showed an increase not only in MPAV in assisted period versus rest, but also in assisted beats versus unassisted (8.42+/-6.98% and 7.55+/-3.07%).

CONCLUSIONS

Intravascular Doppler proved real systolic assistance in DDCMP; in DDCMP systolic assistance is correlated to the LD wrap speed of contraction, suggesting that demand stimulation could be the most effective protocol in dynamic cardiomyoplasty.