Access the full text.
Sign up today, get DeepDyve free for 14 days.
Loading next page...
/lp/wolters-kluwer-health/letter-by-kern-regarding-article-ldquo-primary-stenting-of-an-4WRnVlLVj3
References
References for this paper are not available at this time. We will be adding them shortly, thank you for your patience.
- ISSN
- 1941-9651
- eISSN
- 1942-0080
- DOI
- 10.1161/CIRCIMAGING.109.894717
- pmid
- 19920037
- Publisher site
- See Article on Publisher Site
Abstract
Correspondence approaches 25% when placed on arteries with nonsignificant phys- Letter by Kern Regarding Article “Primary iological narrowings. Stenting of an Anomalous Left Main Coronary In this particular case, because the patient’s cardiac arrest proba- Artery With an Interarterial Course During bly was related to the critical mid vessel lesion and ST-segment– Cardiac Arrest: Imaging With CT Angiography” elevation myocardial infarction more than the long-standing left main orifice narrowing, an assessment beyond anatomy alone would To the Editor: reduce or eliminate any uncertainty of the treating physicians relying I read with interest the case of Jaffe et al on the management of the on a single cross-sectional area alone for important decision-making patient with ST-segment–elevation myocardial infarction and car- regarding coronary artery bypass grafting. diac arrest due to a critical lesion in an anomalous left main coronary artery originating from the right sinus of Valsalva. The requisite Disclosures stenting of the critical lesion in the mid portion and the patient’s Dr Kern is speaker for St Jude Medical, Volcano Therapeutics, and subsequent recovery was followed by an evaluation of the slitlike Consultant to Merit Medical and Infraredx Inc. ostial orifice by both intravascular ultrasound and unique computed tomography angiographic imaging. Morton J. Kern, MD My compliments on the interesting computed tomography angio- Long Beach Veterans Administration Hospital graphic imaging, but my reason for writing was to remind the University of California, Irvine Medical Center interventionalists that a 6.3-mm cross-sectional area of this anom- Orange, Calif alous and eccentrically shaped left main orifice, whether obtained by computed tomography angiography or intravascular ultrasound, may References or may not represent a significant obstruction to coronary blood 1. Botman CJ, Schonberger J, Koolen S, Penn O, Botman H, Dib N, Eeckhout flow. A debate exists about the flow-limiting nature of a single E, Pijls N. Does stenosis severity of native vessels influence bypass graft cross-sectional area (excluding the other factors of anatomy such as patency? A prospective fractional flow reserve-guided study. Ann Thorac Surg. 2007;83:2093–2097. length, entrance angulation, and so forth, that constitute additional 2. Bech GJ, Droste H, Pijls NH, DeBruyne B, Bonnier JJ, Michels HR, Peels components of flow resistance) when comparing results with stress KH, Koolen JJ. Value of fractional flow reserve in making decisions about testing, late outcomes, and simultaneous measurement of transle- bypass surgery for equivocal left main coronary artery disease. Heart. sional pressure. Studies of pressure-derived fractional flow reserve 2001;86:547–552. have demonstrated excellent clinical outcomes of medical manage- 3. Botman CJ, Schonberger J, Koolen S, Penn O, Botman H, Dib N, Eeckhout ment for left main narrowings with nonischemic physiology (frac- E, Pijls N. Does stenosis severity of native vessels influence bypass graft 1,2 tional flow reserve 0.75). Moreover, and perhaps more impor- patency? A prospective fractional flow reserve-guided study. Ann Thorac tantly, the likelihood of coronary bypass graft failure at 1 year Surg. 2007;83:2093–2097. (Circ Cardiovasc Imaging. 2009;2:e51.) © 2009 American Heart Association, Inc. Circ Cardiovasc Imaging is available at http://circimaging.ahajournals.org DOI: 10.1161/CIRCIMAGING.109.894717 e51
Journal
Circulation: Cardiovascular Imaging – Wolters Kluwer Health
Published: Nov 1, 2009