Journal of

Introduction: Coronary endarterectomy is not a perfect procedure. However, it is sometimes the only available alternative for cardiac surgeons in patients suffering from diffuse coronary artery disease. According to a large volume of studies, coronary endarterectomy results (such as survival, recurrence of the symptoms of myocardial ischemia, and graft patency) are not as satisfactory as standard coronary artery bypass grafting (CABG). While the left anterior descending artery (LAD) is the artery most commonly involved in coronary endarterectomy, RCA can be treated with coronary endarterectomy. This study aimed to evaluate clinical evidence and early results of right coronary artery endarterectomy.

Methods: A total of 20 cases of coronary endarterectomy of the RCA was studied from January 2015 to January 2016 in this retrospective study. Endarterectomy procedure was performed in Imam Reza Hospital affiliated to Mashhad University of Medical Sciences.

Results: The mean age of the subjects was 60±5.2 years (range: 48-75 years).  From among them, 14 were male (70%), and the mean ejection fraction index was 36±5.7 (range: 15-60). Further, in 8 cases, a prior history of myocardial infarction was documented (40%). The mortality rate among patients was 10% (n=2). In total, 7 (35%) and 12 (60%) patients required intra-aortic balloon pump support and high-dose inotropic support, respectively. Perioperative myocardial infarction was observed in 5 (25%) cases, and 3 (15%) patients required re-exploration due to significant hemorrhage. Severe RV failure at the end of procedure was noticed in 4 patients (20%) with resultant mortality in half of them. Some type of heart block w occurred in 1 patient (5%).

Conclusions: In case coronary endarterectomy of the RCA is performed by an experienced cardiac surgeon, favorable outcomes can be expected.

• The case in this study was a 33-year-old woman suffering from acute pericardial tamponade with severe left ventricular systolic dysfunction (LVEF=10%) after myocarditis as a result of possible viral respiratory infection.
• The diagnosis was confirmed with two transthoracic echocardiography (TTE) evaluation showing moderate pericardial effusion with diastolic right atrium and ventricle collapse. The hemodynamic and respiratory condition of the patient was unstable and emergent. The drainage of pericardial space was life-saving with good results.

• Introduction: Peripheral arterial disease in coronary artery disease (CAD) is associated with poor cardiovascular outcomes. This issue is more highlighted in patients undergoing coronary artery bypass graft surgery after catheterization procedures.
• Methods: This study was observational on participants who recourse to the heart clinics and candidates for coronary angiography, based on inclusion and exclusion criteria. In the first, coronary angiography was performed, and so, if the patients had significant involvement of coronary arteries and had at least one inclusion criteria, for assessment of peripheral arterial disease (PAD), peripheral angiography through the femoral artery was performed. The statistical analysis was done by SPSS software (Version 16) and the data were analyzed using the descriptive statistics method, variance analysis, and Fisher's Exact Test. The level of significance was considered to be (0.05).
• Results: Among all patients, there was no significant difference in the demographic variables such as gender (P= 0.497) and age (P= 0.069). The commonest peripheral artery involved in patients was the right femoral artery. A statistically significant relationship between gender and PAD was seen (P=0.001). There was no significant relationship between the type of involved coronary artery and gender (p=0.043; Fisher's Exact Test = 10.719).
• Conclusion: More than one-third of participants with CAD had peripheral arterial involvement in iliofemoral arteries in this study. This situation increased the risk of complications in vascular blind catheterization. So, Improving PAD detection is crucial for more effective cardiovascular prevention and treatment.