“Wedge effect-in stenosed coronary artery assessed using a PressureWire

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• 作者：Kosuke Nakasuka (1)
  Shigenori Ito (1)
  
• 关键词：Coronary–cameral fistula ; Coronary artery ; left ventricular fistula ; Wedge effect ; Fractional flow reserve ; Coronary PressureWire
• 刊名：Heart and Vessels
• 出版年：2014
• 出版时间：May 2014
• 年：2014
• 卷：29
• 期：3
• 页码：413-416
• 全文大小：
• 参考文献：1. Yamanaka O, Hobbs RE (1990) Coronary artery anomalies in 126,595 patients undergoing coronary angiography. Cathet Cardiovasc Diagn 21:28-0 CrossRef
  2. Yoshino S, Minagoe S, Yu B, Kosedo I, Yamashita M, Ishizawa M, Kono M, Setoguchi M, Nakashima H, Matsuoka T, Suehiro S, Yotsumoto G, Yamashita M, Tei C (2012) Cardiac tamponade due to rupture of coronary artery fistula to the coronary sinus with giant aneurysm of coronary artery: usefulness of transthoracic echocardiography. Heart Vessels. doi:10.1007/s00380-012-0279-9
  3. Stierle U, Giannitsis E, Shelkhzadeh A, Potratz J (1998) Myocardial ischemia in generalized coronary artery-left ventricular microfistulae. Int J Cardiol 63:47-2 CrossRef
  4. Ishii H, Kataoka T, Kobayashi Y, Tsumori T, Takeshita H, Matsumoto R, Shirai N, Nishioka H, Hasegawa T, Nakata S, Shimada Y, Ehara S, Muro T, Yoshiyama M (2011) Utility of myocardial fractional flow reserve for prediction of restenosis following sirolimus-eluting stent implantation. Heart Vessels 26:572-81 CrossRef
  5. Muller O, Verstreken S, Vanderheyden M (2010) Assessment of coronary artery fistula using coronary pressure wire. Circ J 74:1026-027 CrossRef
  
• 作者单位：Kosuke Nakasuka (1)
  Shigenori Ito (1)
  
  1. Division of Cardiology, Nagoya City East Medical Center, 1-2-23 Wakamizu, Chikusa-ku, Nagoya, Aichi, 464-8547, Japan
  
• ISSN：1615-2573

文摘

In this case report, we describe the recovery of abnormal coronary pressure waveform using a PressureWire Certus during percutaneous coronary intervention in a patient with severe stenosis in the proximal segment of the left anterior descending coronary artery. Since the diastolic pressure in the distal left anterior descending coronary artery was lower than that in the aorta, the pressure waveform before percutaneous coronary intervention represented the left ventricular pressure through a fistula due to a “wedge effect-in the stenosis as if the pulmonary artery wedge pressure determined by a Swan–Ganz catheter reflected the pressure in the distal portion (left atrium). We diagnosed this case coronary artery-left ventricular fistula based on the above findings. PressureWire Certus may be a valuable tool with which to estimate the hemodynamics in a patient with a coronary anomaly.