By Alfred North Whitehead
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It was assumed to be idiopathic. The left ventricular function was normal. He had no symptoms at all. His referral physician sent him to perform an MSCT to rule out CAD, trying to better deﬁne the needs of surgery. Patients who are scheduled to undergo open heart surgery with purely regurgitant valves, often do not need concomitant CABG but mitral regurgitation could be the consequence of CAD, as signiﬁcant CAD is found in approximately one-third of these patients. The American College of Cardiology/AHA committee indicates preoperative coronary angiography in symptomatic patients and/or those with left ventricular dysfunction in men >35 years, premenopausal women >35 years with risk factors for CAD, and postmenopausal women.
Comments Multiplanar reconstruction, 3D volume rendering, and LVA of left main (LM) and anterior descending artery (LAD) showed LM of important length and large caliber. There was a mild calciﬁed nonobstructing plaque. The LAD was a long artery of large caliber. There was a soft plaque in the proximal LAD, with moderate to severe stenosis. There was no disease in the distal LAD (Figs. The ﬁrst diagonal had a moderate soft plaque (Fig. 4). The left circumﬂex was dominant; it had large caliber and important length.
4 Macroscopic image of a surgically excised mass. Note the exact position of each portion of the mixoma within the heart and adjacent vascular structures. SVC superior vena cava; RA right atrium; RV right ventricle; PA pulmonary artery (trunk); RPA right pulmonary artery. Findings 47 48 P. 5 Lateral Left Ventricular Wall Rupture Following Acute Myocardial Infarction LW LV PA VFWR IVS RA LA Fig. 3 Fig. 1 Fig. 2 Fig. 4 A 79-year-old man with a history of chronic obstructive pulmonary disease due to smoking and a long-standing history of coronary artery disease requiring surgical myocardial revascularization (left internal mammary artery to left anterior descending coronary artery and a vein graft to right coronary artery) 10 years prior to this admission presented with new onset of resting chest pain.