title: Patient-Specific Three-Dimensional Aortocoronary Model for Percutaneous Coronary Intervention of a Totally Occluded Anomalous Right Coronary Artery.
abstract: Percutaneous coronary intervention (PCI) for anomalous coronary arteries is often difficult because the support provided by the guide catheter is insufficient. We encountered a patient with severe three-vessel coronary disease including a totally occluded anomalous right coronary artery (RCA) originating from the left sinus of Valsalva. Initial PCI for the anomalous RCA via the transradial approach failed. Therefore, we constructed a three-dimensional (3D) aortocoronary model and conducted an in vitro simulation to plan the second PCI and found that a Judkins left (JL) 3.5 guide catheter in the power position yielded maximum backup support for the anomalous RCA. Thus, the second PCI was conducted using an 8 Fr JL 3.5 guide catheter in the power position via the transfemoral approach. The procedure was smooth and successful, without any adverse events. Our experience suggests that case-specific 3D models are useful for strategic planning of complex PCIs.
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan. naritatu@kuhp.kyoto-u.ac.jp.
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Watanabe
authors.forename: Naritatsu
authors.initials: N
authors.lastname: Saito
authors.forename: Syojiro
authors.initials: S
authors.lastname: Tatsushima
authors.forename: Junichi
authors.initials: J
authors.lastname: Tazaki
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Toyota
authors.forename: Masao
authors.initials: M
authors.lastname: Imai
authors.forename: Shin
authors.initials: S
authors.lastname: Watanabe
authors.forename: Erika
authors.initials: E
authors.lastname: Yamamoto
authors.forename: Bingyuan
authors.initials: B
authors.lastname: Bao
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakatsuma
authors.forename: Hiroki
authors.initials: H
authors.lastname: Watanabe
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shizuta
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
mesh_terms: D006328:Cardiac Catheterization; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D054059:Coronary Occlusion / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D015607:Stents; D025321:Surgery, Computer-Assisted / Q000379:methods*