Welkom bij THIM Hogeschool voor Fysiotherapie & Bohn Stafleu van Loghum
THIM Hogeschool voor Fysiotherapie heeft ervoor gezorgd dat je Mijn BSL eenvoudig en snel kunt raadplegen. Je kunt je links eenvoudig registreren. Met deze gegevens kun je thuis, of waar ook ter wereld toegang krijgen tot Mijn BSL. Heb je een vraag, neem dan contact op met helpdesk@thim.nl.
Om ook buiten de locaties van THIM, thuis bijvoorbeeld, van Mijn BSL gebruik te kunnen maken, moet je jezelf eenmalig registreren. Dit kan alleen vanaf een computer op een van de locaties van THIM.
Eenmaal geregistreerd kun je thuis of waar ook ter wereld onbeperkt toegang krijgen tot Mijn BSL.
Login
Als u al geregistreerd bent, hoeft u alleen maar in te loggen om onbeperkt toegang te krijgen tot Mijn BSL.
Video 1 Operative video showing entire course of left anterior descending artery after unroofing
Opmerkingen
Video online
The online version of this article contains one video. The article and the video are online available (https://doi.org/10.1007/s12471-024-01866-8). The video can be found in the article back matter as “Electronic Supplementary Material”.
A 50-year-old male had been suffering from angina pectoris functional class III/IV for the past 9 years. Initially, medical therapy was attempted, but the patient continued to experience disabling angina. The coronary angiogram revealed an intramyocardial left anterior descending artery (LAD) extending from the second diagonal branch to the apex (Fig. 1a). Echocardiography indicated normal ventricular function. The patient was accepted for minimally invasive unroofing surgery. During the procedure, a left-sided mini-thoracotomy was performed and the LAD course was identified. The entire intramyocardial course could be unroofed using minimally invasive off-pump techniques (Fig. 1b, and see Video 1 in Electronic Supplementary Material). The LAD diameter was significantly larger than initially suspected. When we compared the pre- and postoperative coronary angiograms, we noticed the LAD diameter had increased 2–3 times (Fig. 1). The postoperative course was uneventful and the patient was discharged after 3 days. Follow-up assessments revealed complete remission of chest pain. Minimally invasive unroofing surgery can be a solution for selected patients with this complex disease [1].
Fig. 1
a Preoperative (left panel) and postoperative (right panel) coronary angiograms. Yellow arrows indicate left anterior descending artery (LAD). Postoperatively, the LAD diameter is evidently larger. b (Minimally invasive) surgical view of LAD after coronary unroofing. The entire course of the LAD is now clearly visible
×
Conflict of interest
M.-L. Wester, A.M.J. De Vos, P. Elsman, J. Ter Woorst and F. Akca declare that they have no competing interests.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...
