Introduction: Ischemic heart disease is the most common cause of mortality in developed countries. CABG (coronary artery Bypass Graft) is one of the therapeutic methods in ischemic heart disease.Methods and Materials: Considering the increased incidence of coronary artery disease in Iran, and with increased rate of CABG, we performed a cross sectioned study (1996-1999). In 635 patients 467 male (73.5 percent), 168 female (26.5 percent) about risk factors of mortality after CABG in cardiac surgery department "Imam Khomeini hospital. 20 risk factors were included in our study: age, gender, smoking, family history, diabetes mellitus, morbid obesity, hypercholesterolemia, hypertension, palpitation, renal failure COPD, (chronic obstructive pulmonary disease), history of myocardial infarction, CHF, angina, cerebral vascular disease, pace maker, Ejection fraction<40 percent, history of PTCA, history of CPR, and coronary endarterectomy. Results: Cigarette smoking (P=0.40), CHF in female (P=0.003). Endarterectomy in both gender (P=0.0001). Pace maker in both gender (P=0.00006), palpitation in both gender (P=0.0001). CPR in both gender (P=0.0000001), were associated with increased risk of mortality after CABG. Conclusion: We found that, endarterctomy, cigarette smoking, CHF. Pace maker, CPR, and palpitation are important risk factors for mortality after CABG.

Objective(s): To determine One-month survival after CABG in Shariati Hospital.Methods: We followed 340 patients who underwent Isolated-CABG in Shariati Hospital and used survival analysis to compare common coronary risk factors and to assess surgical factors related to survival after CABG.Results: Smoking was more prevalent in males than in females but prevalence of hypertension, diabetes and hperlipidemia was greater in women. Female subjects were older, had greater Body Mass Index (BMI) and left ventricular ejection fraction (LVEF) and had undergone more non-elective surgery compared to males. Most patients had received 3 or 4 grafts (range 1-6 grafts). There was no difference in aortic cross clamp and anesthesia time between the two genders. Females were hospitalized for longer periods after surgery and their mortality rates were greater. One-month survival ratio estimated by the Kaplan Meier method was 97.1% and 88.4% in males and females respectively. The overall survival rate was 95.3%.Conclusion: The factors related to poor survival were: female gender, non-elective surgery, lengthy aortic cross clamp and anesthesia time and the history of: hypertension, hyperlipidemia, previous CABG and CCU hospitalization.

A 70-year-old woman with hypertension presented to our clinic for evaluation of chest pain. A very rare anomaly, in which the right coronary artery originated from the left anterior descending artery, was incidentally found on coronary angiography. The acute angle made by the anomalous right coronary artery may have reduced the flow velocity and led to signs of myocardial ischemia.

We report a case of an 87-year-old man where coronary CT angiography incidentally demonstrated a “split” right coronary artery (RCA) featuring a “split” posterior descending artery. This case focusses on the morphological description of this variant as well as its differentiation from a “dual” or “duplicated” RCA.

A 50–year–old woman presented to our center with effort angina. Angiography showed normal left main coronary artery, normal left circumflex (LCX) artery and critical discrete lesion (99% stenosis) in mid part of left anterior descending (LAD) artery with good distal flow. However, the right coronary artery (RCA) originated from the left main coronary artery. There was no evidence of external compression of the proximal portion of the RCA during systole or diastole. Consult with cardiac surgeon was done but the patient refused from the operation.

Iatrogenic aortocoronary dissection and ostial coronary avulsion are rare and devastating complications of Percutaneous coronary Intervention (PCI), which mandate a challenging management. Herein, we described a case of right coronary ostial avulsion in a dwarf woman with chronic total occlusion of the vessel during PCI and discussed about the results and pitfalls.

Introduction: Although the coronary artery aneurysms (CAA) are common, giant aneurysms are rare. Clinical presentation, prognosis and management of giant CAA are not well defined due to a limited experience. Recently, there are increasing reports suggesting the occurrence of CAA as a complication of drug eluting stent implantation and angioplasty. The majority are atherosclerotic in origin. Other causes include connective tissue disorders, trauma, vasculitis, congenital, mycotic and idiopathic. The primary complication is myocardial ischemia or infarction, with rupture being rare. Treatment options include anticoagulation, custom made covered stents, reconstruction, resection, and exclusion with bypass.Case Presentation: A 51 year-old man was referred for autopsy, Findings in autopsy: Finding front of a heart 10×10 centimeter saccular aneurysm, originating from the right coronary artery , heart larger than normal size (460 g), calcification, atherosclerosis & stenosis in all coronary artery ,calcification in heart valve, old ischemia in left ventricle. Findings in microscopy: Infiltration hemorrhage & clot in RCA and aneurysm. There were associated calcification and severe stenosis of the RCA, LM & LAD. The past medical history was unclear, but smoking is noted.Conclusion: right coronary artery aneurysms in adult patients are predominantly atherosclerotic in origin. The clinical presentation is due to myocardial ischemia, likely from associated embolism. Rupture is rare. Operative treatment is exclusion and revascularization.

Anomalous coronary artery origin is a rare clinical entity with varied clinical outcomes ranging from asymptomatic to sudden cardiac death. The incidence of anomalous origin of left coronary artery arising from the right coronary cusp is 0.3-1%. CT angiography is the choice method for coronary anomalies, but often coronary angiography in RAO (right anterior oblique) view shows the coronary course. We present a case that referred to our hospital with post myocardial infarction angina for coronary angiography. A resting 12-lead electrocardiogram showed ST-segment elevation in leads v2, v3, v4. A transthoracic echocardiogram indicated LVEF 25% (Left ventricular ejection fraction), septal akinesia and apical dyskinesia. coronary Angiography showed an anomalous origin of the left coronary artery from the right coronary cusp and significant stenosis in LAD (left anterior descending) and LCX (left circumflex) arteries with poor run off.