Cardiac Catheterization Cases

That's interesting.

An unexpected guest at the catheterization party. Turned out to be a calcified bronchial mass. 

Trapped sternal wires.

Sternal wires from previous surgery sometimes break. Broken sternal wires sometimes get attached or migrate to the epicardium. When that happens, this happens. 

Ranks

Yamaguchi, according to wikipedia, is the 15th most common japanese name. Go Yamaguchi! Its also like my seventh favorite cardiomyopathy. 

Anomalous Circumflex

Good looking anomolous circunflex. That's it. 

Redundant Leads and Misplaced Arteries

2 Atrial leads can be seen in the right atrium. The LV gram also shows an anomalous RCA coming from the left cusp. 

Lost and Damaged

Anomalous RCA from the left cusp with severe disease in the mid to distal segment. 

Branching LIMA

Most big branches of the LIMA are usually removed during surgery. Sometimes, however, a branch is left out. This can potentially cause a steal like phenomenon. 

Disaster.

A deeply engaged RCA catheter, a forceful RCA injection and a shepherds crook RCA resulted in this disastrous dissection during a diagnostic cath. 

Dual ICD

No. Not a dual chamber. Not just a dual coil. 2 actual ICDs. Not a common sight. 

Collaterals.

Massive collateral circulation from proximal to distal RCA (which is CTO). We will leave it up to y'all to decide whether this fits one of the many definitions for Kugel's artery. 

Territory mismatch

This overzealous LAD has gone on to send one of its diagonals over to the territory of the lcx. Unusual. 

Rare circumflex

If anomalous circs are a dime a dozen, anomalous dominant circs are at least a few dollars. 

Spoil sport

This little bad boy spoilt a radial access catheterization for us. What is the nail doing there anyway? (Hint: Think brachial vein access). 

Epicardial BivICD

for those of us who haven't had a chance to see one of these. 

Left main from hell!

Nope. No previous history of bypasses. 

Left main ulcer.

Left main ulcer. Nasty. 

why this "Y"

You have probably seen Y grafts connecting two SVGs. Have you seen a Y graft with an arterial and vein combined. Here is a LIMA coming off of an SVG graft.