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Myocardial infarction caused by compression of anomalous circumflex coronary artery after mitral valve replacement
G Speziale1, K Fattouch, G Ruvolo
1Institute of Cardiac Surgery, University La Sapienza, Rome, Italy.
Minerva Cardioangiologica
|April 20, 1999
Insights
A rare coronary anomaly caused myocardial infarction after mitral valve replacement. This case highlights the risks associated with anomalous left circumflex coronary artery in cardiac surgery.
Area of Science:
- Cardiovascular Surgery
- Cardiac Anatomy
- Pathophysiology
Background:
- Mitral valve replacement is a common cardiac procedure.
- Coronary artery anomalies can complicate surgical outcomes.
- Anomalous origin of the left circumflex coronary artery from the right coronary sinus is a rare finding.
Observation:
- A patient with an anomalous left circumflex coronary artery underwent mitral valve replacement and tricuspid annuloplasty.
- The patient received a size 27 Carbomedics prosthesis.
- The tricuspid annuloplasty was performed using the De Vega technique.
Findings:
- The patient developed myocardial infarction post-operatively.
- The anomalous coronary artery anatomy is a potential contributing factor to the infarction.
- Postoperative mortality occurred on the 20th day.
Implications:
- This case underscores the importance of pre-operative coronary imaging in patients undergoing valve surgery.
- Awareness of coronary anomalies is crucial for surgical planning and risk mitigation.
- Further research into managing patients with similar anatomical variations is warranted.
Abstract:
We report a case of myocardial infarction after mitral valve replacement occurring in a patient with the left cyrcumflex coronary artery arising from the right one. The patient underwent mitral valve replacement with a size 27 Carbomedics prosthesis and a tricuspidal annuloplasty was performed according to the De Vega technique. Patient died on the 20th postoperative day.