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[Congenital bicuspid aortic valve associated with aberrant coronary artery origin: a case report]
H Masuda1, K Arikawa, M Maruko
1Department of Cardiovascular Surgery, National Southkyusyu Central Hospital.
Insights
This case report details a 61-year-old man with a congenital bicuspid aortic valve and aberrant coronary artery origin. The study highlights the rare anatomical association and potential genetic links between these cardiovascular anomalies.
Area of Science:
- Cardiovascular Medicine
- Congenital Heart Disease
- Cardiac Surgery
Background:
- Bicuspid aortic valve (BAV) is a common congenital heart defect.
- Aberrant coronary artery origin is a rare anomaly.
- The co-occurrence of BAV and aberrant coronary artery origin presents unique surgical challenges.
Observation:
- A 61-year-old male presented with severe aortic stenosis due to a calcified bicuspid aortic valve.
- Intraoperative findings revealed close proximity of the coronary ostia to the bicuspid aortic valve within the sinus of Valsalva.
- The patient had an aberrant coronary artery origin, a rare finding associated with BAV.
Findings:
- The study documents a rare case of congenital bicuspid aortic valve with aberrant coronary artery origin.
- Severe aortic valve stenosis and calcification were noted.
- The anatomical relationship between the bicuspid aortic valve and coronary ostia was critically close.
Implications:
- This case underscores the importance of meticulous pre-operative assessment and intraoperative vigilance in patients with complex congenital heart anomalies.
- Understanding the genetic mechanisms underlying these co-occurring anomalies may improve diagnostic and therapeutic strategies.
- Such anatomical variations necessitate tailored surgical approaches during aortic valve replacement.
Abstract:
A 61-year-old man with congenital bicuspid aortic valve associated with aberrant coronary artery origin is presented. His aortic valve was severely stenotic with marked calcification. At the aortic valve replacement, it was found that the valve was markedly calcified and the bicuspid valve and both coronary ostia were very close to each other in a posteriorly positioned sinus of Valsalva. There have been a few reports concerning the combination of the bicuspid aortic valve and aberrant coronary artery origin, and it is well known that the bicuspid aortic valve more frequently accompanies short left main trunk or left coronary arterial dominance than a normal aortic valve. Some genetic mechanisms surrounding the coronary artery, aortic valve and aorta are suggested to occur with such anomalies.