[Aortic sigmoid cusp anomaly: rare cause of myocardial infarction in children]

A three and a half year old child with no previous medical history died, 20 hours after extensive anterior myocardial infarction. Post-mortem examination showed an abnormal aortic valve: the cusps were thick, indurated and white in colour. The free edge of the left antero-lateral cusp was higher than that of the other two cusps and presented a discrete thickening which overlapped the superior border of the left coronary ostium, obstructing the orifice at its thickest part. The other two cusps were tipped by fibrous spurs, one of which partially obstructed the right coronary ostium which was slightly narrowed at its origin. A review of the literature on aortic pathology causing coronary obstruction revealed rare cases of malignant disease and, more commonly, malformations usually associated with supravalvular aortic stenosis. This case might illustrate a partial and atypical form of supravalvular aortic stenosis.