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      Mitral Valve Repair and Anomalous Origin of Circumflex Artery : To Ring or Not to Ring

      case-report

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          Abstract

          We describe a case of an adult patient with mitral valve regurgitation and the anomalous origin and course of the left circumflex coronary artery. Use of a ringless procedure or a microinvasive approach, such as transapical neochordae implantation, would have possibly avoided a life-threatening post-operative complication. ( Level of Difficulty: Advanced.)

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          Abstract

          We describe a case of an adult patient with mitral valve regurgitation and the anomalous origin and course of the left circumflex coronary artery. Use…

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          Coronary artery anomalies in 126,595 patients undergoing coronary arteriography.

          O Yamanaka, R. E. Hobbs (1990)
          Coronary artery anomalies were found in 1,686 patients (1.3% incidence) undergoing coronary arteriography at the Cleveland Clinic Foundation from 1960 to 1988. Of the 1,686 patients, 1,461 (87%) had anomalies of origin and distribution, and 225 (13%) had coronary artery fistulae. Most coronary anomalies did not result in signs, symptoms, or complications, and usually were discovered as incidental findings at the time of catheterization. Eighty-one percent were "benign" anomalies: 1) separate origin of the left anterior descending and circumflex from the left sinus of Valsalva; 2) ectopic origin of the circumflex from the right sinus of Valsalva; 3) ectopic coronary origin from the posterior sinus of Valsalva; 4) anomalous coronary origin from the ascending aorta; 5) absent circumflex; 6) intercoronary communications; and 7) small coronary artery fistulae. Other anomalies may be associated with potentially serious sequelae such as angina pectoris, myocardial infarction, syncope, cardiac arrhythmias, congestive heart failure, or sudden death. Potentially serious anomalies include: 1) ectopic coronary origin from the pulmonary artery; 2) ectopic coronary origin from the opposite aortic sinus; 3) single coronary artery; and 4) large coronary fistulae. Coronary artery anomalies require accurate recognition, and at times, surgical correction.
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            Sudden death from cardiac causes in children and young adults.

            Richard R. Liberthson (1996)
            Article 0 comments Cited 80 times – based on 0 reviews     Review now
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              An early European experience with transapical off-pump mitral valve repair with NeoChord implantation.

              Andrea Colli, Erica Manzan, Audrius Aidietis … (2018)
              Transapical off-pump NeoChord repair is a novel minimally invasive surgical procedure to treat degenerative mitral valve regurgitation. The aim was to evaluate 1-year clinical results of the NeoChord procedure in a consecutive cohort of patients.
              Article 0 comments Cited 37 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Gino Gerosa
                Journal
                Journal ID (nlm-ta): JACC Case Rep
                Journal ID (iso-abbrev): JACC Case Rep
                Title: JACC Case Reports
                Publisher: Elsevier
                ISSN (Electronic): 2666-0849
                Publication date PMC-release: 18 December 2019
                Publication date Collection: December 2019
                Publication date (Electronic): 18 December 2019
                Volume: 1
                Issue: 4
                Pages: 503-507
                Affiliations
                [1]Department of Cardio-Thoracic-Vascular Science and Public Health, Cardiac Surgery Unit, Hospital of Padova, Padova, Italy
                Author notes
                [∗ ] Address for correspondence: Dr. Gino Gerosa, Department of Cardio-Thoracic-Vascular Science and Public Health, Cardiac Surgery Unit, Hospital of Padova, Via Giustiniani 2, Padova, Italy, 35128. gino.gerosa@ 123456unipd.it
                Article
                Publisher Item ID: S2666-0849(19)30451-6
                DOI: 10.1016/j.jaccas.2019.08.030
                PMC ID: 8289087
                PubMed ID: 34316865
                SO-VID: 80f05ebf-239c-4a22-91af-5ba2214a5c19
                Copyright © © 2019 Published by Elsevier on behalf of the American College of Cardiology Foundation.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 29 April 2019
                Date revision received : 11 July 2019
                Date accepted : 15 August 2019
                Categories
                Subject: Valvular Heart Disease Mini-Focus Issue
                Subject: Case Report: Clinical Case

                Keywords: cardiac risk,coronary vessel anomaly,computed tomography,mitral valve,aaoca, anomalous aortic origin of coronary artery,lca, left coronary artery,lcx, left circumflex coronary artery,lv, left ventricular,rcs, right coronary sinus,tte, transthoracic echocardiogram,v-a ecmo, veno-arterial extracorporeal circulatory membrane oxygenator
                Data availability:
                Keywords: cardiac risk, coronary vessel anomaly, computed tomography, mitral valve, aaoca, anomalous aortic origin of coronary artery, lca, left coronary artery, lcx, left circumflex coronary artery, lv, left ventricular, rcs, right coronary sinus, tte, transthoracic echocardiogram, v-a ecmo, veno-arterial extracorporeal circulatory membrane oxygenator

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