Aortic valve replacement for a patient with anomalous left coronary artery from the right sinus of Valsalva

Abstract

Anomalous origin of the left coronary artery (LCA) from the right sinus of Valsalva (RSOV) is an uncommon but clinically important feature. A 75-year-old man with progressive nocturnal dyspnea was diagnosed with severe aortic valve stenosis and moderate regurgitation. Preoperative computed tomographic scan revealed that the LCA originated from the RSOV separate from the right coronary artery and coursed into the ventricular septum. Because he did not experience any episodes of cardiac ischemia, isolated aortic valve replacement was performed using a 23-mm stented bioprosthesis without concomitant coronary revascularization. The postoperative course was free from coronary ischemia.

Double raphed bicuspid aortic valve and the "reverse S" coronary angiographic sign

“…Our patient denied angina and neither the intraseptal LMCA nor the intramyocardial LAD artery showed angiographic evidence of phasic external muscular compression; t hus coronary revascularisation was not performed. Because an intraseptal anomalous coronary artery courses far from the aortic annulus, aortic valve replacement can be performed with a low risk of injury to the anomalous vessel [9].…”

Surgical treatment of a patient with heart disease and congenital coronary anomaly

“…The preceding case report by Hamamoto and colleagues [1] on aortic valve replacement for a patient with ectopic coronary arterial origin stimulates a few discussion and comments on congenital coronary anomalies.…”