Entrapment of the Left Coronary Artery Ostium by the Aortic Valve Leaflet, Promoting Myocardial Ischemia

Abstract

A 13-year-old girl was referred to us after an episode of post-exercise ischemic heart event. Ascending aortography, left coronary angiography (Online Videos 1A and 1B), multidetector X-ray computed tomography (A to C), and transesophageal echocardiography (Online Videos 2A and 2B) showed sequestration of the left coronary sinus by the aortic valve leaflet. Stress myocardial scintigraphy revealed perfusion defect, suggesting anteroseptal myocardial ischemia. The patient is scheduled to have corrective operation. This case illustrates that entrapment of the left coronary artery ostium can be one of the causes of ischemic heart disease (1,2).