Left ventricular—Coronary sinus shunt through a septal aneurysm after mitral valve re-replacement

Tokunaga, Shigehiko; M, Yoshitoshi; Mayumi, Hisanori; Nakano, E.; Toshima, Yoshihiro; Kawachi, Yoshito; Yasui, Hirofumi

doi:10.1016/0003-4975(94)00347-a

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…In six selected references [2][3][4][5][6][7], the reported cases presented as left ventricular coronary fistula. Three of them were diagnosed by Doppler echocardiography [3,4,6], and the other three cases were re-operated as peri-prosthetic leaks [1,2,5]. All these six cases presented systolic murmurs, which led to diagnostic investigations and consequent surgical treatment.…”

Section: Commentsmentioning

confidence: 99%

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Coronary sinus iatrogenic lesion during repeated mitral valve replacement: case report of an immediate transmitral annulus repair

Évora¹,

Ribeiro²,

Menardi³

et al. 2003

Rev Bras Cir Cardiovasc

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We report a case and evolution of a patient in whom the coronary sinus was damaged and reconstructed through the mitral annulus. The surgical accident happened during a degenerated biological valve prosthesis instrumentation. An almost complete left circumflex coronary artery division was our first hypothesis. A coronary probe introduced through the vascular injury was distally detected inside the right atrium confirming a coronary sinus lesion. The surgical correction was performed using running polypropylene 7-0 sutures through the mitral ring. After fourteen months, a coronary sinus angiographic image was taking observing the venous phase of selective left coronary arteriography. The image demonstrated an acceptable narrowing of the local venous repair. In our opinion the single coronary sinus division or its repair, in this iatrogenic situation, is a matter of speculation.Descriptors: Coronary sinus. Mitral valve. Cardiac surgery. Heart valve diseaseS. Heart valve prosthesis. Mitral valve annulus.Resumo Apresenta-se a história e a evolução de uma paciente no qual o seio coronariano foi lesado e, imediatamente, reconstruído através do anel valvar mitral. O acidente cirúrgico aconteceu durante a instrumentação para remoção de uma prótese biológica degenerada. Uma quase completa lesão da artéria coronária circunflexa foi a primeira impressão. Um calibrador coronariano foi distalmente detectado dentro do átrio direito, mostrando tratar-se de uma lesão do seio coronariano. A correção cirúrgica foi realizada por sutura contínua com fio de polipropileno 7-0 através do anel valvar. Uma angiografia, realizada após 14 meses, mostrou apenas discreto estreitamento do seio coronariano no local da sutura, observando-se a fase venosa de uma arteriografia seletiva da artéria coronária descendente anterior. Os autores acreditam que a simples ligadura ou a reconstrução do seio coronariano, na condição iatrogênica apresentada, é motivo para especulações.Descritores: Seio coronariano, cirurgia. Valva mitral, cirurgia. Valvas cardíacas, cirurgia. Prótese das valvas cardíacas.

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Section: Commentsmentioning

confidence: 99%

“…In addition, the posterior atrioventricular groove leading to hematoma, myocardial rupture and/or intracardiac shunt may be another iatrogenic problem. Intracardiac shunts have been described since the seventies and at least six cases have been reported [2][3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%