Suture obliteration of the circumflex coronary artery in three patients undergoing mitral valve operation

Virmani, Renu; Chun, Patrick K.C.; Parker, John O.; Colonel, Lieutenant; McAllister, Hugh A.

doi:10.1016/s0022-5223(19)38969-x

Cited by 74 publications

(62 citation statements)

References 2 publications

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“…Mitral valve surgery is associated with a potential risk of iatrogenic CX injury and subsequent myocardial ischemia. The true mechanism for this is still unclear with authors suggesting direct suturing, 4 lacerations, or annuloplasty device distortion during mitral valve repair 5 . In this case report, the iatrogenic injury was due to a distortion caused by the device implanted: the restitutio ad integrum of the CX patency after the implant of a flexible device confirmed the importance of the type of annuloplasty device used to respect the relationship between the mitral valve and CX.…”

Section: Discussionmentioning

confidence: 61%

Dramatic resolution of an immediate postoperative distortion of the circumflex artery during mitral valve surgery

2020

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Injury or distortion of the circumflex coronary artery can occur during mitral valve surgery, due to its proximity to the mitral valve annulus. We present the case of a 72-year-old male patient with symptomatic mitral regurgitation, who underwent minimally invasive mitral valve surgery. The initial reparative gesture was complicated by intraoperative infarct due to a distortion of the circumflex artery (CX) caused by the rigidity of the ring used; the mainstay of the treatment was the removal of the previous device implanted in favor of a flexible one with restitutio ad integrum of the CX patency. K E Y W O R D S annuloplasty devices, circumflex artery, mitral valve repair | CARUSO ET AL.

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Section: Discussionmentioning

confidence: 61%

Dramatic resolution of an immediate postoperative distortion of the circumflex artery during mitral valve surgery

2020

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“…A congenital anomaly of the right coronary artery cannot be excluded; however, previous reports have demonstrated complete opacification of the right coronary from the circumflex artery [Kang 2006], which was not the case in our patient. Circumflex artery lesion caused by sutures is a known complication of mitral annuloplasty [Virmani 1982]. The middle portion of the circumflex artery, however not the proximal, is at risk, because that is the location closest to the mitral annulus.…”

Section: Discussionmentioning

confidence: 99%

Rescue Circumflex Artery Stenting for Major Right Ventricular Dysfunction after Ross-Konno Operation

Myers¹,

Aggoun²,

Çıkırıkçıoğlu³

et al. 2009

The Heart Surgery Forum

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A single coronary artery is an anomaly in which only 1 coronary artery arises from the aortic root, supplying the entire heart. We report the case of a 5-year-old girl in whom a single coronary artery ostium was discovered during a Ross-Konno operation. This patient required extracorporeal membrane oxygenation for postoperative right ventricular infarction due to proximal stenosis of a dominant left circumflex artery in combination with an occluded minor right coronary artery. Rescue stent implantation allowed for recovery of right ventricular function and weaning from extracorporeal membrane oxygenation.

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“…Ramus circumfl exus probíhá blízko zadního cípu mitrální chlopně a anterolaterální komisury. Anatomické studie [8][9][10] uvádějí, že nejkratší vzdálenost je v oblasti přední komisury mitrální chlopně, kde může být i < 1 mm. Vzdálenost se liší i v závislosti na dominanci levé či pravé věnčité tepny.…”

Section: Diskuseunclassified

“…Obrázek 4 Rekoronarografi e -balonková predilatace stenózy (šipka) je tedy největší v proximální třetině koronární cévy při dominanci levé věnčité tepny. [8][9][10] Mechanismy poškození věnčité tepny jsou různé a v některých případech ne zcela jasné. Tepna může být poškozena stehem s následkem významné (i dynamické) stenózy či uzávěru cévy, 1,2,5-6 steh může zasáhnout pouze stěnu cévy, což může být příčinou spasmu cévy, subintimální hemoragie nebo trombotické okluze z důvodu dysfunkce endotelu.…”

Section: Obrázek 3 Rekoronarografi E (Měsíc Po Operaci) -Rc S Iatrogeunclassified

Mitral valve ring as a rare cause of acute coronary syndrome

Juránek¹,

Nykl²

2010

Cor Vasa

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Juránek P, Nykl I. Prstenec mitrální chlopně jako raritní příčina akutního koronárního syndromu. Cor Vasa 2010;52:618-621. Mezi vzácné komplikace operace mitrální chlopně patří poškození věnčitých tepen. Ramus circumfl exus probíhá v těsné blízkosti mitrálního anulu. Iatrogenní poškození této tepny má poté za následek vznik non-aterosklerotické ischemické choroby srdeční s různou klinickou manifestací. V naší kasuistice popisujeme poškození ramus circumfl exus manifestující se akutním koronárním syndromem u pacientky s původně negativním koronarogramem. Klíčová slova: Chirurgie mitrální chlopně -Myokardiální ischemie -Akutní koronární syndromJuránek P, Nykl I. Mitral valve ring as a rare cause of acute coronary syndrome. Cor Vasa 2010;52:618-621.Rare complications of mitral valve surgery include damage to the coronary arteries. Left circumfl ex coronary artery (LCx) is in close proximity to the mitral annulus. Iatrogenic injury to this artery then gives rise to non-atherosclerotic coronary heart disease with diff erent clinical manifestations. In our case report we present injury to the LCx manifesting by acute coronary syndrome in a patient with initially negative coronary angiography.

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Suture obliteration of the circumflex coronary artery in three patients undergoing mitral valve operation

Cited by 74 publications

References 2 publications

Dramatic resolution of an immediate postoperative distortion of the circumflex artery during mitral valve surgery

Dramatic resolution of an immediate postoperative distortion of the circumflex artery during mitral valve surgery

Rescue Circumflex Artery Stenting for Major Right Ventricular Dysfunction after Ross-Konno Operation

Mitral valve ring as a rare cause of acute coronary syndrome

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