Mitral Valve Repair and Anomalous Origin of Circumflex Artery

Fabozzo, Assunta; Rossi, Elena; Facci, Gabriele; Bottio, Tomaso; Gerosa, Gino

doi:10.1016/j.jaccas.2019.08.030

Cited by 3 publications

(2 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The risk of LCx injury seems to be greater also in patients with an anomalous course of the LCx 51 . Fabozzo et al described a case of LCx occlusion with anomalous origin and retroaortic course and suggested that cardiac computed tomography scanning (CT‐scan) may provide precious information regarding coronary anatomy in patients undergoing valve surgery to reduce perioperative complications 32 . However, the role of cardiac CT‐scan in this setting has not been sufficiently investigated so far.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous treatment of left circumflex coronary artery injury related to mitral valve surgery: Case series and systematic review of the literature

Benedetti

Castaldi

Poletti

et al. 2023

Cathet Cardio Intervent

View full text Add to dashboard Cite

Left circumflex coronary artery (LCx) injury related to mitral valve surgery is a rare complication. The best treatment option is not defined, and percutaneous coronary intervention (PCI) may represent an effective treatment to avoid prolonged myocardial ischemia. To evaluate feasibility and efficacy of PCI treatment, all records of LCx injury related to mitral valve surgery and treated with PCI were included after a systematic PubMed searching. Moreover, we retrospectively analyzed our single‐center PCI database and patients fulfilling the inclusion criteria were included. Patients undergoing transcatheter mitral valve intervention, non‐mitral valve surgery, conservatively or surgically treated after LCx injury were excluded. Data about patient characteristics, procedural details, PCI success, and in‐hospital mortality were collected. Fifty‐six patients were included, 58.9% were male (n = 33) and the median age was 60.5 years (IQR = 21.75). The majority had left dominant or codominant coronary system (62.2%, n = 28 and 15.6%, n = 7, respectively). Clinical manifestations ranged from hemodynamic stability (21.1%, n = 8) to hemodynamic instability (42.1%, n = 16) and cardiac arrest (18.4%, n = 7). On ECG, 23.5% of patients (n = 12) presented ST‐segment depression, 58.8% (n = 30) ST‐segment elevation, 7.8% (n = 4) atrioventricular block, and 29.4% (n = 15) ventricular arrhythmias. Left ventricle dysfunction was present in 52.3% (n = 22) of patients and wall motion abnormalities in 71.4% (n = 30). PCI success rate was 82.1% (n = 46) and in‐hospital mortality 4.5% (n = 2). LCx injury related to mitral surgery is a rare complication characterized by an increased risk of mortality. PCI seems a feasible treatment option, still burdened by suboptimal results, probably related to the technical challenges posed by the surgical failure.

show abstract

Section: Discussionmentioning

confidence: 99%

Percutaneous treatment of left circumflex coronary artery injury related to mitral valve surgery: Case series and systematic review of the literature

Benedetti

Castaldi

Poletti

et al. 2023

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

“…In this issue of JACC: Case Reports , Fabozzo et al. ( 4 ) present a case of what initially appeared to be a routine elective repair of degenerative mitral prolapse (if “routine” could describe the appropriate nuance of diversity and unique complexity inherent to degenerative valve pathology; it does not) ( 4 ). As such, the vignette describes a young (49 years of age), asymptomatic man recently made aware during a routine physical examination of an incidental, previously unknown systolic heart murmur, subsequently referred to the investigators’ service for surgical consultation and further management.…”

mentioning

confidence: 99%

Mitral Valve Repair

Pandis

Isselbacher

2019

JACC: Case Reports

View full text Add to dashboard Cite

show abstract

Do anomalous aortic origin of a coronary artery patients have higher risk of myocardial ischaemia and adverse cardiac events during aortic and mitral valve replacements?

McCloskey,

Vaidya,

Jiang

et al. 2024

Cardiol Young

View full text Add to dashboard Cite

Objectives: We assessed the effect of anomalous aortic origin of a coronary artery on the risk of early and late postoperative events after aortic or mitral valve replacement in adults. Methods: Between 2005 and 2022, 29,579 adults underwent surgical aortic or mitral valve replacement at Cleveland Clinic. Among these, 29 had an unrepaired coronary artery rising anomalously from the aorta that was not intervened upon during valve surgery, 19 (65%) an anomalous circumflex, and 9 (31%) an anomalous right. Operative outcomes were compared between the 29 patients with anomalous coronary arteries and 87 balancing score (1:3) matched patients with normal coronary origin. Median follow-up was 6.5 years. Results: Among matched groups, major morbidity and mortality 24% (n = 7) in patients with anomalous coronaries and 20% (n = 17) among patients with normal coronary origin (P = .7). Ten-year freedom from coronary reintervention was 83% versus 100% (P[log-rank] = .005), and 10-year survival was 59% versus 53% (P[log-rank] = .8). One patient experienced a coronary injury from valve surgery, in which the incidentally found anomalous retroaortic circumflex was immediately repaired without further complication. There was no coronary reintervention after discharge in the normal coronary origin group and three in the anomalous coronary group; however, only one of these patients required intervention on the anomalous coronary. Conclusions: Anomalous coronaries were uncommon in surgical valve replacement patients at a high-volume centre. The origin and course of each coronary should be assessed before valve replacement. With careful planning, valve replacement does not result in a significantly higher prevalence of postoperative ischaemia, mortality, or reintervention.

show abstract

Mitral Valve Repair and Anomalous Origin of Circumflex Artery

Cited by 3 publications

References 10 publications

Percutaneous treatment of left circumflex coronary artery injury related to mitral valve surgery: Case series and systematic review of the literature

Percutaneous treatment of left circumflex coronary artery injury related to mitral valve surgery: Case series and systematic review of the literature

Mitral Valve Repair

Do anomalous aortic origin of a coronary artery patients have higher risk of myocardial ischaemia and adverse cardiac events during aortic and mitral valve replacements?

Contact Info

Product

Resources

About