Left circumflex artery injury postmitral valve surgery, single center experience
Autor: | Ziad Dahdouh, Aly Alsanei, Ali Almasood, Zohair Al-Halees, Mohammed Tahir, Aysha Husain |
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Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
lcsh:Diseases of the circulatory (Cardiovascular) system
medicine.medical_specialty business.industry medicine.medical_treatment Left circumflex artery Percutaneous coronary intervention 030204 cardiovascular system & hematology medicine.disease Single Center Surgery Coronary artery disease 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure lcsh:RC666-701 Mitral valve medicine Original Article 030212 general & internal medicine Circumflex business Complication Artery |
Zdroj: | Journal of the Saudi Heart Association, Vol 31, Iss 2, Pp 94-99 (2019) |
Popis: | The left circumflex (LCX) artery is located close to the mitral valve (MV), making it susceptible to injury during MV surgery. We are reporting our experience in the diagnosis and management of this complication. We retrospectively reviewed our surgical and coronary angiography databases for patients with documented LCX artery injury during MV surgery between January 2000 and December 2016. The complication was associated with MV replacement (9/1313, 0.7%) but not MV repair (0/393, 0.0%). Eight patients (88.9%) were female and the mean age was 40.4 ± 14.2 years. There was roughly similar distribution of left and right dominant coronary circulations (5 and 4 patients, respectively). Eight patients (88.9%) had ischemic changes on electrocardiogram and ventricular arrhythmias were documented on six patients (66.7%). Three patients (33.3%) were treated with percutaneous coronary intervention while six patients (66.7%) required redo surgery to graft the LCX artery. The 30-day mortality was high (33.3%). A high index of suspicion is required to diagnose this injury. At the moment, no consensus is available on the optimal treatment strategy. We propose percutaneous approach as the first option to spare the patients from undergoing open-heart surgery for the second time. Keywords: valvular surgery, percutaneous coronary intervention, coronary artery disease, coronary bypass grafts, mitral valve disease |
Databáze: | OpenAIRE |
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