Anomalous aortic origin of right and circumflex coronary arteries - procedural risks during combined aortic valve replacement and coronary artery bypass grafting
| Autor: | Mladen J. Kocica, Ljiljana Soskic, Milica Karadzic, Dragan Cvetković, Miloš Grujić |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
business.industry lcsh:R lcsh:Medicine General Medicine coronary vessel anomalies medicine.disease heart valve prosthesis implantation Surgical pathology Coronary arteries Coronary circulation medicine.anatomical_structure Aortic valve replacement myocardial revascularization Internal medicine Aortic valve stenosis medicine Cardiology Circumflex Myocardial infarction business cardiac surgical procedures Artery |
| Zdroj: | Srpski Arhiv za Celokupno Lekarstvo, Vol 146, Iss 7-8, Pp 440-444 (2018) |
| ISSN: | 2406-0895 0370-8179 |
| Popis: | Introduction. Anomalous aortic origin of the right and the circumflex coronary arteries presents extremely rare and potentially dangerous combination in patients scheduled for combined coronary bypass grafting and aortic valve replacement surgery. We report this illustrative case to emphasize the importance of meticulous diagnostic setup enabling the surgeon to anticipate and avoid numerous possible pitfalls. Case outline. A 74-year-old woman, with anterior-wall myocardial infarction and aortic valve stenosis, underwent successful combined coronary artery bypass grafting and aortic valve replacement. Preoperative coronary angiography revealed unusually high take-off of the right main coronary trunk and anomalous origin and course of the circumflex coronary artery. Anatomy of both anomalous coronary arteries in the light of underlying surgical pathology necessitated a meticulous preparation and caution during successive phases of surgical treatment. Conclusion. Estimating potential procedural risk should be standard practice for each patient with known congenital coronary artery anomalies, regardless of the natural risk imposed by a particular anomaly. Preoperative evaluation of coronary circulation, with high surgical awareness and knowledge of different congenital coronary artery anomalies, should be a standard approach in cardiac surgical practice. This would add a predictive value for an actual procedural risk in cases of previously unrecognized anomalies. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|