Aortic Valve Replacement in 8 Adults with Anomalous Aortic Origin of Coronary Artery
| Autor: | Brian Binnall, Abdallah K. Alameddine, Patrick J. Broderick, Frederick Conlin |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Percutaneous coronary intervention 030204 cardiovascular system & hematology medicine.disease 03 medical and health sciences Stenosis 0302 clinical medicine medicine.anatomical_structure 030228 respiratory system Aortic valve replacement Right coronary artery medicine.artery Internal medicine Aortic sinus Anomalous aortic origin of a coronary artery medicine Cardiology cardiovascular system Case Series Myocardial infarction Cardiology and Cardiovascular Medicine business Artery |
| Popis: | Patients with anomalous origin of a coronary artery during aortic valve replacement (AVR) are at risk of coronary compromise. Large case series are lacking. In this retrospective study, we review our experience with this condition. From August 2014 through June 2016, 8 adult patients (mean age, 74 ± 17.5 yr; age range, 33–86 yr; 5 men) with anomalous aortic origin of a coronary artery underwent surgical or transcatheter AVR at our institution. Six patients had aortic stenosis; 2 had aortic insufficiency, one of whom had an associated aortic root aneurysm. In 7 patients, the left anomalous coronary artery originated from the right aortic sinus, and in one, the right coronary artery arose from the left cusp. The anatomic course was revealed by means of 3-dimensional computed tomographic angiography. No patient underwent primary aortic reimplantation of the anomalous artery. Two had the artery mobilized from encircling the annulus too closely and then underwent coronary artery bypass grafting. Two high-risk patients underwent transcatheter AVR. After surgical AVR, 2 patients had perioperative myocardial infarction caused by coronary compression, so percutaneous coronary intervention was performed. One patient died of sepsis 3 months after discharge from the hospital. In our patients, AVR sometimes led to severe perioperative complications. Successful AVR depended on 3-dimensional computed tomographic angiographic findings, individual anatomic variations, and appropriate treatment choices. |
| Databáze: | OpenAIRE |
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