title: Atherosclerosis in type IV dual left anterior descending artery and anomalous aortic origin of the left circumflex artery in association with rheumatic valve disease: a case report.
abstract: Double left anterior descending coronary artery arising from the left and right coronary arteries is a very rare congenital coronary artery anomaly. In this case, there was also a circumflex artery arising from the right sinus Valsalva and in association with severe rheumatic valve disease. Subsequently, the patient underwent mechanical aortic valve replacement with a 21-mm bileaflet mechanical aortic valve and coronary artery bypass grafting. We performed coronary artery bypass grafting of 3 vessels, including the left internal mammary artery to the large diagonal branch and the saphenous vein graft to the circumflex artery and the right coronary artery, under cardiopulmonary bypass. In this report, we describe an unusual case of this combination in association with both atherosclerosis and rheumatic aortic and mitral valve disease.
authors.affiliation: Department of Cardiology, Kartal Kosuyolu Yüksek Ihtisas Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Atila
authors.initials: A
authors.lastname: Bitigen
authors.forename: Ayhan
authors.initials: A
authors.lastname: Erkol
authors.forename: Vecih
authors.initials: V
authors.lastname: Oduncu
authors.forename: Taylan
authors.initials: T
authors.lastname: Akgün
authors.forename: Denyan
authors.initials: D
authors.lastname: Mansuroglu
authors.forename: Nihal
authors.initials: N
authors.lastname: Ozdemir
mesh_terms: D001011:Aorta / Q000002:abnormalities* / Q000601:surgery*; D001027:Aortography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000601:surgery; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012214:Rheumatic Heart Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome