title: Management of anomalous left circumflex artery encircling the aortic annulus in a patient undergoing multivalvular surgery.
abstract: The abnormal origin of left circumflex artery from the right sinus of Valsalva with a retroaortic course is a well-known coronary anomaly usually without consequences. In patients undergoing aortic valve replacement, this finding becomes crucial because the left circumflex is at risk of injury during the procedure. The scenario is even more complex in patients undergoing multi-valve surgery. We report the diagnosis and successful operative strategy in a patient with anomalous left circumflex arising from the proximal right sinus of Valsalva undergoing double aortic and tricuspid valve surgery for active bacterial endocarditis.
authors.affiliation: Department of Cardiothoracic Surgery, Mount Sinai School of Medicine, New York, New York, USA.
authors.forename: Javier G
authors.initials: JG
authors.lastname: Castillo
authors.forename: Javier
authors.initials: J
authors.lastname: Sanz
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Fischer
authors.forename: Kimberley
authors.initials: K
authors.lastname: Bowman
authors.forename: Farzan
authors.initials: F
authors.lastname: Filsoufi
mesh_terms: D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000601:surgery*; D001705:Bioprosthesis; D002315:Cardiopulmonary Bypass; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000175:diagnosis / Q000601:surgery*; D020878:Device Removal; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D011183:Postoperative Complications / Q000175:diagnosis; D016459:Prosthesis-Related Infections / Q000601:surgery; D012850:Sinus of Valsalva / Q000002:abnormalities*; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000601:surgery*; D013212:Staphylococcus epidermidis; D036542:Tomography, Spiral Computed; D014261:Tricuspid Valve / Q000601:surgery*