Congenital coronary artery anomaly simulating a ventricular septal defect.
Anomalous origin of the circumflex artery of the right sinus of Valsalva is a rare finding which may be present with other cardiac malformations. A 19-year-old man presented with syncope. A transthoracic echocardiogram revealed discrete subaortic stenosis with a small defect just below the aortic valve, suggesting a ventricular septal defect. Transesophageal echocardiography showed anomalous origin of the circumflex artery from the right sinus of Valsalva. This was confirmed by coronary angiography. The patient underwent successful web resection without concomitant coronary surgery. Failure to demonstrate a coronary artery anomaly can be misleading for surgeons and perilous for patients.
Department of Cardiac Surgery, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Atherosclerosis Prevention Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Ali
A
Azari
Cardiovascular Research Center, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Students Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Zahra
Z
Moravvej
Cardiovascular Research Center, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Department of Cardiology, Ghaem hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Afsoon
A
Fazlinezhad
Cardiovascular Research Center, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Atherosclerosis Prevention Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Department of Cardiology, Ghaem hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran bigdelul@gmail.com.
Leila
L
Bigdelu
D006348:Cardiac Surgical Procedures; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D003951:Diagnostic Errors; D021922:Discrete Subaortic Stenosis / Q000175:diagnosis / Q000209:etiology; D017548:Echocardiography, Transesophageal; D006345:Heart Septal Defects, Ventricular / Q000175:diagnosis*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012850:Sinus of Valsalva / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D013575:Syncope / Q000175:diagnosis / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult
Aortic stenosis; congenital; coronary vessel anomalies; echocardiography; heart defects; sinus of valsalva; transesophageal