title: Unrecognized anomalous left circumflex coronary artery arising from right sinus of Valsalva: a source of perioperative complication.
abstract: : In this article we provide a very interesting and challenging PCI of unrecognized anomalous left circumflex coronary artery (LCx) arising from right sinus of Valsalva (RSV) after aortic valve replacement (AVR).This case presentation focuses the attention on important criteria for recognition of abnormal LCx coronary artery, that is the most frequent congenital coronary variant. Failure to demonstrate the anomaly can lead to erroneous interpretation of coronary anatomy with fatal complication in case of aortic valve replacement, as a consequence of accidental ligation or compression of the anomalous vessel. This procedure, especially in the presence of a bioprosthesis aortic valve just implanted, constitutes a challenge for the interventional cardiologist and at the same time a question mark regarding the strategy, choice of guiding catheter, guide wire, and type of stent to use.
authors: Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.
authors: Mariano
authors: M
authors: Pellicano
authors: Gabor
authors: G
authors: Toth
authors: Giuseppe
authors: G
authors: Di Gioia
authors: Dan
authors: D
authors: Rusinaru
authors: William
authors: W
authors: Wijns
authors: Emanuele
authors: E
authors: Barbato
authors: Bernard
authors: B
authors: De Bruyne
authors: Ivan
authors: I
authors: Degrieck
authors: Carlos
authors: C
authors: Van Mieghem
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001705:Bioprosthesis; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000000981:diagnostic imaging; D003951:Diagnostic Errors; D054855:Drug-Eluting Stents; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D012850:Sinus of Valsalva / Q000002:abnormalities* / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000209:etiology