title: Incidental finding of anomalous circumflex coronary artery from right coronary sinus prior to aortic valve surgery.
abstract: Anomalous origin of the left circumflex (Cx) artery is a common and mostly benign coronary artery anomaly. We report the case of a man aged 52 years who presented to his local hospital with progressive breathlessness on exertion and syncopal episodes. His admission transthoracic echocardiography (TTE) showed bicuspid aortic valve, severe aortic stenosis with a valve area of 0.5 cm2and his left ventricular ejection fraction (LVEF) was 27%. His coronary angiogram showed normal coronary arteries but anomalous origin of the Cx artery from the right coronary. He underwent elective bioprosthetic aortic valve replacement. His postoperative recovery was uneventful and he was discharged on day 5 postoperatively. His TTE postoperatively showed well-seated aortic valve, improved LVEF to 51%. We here report a case of incidental finding of anomalous Cx artery arising from the right coronary while the patient is being worked up for aortic valve replacement for congenital bicuspid aortic valve.
authors.affiliation: Department of Cardiothoracic Surgery, Barts Heart Centre, St Bartholomew's Hospital, London, UK.
authors.forename: Amer
authors.initials: A
authors.lastname: Harky
authors.affiliation: Department of Cardiovascular Surgery, Heinrich-Heine-University, Medical Faculty, Düsseldorf, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Hof
authors.affiliation: University of Liverpool School of Medicine, Liverpool, UK.
authors.forename: Mohammad U
authors.initials: MU
authors.lastname: Ahmad
authors.affiliation: Department of Cardiothoracic Surgery, Barts Heart Centre, St Bartholomew's Hospital, London, UK.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Uppal
mesh_terms: D001021:Aortic Valve / Q000002:abnormalities* / Q000601:surgery; D000082882:Bicuspid Aortic Valve Disease; D054326:Coronary Sinus; D003330:Coronary Vessel Anomalies / Q000601:surgery*; D003331:Coronary Vessels / Q000473:pathology*; D006349:Heart Valve Diseases / Q000151:congenital / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome