1. Left circumflex coronary artery occlusion after mitral valve annuloplasty: "a stitch in time".
- Author
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Somekh NN, Haider A, Makaryus AN, Katz S, Bello S, and Hartman A
- Subjects
- Aged, Coronary Angiography, Coronary Occlusion diagnostic imaging, Coronary Occlusion therapy, Echocardiography, Doppler, Color, Female, Fistula etiology, Heart Diseases etiology, Heart Injuries diagnostic imaging, Heart Injuries therapy, Humans, Myocardial Infarction etiology, Reoperation, Stents, Treatment Outcome, Vascular System Injuries diagnostic imaging, Vascular System Injuries therapy, Coronary Occlusion etiology, Heart Injuries etiology, Heart Valve Prosthesis Implantation adverse effects, Mitral Valve surgery, Mitral Valve Annuloplasty adverse effects, Vascular System Injuries etiology
- Abstract
The left circumflex coronary artery is susceptible to injury during mitral valve surgery because of its proximity to the mitral valve annulus. We report the case of a 73-year-old woman who had undergone mitral valve repair and experienced a perioperative myocardial infarction due to occlusion of the left circumflex coronary artery. After percutaneous coronary intervention, a fistulous communication had developed between the stented portion of the left circumflex coronary artery and the left atrium, which, to our knowledge, is the first report of such a complication. The patient underwent successful mitral valve replacement. Although injuries to the left circumflex coronary artery are rare during mitral valve surgery, we believe that increasing awareness of the risk will help to prevent potentially fatal complications. We also recommend that surgeons gather as much detail as possible about the patient's anatomy before operation, use careful and meticulous surgical techniques, and use transesophageal echocardiography to look for wall-motion abnormalities before closing the incision.
- Published
- 2012