Circumflex artery injury during mitral valve repair: Not well known, perhaps not so infrequent—lessons learned from a 6-case experience Gonçalo F. Coutinho,

Slides:

Advertisements

Similar presentations

Total arterial revascularization of triple vessel coronary disease based on combined internal thoracic and radial artery grafts Robert H. Habib, PhD,

Advertisements

Max B. Mitchell, MD The Journal of Thoracic and Cardiovascular Surgery

Manuel J. Antunes, MD, PhD, DSc

Two-stage hybrid repair for a Kommerell diverticulum in a right-sided aortic arch associated with multivessel coronary disease and atrial septal defect

Is individualized mitral valve repair in the future?

Saphenous vein graft patency and fountain of youth

Translocation of a single coronary artery from the nonfacing sinus in the arterial switch operation: Long-term patency of the interposition graft Igor.

Myocardial bridging over the left anterior descending: Myotomy, bypass, or both? Chigozirim N. Ekeke, BS, Stephen Noble, MD, Ernest Mazzaferri, MD, Juan.

The hybrid procedure for hypoplastic left heart syndrome: A procedure still looking for its place Carlos M. Mery, MD, MPH The Journal of Thoracic and.

First successful transapical aortic valve implantation after aortic allograft replacement Michael Schmoeckel, MD, Peter Boekstegers, MD, Konstantin Nikolaou,

Stenotic false lumen as inflow of coronary aneurysm and full-metal jacket Suguru Ohira, MD, PhD, Hitoshi Yaku, MD, PhD, Shuichiro Takanashi, MD, PhD

Long-term (5- to 20-year) patency of the radial artery for coronary bypass grafting Paul Achouh, MD, Redha Boutekadjirt, MD, Daniel Toledano, MD, Nadjib.

Novel mechanism of mitral regurgitation after lung transplantation in a patient with scleroderma and pulmonary hypertension Christian A. Bermudez, MD,

Neoaortic root dilatation with saccular aneurysm formation after the arterial switch operation for Taussig–Bing anomaly Yoshitaka Hayashi, MD, PhD, Andrew.

Standardizing definitions for hybrid coronary revascularization

Delayed surgery for traumatic rupture of aortic arch with dissection of the left anterior descending artery John EV, MCh, DNB, Gopalakrishnan Mundayat,

Expanding options to manage traumatic thoracic vascular injuries

The present day potential role of fractional flow reserve–guided coronary artery bypass graft surgery Filip Casselman, MD, PhD, FETCS, Johan Van der.

Results of a hybrid procedure for patients with proximal left subclavian artery stenosis and coronary artery disease Hao Hong, MD, Long Wu, MD, Chao.

Anomalous aortic origin of a coronary artery in the Ross operation: Attention to minor details averts major problems Igor E. Konstantinov, MD, PhD, FRACS

CD133+ cells: How could they have an IMPACT?

Use of a polytetrafluoroethylene graft to prevent recurrence of saphenous vein graft aneurysm after coronary artery bypass grafting Syed T. Hussain,

Right internal thoracic artery or saphenous vein grafting

Patrick H McNulty, MD, Ian C Gilchrist, MD

Pulmonary hypertension in valve disease: A beast of the past?

Intrinsic cardiac stem cells are essential for regeneration

Successful repair of coronary artery–pulmonary artery fistula with coronary artery disease and atrial septal defect in an adult Živojin S. Jonjev, MD,

Progressive improvement of myocardial perfusion after off-pump revascularization with bilateral internal thoracic arteries: Comparison of early versus.

Aneurysmal circumflex coronary artery with fistulous connection to the coronary sinus Afksendiyos Kalangos, MD, PhD, DSc(Hon), Saziye Karaca, MD, Mustafa.

Extracorporeal membrane oxygenation as a bridge to surgery for ischemic papillary muscle rupture Benjamin Obadia, JD, Alexis Théron, MD, Vlad Gariboldi,

Functional mitral stenosis after mitral valve repair is a true anatomic problem that originates from the time of surgery Vincent Chan, MD, MPH, Thierry.

Multilevel data analysis: What? Why? How?

A stitch too far: The circumflex artery in jeopardy during mitral valve repair Jeswant Dillon, MD, FRCS The Journal of Thoracic and Cardiovascular Surgery

Is individualized mitral valve repair in the future?

Surgical economics: MACRA, MIPS, and bundles—Lessons learned in the first 3 years of a coronary artery bypass grafting alternative payment model Daniel.

The variability of the mitral valve anatomy and terminology

Echocardiographic Identification of Iatrogenic Injury of the Circumflex Artery During Minimally Invasive Mitral Valve Repair Joerg Ender, MD, Michael.

Does the degree of preoperative mitral regurgitation predict survival or the need for mitral valve repair or replacement in patients with anomalous origin.

Giant vein graft pseudoaneurysm with pulmonary hemorrhage

Use of the hybrid operating room for aortic valve replacement in a patient with anomalous left circumflex artery Ramanan Umakanthan, MD, Zachary E. Brewer,

Circumflex artery injury during mitral valve repair: Not well known, perhaps not so infrequent—lessons learned from a 6-case experience Gonçalo F. Coutinho,

It's not “just a shunt” but sometimes it should be…

Management of new-onset mitral regurgitation with intraoperative angiography and intraoperative percutaneous coronary intervention James P. Greelish,

Surgery for aortic and mitral valve disease in the United States: A trend of change in surgical practice between 1998 and 2005 Scott D. Barnett, PhD,

Derrick Y. Tam, MD, Stephen E. Fremes, MD, MSc

Sinus of Valsalva aneurysms: Stabilizing the repair destabilizing the aortic valve? M. Sertaç Çiçek, MD, FACC The Journal of Thoracic and Cardiovascular.

Guidelines should bother us, not comfort us

Left atrial pressure measurement in a rat is currently impossible due to size limitations of balloon occlusion catheter Filip Konecny, MSc, DVM, PhD

Replicating the success of mitral valve repair in the aortic valve

Hisato Takagi, MD, PhD, Takuya Umemoto, MD, PhD

Anomalous aortic origin of the coronary artery: Does pulmonary artery translocation affect coronary artery course? Vitor C. Guerra, MD, Michael R. Recto,

Manuel J. Antunes, MD, PhD, DSc

Yinsu Zhu, MD, Lijun Tang, MD, PhD, Yi Xu, MD

Compression of an Anomalous Left Circumflex Artery After Aortic and Mitral Valve Replacement Prashant Vaishnava, MD, Robert Pyo, MD, Farzan Filsoufi,

Shunt right or left? Decision 2016

Warfarin or aspirin after mitral valve repair: Why work harder?

Preserving the V-engine shape of the left ventricle with Melody mitral valve replacement in small children Patrick O. Myers, MD The Journal of Thoracic.

Branch graft patency after open repair of thoracoabdominal aortic aneurysms Nicholas T. Kouchoukos, MD, Alexander Kulik, MD, MPH, Catherine Castner, RN,

The Journal of Thoracic and Cardiovascular Surgery

Discussion The Journal of Thoracic and Cardiovascular Surgery

Tissue valve, nitinol stent, or storage solution

Spot the mesh: Six-month follow-up

Another case of underprovision of mitral valve repair surgery: Lessons from the Veterans Affairs health system Anelechi C. Anyanwu, MD, David H. Adams,

Marc Ruel, MD, MPH, Masood A

Concomitant giant coronary artery and coronary sinus aneurysms

Aneurysmal right coronary with fistula to the coronary sinus combined with severe stenosis of the left anterior descending artery: A snake on the heart

Apples remain apples NO matter what

A large international single-center case-series of coronary artery fistulas in children: When high clinical research standards adopted globally create.

IS local wound infection rate more important than long-term graft patency in coronary artery bypass grafting? Tomislav Kopjar, MD, PhD, Michael R. Dashwood,

Intraoperative endocardial ultrasonography: Improving safety in mitral valve surgery Juan A. Crestanello, MD The Journal of Thoracic and Cardiovascular.

Presentation transcript:

Circumflex artery injury during mitral valve repair: Not well known, perhaps not so infrequent—lessons learned from a 6-case experience Gonçalo F. Coutinho, MD, PhD, Filipe Leite, MD, Manuel J. Antunes, MD, PhD, DSc The Journal of Thoracic and Cardiovascular Surgery Volume 154, Issue 5, Pages 1613-1620 (November 2017) DOI: 10.1016/j.jtcvs.2017.05.043 Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Coronary angiogram in case 1 revealing total occlusion of the circumflex artery. The Journal of Thoracic and Cardiovascular Surgery 2017 154, 1613-1620DOI: (10.1016/j.jtcvs.2017.05.043) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 A, Immediate postoperative coronary angiogram in case 2, revealing a 90% occlusion of the CxA (arrow). B, Result after stent implantation. The Journal of Thoracic and Cardiovascular Surgery 2017 154, 1613-1620DOI: (10.1016/j.jtcvs.2017.05.043) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 A, Coronary angiogram in case 3 revealing an “elbow-like” distortion of the CxA, with incomplete occlusion of the vessel (arrow). B, Angiogram performed 1 month after the surgery, showing no lesions. The Journal of Thoracic and Cardiovascular Surgery 2017 154, 1613-1620DOI: (10.1016/j.jtcvs.2017.05.043) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 A, Immediate postoperative coronary angiogram performed in case 4, showing a subtotal occlusion of the CxA (arrow). B, Angiogram performed 1 month after discharge revealed a 50% lesion of the CxA involving the origin of the first obtuse marginal artery. The Journal of Thoracic and Cardiovascular Surgery 2017 154, 1613-1620DOI: (10.1016/j.jtcvs.2017.05.043) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 A, Coronary angiogram performed in case 5, showing a 50% to 75% lesion of the distal CxA (arrow). B, Result after balloon dilation (arrow). The Journal of Thoracic and Cardiovascular Surgery 2017 154, 1613-1620DOI: (10.1016/j.jtcvs.2017.05.043) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 A, Immediate postoperative coronary angiogram performed in case 6, showing total occlusion of the CxA (arrow). B, Angiogram performed during hospitalization, revealing full patency of the CxA and the saphenous venous graft. The Journal of Thoracic and Cardiovascular Surgery 2017 154, 1613-1620DOI: (10.1016/j.jtcvs.2017.05.043) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure 7 Color Doppler of the CxA. Large asterisk shows strong echodense wall of the CxA, and small asterisk shows weak echodense wall of the coronary sinus. LA, Left atrium; LAD, left anterior descending artery; left main, left main coronary artery. From Ender et al.24 The Journal of Thoracic and Cardiovascular Surgery 2017 154, 1613-1620DOI: (10.1016/j.jtcvs.2017.05.043) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

The close spacial relationship between the circumflex artery and the mitral annulus. Reprinted with permission from: Carpentier A, Adams DH, Filsoufi F. Carpentier's Reconstructive Valve Surgery. Philadelphia, PA: Saunders; 2010. The Journal of Thoracic and Cardiovascular Surgery 2017 154, 1613-1620DOI: (10.1016/j.jtcvs.2017.05.043) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions