Iatrogenic Lesion of an Anomalous Circumflex Coronary Artery During Mitral Surgery Ana Lopez-Marco, MD, Aidil Syed, MD, Tom Combellack, MD, Dheeraj Mehta,

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Presentation transcript:

Iatrogenic Lesion of an Anomalous Circumflex Coronary Artery During Mitral Surgery Ana Lopez-Marco, MD, Aidil Syed, MD, Tom Combellack, MD, Dheeraj Mehta, MD The Annals of Thoracic Surgery Volume 102, Issue 6, Pages e525-e527 (December 2016) DOI: 10.1016/j.athoracsur.2016.05.029 Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Coronary angiography injection in the right coronary artery. The anomalous origin of the left anterior descending artery can be seen in this projection, running horizontally (red arrow). Acute occlusion of the posterior descending artery is also demonstrated. (B) Selective injection of the left anterior descending artery. Note that the mid segment was considerably narrowed compared with the proximal and distal segments. (C) Selective injection of the left circumflex artery, which had no flow limiting lesions. The Annals of Thoracic Surgery 2016 102, e525-e527DOI: (10.1016/j.athoracsur.2016.05.029) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Coronary computed tomography (CT) showing the normal origin of the right coronary artery from the anterior aortic sinus and the anomalous origin of the left anterior descending artery from the right coronary artery itself (red arrow). (B) Coronary CT showing the anomalous origin (red arrow) and trajectory of the left circumflex artery from the anterior aortic sinus and its trajectory around (green arrow). The green dotted line represents the trajectory in the roof of the left atrium, where the artery was accidentally injured. (C) Coronary CT showing the anomalous left circumflex artery on its trajectory behind the aortic root, close to the roof of the left atrium (red arrow). The Annals of Thoracic Surgery 2016 102, e525-e527DOI: (10.1016/j.athoracsur.2016.05.029) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions