Circumflex coronary artery injury after mitral valve surgery: A report of four cases and comprehensive review of the literature

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
Nick HiltropWalter Desmet

Abstract

As the LCx is closely related to the mitral valve annulus, it is susceptible to perioperative injury. Various underlying mechanisms, predisposing factors, and therapeutic strategies have been suggested but disagreement exists. Using a MeSH terms-based PubMed search, 44 cases of mitral valve surgery-related LCx injury were detected, including our 4 cases. We provide a comprehensive review of current knowledge regarding mitral valve surgery-related left circumflex coronary artery (LCx) injury. Preoperative coronary angiography was performed in 55% (n = 24). Coronary abnormalities were present in 11% (n = 5). Coronary dominance was reported in 73% (n = 32), predominantly showing left (69%, n = 22) or balanced (19%, n = 6) circulations. Right coronary dominance was present in 12% (n = 4). Ischemia was detected in the perioperative or early postoperative phase in 86% (n = 30). Delayed symptoms were present in 14% (n = 5). Echocardiography demonstrated new regional wall motion abnormalities in 80% (n = 24), but was negative in 20% (n = 6) despite coronary compromise. Electrocardiography showed myocardial ischemia in 97% (n = 34), including regional ST-segment elevations in 68% (n = 23). Primary treatment was surgical in 42% (n = 15) ...Continue Reading

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Citations

Mar 21, 2015·The Annals of Thoracic Surgery·Mario GaudinoMassimo Massetti
Oct 12, 2016·The Journal of Thoracic and Cardiovascular Surgery·Juan A Crestanello
Oct 1, 2018·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Fahad AlqahtaniMohamad Alkhouli
Feb 16, 2019·Journal of the Saudi Heart Association·Aysha HusainAli AlMasood
Nov 7, 2019·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Heath S L AdamsSimon Redwood
Aug 30, 2017·Journal of Cardiac Surgery·Haytham ElgharablyGösta B Pettersson
Oct 9, 2020·General Thoracic and Cardiovascular Surgery·Koji MiuraTakehiko Matsuo
Oct 22, 2020·The Thoracic and Cardiovascular Surgeon·Bálint FábiánTamás Ruttkay
Aug 4, 2020·The Annals of Thoracic Surgery·Marta BargagnaMichele De Bonis
Mar 27, 2021·Clinical Case Reports·Negin YavariSeyed Hossein Ahmadi Tafti
Jun 29, 2021·Frontiers in Cardiovascular Medicine·Faraj KargoliAzeem Latib
Jul 29, 2021·JACC. Case Reports·Volkmar FalkAntonio Colombo
Jul 29, 2021·JTCVS Techniques·Vincent ChauvetteLouis P Perrault
Jul 16, 2021·General Thoracic and Cardiovascular Surgery·Fahd BennaniOlivier Chavanon
Sep 3, 2021·Seminars in Cardiothoracic and Vascular Anesthesia·Jose Liza ReshmiAveek Jayant
Oct 16, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Noriaki KishimotoToshihiko Shibata

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