Left circumflex artery injury postmitral valve surgery, single center experience

Journal of the Saudi Heart Association
Aysha HusainAli AlMasood

Abstract

The left circumflex (LCX) artery is located close to the mitral valve (MV), making it susceptible to injury during MV surgery. We are reporting our experience in the diagnosis and management of this complication. We retrospectively reviewed our surgical and coronary angiography databases for patients with documented LCX artery injury during MV surgery between January 2000 and December 2016. The complication was associated with MV replacement (9/1313, 0.7%) but not MV repair (0/393, 0.0%). Eight patients (88.9%) were female and the mean age was 40.4 ± 14.2 years. There was roughly similar distribution of left and right dominant coronary circulations (5 and 4 patients, respectively). Eight patients (88.9%) had ischemic changes on electrocardiogram and ventricular arrhythmias were documented on six patients (66.7%). Three patients (33.3%) were treated with percutaneous coronary intervention while six patients (66.7%) required redo surgery to graft the LCX artery. The 30-day mortality was high (33.3%). A high index of suspicion is required to diagnose this injury. At the moment, no consensus is available on the optimal treatment strategy. We propose percutaneous approach as the first option to spare the patients from undergoing ope...Continue Reading

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Citations

Oct 9, 2020·General Thoracic and Cardiovascular Surgery·Koji MiuraTakehiko Matsuo
Oct 22, 2020·The Thoracic and Cardiovascular Surgeon·Bálint FábiánTamás Ruttkay
Jan 15, 2021·European Heart Journal. Case Reports·Ana DevesaÁlvaro Aceña
Mar 27, 2021·Clinical Case Reports·Negin YavariSeyed Hossein Ahmadi Tafti
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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