Opacification d'une veine coronaire lors d'une angiographie ventriculaire gauche avec myographie accidentelle chez une femme de 78 ans porteuse d'un rétrécissement aortique serré

Abstract

A 78 year-old woman had a NYHA II dyspnoea, which was related to a calcified aortic stenosis. Functional aortic valvular surface was calculated to 0.75 cm 2 by echocardiography. In addition, there were important mitral calcifications without mitral stenosis. The left ventricular contractility was normal, but there was a significant left ventricular hypertrophy. At the time of the coronary angiography, the aortic valve was crossed with difficulty. A “pigtail” probe was positioned and during left ventricular angiography, an unexpected aspect of myography was observed with an unusual opacification of the interventricular posterior coronary vein, draining in the coronary sinus. The patient remained strictly asymptomatic during all the procedure. Two echographic controls carried out in the 24 following hours appeared normal, without pericardial effusion nor new parietal anomaly of the left ventricle. Five weeks later, the patient underwent an aortic valve replacement without complication.