Anomalous Origin Of Circumflex Artery Research Articles

Anomalous circumflex artery encircling the aortic annulus: implications for mitral valve repair

Injury to coronary arteries during mitral surgery is a rare but life-threatening procedural complication, an anomalous origin and course of the left circumflex artery (LCx) increase this risk. Recognizing the anomaly by the characteristic angiographic pattern and identifying its relationship with the surrounding anatomical structure using imaging techniques, mainly transesophageal echocardiography (TOE) or coronary computed tomography angiography (CCTA), is of crucial importance in setting up the best surgical strategy. We report a case of anomalous origin of a circumflex artery (LCx) from the proximal portion of the right coronary artery (RCA) with a pathway running retroaortically through the mitro-aortic space. An integrated diagnostic approach using a multidisciplinary team with a cardiologist and an imaging radiologist allowed us to decide the surgical strategy. We successfully performed a mitral valvular repair using a minimally invasive minithoracotomic approach and implanting a complete semirigid ring.

Anomalous Origin of Left Circumflex Artery from the Right Sinus of Valsalva in Cardiac Computed Tomography in a Group of 16,680 Patients—Radiologic and Clinical Characteristics

Background: Anomalous aortic origin of a coronary artery (AAOCA) is the most prevalent form of coronary anomaly. One variant of AAOCA is the anomalous origin of the left circumflex artery from the right sinus of Valsalva, which can be detected using cardiac computed tomography (CT). However, limited data are available regarding the natural history of this anomaly, its impact on myocardial function, and associated symptoms. Methods: We conducted a retrospective analysis of 16,680 CT exams (cardiac and chest) performed between 2015 and 2022 at our Heart Imaging Department, utilising a dual-source 128-slice CT scanner (SOMATOM Definition Flash, Siemens Healthineers, Forchheim, Germany). A registry of patients with anomalous origin of the circumflex artery from the right sinus of Valsalva (RCx) was established. The study included 56 cases of RCx (0.33%). Clinical information was obtained from medical records. RCx was defined as a circumflex artery originating from the right sinus of Valsalva (type I or II) or the right coronary artery (type III). Two researchers independently reevaluated each CT exam in our study group to ensure accurate radiologic descriptions and provide additional precise radiologic information regarding the anomaly, including high-risk features. Results: Our study comprised 56 patients, with approximately equal distribution between males (n = 30, 54%) and females (n = 26, 46%), and with a median age of 59 years. Coronary heart disease (CAD) was known in 23% of patients (n = 13), while 11% (n = 6) were obese (defined as a BMI > 30 kg/m2), and 13% (n = 7) were diagnosed with type 2 diabetes. Only 9% of patients (n = 5) were smokers. Dyslipidemia was the most prevalent atherosclerotic risk factor, affecting approximately one third of patients (n = 17, 30%). In 14% (n = 8) of patients, heart failure was observed, while 13% (n = 7) were diagnosed with atrial fibrillation. Type I RCx was the most common subtype, identified in 48% of patients (n = 27) with this anomaly. Type II and Type III were found in 25% (n = 14) and 27% (n = 15) of patients, respectively. Conclusions: Our findings suggest that RCx is frequently encountered as an incidental finding, and we did not identify a consistent clinical characteristic in all patients with this type of anomaly. Furthermore, no gender predominance was associated with RCx. The natural history of this anomaly and its clinical implications seem benign. Further research is warranted to better understand this anomaly’s natural course and clinical implications.

Abnormal origin of the coronary arteries by echocardiography. And then what?

Abstract Funding Acknowledgements Type of funding sources: None. Introduction The anomalous origin of the coronary arteries from the opposite sinus (AOCA) is increasingly recognized. The most frequent diagnosed by echocardiography is the circumflex artery arising from the right sinus of Valsalva with a retroaortic course. Classically is believed to be a low-risk malformation, nevertheless, whether this anomaly is associated with other high risk features (coexistence with other high-risk AOACA, acute take off angle, intramural course, etc) not easily identify by echocardiography is unknown. Objectives The objectives of this study are to know the prevalence of anomalies of the origin of the coronary arteries diagnosed by echocardiography, to determine the use of additional diagnostic tests and to evaluate the coexistence of the anomalous origin of the circumflex artery with other anomalies and / or risk characteristics. Materials and methods A retrospective search of AOCA diagnosis was performed among echocardiography reports of outpatients in a high complexity cardiology center between March 2018 and December 2021. The clinical history was investigated to identify if the AOCA diagnosis led to further testing (coronary Angio CT or Ischemia diagnosis test) and if these studies provided clinically relevant information. Results Of a total of 26260 echocardiogram reports investigated, 50 presented suspected AOCA (0. 2%), 49 circumflex arteries with anomalous arising from the right sinus with retroaortic course and 1 left coronary artery arising from the right sinus with a subpulmonary course. 18 coronary CT angiography (36%) and 13 stress tests (26%) were requested. In 17 of 18 patients (98%) coronary CT angiography confirmed the diagnosis of anomalous origin of circumflex artery arising from the right sinus with retroaortic course (true positive). In 4 of the 17 OAAC confirmed by CT angiography, the study provided additional important information (2 associated anomalies of the origin of the anterior descending, 1 interarterial course and 1 circumflex artery arising from the right sinus with a retroaortic course and an angle take-off from the aortic wall ‹45°). Conclusion The diagnosis of AOCA by echocardiography is an uncommon finding and most of them are low risk. The most frequent variant is the circumflex artery arising from the right sinus with a retroaortic course. CT angiography adds additional information by identifying associated abnormalities of other coronary arteries and evaluating the angulation of the origin of abnormal coronary arteries.

The ascending aorta valve-sparing prosthetics with abnormal location of the coronary artery circumflex

Highlights. The combination of congenital aortic valve insufficiency and abnormal coronary artery discharge is rare. Taking into account the fact that coronary angiography is not indicated for young patients, there may be a risk of injury to the coronary artery during the correction of aortic malformation. The published case indicates the need for routine coronary angiography for all patients, regardless of their age, who are going to have aortic valve surgery.Background. Anomalous origin from right sinus and pathway of circumflex coronary artery can complicate aortic valve and root procedures. Computed tomography scan with contrast and selective angiography help to recognize the malformation and protect circumflex artery. Herein we present the case of valve sparing root replacement in patient with bicuspid regurgitant aortic valve and anomalous origin of circumflex artery.

Anomalous origin of circumflex artery and LAD deep intramyocardial bridge: clinical implications.

Anomalous origin of circumflex artery and LAD deep intramyocardial bridge: clinical implications.

Anomalous origin of circumflex artery with atypical aortic coarctation

Anomalous origin of circumflex artery with atypical aortic coarctation

Bentall operation in a patient with an anomalous left circumflex artery: Case report and review

Anomalous origin of a left circumflex artery from the right coronary sinus represents a technical challenge in patients who require aortic valve/root procedures. This case report describes a patient who presented with bicuspid aortic valve, anomalous origin of the circumflex artery, severe aortic regurgitation, and aneurysm of the ascending aorta as well as aortic root that was safely managed following the Bentall procedure with the combined button technique.

Reverse type IV dual left anterior descending coronary artery accompanying with anomalous origin of circumflex artery from right coronary sinus

Abstract Dual left anterior descending (LAD) artery is an infrequent coronary anomaly classified into six types. Short LAD arising from left main coronary artery (LMCA) and long LAD sourcing from proximal right coronary artery comprise Type IV dual LAD. We reported anomalous origin of circumflex artery (Cx) with reverse Type IV LAD including short LAD arising from right coronary sinus and long LAD originated form LMCA.

Valve-sparing aortic root replacement in a patient with anomalous origin of circumflex artery: a case report

OZ Gunumuzde, kapak koruyucu aort koku replasman teknikleri giderek yaygin olarak uygulanan guvenli secenekler olmaya baslamistir. Bu yazida, sinus valsalva anevrizmasi ile birlikte sag koroner sinusten koken alan sirkumfleks arter anomalili 19 yasinda bir erkek hastadaki basarili kapak koruyucu aort koku replasmani deneyimi sunuldu. Anah tar soz cuk ler: Koroner arter anomalisi; aort kapak koruyucu; reimplantasyon. ABSTRACT Today, valve-sparing aortic root replacement techniques have started to become safe alternatives which are being used more commonly. In this article, we present a successful valve-sparing aortic root replacement experience in a 19-year-old male patient of sinus valsalva aneurysm associated with anomalous circumflex artery arising from right coronary sinus.

OP-248 The Incidence of Coronary Artery Anomalies and Myocardial Bridge in Our Coronary Angiography Series

The American Journal of Cardiology MARCH 13e16, 2014 10 IN AND C The incidence of the coronary artery anomalies ranges between 0.3-1%. Although coronary artery anomalies are present at birth, relatively few of them become symptomatic during childhood. The majority of anomalies are identified as incidental findings during coronary arteriography or at autopsy. However, some may become evident with angina pectoris, myocardial infarction, syncope, cardiac arrhythmias, congestive heart failure and even, sudden death. In this study, rate and pattern of congenital coronary artery anomalies in adult patients undergoing coronary angiography (CA) in a high volume tertiary medical center were reported. Among the 52 887 coronary angiographies performed between 2003 and 2009. 555 (390 male, 165 female) cases of coronary artery anomalies (1.05%) were identified. The mean age of patients with coronary artery anomaly was 52 13 years. Detailed description of coronary artery anomalies in our CA series is presented in Table 1. Atherosclerotic coronary artery disease accompanied to congenital coronary anomaly in (47.6 %) of cases. Myocardial bridges were the most common coronary artery anomaly and detected in 297 (53.5 %) patients. In 195 of cases (35%) anomalous origin or anomalous course of coronary arteries was present. Among them, anomalous origin of circumflex artery from the right coronary sinus was the most common form (n1⁄486, 15.5% of all cases). The second most common pattern regarding anomalous origin was the origin of right coronary artery from the left coronary sinus (n1⁄434, 6.1% of all cases). The rate of separate ostia of the left circumflex and left anterior descending coronary arteries from left coronary sinus or in other words, absence of left main coronary artery in our series was 2.5 % (n1⁄414). Although the absence of left main coronary artery is thought to be higher, this anomaly might not be specified by operator due to its benign course or inadequate imaging during procedure. Coronary artery fistulae were detected in 57 (10.2%) cases and congenital coronary aneurysm was present in 6 (1.1%) cases. The recognition of coronary artery anomalies shortens the duration of coronary angiography and mitigates the radiation exposure for both the operators and the patients. Also, it is important to know if there is any anomaly in origin or in course of coronary arteries before cardiac surgery to avoid complications.

Anomalous origin of circumflex artery from right sinus of Valsalva: A rare cause of non-ST elevation syndrome

We present a case with anomalous origin of the left circumflex artery from the right coronary artery ostium, which caused a non-ST elevation coronary syndrome. A review of the literature indicates this to be an extremely rare case.

A case of anomalous origin of circumflex artery from non-sinus of valsalva recognized by transesophageal echocardiography

A case of anomalous origin of circumflex artery from non-sinus of valsalva recognized by transesophageal echocardiography