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Case reports

Circumflex coronary artery injury following mitral annuloplasty treated by emergency angioplasty

Department of Cardiac Surgery, Heart Institute, Hôpital de la Salpétrière, 50-52 Bd Vincent Auriol, 75013 Paris, France

Received 30 May 2008; received in revised form 9 July 2008; accepted 14 July 2008.

^_* Corresponding author. Tel.: +33 1 42 16 56 86; fax: +33 1 42 16 56 78. (Email: c.acar{at}psl.aphp.fr).

Iatrogenic injury to the circumflex coronary artery following mitral annuloplasty is a potentially fatal complication. It can be clinically silent or else be responsible for a cardiogenic shock. The diagnosis should be suspected on EKG changes with segmental dysfunction of the lateral wall on the intraoperative echography. The author reports one case whose recognition relied on emergency angiography; the patient was successfully treated by angioplasty and stenting. The management of this complication remains controversial and the various treatment modalities are discussed.

Key Words: Mitral repair • Circumflex coronary artery • Annuloplasty