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European Journal of Cardio-Thoracic Surgery, Vol 8, 663-664, Copyright © 1994 by European Association for Cardio-thoracic Surgery

ARTICLES

Isolation of the left coronary artery ostium by an aortic cusp attachment: a rare cause of myocardial ischemia

M Amrani, J Rubay, B Pirenne, J Col and R Dion
Department of Cardiovascular and Thoracic Surgery, Cliniques Universitaires Saint-Luc, Brussels, Belgium.

A 34-year-old woman experienced a 3-month history of recurrent chest pain on exertion. Extensive investigation, including coronary angiography, revealed severe aortic incompetence with suspicion of single-vessel coronary disease. At operation the aortic valve was tricuspid but the left coronary cusp was adherent to the aortic wall, resulting in isolation of the left coronary artery with only a tiny communication with the aortic lumen. The three cusps were excised. An aortic valve replacement was performed with an aortic homograft. The postoperative course was uneventful and myocardial ischemia was totally relieved.

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