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Letters to the Editor

Re: Injury to the circumflex coronary artery following mitral valve repair

Chirurgie Cardiovasculaire, Institut de Cardiologie, Hôpital de la Salpétrière, 50-52 Bd Vincent Auriol, 75013 Paris, France

Received 26 June 2007; accepted 20 July 2007.

^_* Corresponding author. Tel.: +33 6 10 14 59 24; fax: +33 42 16 56 78. (Email: c.acar{at}psl.ap-hop-paris.fr).

Key Words: Mitral repair • Annuloplasty • Myocardial ischemia

In a recent issue of the journal, Zegdi et al. [1] courageously reported a complication that occurred after a mitral valve repair case in which the circumflex coronary artery was acutely occluded due to the prosthetic ring implantation. We too encountered the same complication in three cases: two patients following an extensive annulus decalcification and another following a simple posterior leaflet quadrangular resection. In all patients, the diagnosis of acute myocardial ischemia was suspected in the operating room when facing a variable degree of hemodynamic instability with localized EKG abnormalities; intraoperative echography revealed a segmental lateral wall dysfunction.

Revascularization with a saphenous vein graft anastomosed to the obtuse margin immediately improved the situation and all three patients had a normal postoperative outcome. As in Zegdi et al.'s case, all patients had a large and dominant left coronary artery. The circumflex coronary artery is in intimate relation with the mitral annulus, particularly in its anterolateral commissure, P1 and to a lesser degree P2 portions; it is noteworthy that injury to this vessel can occur even in teams with a significant experience in mitral valve repair surgery.

References

1. Zegdi R, Jouan J, Fabiani JN, Deloche A. Injury to the circumflex coronary artery following mitral valve repair. Eur J Cardiothorac Surg 2007;31:740.[Free Full Text]

This article has been cited by other articles:

				S. Aubert, O. Barthelemy, M. Landi, and C. Acar Circumflex coronary artery injury following mitral annuloplasty treated by emergency angioplasty Eur. J. Cardiothorac. Surg., October 1, 2008; 34(4): 922 - 924. [Abstract] [Full Text] [PDF]

				W. J. Gomes Injury to the circumflex coronary artery following mitral valve repair: a rather opposite strategy Eur. J. Cardiothorac. Surg., May 1, 2008; 33(5): 949 - 949. [Full Text] [PDF]

				R. Zegdi, G. Sleilaty, J.-N. Fabiani, and A. Deloche Reply to Acar Eur. J. Cardiothorac. Surg., November 1, 2007; 32(5): 818 - 819. [Full Text] [PDF]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Christophe Acar Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Acar, C. Search for Related Content PubMed PubMed Citation Articles by Acar, C. Related Collections Valve disease