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J Thorac Cardiovasc Surg 2007;134:1586-1587
© 2007 The American Association for Thoracic Surgery

Brief Communication

Occlusion of the left coronary ostium by an aortic valve leaflet

Shafi Mussa, MA, MRCSa, Paul Miller, MBChB, DCH, FRCPb, David J. Barron, MD, FRCP, FRCSa, William J. Brawn, FRCS, FRACSa,*

a Department of Cardiothoracic Surgery, Birmingham Children’s Hospital, Birmingham, United Kingdom
b Department of Pediatric Cardiology, Birmingham Children’s Hospital, Birmingham, United Kingdom.

Received for publication July 25, 2007; accepted for publication August 7, 2007.

* Address for reprints: William J. Brawn, FRCS, FRACS, Consultant Cardiothoracic Surgeon, Department of Cardiothoracic Surgery, Birmingham Children’s Hospital, Steelhouse Lane, Birmingham B4 6NH, United Kingdom. (Email: william.brawn@bch.nhs.uk).

The first 20% of the full text of this article appears below.

Occlusion of the left coronary ostium by an aortic valve leaflet is a rare but well-described variant of aortic valve morphology. We report this finding in a neonate with a number of cardiac abnormalities, substantiating the theory that it is a congenital abnormality of aortic valve development.

Clinical Summary

A 3-day-old boy who weighed 2.7 kg presented with poor feeding and lethargy after an uneventful normal vaginal delivery at term. Examination revealed tachypnea, poor peripheral pulses, and a systolic murmur. An echocardiogram revealed normal atrial arrangement, atrial septal defect with bidirectional flow, muscular outlet ventricular septal defect, subaortic stenosis (left ventricular outflow tract diameter of 4 mm), dysplastic stenotic aortic valve with a maximum root diameter of 4.8 mm (Figure 1), type A interrupted aortic arch, moderate-sized ductus arteriosus, and normal-volume left ventricle with impaired systolic function. After stabilization with prostaglandin E2 (7.5 ng/kg/min) and dobutamine (5 µg/kg/min), surgery was undertaken at 9 days.


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  		Figure 1. A, Still of a long-axis transthoracic echocardiogram depicting the dysplastic aortic valve . . . [Full Text of this Article]

 



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Occlusion of the right coronary artery ostium by an aortic cusp attachment
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[Abstract] [Full Text] [PDF]


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