Left circumflex artery occlusion during aortic valvuloplasty in a young patient with bicuspid aortic valve: a case report.

IF 1 Q3 ANESTHESIOLOGY

JA Clinical Reports Pub Date : 2025-07-24 DOI:10.1186/s40981-025-00806-8

Yutaro Otsuka, Tsunehisa Tsubokawa

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引用次数: 0

Abstract

Background: Aortic valvuloplasty serves as a valve-preserving alternative to aortic valve replacement and offers advantages in younger patients. However, intraoperative complications associated with this technique have rarely been reported.

Case presentation: A 15-year-old male with severe aortic regurgitation due to a congenital bicuspid aortic valve underwent aortic valvuloplasty. During separation from cardiopulmonary bypass, ST-segment elevation was noted on electrocardiography, and transesophageal echocardiography (TEE) revealed regional wall motion abnormalities. Color Doppler imaging revealed absent flow in the left circumflex artery (LCx). The anesthesiology team promptly alerted the surgeons, and LCx occlusion due to suture annuloplasty was suspected. Removal of the implicated suture restored flow and stabilized hemodynamics.

Conclusions: Systematic intraoperative assessment and documentation of coronary flow via TEE are instrumental in diagnosing coronary artery occlusion. Moreover, mutual trust and clear, timely communication between anesthesiologists and surgeons are essential to maintaining surgical safety.

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年轻二尖瓣主动脉瓣成形术中左旋动脉闭塞1例。

背景：主动脉瓣成形术作为主动脉瓣置换术的一种保留瓣膜的替代方法，在年轻患者中具有优势。然而，与此技术相关的术中并发症很少报道。病例介绍：一名15岁男性，因先天性二尖瓣主动脉瓣严重主动脉反流而行主动脉瓣成形术。在体外循环分离期间，心电图显示st段抬高，经食管超声心动图（TEE）显示局部壁运动异常。彩色多普勒显示左旋动脉（LCx）无血流。麻醉小组立即通知外科医生，怀疑是缝合环成形术导致的LCx闭塞。切除牵连缝合线恢复血流并稳定血流动力学。结论：术中系统评估和记录TEE冠状动脉血流有助于诊断冠状动脉闭塞。此外，麻醉师和外科医生之间的相互信任和清晰、及时的沟通对于维护手术安全至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.