Key result
TAVI succeeds without occluding an anomalous LCX.
Why the study?
An anomalous LCX has been described only in a few TAVI cases, with potential risk of occlusion after valve deployment.
Case Report (n=1)
This case demonstrates that TAVI can be performed without obstructing an anomalous LCX originating from the right coronary cusp when guided by careful pre-procedural imaging and precautions.
Supports TAVI feasibility in anomalous LCX with imaging guidance; hypothesis-generating and should not yet change practice.
This is a case of an anomalous left circumflex coronary artery (LCX) originating from the right coronary cusp with a retroaortic course in a patient with severe aortic valve stenosis requiring transcatheter aortic valve implantation (TAVI). In the context of TAVI, an anomalous LCX has been described only in a few case reports. In some, the LCX remains unaffected. However, occlusion after TAVI valve deployment has been described. We report pre-procedural imaging and procedural precautions prior to valve deployment in our case in which the LCX remained unaffected by the TAVR valve. More case reports or series are needed to help assess which characteristics are associated with an increased risk of anomalous LCX obstruction.
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Mbai et al. (2020) conducted a case report in Severe aortic valve stenosis with anomalous left circumflex coronary artery (n=1). Transcatheter aortic valve implantation (TAVI) was evaluated. Transcatheter aortic valve implantation was successfully performed without occlusion of the anomalous left circumflex coronary artery.
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