Minimally Invasive Valve Repair and Hybrid Treatment for Racemose Bronchial Artery Malformation With Coronary Arterial Inflow

Racemose haemangioma of the bronchial artery is a rare vascular malformation characterized by abnormal communication between the bronchial and pulmonary vasculature. Coronary arterial inflow may further complicate minimally invasive cardiac surgery because excessive collateral flow can impair myocardial protection and increase intracardiac return during cardiac arrest. We report a case of atrial functional mitral regurgitation and tricuspid regurgitation associated with racemose bronchial artery malformation with coronary arterial inflow from the left circumflex artery. Preoperative embolization of systemic feeders from the bronchial and left subclavian arteries was followed by minimally invasive valve repair and surgical ligation of the coronary inflow vessel. The postoperative course was uneventful. A staged hybrid strategy may be effective for managing racemose bronchial artery malformation with coronary arterial inflow.