Damage to Coronary Arteries during Mitral Valve Surgery
Background: The rheumatic cardiac valve diseases are one of the most important heart problems in Turkey. In mitral valve surgery, the relationship between the anulus fibrosus sinister and the coronary arteries is extremely critical for the postoperative life of the patient.
Methods: The study was performed with human adult hearts. The aim of this study of 50 hearts was to understand the existing correlations between the mitral annulus and the coronary arteries. We determined the right or left dominance or codominance of the anulus fibrosus sinister on each heart and studied the relationship of the mitral annulus to the circumflex coronary artery (CCA) and the left posterior descending coronary artery.
Results: The distances of the anulus fibrosus sinister from the CCA and interventricularis posterior arteries were measured with a flexible ruler. In 19 of 50 cases, the distance of the coronary artery from the annulus was 3 mm at 23 different points, 2 mm at 8 different points, and 1 mm at 2 different points.
Conclusions: In mitral valve surgery, damage to the CCA can occur, especially in patients with left coronary dominance or codominance in which the CCA is running in the atrioventricular groove very close to the mitral annulus. Therefore, this study emphasizes the importance of knowing the coronary artery anatomy preoperatively.The predominant cause of mitral stenosis is rheumatic fever
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