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Severe cardiomyopathy caused by a critically stenosed anomalous left coronary artery ostium originating in the left ventricle
Author(s) -
Singh Navneet,
Nand Parma
Publication year - 2019
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14080
Subject(s) - medicine , cardiology , ejection fraction , heart failure , ventricle , artery , ostium , left coronary artery , stenosis , dilated cardiomyopathy , coronary sinus , ischemic cardiomyopathy , cardiomyopathy
We report a case of a 44‐year‐old patient presenting with new‐onset severe decompensated congestive heart failure, which was refractory to aggressive inpatient medical treatment. Left ventricular ejection fraction was 16%. Radiological investigations revealed the presence of an anomalous subannular origin of the left coronary artery, with an associated 95% ostial stenosis. The artery was supplied by collaterals from the right coronary system. This included a proximal collateral from the right marginal artery, which had its own separate ostium in the right aortic sinus. A diagnosis of ischemic dilated cardiomyopathy was made. The patient successfully underwent urgent coronary artery bypass grafting with a view to improve his left ventricular function and congestive heart failure symptoms.