{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T00:35:15Z","timestamp":1715128515049},"reference-count":5,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T00:00:00Z","timestamp":1715040000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T00:00:00Z","timestamp":1715040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Injury to coronary arteries during mitral surgery is a rare but life-threatening procedural complication, an anomalous origin and course of the left circumflex artery (LCx) increase this risk. Recognizing the anomaly by the characteristic angiographic pattern and identifying its relationship with the surrounding anatomical structure using imaging techniques, mainly transesophageal echocardiography (TOE) or coronary computed tomography angiography (CCTA), is of crucial importance in\u00a0setting up the best surgical strategy. We report a case of anomalous origin of a circumflex artery (LCx) from the proximal portion of the right coronary artery (RCA) with a pathway running retroaortically through the mitro-aortic space. An integrated diagnostic approach using a multidisciplinary team with a cardiologist and an imaging radiologist allowed us to decide the surgical strategy. We successfully performed a mitral valvular repair using a minimally invasive minithoracotomic approach and implanting a complete semirigid ring.<\/jats:p>","DOI":"10.1186\/s13019-024-02779-8","type":"journal-article","created":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T10:02:09Z","timestamp":1715076129000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anomalous circumflex artery encircling the aortic annulus: implications for mitral valve repair"],"prefix":"10.1186","volume":"19","author":[{"given":"Michele","family":"Portoghese","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Mureddu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Balata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Contini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giangiacomo","family":"Carta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,5,7]]},"reference":[{"key":"2779_CR1","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1111\/jocs.12374","volume":"29","author":"RC Bakker","year":"2014","unstructured":"Bakker RC, Bouma W, Wijdh-den Hamer IJ, Natour E, Mariani MA. Mitral valve repair in a patient with an anomalous left coronary artery. J Card Surg. 2014;29:782\u20134.","journal-title":"J Card Surg"},{"key":"2779_CR2","doi-asserted-by":"publisher","first-page":"e525","DOI":"10.1016\/j.athoracsur.2016.05.029","volume":"102","author":"A Lopez-Marco","year":"2016","unstructured":"Lopez-Marco A, Syed A, Combellack T, Mehta D. Iatrogenic lesion of an anomalous circumflex coronary artery during mitral surgery. Ann Thorac Surg. 2016;102:e525\u20137.","journal-title":"Ann Thorac Surg"},{"key":"2779_CR3","doi-asserted-by":"publisher","unstructured":"Falk V, Baumgartner H, Bax JJ, De Bonis M, Hamm C, Holm PJ, Iung B, Lancellotti P, Lansac E, Mu\u00f1oz DR, Rosenhek R, Sj\u00f6gren J, Tornos Mas P, Vahanian A, Walther T, Wendler O, Windecker S, Zamorano JL; ESC Scientific Document Group. 2017 ESC\/EACTS Guidelines for the management of valvular heart disease. Eur J Cardiothorac Surg. 2017;52(4):616\u201364. https:\/\/doi.org\/10.1093\/ejcts\/ezx324.","DOI":"10.1093\/ejcts\/ezx324"},{"key":"2779_CR4","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1016\/j.ejcts.2008.07.057","volume":"34","author":"P Modi","year":"2008","unstructured":"Modi P, Hassan A, Chitwood WR Jr. Minimally invasive valve surgery: a systematic review and meta-analysis. Eu J Cardiothorac. 2008;34:943\u201352.","journal-title":"Eu J Cardiothorac"},{"key":"2779_CR5","doi-asserted-by":"publisher","first-page":"1437","DOI":"10.1016\/j.athoracsur.2014.12.053","volume":"100","author":"M Pettinari","year":"2015","unstructured":"Pettinari M, Gutermann H, Van Kerrebroek C, Dion R. Anomalous origin of the circumflex artery: an underestimated threat during mitral valve surgery. Ann Thorac Surg. 2015;100:1437\u20139.","journal-title":"Ann Thorac Surg"}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-024-02779-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13019-024-02779-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-024-02779-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T10:10:09Z","timestamp":1715076609000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardiothoracicsurgery.biomedcentral.com\/articles\/10.1186\/s13019-024-02779-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,7]]},"references-count":5,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["2779"],"URL":"https:\/\/doi.org\/10.1186\/s13019-024-02779-8","relation":{},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,7]]},"assertion":[{"value":"1 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 April 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 May 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethics approval and consent to partecipate was obtained from the patient.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for pubblication of this case report and any accompaning images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"281"}}