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Salsano et al. Vessel Plus 2020;4:21 Vessel Plus
DOI: 10.20517/2574-1209.2020.12

Case Report Open Access

Aortopathy and coronary anomaly in bicuspid aortic
valve: an uncommon tricky association

Antonio Salsano , Roberto Natali , Giulia Parolari , Davide Ricci , Francesco Santini 1,2
1,2
1,2
1,2
1,2
1 Division of Cardiac Surgery, Ospedale Policlinico San Martino, Genoa 16132, Italy.
2 Department of Surgical and Integrated Diagnostic Sciences (DISC), University of Genoa,Genoa 16132, Italy.
Correspondence to: Dr. Antonio Salsano, Division of Cardiac Surgery, Ospedale Policlinico San Martino, L.go Rosanna Benzi 10,
Genoa 16132, Italy; Department of Surgical and Integrated Diagnostic Sciences (DISC), University of Genoa, L.go Rosanna Benzi
10, Genoa 16132, Italy. E-mail: ant.salsano@gmail.com
How to cite this article: Salsano A, Natali R, Parolari G, Ricci D, Santini F. Aortopathy and coronary anomaly in bicuspid aortic
valve: an uncommon tricky association. Vessel Plus 2020;4:21. http://dx.doi.org/10.20517/2574-1209.2020.12
Received: 26 Apr 2020 First Decision: 26 Apr 2020 Revised: 5 Jun 2020 Accepted: 16 Jun 2020 Published: 19 Jul 2020

Academic Editor: Narasimham L. Parinandi, Antonio Nenna Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Received: First Decision: Revised: Accepted: Published: x
Bicuspid aortic valves (BAV) can be associated with aortopathy and coronary anomalies. We report the case
Science Editor: Copy Editor: Production Editor: Jing Yu of a 60 year-old woman undergoing surgery for severe aortic stenosis due to BAV and an ascending aortic
aneurysm. During the procedure, an uncommon anomalous origin of the left main coronary artery from the
posterior commissure with intramural takeoff of the left coronary artery was found. Routine pre-operative
coronary angiography had failed to identify this anomaly. To avoid ischemic events or left main coronary lesions,
we placed the aortic bioprosthesis by respecting the commissures, not to occlude the anomalous coronary ostium.
The association of BAV, aortopathy and coronary anomalies is a rare finding. Awareness of the anatomy of the
coronary arteries in patients with BAV should be considered mandatory to avoid catastrophic consequences and
to select the appropriate surgical procedure.

Keywords: Aortic surgery, aortic valve, bicuspid aortic valve, coronary anomaly

INTRODUCTION
Bicuspid aortic valves (BAV) are the most common congenital heart defect, affecting 1% to 2% of the
general population , and are often associated with aortic aneurysms and occasionally, with coronary
[1]
anomalies.

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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