The Annals of Thoracic Surgery, Vol 55, 523-524, Copyright © 1993 by The Society of Thoracic Surgeons
Sequestration of the left coronary artery from the aorta
MJ Swart, JA Odell and RC Fraser
Department of Cardio-thoracic Surgery and Cardiology, University of Cape Town Medical School, South Africa.
A patient with the left coronary artery isolated from the ascending aorta
is discussed. This is the seventh case described and the third diagnosed
preoperatively. In contrast to other patients she had predominant aortic
incompetence and was much older (52 years compared with the other patients,
all younger than 25 years). She also had two angiograms demonstrating
progressive isolation of the coronary artery with time. The patient was
managed by aortic valve replacement. It is our belief that the condition is
acquired and resulted from fusion of the free edge of the aortic valve
leaflet to the supravalvar ridge secondary to an inflammatory process.