[Anomaly of the origin of the circumflex artery. Effects on the risk of mitral and mitro-aortic valve replacement].

An anomalous circumflex coronary artery arising from the main right coronary artery is an added risk in mitro-aortic valve replacement. The infortunate history of a patient with an anomalous circumflex artery visualised on pre-operative cineangiography who underwent a double valve replacement is reported. The first 10 post-operative days were uncomplicated with no haemodynamic disturbances. Thereafter, major ventricular arrhythmiad 54th post-operative days) without signs of myocardial infarction, which were responsible for her death. On autopsy a large anomalous circumflex artery arising from the main right coronary artery was shown. In its course, posterior to the aorta, it was literally wedged between the rigid sewing rings of the two prosthetic valves. No thrombus was found within, and there were no myocardial lesions. The only apparent cause of the arrhythmias and death of the patient was the compression of this large circumflex artery.