Rapid Deployment Aortic Valve Replacement: Valve of Choice in Patients With a Left Circumflex Anomaly?

We present a successful application of rapid deployment surgical aortic valve replacement in a patient with an anomalous origin of the left circumflex coronary artery, which originated from the right coronary ostium. The patient presented with cardiac decompensation, with resting dyspnea and angina pectoris. Imaging revealed high-grade aortic valve insufficiency, a reduced left ventricular ejection fraction, an aneurysm of the ascending aorta (58 mm), and relevant stenoses of the coronary arteries. She underwent rapid deployment surgical aortic valve replacement, after careful dissection of the left circumflex artery and replacement of the ascending aorta, proximal arch, and bypasses. Her left ventricular ejection fraction improved postoperatively, and there were no complications during the inpatient course and at 1-year follow-up.