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The Annals of Thoracic Surgery, Vol 45, 16-20, Copyright © 1988 by The Society of Thoracic Surgeons

ARTICLES

Obstruction to left coronary artery blood flow secondary to obliteration of the coronary ostium in supravalvular aortic stenosis

MM Martin, JH Lemmer Jr, E Shaffer, M Dick 2d and EL Bove
Department of Surgery, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor.

Supravalvular aortic stenosis is characterized by obstruction of the left ventricular outflow tract distal to the aortic valve, and may result in diminished coronary artery blood flow. This report describes the cases of 2 patients in whom obstruction to left coronary artery flow was caused by obliteration of the coronary ostium itself. This mechanism differs from the more commonly recognized cause--valve leaflet adhesion to the obstructing ridge of aortic tissue. The coronary artery obstruction found in these 2 patients required direct enlargement of the left coronary ostium in both. This mechanism of impaired coronary artery flow deserves emphasis, as traditional methods of extended patch aortoplasty may fail to relieve the coronary ostial narrowing.

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