Anomalous origin of the circumflex coronary artery from the right aortic si
nus, with a retroaortic course, is usually without consequence. We report a
patient who underwent aortic valve replacement for bicuspid aortic valve.
The prosthesis sewing ring distorted the circumflex, producing myocardial i
nfarcts and sudden death during exercise. (C) 1998 by The Society of Thorac
ic Surgeons.