Fusion of the Left Aortic Cusp to the Aortic Wall with Occlusion of the Left Coronary Ostium, and Aortic Stenosis and Insufficiency

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Abstract
The case of a 16-year-old girl with a unique anomaly of the coronary arterial tree is presented. This report concerns the first known case of isolated adherence of the left coronary aortic valve cusp to the aortic wall. This produced total obstruction of the left coronary artery ostium, angina pectoris, syncope, aortic stenosis, and aortic insufficiency. Freeing the adherent cusp from the aortic wall restored patency of the left coronary artery, relieved the aortic insufficiency, and resulted in disappearance of the angina pectoris and syncope. This case adds to the growing spectrum of nonatherosclerotic coronary abnormalities which are capable of producing myocardial ischemia.