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Cardiovascular Medicine
Volume 17
Issue 4
10.4414/cvm.2014.00229
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Cardiovascular Medicine is published by MDPI from Volume 28 Issue 1 (2025). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Editores Medicorum Helveticorum (EMH).
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Case Report

Double Raphed Bicuspid Aortic Valve and the “Reverse S” Coronary Angiographic Sign

by
Andreas Y. Andreou
1,*,
Kyriakos Kyriakou
2,
Nearchos Kasinos
1 and
Panayiotis C. Avraamides
1
1
Department of Cardiology, Limassol General Hospital, Kato Polemidia, Limassol CY-3304, Cyprus
2
Department of Cardiology, Ammochostos General Hospital, Paralimini, Cyprus
*
Author to whom correspondence should be addressed.
Cardiovasc. Med. 2014, 17(4), 115; https://doi.org/10.4414/cvm.2014.00229
Submission received: 16 January 2014 / Revised: 16 February 2014 / Accepted: 16 March 2014 / Published: 16 April 2014
Versions Notes

Abstract

We present the case of a 54-year-old woman with severe symptomatic stenosis of an exceedingly rare type of bicuspid aortic valve (BAV) with two raphes. Preoperative coronary angiography showed an intraseptal right aortic sinus-connected left main coronary artery (LMCA) and a left anterior descending (LAD) artery arising from the intraseptal segment of the LMCA and coursing inside the interventricular septum. The patient underwent successful replacement of his valve and proximal ascending aorta. This case highlights the importance of accurate recognition of this unique LMCA-LAD course prior to aortic valve replacement. The “reverse S” coronary angiographic sign observed in the right anterior oblique view might be useful in this regard.
Keywords: Echocardiography; coronary angiography; aortic stenosis; coronary artery anomaly; bicuspid aortic valve; anomalous left main coronary artery Echocardiography; coronary angiography; aortic stenosis; coronary artery anomaly; bicuspid aortic valve; anomalous left main coronary artery

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MDPI and ACS Style

Andreou, A.Y.; Kyriakou, K.; Kasinos, N.; Avraamides, P.C. Double Raphed Bicuspid Aortic Valve and the “Reverse S” Coronary Angiographic Sign. Cardiovasc. Med. 2014, 17, 115. https://doi.org/10.4414/cvm.2014.00229

AMA Style

Andreou AY, Kyriakou K, Kasinos N, Avraamides PC. Double Raphed Bicuspid Aortic Valve and the “Reverse S” Coronary Angiographic Sign. Cardiovascular Medicine. 2014; 17(4):115. https://doi.org/10.4414/cvm.2014.00229

Chicago/Turabian Style

Andreou, Andreas Y., Kyriakos Kyriakou, Nearchos Kasinos, and Panayiotis C. Avraamides. 2014. "Double Raphed Bicuspid Aortic Valve and the “Reverse S” Coronary Angiographic Sign" Cardiovascular Medicine 17, no. 4: 115. https://doi.org/10.4414/cvm.2014.00229

APA Style

Andreou, A. Y., Kyriakou, K., Kasinos, N., & Avraamides, P. C. (2014). Double Raphed Bicuspid Aortic Valve and the “Reverse S” Coronary Angiographic Sign. Cardiovascular Medicine, 17(4), 115. https://doi.org/10.4414/cvm.2014.00229

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