David J. Kaczorowski, MD, Y. Joseph Woo, MD

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Presentation transcript:

Valve-Sparing Aortic Root Replacement With Translocation of Anomalous Left Coronary Artery David J. Kaczorowski, MD, Y. Joseph Woo, MD The Annals of Thoracic Surgery Volume 96, Issue 4, Pages 1466-1469 (October 2013) DOI: 10.1016/j.athoracsur.2013.01.090 Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Preoperative and intraoperative images of an anomalous left main coronary artery (LMCA) arising from the right coronary artery (RCA). (A) Preoperative computed tomography demonstrating the aneurysmal aortic root as well as the LMCA originating from the right coronary artery and its course between the aorta (Ao) and the pulmonary artery (PA). (B) Intraoperative view demonstrating the presence of a single coronary os in the right sinus (arrow). (C) Absence of the left coronary artery from the left coronary sinus (arrow). (D) View of the anomalous LMCA arising from the RCA after the commissure between the left and right coronary cusps was separated from the main PA. (E) Intraoperative image of the LMCA after it was followed and dissected out underneath the PA and onto the surface of the left ventricle as seen from the patient’s right. The Annals of Thoracic Surgery 2013 96, 1466-1469DOI: (10.1016/j.athoracsur.2013.01.090) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Valve-sparing aortic root replacement and coronary translocation. (A) Aortic root after dissection was completed to a level below the aortic valve annulus. (B) Aortic root after running hemostatic suture lines were placed. (C) Assessment of the length of the left main coronary artery (LMCA). The LMCA was brought through a hole created in the graft and transected at the appropriate length. (D) View of the aortic root after the LMCA had been anastomosed to the graft. (E) The right coronary button was anastomosed to the graft in an area just above the level of the commissures. (RCA = right coronary artery.) The Annals of Thoracic Surgery 2013 96, 1466-1469DOI: (10.1016/j.athoracsur.2013.01.090) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions