Reimplantation of the two coronary ostia as a single button in Ross procedure

A 10-year-old boy presented with severe aortic regurgitation due to a dysplastic aortic valve. He underwent a Ross procedure employing a mini-root replacement technique. At surgery, he was found to have eccentrically located coronary ostia which were both reimplanted as a single button into the pulmonary autograft. Postoperatively, multislice computed tomographic coronary angiography demonstrated satisfactory reimplantation of the coronary artery ostia with no evidence of kinking or compression of the coronary arteries. This case report supports the technique of transfer of coronary ostia as a single button where coronary anatomy is unfavorable for their individual transfer.