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Anomalous coronary artery in a transplanted heart: a technical modification
Bernard G Vasseur1, Mark B Anderson, Ronald S Freudenberger
1Department of Surgery, Division of Thoracic Surgery, University of Medicine and Dentistry of New Jersey, 1Robert Wood Johnson Place, New Brunswick, NJ 08903-0019, USA. bernard.vasseur@umdnj.edu
Summary
A rare anomalous origin of the donor left main coronary artery was identified. A simple geometric modification during transplantation allowed safe implantation, suggesting such hearts can be used for organ donation.
Area of Science:
- Cardiology
- Transplantation Surgery
- Anatomical Variations
Background:
- Orthotopic heart transplantation is a life-saving procedure for end-stage heart failure.
- Valvular cardiomyopathy necessitates transplantation in some patients.
- Coronary artery anomalies can complicate procurement and transplantation.
Observation:
- An anomalous origin of the donor left main coronary artery from the right coronary sinus of Valsalva was identified during pre-transplant cardiac catheterization.
- The anomaly posed a risk of left main coronary artery compression during re-implantation.
Findings:
- A precise geometric adjustment of the aortopulmonary artery angle was performed.
- This technical modification successfully mitigated the risk of coronary artery compression.
- The transplanted heart with the anomalous coronary artery was successfully implanted.
Implications:
- This case demonstrates that hearts with anomalous coronary artery origins can be safely transplanted.
- Simple surgical modifications can overcome anatomical challenges in organ donation.
- Expanded criteria for organ donation may be possible with careful surgical planning.