[Re-do operation for coronary stenosis after Cabrol procedure; report of a case]

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Aortic Surgery

Background:

• The Cabrol technique is a method for coronary artery reimplantation during aortic root replacement.
• Coronary artery complications, including stenosis, can arise after this procedure.
• This case involves a patient with Marfan syndrome and chronic type B aortic dissection.

Observation:

• A patient developed chest pain post-aortic root replacement with a Cabrol procedure.
• Computed tomography (CT) and angiography revealed bilateral stenosis at the coronary anastomotic sites.
• The stenosis was attributed to pannus formation around the coronary anastomosis.

Findings:

• Surgical re-exploration and revision were performed via median re-sternotomy.
• Pannus was resected, and coronary anastomoses were reconstructed using bovine pericardium patch extension (Piehler procedure).
• Concomitant total aortic arch replacement with elephant trunk technique was also performed.

Implications:

• This case highlights a potential complication of the Cabrol technique and demonstrates a successful surgical solution.
• The described revision technique effectively relieved coronary stenosis and restored adequate coronary flow.
• This approach may be valuable for managing similar complications in patients undergoing aortic root surgery.